Iatrogenic Opioid Withdrawal in Critically Ill Patients: A Review of Assessment Tools and Management.

Science.gov (United States)

Chiu, Ada W; Contreras, Sofia; Mehta, Sangeeta; Korman, Jennifer; Perreault, Marc M; Williamson, David R; Burry, Lisa D

2017-12-01

To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management. Reference list of identified literature was searched for additional references as well as www.clinicaltrials.gov . We restricted articles to those in English and dealing with humans. We identified 2 validated pediatric critically ill opioid withdrawal assessment tools: (1) Withdrawal Assessment Tool-Version 1 (WAT-1) and (2) Sophia Observation Withdrawal Symptoms Scale (SOS). Neither tool differentiated between opioid and benzodiazepine withdrawal. WAT-1 was evaluated in critically ill adults but not found to be valid. No other adult tool was identified. For management, we identified 5 randomized controlled trials, 2 prospective studies, and 2 systematic reviews. Most studies were small and only 2 studies utilized a validated assessment tool. Enteral methadone, α-2 agonists, and protocolized weaning were studied. We identified 2 validated assessment tools for pediatric intensive care unit patients; no valid tool for adults. Management strategies tested in small trials included methadone, α-2 agonists, and protocolized sedation/weaning. We challenge researchers to create validated tools assessing specifically for opioid withdrawal in critically ill children and adults to direct management.

Developing Students' Critical Literacy: Exploring Identity Construction in Young Adult Fiction.

Science.gov (United States)

Bean, Thomas W.; Moni, Karen

2003-01-01

Notes that adolescent readers view characters in young adult novels as living and wrestling with real problems close to their own life experiences as teens. Reviews recent studies related to teaching literature and adolescent identity construction. Offers a framework teachers can use to initiate discussions based on critical literacy in their own…

Milrinone for cardiac dysfunction in critically ill adult patients: a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis.

Science.gov (United States)

Koster, Geert; Bekema, Hanneke J; Wetterslev, Jørn; Gluud, Christian; Keus, Frederik; van der Horst, Iwan C C

2016-09-01

Milrinone is an inotrope widely used for treatment of cardiac failure. Because previous meta-analyses had methodological flaws, we decided to conduct a systematic review of the effect of milrinone in critically ill adult patients with cardiac dysfunction. This systematic review was performed according to The Cochrane Handbook for Systematic Reviews of Interventions. Searches were conducted until November 2015. Patients with cardiac dysfunction were included. The primary outcome was serious adverse events (SAE) including mortality at maximum follow-up. The risk of bias was evaluated and trial sequential analyses were conducted. The quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation criteria. A total of 31 randomised clinical trials fulfilled the inclusion criteria, of which 16 provided data for our analyses. All trials were at high risk of bias, and none reported the primary composite outcome SAE. Fourteen trials with 1611 randomised patients reported mortality data at maximum follow-up (RR 0.96; 95% confidence interval 0.76-1.21). Milrinone did not significantly affect other patient-centred outcomes. All analyses displayed statistical and/or clinical heterogeneity of patients, interventions, comparators, outcomes, and/or settings and all featured missing data. The current evidence on the use of milrinone in critically ill adult patients with cardiac dysfunction suffers from considerable risks of both bias and random error and demonstrates no benefits. The use of milrinone for the treatment of critically ill patients with cardiac dysfunction can be neither recommended nor refuted. Future randomised clinical trials need to be sufficiently large and designed to have low risk of bias.

Short- and long-term impact of critical illness on relatives: literature review.

Science.gov (United States)

Paul, Fiona; Rattray, Janice

2008-05-01

This paper is a report of a literature review undertaken to identify the short- and long-term impact of critical illness on relatives. Patients in intensive care can experience physical and psychological consequences, and their relatives may also experience such effects. Although it is recognized that relatives have specific needs, it is not clear whether these needs are always met and whether further support is required, particularly after intensive care. The following databases were searched for the period 1950-2007: Medline, British Nursing Index and Archive, EMBASE, CINAHL, PsycINFO and EMB Reviews--Cochrane Central Register of Clinical Trials. Search terms focused on adult relatives of critically ill adult patients during and after intensive care. Recurrent topics were categorized to structure the review, i.e. 'relatives needs', 'meeting relatives' needs', 'interventions', 'satisfaction', 'psychological outcomes' and 'coping'. Studies have mainly identified relatives' immediate needs using the Critical Care Family Needs Inventory. There are few studies of interventions to meet relatives' needs and the short- and long-term effects of critical illness on relatives. Despite widespread use of the Critical Care Family Needs Inventory, factors such as local or cultural differences may influence relatives' needs. Relatives may also have unidentified needs, and these needs should be explored. Limited research has been carried out into interventions to meet relatives' needs and the effects of critical illness on their well-being, yet some relatives may experience negative psychological consequences far beyond the acute phase of the illness.

Home Delivered Meals to Older Adults: A Critical Review of the Literature.

Science.gov (United States)

Gualtieri, Marie C; Donley, Amy M; Wright, James D; Vega, Sara Strickhouser

The United States is witnessing a growing aging population stemming in part from medical advancements allowing people to live decades longer than previous generations. Simultaneously, food insecurity among older adults has increased, and is projected to get worse as the Baby Boomer generation ages. This review focuses on an assistance program for older adults: home-delivered meals. Specifically, we focus on the effects of Meals on Wheels (MOW) on the physical and emotional well-being of older adults, and the wide variety of procedural and operational issues that various MOW programs around the country experience. Findings from the literature highlight the positive outcomes these programs have on their clients. Although there have been recent budget cut threats from the federal government, evidence suggests that more funding should be allocated so these programs can provide services to everyone in need, and even expand what they are able to offer to older adults.

Functional disability and suicidal behavior in middle-aged and older adults: A systematic critical review.

Science.gov (United States)

Lutz, Julie; Fiske, Amy

2018-02-01

Middle-aged and older adults have elevated rates of suicide around the globe, but there is a paucity of knowledge about risk factors for suicide in these age groups. One possible risk factor may be functional disability, which is more common at later ages. The current systematic critical review examined findings regarding the associations between functional disability and suicidal behavior (suicidal ideation, suicide attempts, and death by suicide) in middle-aged and older adults (i.e. age 50 and older). Forty-five studies were found that examined these associations. The majority of studies supported a significant association between functional disability and suicidal ideation. In addition, findings to date strongly suggest that depression serves as a mediator of the association between functional disability and suicidal ideation, though most studies did not directly test for mediation. Firm conclusions regarding suicide attempts and death by suicide, as well as mediation, cannot be drawn due to a relative lack of research in these areas. The association between functional disability and suicidal behavior suggests an important area for prevention and intervention among middle-aged and older adults, but additional research is necessary to clarify the specifics of these associations and examine appropriate intervention strategies. Important future directions for research in this area include the direct comparison of associations of risk factors with different types of suicidal behavior, greater use of longitudinal data with multiple time points, and further examination of potential mediators and moderators of the association between functional disability and suicidal behavior. Copyright © 2017 Elsevier B.V. All rights reserved.

Epidemiological studies of leukaemia in children and young adults around nuclear facilities: a critical review

International Nuclear Information System (INIS)

2008-01-01

An epidemiological study published in late 2007 described an increased risk of leukaemia in children under 5 living within 5 kilometres of German nuclear power plants. A great deal of research has been carried out on this subject since the early 1980's. The aim of this report was to provide a synthesis and critical analysis of results related to the risk of leukaemia in children and young adults aged under 25 living close to nuclear facilities. The report is structured in three sections: - a reminder of the main characteristics of childhood leukaemia and a description of the methods used to conduct epidemiological studies; - the most exhaustive review possible of epidemiological studies published in the international literature describing the frequency of leukaemia close to nuclear facilities in different countries around the world. A critical analysis is made of the published results. Some results from studies not focused on nuclear facilities are also presented. The methodological limitations associated with descriptive studies are explained and discussed; - the last section discusses the possible causes of childhood leukaemia and the main hypotheses explored to explain certain clusters of cases observed locally close to some nuclear sites. Appendices at the end of the document provide additional explanations of the concepts and methods used in epidemiology and statistics, and of the classification of malignant hemopathies. (authors)

Repositioning Ideology Critique in a Critical Theory of Adult Learning.

Science.gov (United States)

Brookfield, Stephen

2001-01-01

Reexamines critical theory as a response to Marxism and repositions ideology critique as a crucial adult learning process. Argues that a critical theory of adult learning should focus on how adults learn to recognize and challenge ideological domination and manipulation. (Contains 31 references.) (SK)

A Review of the Literature on LGBTQ Adults Who Experience Homelessness.

Science.gov (United States)

Ecker, John; Aubry, Tim; Sylvestre, John

2017-12-05

Little is known about lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults who experience homelessness. The current review critically analyzes the scant literature on LGBTQ adults who experience homelessness, with a particular focus on: (1) pathways into homelessness; (2) support needs; (3) targeted programming; and (4) exits out of homelessness. A total of 143 articles were identified, and 16 articles met the criteria of appropriate age range, article quality, and relevance of topic. Results from this review demonstrate that homeless LGBTQ adults have unique physical and mental health challenges, largely concerning HIV and substance use. Transgender and gender non-conforming adults who experience homelessness encounter several challenges in the homelessness system, particularly in regard to safety and gender-affirming supports. Recommendations focus on practical implications for support and suggestions for future research.

A critical review: early life nutrition and prenatal programming for adult disease.

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Carolan-Olah, Mary; Duarte-Gardea, Maria; Lechuga, Julia

2015-12-01

To present the evidence in relation to early life nutrition and foetal programming for adult disease. Epigenetics is a new and growing area of study investigating the impact of the intrauterine environment on the lifelong health of individuals. Discursive paper. Searches were conducted in a range of electronic health databases. Hand searches located additional articles for review. Maternal search terms included: pregnancy; nutrition; diet; obesity; over nutrition; under nutrition. Offspring related search terms included: macrosomia; intrauterine growth restriction; epigenetics; foetal programming; childhood obesity; adolescent obesity; adolescent type 2 diabetes. Results indicate that foetal programming for adult disease occurs in response to particular insults during vulnerable developmental periods. Four main areas of foetal exposure were identified in this review: (1) under nutrition; (2) over nutrition; (3) gestational diabetes mellitus; and (4) infant catch-up growth. Numerous studies also described the trans-generational nature of foetal programming. Overall, foetal exposure to excess or insufficient nutrition during vulnerable developmental periods appears to result in a lifelong predisposition to obesity and adult disease, such as type 2 diabetes and cardiac disease. For the infant who has been undernourished during early life, a predisposition to renal disease also occurs. Pregnancy is a time when women are engaged in health systems and are receptive to health messages. These factors suggest that pregnancy may be an optimal time for dietary education and intervention. There is a particular need for education on healthy diet and for interventions which aim to limit over consumption of calories. © 2015 John Wiley & Sons Ltd.

Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews

Science.gov (United States)

Connolly, Bronwen; O'Neill, Brenda; Salisbury, Lisa; Blackwood, Bronagh

2016-01-01

Background Physical rehabilitation interventions aim to ameliorate the effects of critical illness-associated muscle dysfunction in survivors. We conducted an overview of systematic reviews (SR) evaluating the effect of these interventions across the continuum of recovery. Methods Six electronic databases (Cochrane Library, CENTRAL, DARE, Medline, Embase, and Cinahl) were searched. Two review authors independently screened articles for eligibility and conducted data extraction and quality appraisal. Reporting quality was assessed and the Grading of Recommendations Assessment, Development and Evaluation approach applied to summarise overall quality of evidence. Results Five eligible SR were included in this overview, of which three included meta-analyses. Reporting quality of the reviews was judged as medium to high. Two reviews reported moderate-to-high quality evidence of the beneficial effects of physical therapy commencing during intensive care unit (ICU) admission in improving critical illness polyneuropathy/myopathy, quality of life, mortality and healthcare utilisation. These interventions included early mobilisation, cycle ergometry and electrical muscle stimulation. Two reviews reported very low to low quality evidence of the beneficial effects of electrical muscle stimulation delivered in the ICU for improving muscle strength, muscle structure and critical illness polyneuropathy/myopathy. One review reported that due to a lack of good quality randomised controlled trials and inconsistency in measuring outcomes, there was insufficient evidence to support beneficial effects from physical rehabilitation delivered post-ICU discharge. Conclusions Patients derive short-term benefits from physical rehabilitation delivered during ICU admission. Further robust trials of electrical muscle stimulation in the ICU and rehabilitation delivered following ICU discharge are needed to determine the long-term impact on patient care. This overview provides recommendations for

Unmasked adult-onset urea cycle disorders in the critical care setting.

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Summar, Marshall L; Barr, Frederick; Dawling, Sheila; Smith, Wendy; Lee, Brendan; Singh, Rani H; Rhead, William J; Sniderman King, Lisa; Christman, Brian W

2005-10-01

Most often, urea cycle disorders have been described as acute onset hyperammonemia in the newborn period; however, there is a growing awareness that urea cycle disorders can present at almost any age, frequently in the critical care setting. This article presents three cases of adult-onset hyperammonemia caused by inherited defects in nitrogen processing in the urea cycle, and reviews the diagnosis, management, and pathophysiology of adult-onset urea cycle disorders. Individuals who have milder molecular urea cycle defects can lead a relatively normal life until a severe environmental stress triggers a hyperammonemic crisis. Comorbid conditions such as physical trauma often delay the diagnosis of the urea cycle defect. Prompt recognition and treatment are essential in determining the outcome of these patients.

Evaluation of Adult Literacy Education in the United States: A Review of Methodological Issues

Science.gov (United States)

Shi, Yan; Tsang, Mun C.

2008-01-01

This is a critical review of methodological issues in the evaluation of adult literacy education programs in the United States. It addresses the key research questions: What are the appropriate methods for evaluating these programs under given circumstances. It identifies 15 evaluation studies that are representative of a range of adult literacy…

Physical Activity Benefits and Needs in Adults with Intellectual Disabilities: Systematic Review of the Literature

Science.gov (United States)

Bartlo, Pamela; Klein, Penelope J.

2011-01-01

Regular physical activity is vital for adult individuals with intellectual disabilities. The purpose of this review was to assess critically the evidence on effectiveness of physical activity interventions for adults with intellectual disability. An electronic database search was conducted. Research was then assessed for methodological rigor, and…

We’re All YA Now: A Review of Graphic Novels for Children and Young Adults

Directory of Open Access Journals (Sweden)

Lee Skallerup Bessette

2018-01-01

Full Text Available 'Graphic Novels for Children and Young Adults: A Collection of Critical Essays', edited by Michelle Ann Abate and Gwen Athene Tarbox, University Press of Mississippi, 352 pages, 2017, ISBN 978-1-4968-1167-7   This article is a review of 'Graphic Novels for Children and Young Adults: A Collection of Critical Essays', edited by Michelle Ann Abate and Gwen Athene Tarbox (University Press of Mississippi, 2017. Filling a significant gap in current scholarly research in comic studies, the collection will appeal to a wide range of scholars and educators. The review argues that reading this collection is less of a chore and more of a joyful journey of discovery.

Parental verbal abuse and the mediating role of self-criticism in adult internalizing disorders.

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Sachs-Ericsson, Natalie; Verona, Edelyn; Joiner, Thomas; Preacher, Kristopher J

2006-07-01

Researchers (e.g., [Gibb, B.E., 2002. Childhood maltreatment and negative cognitive styles. A quantitative and qualitative review. Clinical Psychology Review, 22 (2), 223-246]; [Rose, D.T., Abramson, L.Y., 1992. Developmental predictors of depressive cognitive styles: developmental perspectives on depression. In Cicchetti, D., Toth, S.L. (Eds.), Developmental Perspectives on Depression. Rochester symposium on developmental psychopathology, vol. 4, pp. 323-349]) have proposed that when childhood abuse is verbal (rather than sexual or physical), the child is more likely to develop a negative self-schema because the negative self-cognitions are directly supplied to the child by the abuser (e.g., "you are stupid"). In a test of this theory in adult participants, and drawing on the National Comorbidity Survey (NCS) (N=5877), we investigate the mediating role of current levels of self-criticism on the relationship between retrospective reports of parental verbal abuse, as well as sexual and physical abuse, and adult internalizing symptoms. We found self-criticism, but not dependency traits, to fully mediate the relationship between childhood verbal abuse perpetrated by parents and internalizing (depression, anxiety) symptoms. On the other hand, self-criticism was only a partial mediator of the relationship between the other types of abuse and internalizing symptoms. The NCS data is cross-sectional, which limits any firm conclusions regarding causality. While these results are suggestive that self-criticism is a mediator of the relationship between abuse and internalizing symptoms, longitudinal data are necessary to help rule out alternative explanations. Results of this study suggest that childhood abuse experiences, and in particular verbal abuse, may confer risk for internalizing disorders in part because verbal abuse influences the development of a self-critical style.

Financial Literacy: A Critical Adult Education Appraisal

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English, Leona M.

2014-01-01

This chapter critically examines financial literacy education, asking what its assumptions are and what adult educators need to ask of its curriculum, its bases, and the people being taught to be financially literate.

Critical Conversations on Whiteness with Young Adult Literature

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Schieble, Melissa

2012-01-01

In this article, the author argues that whiteness remains an overwhelmingly absent dimension in literacy teaching that addresses systems of power from a critical perspective. One way literacy teachers may bring this dimension more explicitly into the classroom is by facilitating critical conversations on whiteness with young adult literature. As…

Predictors of agitation in critically ill adults.

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Burk, Ruth S; Grap, Mary Jo; Munro, Cindy L; Schubert, Christine M; Sessler, Curtis N

2014-09-01

Agitation in critically ill adults is a frequent complication of hospitalization and results in multiple adverse outcomes. Potential causes of agitation are numerous; however, data on factors predictive of agitation are limited. To identify predictors of agitation by examining demographic and clinical characteristics of critically ill patients. A medical record review was performed. Documentation of agitation was indicated by scores on the Richmond Agitation-Sedation Scale or the use of an agitation keyword. Records of 200 patients from 1 medical and 1 surgical intensive care unit were used for the study. Risk factors were determined for 2 points in time: admission to the intensive care unit and within 24 hours before the first episode of agitation. Data on baseline demographics, preadmission risk factors, and clinical data were collected and were evaluated by using logistic multivariable regression to determine predictors of agitation. Predictors of agitation on admission to intensive care were history of use of illicit substances, height, respiratory and central nervous system subscores on the Sequential Organ Failure Assessment, and use of restraints. Predictors of agitation within 24 hours before the onset of agitation were history of psychiatric diagnosis, height, score on the Sequential Organ Failure Assessment, ratio of Pao2 to fraction of inspired oxygen less than 200, serum pH, percentage of hours with restraints, percentage of hours of mechanical ventilation, pain, and presence of genitourinary catheters. Predictors of agitation on admission and within 24 hours before the onset of agitation were primarily clinical variables. ©2014 American Association of Critical-Care Nurses.

Critical thermal limits affected differently by developmental and adult thermal fluctuations

DEFF Research Database (Denmark)

Salachan, Paul Vinu; Sørensen, Jesper Givskov

2017-01-01

the developmental and adult life stages. For developmental acclimation, we found mildly detrimental effects of high amplitude fluctuations for critical thermal minima, while the critical thermal maxima showed a beneficial response to higher amplitude fluctuations. For adult acclimation involving shifts between...... fluctuating and constant regimes, cold tolerance was shown to be dictated by developmental temperature conditions irrespective of the adult treatments, while the acquired heat tolerance was readily lost when flies developed at fluctuating temperature were shifted to a constant regime as adults. Interestingly......, we also found that effect of fluctuations at any life stage was gradually lost with prolonged adult maintenance suggesting a more prominent effect of fluctuations during developmental compared to adult acclimation in Drosophila melanogaster....

Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

Science.gov (United States)

Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

2017-11-01

Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

The Three-Part Harmony of Adult Learning, Critical Thinking, and Decision-Making

Science.gov (United States)

Moore, Kyle

2010-01-01

Adult learning, critical thinking, and decision-making are fields that receive attention individually, although they are interspersed with elements of each other's theories and philosophies. In addressing adult learning precepts, it is essential to include critical thinking and decision-making. One without the other creates weakness; all must be…

Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values.

Science.gov (United States)

Cantinotti, Massimiliano; Giordano, Raffaele; Paterni, Marco; Saura, Daniel; Scalese, Marco; Franchi, Eliana; Assanta, Nadia; Koestenberg, Martin; Dulgheru, Raluca; Sugimoto, Tadafumi; Bernard, Anne; Caballero, Luis; Lancellotti, Patrizio

2017-12-01

There is a crescent interest on normal adult echocardiographic values and the introduction of new deformation imaging and 3D parameters pose the issue of normative data. A multitude of nomograms has been recently published, however data are often fragmentary, difficult to find, and their strengths/limitations have been never evaluated. (I) to provide a review of current echocardiographic nomograms; (II) to generate a tool for easy and fast access to these data. A literature search was conducted accessing the National Library of Medicine using the keywords: 2D/3D echocardiography, strain, left/right ventricle, atrial, mitral/tricuspid valve, aorta, reference values/nomograms/normal values. Adding the following keywords, the results were further refined: range/intervals, myocardial velocity, strain rate and speckle tracking. Forty one published studies were included. Our study reveals that for several of 2D/3D parameters sufficient normative data exist, however, a few limitations still persist. For some basic parameters (i.e., mitral/tricuspid/pulmonary valves, great vessels) and for 3D valves data are scarce. There is a lack of studies evaluating ethnic differences. Data have been generally expressed as mean values normalised for gender and age instead of computing models incorporating different variables (age/gender/body sizes) to calculate z scores. To summarize results a software ( Echocardio-Normal Values ) who automatically calculate range of normality for a broad range of echocardiographic measurements according to age/gender/weight/height, has been generated. We provide an up-to-date and critical review of strengths/limitation of current adult echocardiographic nomograms. Furthermore we generated a software for automatic, easy and fast access to multiple echocardiographic normative data.

The Cochrane Collaboration withdraws a review on methylphenidate for adults with attention deficit hyperactivity disorder

DEFF Research Database (Denmark)

Boesen, Kim; Saiz, Luis Carlos; Erviti, Juan

2017-01-01

A Cochrane systematic review on immediate-release methylphenidate for adults with attention deficit hyperactivity disorder (ADHD) was withdrawn from the Cochrane Library on 26 May 2016 after substantial criticism of its methods and flawed conclusions. Retraction of scientific papers on this basis...

Breckinridge Project, initial effort. Report XI, Volume V. Critical review of the design basis. [Critical review

Energy Technology Data Exchange (ETDEWEB)

None

1982-01-01

Report XI, Technical Audit, is a compendium of research material used during the Initial Effort in making engineering comparisons and decisions. Volumes 4 and 5 of Report XI present those studies which provide a Critical Review of the Design Basis. The Critical Review Report, prepared by Intercontinental Econergy Associates, Inc., summarizes findings from an extensive review of the data base for the H-Coal process design. Volume 4 presents this review and assessment, and includes supporting material; specifically, Design Data Tabulation (Appendix A), Process Flow Sheets (Appendix B), and References (Appendix C). Volume 5 is a continuation of the references of Appendix C. Studies of a proprietary nature are noted and referenced, but are not included in these volumes. They are included in the Limited Access versions of these reports and may be reviewed by properly cleared personnel in the offices of Ashland Synthetic Fuels, Inc.

Sedentary time in older adults: a critical review of measurement, associations with health, and interventions.

Science.gov (United States)

Copeland, Jennifer L; Ashe, Maureen C; Biddle, Stuart Jh; Brown, Wendy J; Buman, Matthew P; Chastin, Sebastien; Gardiner, Paul A; Inoue, Shigeru; Jefferis, Barbara J; Oka, Koichiro; Owen, Neville; Sardinha, Luís B; Skelton, Dawn A; Sugiyama, Takemi; Dogra, Shilpa

2017-11-01

Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults. A trained librarian created a search strategy that was peer reviewed for completeness. Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine. �

The rumination syndrome in adults: A review of the pathophysiology, diagnosis and treatment

Directory of Open Access Journals (Sweden)

Papadopoulos V

2007-01-01

Full Text Available Rumination in adults is considered to be the effortless regurgitation of recently ingested food into the mouth, followed by either rechewing and reswallowing or expulsion of the regurgitate. On the basis of the definition of rumination as a unique category of functional gastroduodenal disorders, according to the newly established Rome III classification, a review of the pathophysiology, diagnosis and treatment of the rumination syndrome in adults is presented after systematic and critical approach of all articles that could be retrieved through PubMed using the term "rumination".

Lateral positioning for critically ill adult patients.

Science.gov (United States)

Hewitt, Nicky; Bucknall, Tracey; Faraone, Nardene M

2016-05-12

lateral positioning in critically ill adults. We included manual or automated turns but limited eligibility to studies that included duration of body position of 10 minutes or longer. We examined each lateral position versus at least one comparator (opposite lateral position and/or another body position) for single therapy effects, and the lateral positioning schedule (repeated lateral turning) versus other positioning schedules for repetitive therapy effects. We pre-specified methods to be used for data collection, risk of bias assessment and analysis. Two independent review authors carried out each stage of selection and data extraction and settled differences in opinion by consensus, or by third party adjudication when disagreements remained unresolved. We planned analysis of pair-wise comparisons under composite time intervals with the aim of considering recommendations based on meta-analyses of studies with low risk of bias. We included 24 studies of critically ill adults. No study reported mortality as an outcome of interest. Two randomized controlled trials (RCTs) examined lateral positioning for pulmonary morbidity outcomes but provided insufficient information for meta-analysis. A total of 22 randomized trials examined effects of lateral positioning (four parallel-group and 18 cross-over designs) by measuring various continuous data outcomes commonly used to detect adverse cardiopulmonary events within critical care areas. However, parallel-group studies were not comparable, and cross-over studies provided limited data as the result of unit of analysis errors. Eight studies provided some data; most of these were single studies with small effects that were imprecise. We pooled partial pressure of arterial oxygen (PaO2) as a measure to detect hypoxaemia from two small studies of participants with unilateral lung disease (n = 19). The mean difference (MD) between lateral positions (bad lung down versus good lung down) was approximately 50 mmHg (MD -49.26 mmHg, 95

The effect of chronotherapy on delirium in critical care - a systematic review.

Science.gov (United States)

Luther, Roseanne; McLeod, Anne

2017-05-15

Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units. This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care? This study is a systematic review of quantitative studies. Six major electronic databases were searched, and a hand search was undertaken using selected key search terms. Research quality was assessed using the critical appraisal skills programme tools. The studies were critically appraised by both authors independently, and data were extracted. Four themes addressing the research question were identified and critically evaluated. Six primary research articles that investigated different methods of chronotherapy were identified, and the results suggest that multi-component non-pharmacological interventions are the most effective for reducing the prevalence of delirium in critical care. The melatonergic agonist Ramelteon demonstrated statistically significant reductions in delirium; however, the reliability of the results in answering the review question was limited by the research design. The use of bright light therapy (BLT) and dynamic light application had mixed results, with issues with the research design and outcomes measured limiting the validity of the findings. Multi-component non-pharmacological interventions, such as noise and light control, can reduce delirium in critical care, whereas other interventions, such as BLT, have mixed outcomes. Melatonin, as a drug, may be a useful alternative to sedative-hypnotics. Chronotherapy can reduce the incidence of delirium within critical care, although

Adult and Community Education in Complex Societies: Reconsidering Critical Perspectives

Science.gov (United States)

Wildemeersch, Danny

2014-01-01

In this contribution, I explore how critical pedagogical perspectives can inspire adult and community education practices. The central argument is that today, in contrast with the heydays of emancipatory practices and theories, the classical critical approaches need reconsideration. The paper explores how these approaches sometimes have a…

Skeletal Muscle Ultrasonography in Nutrition and Functional Outcome Assessment of Critically Ill Children: Experience and Insights From Pediatric Disease and Adult Critical Care Studies [Formula: see text].

Science.gov (United States)

Ong, Chengsi; Lee, Jan Hau; Leow, Melvin K S; Puthucheary, Zudin A

2017-09-01

Evidence suggests that critically ill children develop muscle wasting, which could affect outcomes. Muscle ultrasound has been used to track muscle wasting and association with outcomes in critically ill adults but not children. This review aims to summarize methodological considerations of muscle ultrasound, structural findings, and possibilities for its application in the assessment of nutrition and functional outcomes in critically ill children. Medline, Embase, and CINAHL databases were searched up until April 2016. Articles describing skeletal muscle ultrasound in children and critically ill adults were analyzed qualitatively for details on techniques and findings. Thickness and cross-sectional area of various upper and lower body muscles have been studied to quantify muscle mass and detect muscle changes. The quadriceps femoris muscle is one of the most commonly measured muscles due to its relation to mobility and is sensitive to changes over time. However, the margin of error for quadriceps thickness is too wide to reliably detect muscle changes in critically ill children. Muscle size and its correlation with strength and function also have not yet been studied in critically ill children. Echogenicity, used to detect compromised muscle structure in neuromuscular disease, may be another property worth studying in critically ill children. Muscle ultrasound may be useful in detecting muscle wasting in critically ill children but has not been shown to be sufficiently reliable in this population. Further study of the reliability and correlation with functional outcomes and nutrition intake is required before muscle ultrasound is routinely employed in critically ill children.

Reassessing Subjectivity, Criticality, and Inclusivity: Marcuse's Challenge to Adult Education.

Science.gov (United States)

Brookfield, Stephen

2002-01-01

Although Herbert Marcuse did not write as an adult educator, his analysis of subjectivity, criticality, and inclusivity has implications for adult education. He demonstrated how apparently humanistic tolerance for diversity can be manipulated to reinforce dominant ideology, and he made a case for aesthetic education as a site for critical…

Liberation From Mechanical Ventilation in Critically Ill Adults

DEFF Research Database (Denmark)

Schmidt, Gregory A; Girard, Timothy D; Kress, John P

2017-01-01

BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST). METHODS: A ...

Healthcare avoidance: a critical review.

Science.gov (United States)

Byrne, Sharon K

2008-01-01

The purpose of this study is to provide a critical review and synthesis of theoretical and research literature documenting the impact of avoidance on healthcare behaviors, identify the factors that influence healthcare avoidance and delay in the adult population, and propose a direction for future research. The Theory of Reasoned Action, Theory of Planned Behavior, Theory of Care-Seeking Behavior, the Transtheoretical Model, and the Behavioral Model of Health Services Use/Utilization are utilized to elaborate on the context within which individual intention to engage in healthcare behaviors occurs. Research literature on the concept of healthcare avoidance obtained by using computerized searches of CINAHL, MEDLINE, PSYCH INFO, and HAPI databases, from 1995 to 2007, were reviewed. Studies were organized by professional disciplines. Healthcare avoidance is a common and highly variable experience. Multiple administrative, demographic, personal, and provider factors are related to healthcare avoidance, for example, distrust of providers and/or the science community, health beliefs, insurance status, or socioeconomic/income level. Although the concept is recognized by multiple disciplines, limited research studies address its impact on healthcare decision making. More systematic research is needed to determine correlates of healthcare avoidance. Such studies will help investigators identify patients at risk for avoidant behaviors and provide the basis for health-promoting interventions. Methodological challenges include identification of characteristics of individuals and environments that hinder healthcare behaviors, as well as, the complexity of measuring healthcare avoidance. Studies need to systematically explore the influence of avoidance behaviors on specific healthcare populations at risk.

SPI Project Criticality Task Force initial review and assessment

International Nuclear Information System (INIS)

McKinley, K.B.; Cannon, J.W.; Marsden, R.S.; Worle, H.A.

1980-03-01

The Slagging Pyrolysis Incinerator (SPI) Facility is being developed to process transuranic waste stored and buried at the Idaho National Engineering Laboratory (INEL) into a chemically inert, physically stable, basalt-like residue acceptable for a Federal Repository. A task force was established by the SPI Project Division to review and assess all aspects of criticality safety for the SPI Facility. This document presents the initial review, evaluations, and recommendations of the task force and includes the following: background information on waste characterization, and criticality control approaches and philosophies, a description of the SPI Facility Waste Processing Building, a review and assessment of potentially relevant codes and regulations; a review and assessment of the present state of criticality and assaying/monitoring studies, and recommendations for changes in and additions to these studies. The review and assessment of potentially relevant codes and regulations indicate that ERDAM 0530, Nuclear Criticality Safety should be the controlling document for criticality safety for the SPI Project. In general, the criticality control approaches and philosophies for the SPI Project comply with this document

Critical Criminological Understandings of Adult Pornography and Woman Abuse: New Progressive Directions in Research and Theory

Directory of Open Access Journals (Sweden)

Walter DeKeseredy

2015-12-01

Full Text Available There is a small, but growing, social scientific literature on the racist and violent nature of contemporary adult pornography. However, considerably more empirical and theoretical work needs to be done to advance a critical criminological understanding of how such hurtful sexual media contribute to various forms of woman abuse in intimate relationships. The main objective of this article is to briefly review the relevant literature and to suggest a few new progressive empirical and theoretical directions.

Critical lnterpretatlon of quality ln adult education

Directory of Open Access Journals (Sweden)

Janko Berlogar

1997-01-01

Full Text Available Critical approach has undoubtedly fo­ und its place in the sociology of adult education, too. The author uses it to interpret the quality in adult education as something far from being absolute and reached ance for ever. Most important - it does not depend on the teachers, educators only. Whatever it really is, the quality in adult education is determined and defined by the power and interests of the »customer«, the stakeholder in educational process- by its participants, enterprises and economy, by the state and by the internal processes in educational organisations, too. The latter themselves usually do not have some real influence on the quality of the process they organise and carry out. The process determined and defined by power and interests of others has nothing in common with quality and is far from educational excellence. In adult education as a political process educational organisations stili have to fight their positions out. Their task therefore is to actively, through negotiations, but aggressively enough, participate in defining the principles of quality first. They will know how to activate them in educational processes later. With all respect to the market (from which adult education cannot run away, but the autonomy in defining educational principles is crucial for the survival of adult education organisations.

SRTC criticality safety technical review: Nuclear Criticality Safety Evaluation 93-04 enriched uranium receipt

International Nuclear Information System (INIS)

Rathbun, R.

1993-01-01

Review of NMP-NCS-930087, open-quotes Nuclear Criticality Safety Evaluation 93-04 Enriched Uranium Receipt (U), July 30, 1993, close quotes was requested of SRTC (Savannah River Technology Center) Applied Physics Group. The NCSE is a criticality assessment to determine the mass limit for Engineered Low Level Trench (ELLT) waste uranium burial. The intent is to bury uranium in pits that would be separated by a specified amount of undisturbed soil. The scope of the technical review, documented in this report, consisted of (1) an independent check of the methods and models employed, (2) independent HRXN/KENO-V.a calculations of alternate configurations, (3) application of ANSI/ANS 8.1, and (4) verification of WSRC Nuclear Criticality Safety Manual procedures. The NCSE under review concludes that a 500 gram limit per burial position is acceptable to ensure the burial site remains in a critically safe configuration for all normal and single credible abnormal conditions. This reviewer agrees with that conclusion

Informed consent and decision-making about adult-to-adult living donor liver transplantation: a systematic review of empirical research.

Science.gov (United States)

Gordon, Elisa J; Daud, Amna; Caicedo, Juan Carlos; Cameron, Kenzie A; Jay, Colleen; Fryer, Jonathan; Beauvais, Nicole; Skaro, Anton; Baker, Talia

2011-12-27

Adult-to-adult living donor liver transplantation (LDLT) is a complex procedure that poses serious health risks to and provides no direct health benefit for the donor. Because of this uneven risk-benefit ratio, ensuring donor autonomy through informed consent is critical. To assess the current knowledge pertaining to informed consent for LDLT, we conducted a systematic review of the empirical literature on donors' decision-making process, comprehension about risks and outcomes, and information needs for LDLT. Of the 1423 identified articles, 24 met final review criteria, representing the perspective of approximately 2789 potential and actual donors. As donors' decisions to donate often occur before evaluation, they often make uninformed decisions. The review found that 88% to 95% of donors reported understanding information clinicians disclosed about risks and benefits. However, donors reported unmet information needs, knowledge gaps regarding risks, and unanticipated complications. Few donors reported feeling pressure to donate. Most studies were limited by cultural differences, small sample sizes, inconsistent measures, and poor methodological approaches. This systematic review suggests that informed consent for LDLT is sub-optimal as donors do not adequately appreciate disclosed information during the informed consent process, despite United Network for Organ Sharing/CMS regulations requiring formal psychological evaluation of donor candidates. Interventions are needed to improve donor-clinician communication during the LDLT informed consent process such as through the use of comprehension assessment tools and e-health educational tools that leverage adult learning theory to effectively convey LDLT outcome data.

Tank farm nuclear criticality review

International Nuclear Information System (INIS)

Bratzel, D.R.

1996-01-01

The technical basis for the nuclear criticality safety of stored wastes at the Hanford Site Tank Farm Complex was reviewed by a team of senior technical personnel whose expertise covered all appropriate aspects of fissile materials chemistry and physics. The team concluded that the detailed and documented nucleonics-related studies underlying the waste tanks criticality safety basis were sound. The team concluded that, under current plutonium inventories and operating conditions, a nuclear criticality accident is incredible in any of the Hanford single-shell tanks (SST), double-shell tanks (DST), or double-contained receiver tanks (DCRTS) on the Hanford Site

Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review.

Science.gov (United States)

Fernando, Eresha; Fraser, Michelle; Hendriksen, Jane; Kim, Corey H; Muir-Hunter, Susan W

2017-01-01

Purpose: People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood. A review is needed to determine a fall risk profile for this population. The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia. Methods: Articles published between January 1988 and October 2014 in EMBASE, PubMed, PsycINFO, and CINAHL were searched. Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment, prospective cohort design, detailed fall definition, falls as the primary outcome, and multi-variable regression analysis. Two authors independently reviewed and extracted data on study characteristics, quality assessment, and outcomes. Adjusted risk estimates were extracted from the articles. Results: A total of 17 studies met the inclusion criteria. Risk factors were categorized into demographic, balance, gait, vision, functional status, medications, psychosocial, severity of dementia, and other. Risk factors varied with living setting and were not consistent across all studies within a setting. Conclusion: Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors, some shared with older adults in general and others unique to the disease. Risk factors vary between community- and institution-dwelling samples of adults with dementia or cognitive impairment.

Evaluation of Altered Drug Pharmacokinetics in Critically Ill Adults Receiving Extracorporeal Membrane Oxygenation.

Science.gov (United States)

Ha, Michael A; Sieg, Adam C

2017-02-01

Extracorporeal membrane oxygenation (ECMO) is a life-support modality used in patients with refractory cardiac and/or respiratory failure. A significant resurgence in the use ECMO has been seen in recent years as a result of substantial improvements in technology and survival benefit. With expanding ECMO use, a better understanding of how ECMO affects drug pharmacokinetics (PK) is necessary. The vast majority of PK studies in patients receiving ECMO have been conducted within neonatal or pediatric populations or within a controlled environment (e.g., in vitro or ex vivo). Because of significant differences in absorption, distribution, metabolism, and excretion, it may be inappropriate to extrapolate these PK data to adults. Thus, the aims of this review are to evaluate the changes in drug PK during ECMO and to summarize the available PK data for common drugs used in the adult critically ill patients during ECMO support. A search of the PubMed (1965-July 2016), EMBASE (1965-July 2016), and Cochrane Controlled Trial Register databases was performed. All relevant studies describing PK alterations during ECMO in ex vivo experiments and in adults were included. Evaluation of the data indicated that drug PK in adults receiving ECMO support may be significantly altered. Factors influencing these alterations are numerous and have intricate relationships with each other but can generally be classified as ECMO circuit factors, drug factors, and patient factors. Commonly used drugs in these patients include antimicrobials, sedatives, and analgesics. PK data for most of these drugs are generally lacking; however, recent research efforts in this patient population have provided some limited guidance in drug dosing. With an improved understanding of altered drug PK secondary to ECMO therapy, optimization of pharmacotherapy within this critically ill population continues to move forward. © 2016 Pharmacotherapy Publications, Inc.

SRTC criticality safety technical review of SRT-CMA-930039

International Nuclear Information System (INIS)

Rathbun, R.

1993-01-01

Review of SRT-CMA-930039, ''Nuclear Criticality Safety Evaluation (NCSE): DWPF Melter-Batch 1,'' December 1, 1993, has been performed by the Savannah River Technical Center (SRTC) Applied Physics Group. The NCSE is a criticality assessment of the Melt Cell in the DWPF. Additionally, this pertains only to Batch 1 operation, which differs from batches to follow. Plans for subsequent batch operations call for fissile material in the Salt Cell feed-stream, which necessitates a separate criticality evaluation in the future. The NCSE under review concludes that the process is safe from criticality events, even in the event that all lithium and boron neutron poisons are lost, provided uranium enrichments are less than 40%. Furthermore, if all the lithium and as much as 98% of the boron would be lost, uranium enrichments of 100% would be allowable. After a thorough review of the NCSE, this reviewer agrees with that conclusion. This technical review consisted of: an independent check of the methods and models employed, independent calculations application of ANSI/ANS 8.1, verification of WSRC Nuclear Criticality Safety Manual( 2 ) procedures

Older Adults and Gambling: A Review

Science.gov (United States)

Ariyabuddhiphongs, Vanchai

2012-01-01

This paper uses the social cognitive theory model to review the literature on older adult gambling, and related personal and environment characteristics. Results show that lottery is the kind of gambling most frequently played by older adults, followed by casino games. Older adults take trips to casinos to socialize, find excitement, and win…

Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients.

Science.gov (United States)

Gosselink, R; Bott, J; Johnson, M; Dean, E; Nava, S; Norrenberg, M; Schönhofer, B; Stiller, K; van de Leur, H; Vincent, J L

2008-07-01

The Task Force reviewed and discussed the available literature on the effectiveness of physiotherapy for acute and chronic critically ill adult patients. Evidence from randomized controlled trials or meta-analyses was limited and most of the recommendations were level C (evidence from uncontrolled or nonrandomized trials, or from observational studies) and D (expert opinion). However, the following evidence-based targets for physiotherapy were identified: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure. Discrepancies and lack of data on the efficacy of physiotherapy in clinical trials support the need to identify guidelines for physiotherapy assessments, in particular to identify patient characteristics that enable treatments to be prescribed and modified on an individual basis. There is a need to standardize pathways for clinical decision-making and education, to define the professional profile of physiotherapists, and increase the awareness of the benefits of prevention and treatment of immobility and deconditioning for critically ill adult patients.

Ethical Considerations Regarding the Use of Smart Home Technologies for Older Adults: An Integrative Review.

Science.gov (United States)

Chung, Jane; Demiris, George; Thompson, Hilaire J

2016-01-01

With the wide adoption and use of smart home applications, there is a need for examining ethical issues regarding smart home use at the intersection of aging, technology, and home environment. The purpose of this review is to provide an overview of ethical considerations and the evidence on these ethical issues based on an integrative literature review with regard to the utilization of smart home technologies by older adults and their family members. REVIEW DESIGN AND METHODS: We conducted an integrative literature review of the scientific literature from indexed databases (e. g., MEDLINE, CINAHL, and PsycINFO). The framework guiding this review is derived from previous work on ethical considerations related to telehealth use for older adults and smart homes for palliative care. Key ethical issues of the framework include privacy, informed consent, autonomy, obtrusiveness, equal access, reduction in human touch, and usability. Six hundred and thirty-five candidate articles were identified between the years 1990 and 2014. Sixteen articles were included in the review. Privacy and obtrusiveness issues appear to be the most important factors that can affect smart home technology adoption. In addition, this article recommends that stigmatization and reliability and maintenance of the system are additional factors to consider. When smart home technology is used appropriately, it has the potential to improve quality of life and maintain safety among older adults, ultimately supporting the desire of older adults for aging in place. The ability to respond to potential ethical concerns will be critical to the future development and application of smart home technologies that aim to enhance safety and independence.

The epidemiological studies of leukemia around nuclear installations for children and young adults: synthesis of the critical review

International Nuclear Information System (INIS)

2008-01-01

An epidemiological study published at the end of 2007 described an increased risk of leukemia among children less than five years leaving at less than 5 kilometers from German nuclear power plants. The objective of this report was to make a synthesis and a critical analysis of the results relative to the risk of leukemia among the children and young adults of less than twenty five years leaving near these nuclear installations. (N.C.)

Development and Use of Health-Related Technologies in Indigenous Communities: Critical Review.

Science.gov (United States)

Jones, Louise; Jacklin, Kristen; O'Connell, Megan E

2017-07-20

Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes. ©Louise Jones, Kristen Jacklin, Megan E O'Connell. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.07.2017.

Marketing in Adult Education. A Critical Review of Literature.

Science.gov (United States)

Wells, Rita L.

In the literature on marketing in adult education there is much debate on the ethics of marketing educational programs; although many individuals have written about the potential negative impacts of big business and high-pressure advertising in education, others have viewed marketing as an acceptable process that attempts to establish mutually…

Oxygen supplementation for critically ill patients

DEFF Research Database (Denmark)

Barbateskovic, M; Schjørring, O L; Jakobsen, J C

2018-01-01

. The objective of this systematic review is to critically assess the evidence of randomised clinical trials on the effects of higher versus lower inspiratory oxygen fractions or targets of arterial oxygenation in critically ill adult patients. METHODS: We will search for randomised clinical trials in major......BACKGROUND: In critically ill patients, hypoxaemia is a common clinical manifestation of inadequate gas exchange in the lungs. Supplemental oxygen is therefore given to all critically ill patients. This can result in hyperoxaemia, and some observational studies have identified harms with hyperoxia...... in international guidelines despite lack of robust evidence of its effectiveness. To our knowledge, no systematic review of randomised clinical trials has investigated the effects of oxygen supplementation in critically ill patients. This systematic review will provide reliable evidence to better inform future...

Nutrition in acute pancreatitis: a critical review

NARCIS (Netherlands)

Lodewijkx, Piet J.; Besselink, Marc G.; Witteman, Ben J.; Schepers, Nicolien J.; Gooszen, Hein G.; van Santvoort, Hjalmar C.; Bakker, Olaf J.

Severe acute pancreatitis poses unique nutritional challenges. The optimal nutritional support in patients with severe acute pancreatitis has been a subject of debate for decades. This review provides a critical review of the available literature. According to current literature, enteral nutrition

Radically Reducing the Costs of Panel Critical Reviews According to ISO 14040

DEFF Research Database (Denmark)

Weidema, Bo Pedersen; Christiansen, Kim; Wernet, Gregor

2013-01-01

We suggest a procedure that radically reduces the critical review costs without compromising their thoroughness and overall quality. This procedure has 3 elements: A fixed panel for all reviews, an already critically reviewed background database, and a software-supported review procedure. The pre....... The presentation discusses these elements in the light of the upcoming ISO 14071 on critical review....

Subclinical hypothyroidism, mood, and cognition in older adults: a review.

Science.gov (United States)

Joffe, Russell T; Pearce, Elizabeth N; Hennessey, James V; Ryan, Joseph J; Stern, Robert A

2013-02-01

To perform a critical review of the literature on the mood and cognitive changes associated with subclinical hypothyroidism (SCH), with an emphasis on older adults. To evaluate these data against the Consensus Statement on the management of SCH from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. A comprehensive literature review. Subclinical hypothyroidism may be associated with an increased risk of mood and cognitive dysfunction, although the strength of this association and the efficacy of replacement hormone therapy require further investigation. It remains unclear whether SCH leads to significant mood and cognitive impairments in most older patients. More research is required to determine the nature and extent of this association and whether thyroid hormone replacement therapy is appropriate and effective in treating SCH-associated neurobehavioral impairments. Copyright © 2012 John Wiley & Sons, Ltd.

SRTC criticality technical review: Nuclear Criticality Safety Evaluation 93-18 Uranium Solidification Facility's Waste Handling Facility

International Nuclear Information System (INIS)

Rathbun, R.

1993-01-01

Separate review of NMP-NCS-930058, open-quotes Nuclear Criticality Safety Evaluation 93-18 Uranium Solidification Facility's Waste Handling Facility (U), August 17, 1993,close quotes was requested of SRTC Applied Physics Group. The NCSE is a criticality assessment to determine waste container uranium limits in the Uranium Solidification Facility's Waste Handling Facility. The NCSE under review concludes that the NDA room remains in a critically safe configuration for all normal and single credible abnormal conditions. The ability to make this conclusion is highly dependent on array limitation and inclusion of physical barriers between 2x2x1 arrays of boxes containing materials contaminated with uranium. After a thorough review of the NCSE and independent calculations, this reviewer agrees with that conclusion

A systematic review of critical thinking in nursing education.

Science.gov (United States)

Chan, Zenobia C Y

2013-03-01

This review aimed to explore how critical thinking is perceived in previous studies of nursing education, and analyse the obstacles and strategies in teaching and learning critical thinking mentioned in these studies. Systematic review. This review was based on the following five databases: The British Nursing Index, Ovid Medline, CINAHL, PsycINFO and Scopus. After the screening process and evaluation through using the Critical Appraisal Skills Programme tool, 17 studies were identified that met the inclusion and quality criteria. The studies were read through several times and analysed through thematic synthesis. A total of three themes were developed. The first theme, components for critical thinkers, suggests the abilities and attitudes that critical thinkers should have. The other two themes, influential factors of critical thinking in nursing education, and strategies to promote critical thinking, describe the obstacles and strategies in teaching and learning critical thinking. The 17 studies illustrated that the definition and concept of critical thinking may change from time to time, and hence there is a need to clarify educators' perspective towards critical thinking. There is also a need to evaluate the efficacy of the new strategies mentioned in several selected studies, such as art-based, questioning, cross-cultural nursing experience, and preceptorship. With a better understanding of critical thinking in nursing education, educators and nursing faculty are able to develop better strategies in enhancing critical thinking development in nursing students, in turn preparing them for future clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

SRTC criticality safety technical review: Nuclear criticality safety evaluation 94-02, uranium solidification facility pencil tank module spacing

International Nuclear Information System (INIS)

Rathbun, R.

1994-01-01

Review of NMP-NCS-94-0087, ''Nuclear Criticality Safety Evaluation 94-02: Uranium Solidification Facility Pencil Tank Module Spacing (U), April 18, 1994,'' was requested of the SRTC Applied Physics Group. The NCSE is a criticality assessment to show that the USF process module spacing, as given in Non-Conformance Report SHM-0045, remains safe for operation. The NCSE under review concludes that the module spacing as given in Non-Conformance Report SHM-0045 remains in a critically safe configuration for all normal and single credible abnormal conditions. After a thorough review of the NCSE, this reviewer agrees with that conclusion

Review Article: A Review Of Adult Orthodontics – Role Of The ...

African Journals Online (AJOL)

Adjunctive and comprehensive orthodontic treatments are the main types of orthodontic therapy recommended for adult malocclusion. The orthodontic therapy and refer to the specialist appropriately. KEY WORDS: Review, Adult Orthodontics, General Dental Practitioner. Nigerian Journal of Clinical Practice Vol.7(1) 2004: ...

Review of teaching methods and critical thinking skills.

Science.gov (United States)

Kowalczyk, Nina

2011-01-01

Critical information is needed to inform radiation science educators regarding successful critical thinking educational strategies. From an evidence-based research perspective, systematic reviews are identified as the most current and highest level of evidence. Analysis at this high level is crucial in analyzing those teaching methods most appropriate to the development of critical thinking skills. To conduct a systematic literature review to identify teaching methods that demonstrate a positive effect on the development of students' critical thinking skills and to identify how these teaching strategies can best translate to radiologic science educational programs. A comprehensive literature search was conducted resulting in an assessment of 59 full reports. Nineteen of the 59 reports met inclusion criteria and were reviewed based on the level of evidence presented. Inclusion criteria included studies conducted in the past 10 years on sample sizes of 20 or more individuals demonstrating use of specific teaching interventions for 5 to 36 months in postsecondary health-related educational programs. The majority of the research focused on problem-based learning (PBL) requiring standardized small-group activities. Six of the 19 studies focused on PBL and demonstrated significant differences in student critical thinking scores. PBL, as described in the nursing literature, is an effective teaching method that should be used in radiation science education. ©2011 by the American Society of Radiologic Technologists.

The epidemiological studies of leukemia around nuclear facilities for children and young adults: critical review

International Nuclear Information System (INIS)

2008-01-01

This objective of this report is to make a review of studies relative to the risk of leukemia among children and young adults less than twenty five years old near the nuclear facilities. the nuclear facilities considered in this report are nuclear power plants (electric power generation), the nuclear research centers, the fuel or weapons fabrication plants, reprocessing plants. This report does not describe the risk analysis near the sites of nuclear weapons test, the consequences of accidents on nuclear facilities such Chernobylsk or the the population near the military and industrial site of Mayak (Ural). The same is for the mining sites and the facilities of uranium extraction that are out of this report. (N.C.)

An Integrative Review of the Concealed Connection: Nurse Educators' Critical Thinking.

Science.gov (United States)

Raymond, Christy; Profetto-McGrath, Joanne; Myrick, Florence; Strean, William B

2017-11-01

The role of nurse educators in the development of students' critical thinking has been overlooked despite the emphasized need for effective teaching methods. An integrative review was performed to examine both quantitative and qualitative research published from 2000 to 2015 related to nurse educators' critical thinking. Many barriers and facilitators existing on individual, interpersonal, and contextual levels affected nurse educators' critical thinking. Various tools have been used to measure nurse educators' critical thinking. This review also highlighted the continued lack of a consensus definition of critical thinking and the limited presence of conceptual models to guide the use of critical thinking in nursing education. Continued examination of nurse educators' critical thinking is needed, given the limited number of studies that have been completed. Much needs to be explored further, including conceptualizations of critical thinking and confirmation of emerging themes identified in this review. [J Nurs Educ. 2017;56(11):648-654.]. © 2017 Raymond, Profetto-McGrath, Myrick, et al.

A critical review of clarifier modelling

DEFF Research Database (Denmark)

Plósz, Benedek; Nopens, Ingmar; Rieger, Leiv

This outline paper aims to provide a critical review of secondary settling tank (SST) modelling approaches used in current wastewater engineering and develop tools not yet applied in practice. We address the development of different tier models and experimental techniques in the field...

Effectiveness of haloperidol prophylaxis in critically ill patients with a high risk of delirium: a systematic review.

Science.gov (United States)

Santos, Eduardo; Cardoso, Daniela; Neves, Hugo; Cunha, Madalena; Rodrigues, Manuel; Apóstolo, João

2017-05-01

). For these reasons, we were unable to perform a meta-analysis. Therefore, the results have been described in a narrative format. Five studies met the inclusion criteria. One of these studies was excluded due to poor methodological quality. The remaining four original studies (total of 1142 patients) were included in this review. Three studies were randomized controlled trials and one was a cohort study.Two studies confirmed the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk of delirium. These studies showed that short-term prophylactic administration of low-dose intravenous haloperidol significantly decreased the incidence of delirium in elderly patients admitted to intensive care units after non-cardiac surgery and in general intensive care unit patients with a high risk of delirium.However, the two remaining studies showed contradictory results in mechanically ventilated critically ill adults, revealing that the administration of haloperidol reduced delirium prevalence, delayed its occurrence, and/or shorten its duration. The evidence related to the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk of delirium is contradictory. However, balancing the benefits and low side effects associated with haloperidol prophylaxis, this preventive intervention may be useful to reduce the incidence of delirium in critically ill adults in intensive care units.

Effectiveness of surgery for adults with hallux valgus deformity: a systematic review.

Science.gov (United States)

Klugarova, Jitka; Hood, Victoria; Bath-Hextall, Fiona; Klugar, Miloslav; Mareckova, Jana; Kelnarova, Zuzana

2017-06-01

Hallux valgus (HV) is a common foot deformity. In severe stages of this condition, surgery is often necessary. Currently, there is no systematic review comparing the effectiveness of surgery over conservative treatment. The objective of this review was to establish the effectiveness of surgery compared to conservatory management for adults with HV. The current review included adults (18 years or over) with HV deformity, excluding adults with neurological problems causing foot deformities, for example, cerebral palsy, neuropathy, stroke and multiple sclerosis. The review included any type of HV surgery compared to no surgery, conservative treatment or different types of HV surgeries. The primary outcome was gait measurement, and secondary outcomes included quality of life, patient satisfaction, pain assessed using any validated assessment tool and adverse events. The review included randomized controlled trials. The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in 16 databases without language and date limitations. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments developed by the Joanna Briggs Institute (JBI). Data were extracted from papers included in the review using the standardized data extraction tool developed by the JBI. Quantitative data were, where possible, pooled in statistical meta-analysis using RevMan5 (Copenhagen: The Nordic Cochrane Centre, Cochrane). Effect sizes expressed as risk ratio (for categorical data) and mean differences (MD) or standardized MD (for continuous data) and their 95% confidence intervals were calculated for analysis. Where statistical pooling was not possible, the findings have been presented in narrative form. Searching identified 2412 citations. After removal of duplicates, paper retrieval and critical appraisal, 25 studies

Do consumer critics write differently from professional critics? A genre analysis of online film reviews

NARCIS (Netherlands)

De Jong, I.K.E.; Burgers, C.F.

2013-01-01

Consumers often base their choices to purchase experience goods like movies on online reviews. These reviews can be written by professional critics or by other consumers. However, little is known on the issue how the texts written by these two groups of reviewers differ. To answer this question, we

Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties.

Science.gov (United States)

Wilberforce, Mark; Challis, David; Davies, Linda; Kelly, Michael P; Roberts, Chris; Loynes, Nik

2016-03-07

Person-centredness is promoted as a central feature of the long-term care of older adults. Measures are needed to assist researchers, service planners and regulators in assessing this feature of quality. However, no systematic review exists to identify potential instruments and to provide a critical appraisal of their measurement properties. A systematic review of measures of person-centredness was undertaken. Inclusion criteria restricted references to multi-item instruments designed for older adult services, or otherwise with measurement properties tested in an older adult population. A two-stage critical appraisal was conducted. First, the methodological quality of included references was assessed using the COSMIN toolkit. Second, seven measurement properties were rated using widely-recognised thresholds of acceptability. These results were then synthesised to provide an overall appraisal of the strength of evidence for each measurement property for each instrument. Eleven measures tested in 22 references were included. Six instruments were designed principally for use in long-stay residential facilities, and four were for ambulatory hospital or clinic-based services. Only one measure was designed mainly for completion by users of home care services. No measure could be assessed across all seven measurement properties. Despite some instruments having promising measurement properties, this was consistently undermined by the poor methodological quality underpinning them. Testing of hypotheses to support construct validity was of particularly low quality, whilst measurement error was rarely assessed. Two measures were identified as having been the subject of the most rigorous testing. The review is unable to unequivocally recommend any measures of person-centredness for use in older adult care. Researchers are advised to improve methodological rigour when testing instruments. Efforts may be best focused on testing a narrower range of measurement properties but to a

Critical review of directional neutron survey meters

International Nuclear Information System (INIS)

Balmer, Matthew J.I.; Gamage, Kelum A.A.; Taylor, Graeme C.

2014-01-01

Having been overlooked for many years, research is now starting to take into account the directional distribution of the neutron work place field. The impact of not taking this into account has led to overly conservative estimates of dose in neutron workplace fields. This paper provides a critical review of this existing research into directional survey meters which could improve these estimates of dose. Instruments which could be adapted for use as directional neutron survey meters are also considered within this review. Using Monte-Carlo techniques, two of the most promising existing designs are evaluated; a boron-doped liquid scintillator and a multi-detector directional spectrometer. As an outcome of these simulations, possible adaptations to these instruments are suggested with a view to improving the portability of the instrument. -- Highlights: • We critically review the existing literature into directional survey meters. • Instruments which could be adapted for this purpose are also reviewed. • Investigate the potential of much lighter portable real-time instrument. • Improvements to existing instruments are suggested to improve their design. • Boron-Doped liquid scintillator design is the most promising, but needs further work

Is the "Health and Physical Education" Curriculum in South Australia Enough? A Critical Review of the SACSA Framework and the New SACE Curriculum

Science.gov (United States)

Talukdar, Joy; Aspland, Tania

2012-01-01

Sexually transmitted diseases as well as the major hepatides, hepatitis A, B and C are on the rise in South Australia, specifically among the adolescents and young adults' age group. Adolescents rely much on school programs for their health-related information. Accordingly, the present review provides critical insights into the existing…

Popular Culture and Critical Media Literacy in Adult Education: Theory and Practice

Science.gov (United States)

Tisdell, Elizabeth J.

2007-01-01

This chapter introduces the volume, provides an overview of the theory and literature on popular culture and critical media literacy in education, and discusses ways to use popular culture in adult education.

Parents' Criticisms and Attributions about Their Adult Children with High Functioning Autism or Schizophrenia

Science.gov (United States)

Wasserman, Stephanie; Weisman de Mamani, Amy; Mundy, Peter

2010-01-01

The current study examined the criticism component of expressed emotion (EE) and attributions in parents of adults diagnosed with schizophrenia/schizoaffective disorder (S/SA) or high functioning autism/Asperger's. Consistent with study hypotheses, parents of adults diagnosed with autism/Asperger's disorder exhibited lower levels of high…

Added value of FM – a critical review

DEFF Research Database (Denmark)

Jensen, Per Anker; van der Voordt, Theo

2015-01-01

The purpose of this paper is to provide a state of the art of how the topic “Added value of FM” has been treated recently in research and practice. The paper is based on research papers from EFMC 2013 and 2014. The paper provides an overview and a critical review of this research. A main focus...... is to examine to which degree there is a cumulative knowledge building in this field. The paper also summarises findings about value adding management in practice and reflects on implications for research and practice. The critical review shows that some of the papers have a strong foundation in former research...

A Critical Review of Studies on Health Needs Assessment of Elderly in the World

Directory of Open Access Journals (Sweden)

Sima Ghasemi

2017-06-01

Full Text Available Introduction: Health improvement, control of communicable diseases and increase in life expectancy among the elderly of developed and developing countries has greatly increased. Since the health care and social needs of older adults differ from that of other adults, it is necessary to identify the needs of the elderly in order to make proper plans that will promote their health. The aim of this paper is to critically review these researches. Methods: A comprehensive literature review on the needs assessment of elderly health was applied searching English and Persian databases in Pub Med, Science Direct, ProQuest, Elsevier, Magiran, ISC and using key words including, Health need, Assessment, Elderly, Aging, Older adults, Aged and Health care needs. Results: Initial search yielded 745 references, considering the inclusion criteria, 21 papers were reviewed. Results revealed that in conducting needs assessment, various methods and procedures in various health dimensions including physical health, mental health, emotional, care, social, cultural, economic, nutritional, service, security, legal and educational needs have been utilized. Some of the dimensions had been more explored and some rarely. Conclusion: Most of the conducted studies had mainly focused on the elderly physical health needs and had neglected to take in to account other needs such as social and health care needs. In order to comprehensively recognize the health needs of the elderly, identifying their health care and care services is also important. Furthermore, in addition to quantitative studies, discovering the older adults’ perceptions of their own health needs is also necessary. It seems that the challenge ahead of managers, experts and researchers on elderly health is trying to design comprehensive mechanisms of health need assessment and considering it as a reference for any future planning.

What is really causing the obesity epidemic? A review of reviews in children and adults.

Science.gov (United States)

Ross, Sharon E; Flynn, Jennifer I; Pate, Russell R

2016-01-01

Obesity prevention is a public health priority and intervention strategies have focused primarily on healthy eating and physical activity in children and adults. To date, no review has systematically compiled and synthesised the scientific evidence from published review articles to determine whether there is clear consensus on the causes of obesity. A systematic review of the literature was conducted searching PubMed/Medline for narrative and systematic review articles published between January 1990 and October 2014 that examined the causes of obesity. In total, 12 of 65 articles met the inclusion criteria; 7 reviews focused on adults (1 systematic, 6 narrative) and 5 reviews on children (2 systematic, 3 narrative). The most popular cause of obesity identified in reviews of adult studies was "combined physical activity and diet" (3 of 7 studies), whereas the most popular cause specified in reviews of child studies was deemed "inconclusive" (2 of 5 studies). While a number of reviews have examined the causes of obesity, the methodology and conclusions varied widely, and few were conducted systematically. Currently, no consensus exists across published literature reviews regarding the primary cause of the obesity epidemic, and more research, particularly prospective studies using state-of-the-art measures, is warranted.

The importance of service-users' perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes.

Science.gov (United States)

Sutcliffe, Katy; Melendez-Torres, G J; Burchett, Helen E D; Richardson, Michelle; Rees, Rebecca; Thomas, James

2018-03-14

Extensive research effort shows that weight management programmes (WMPs) targeting both diet and exercise are broadly effective. However, the critical features of WMPs remain unclear. To develop a deeper understanding of WMPs critical features, we undertook a systematic review of qualitative evidence. We sought to understand from a service-user perspective how programmes are experienced, and may be effective, on the ground. We identified qualitative studies from existing reviews and updated the searches of one review. We included UK studies capturing the views of adult WMP users. Thematic analysis was used inductively to code and synthesize the evidence. Service users were emphatic that supportive relationships, with service providers or WMP peers, are the most critical aspect of WMPs. Supportive relationships were described as providing an extrinsic motivator or "hook" which helped to overcome barriers such as scepticism about dietary advice or a lack confidence to engage in physical activity. The evidence revealed that service-users' understandings of the critical features of WMPs differ from the focus of health promotion guidance or descriptions of evaluated programmes which largely emphasize educational or goal setting aspects of WMPs. Existing programme guidance may not therefore fully address the needs of service users. The study illustrates that the perspectives of service users can reveal unanticipated intervention mechanisms or underemphasized critical features and underscores the value of a holistic understanding about "what happens" in complex psychosocial interventions such as WMPs. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

Plant safety review from mass criticality accident

International Nuclear Information System (INIS)

Susanto, B.G.

2000-01-01

The review has been done to understand the resent status of the plant in facing postulated mass criticality accident. From the design concept of the plant all the components in the system including functional groups have been designed based on favorable mass/geometry safety principle. The criticality safety for each component is guaranteed because all the dimensions relevant to criticality of the components are smaller than dimensions of 'favorable mass/geometry'. The procedures covering all aspects affecting quality including the safety related are developed and adhered to at all times. Staff are indoctrinated periodically in short training session to warn the important of the safety in process of production. The plant is fully equipped with 6 (six) criticality detectors in strategic places to alert employees whenever the postulated mass criticality accident occur. In the event of Nuclear Emergency Preparedness, PT BATAN TEKNOLOGI has also proposed the organization structure how promptly to report the crisis to Nuclear Energy Control Board (BAPETEN) Indonesia. (author)

A review of the evidence linking adult attachment theory and chronic pain: presenting a conceptual model.

Science.gov (United States)

Meredith, Pamela; Ownsworth, Tamara; Strong, Jenny

2008-03-01

It is now well established that pain is a multidimensional phenomenon, affected by a gamut of psychosocial and biological variables. According to diathesis-stress models of chronic pain, some individuals are more vulnerable to developing disability following acute pain because they possess particular psychosocial vulnerabilities which interact with physical pathology to impact negatively upon outcome. Attachment theory, a theory of social and personality development, has been proposed as a comprehensive developmental model of pain, implicating individual adult attachment pattern in the ontogenesis and maintenance of chronic pain. The present paper reviews and critically appraises studies which link adult attachment theory with chronic pain. Together, these papers offer support for the role of insecure attachment as a diathesis (or vulnerability) for problematic adjustment to pain. The Attachment-Diathesis Model of Chronic Pain developed from this body of literature, combines adult attachment theory with the diathesis-stress approach to chronic pain. The evidence presented in this review, and the associated model, advances our understanding of the developmental origins of chronic pain conditions, with potential application in guiding early pain intervention and prevention efforts, as well as tailoring interventions to suit specific patient needs.

The process of death imminence awareness by family members of patients in adult critical care.

Science.gov (United States)

Baumhover, Nancy C

2015-01-01

A focus on cost-effective quality end-of-life care remains a high priority in adult critical care given an aging population, high prevalence of death, and aggressive technologies used to extend or sustain life in this setting. A Glaserian grounded theory design was used to conduct this retrospective study to yield a substantive middle-range theory. The data source was semistructured interviews with 14 family members of decedents who died 6 to 60 months prior to the study. The purpose of this study was to generate a theory on how family members of patients in adult critical care come to realize that their loved one is dying. The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care middle-range theory contained 6 phases: (1) patient's near-death awareness, (2) dying right in front of me, (3) turning points in the patient's condition, (4) no longer the person I once knew, (5) doing right by them, and (6) time to let go. Patient's near-death awareness preceded all other phases, if communicated by the decedent with their family. Then, family members iteratively moved through all the other key phases in the process until a time to let go became evident. This substantive middle-range theory will guide nursing education, practice, and research aimed at providing quality and cost-effective end-of-life care in adult critical care.

Literature review of post-traumatic stress disorder in the critical care population.

Science.gov (United States)

Morrissey, Matthew; Collier, Elizabeth

2016-06-01

To determine which factors relate to the development of post-traumatic stress disorder, in adult patients who are admitted to critical care units. Patient survival rates from critical care areas are improving each year and this has led to interest in the long-term outcomes for patients who have been discharged from such environments. Patients typically require invasive and extensive treatment, which places a stress on physical and mental health. Prevalence estimates of post-traumatic stress disorder in the critical care discharge population vary from 5-63%, yet it remains unclear what the predisposing factors are. A systematised review. Subject heading and keyword searches were conducted in MEDLINE, CINAHL, PsycINFO and ScienceDirect, with 23 articles identified that examined the relationship between critical care and the development of post-traumatic stress disorder. Three main themes were identified; Critical Care Factors, Patient Factors and Experience Factors. Eight key and three potential causative factors were found: younger age, female, previous psychiatric history, length of ICU stay, benzodiazepine sedation, use of stress hormones, delusional memory and traumatic memory, delirium, GCS score of ≤9 on admission & use of mechanical restraint. Post-traumatic stress reactions can be strongly related to the development and presence of traumatic and delusional memories. Younger patients may exclude themselves from research to avoid their traumatic thoughts. The role of prior psychiatric illness is unknown. Distinction between 'factual' and 'false' or delusional memory as occurs in the literature maybe unhelpful in understanding trauma reactions. There are around 38,000 occupied critical care beds each year in England. The scale of the issue is therefore substantial. Risk factors can be isolated from available evidence and provide a rudimentary risk assessment tool to inform practice development in this area. © 2016 John Wiley & Sons Ltd.

Treatment Effects for Dysphagia in Adults with Multiple Sclerosis: A Systematic Review.

Science.gov (United States)

Alali, Dalal; Ballard, Kirrie; Bogaardt, Hans

2016-10-01

Dysphagia or swallowing difficulties have been reported to be a concern in adults with multiple sclerosis (MS). This problem can result in several complications including aspiration pneumonia, reduced quality of life and an increase in mortality rate. No previous systematic reviews on treatment effects for dysphagia in MS have been published. The main objective of this study is to summarise and qualitatively analyse published studies on treatment effects for dysphagia in MS. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied to conduct a systematic search of seven databases, using relevant key words, and subsequent analysis of the identified studies. The studies were required to meet all three inclusion criteria of including a statement on intention to treat, or measure the effects of treatment for dysphagia in adults with MS and data on treatment outcomes for at least one adult diagnosed with MS. Retained studies were evaluated by two independent reviewers using a critical appraisal tool. This study has not been registered. A total of 563 studies were identified from the database searches. After screening and assessment of full articles for eligibility, five studies were included in the review. Three examined electrical stimulation and two examined the use of botulinum toxin. One study testing electrical stimulation was a randomised controlled trial, two were well-designed case series and two were case series lacking experimental control. All studies reported some positive effects on dysphagia; however, treatments that involved the use of electrical stimulation showed larger effect sizes. There is a paucity of evidence to guide treatment of dysphagia in MS, with only electrical stimulation and botulinum toxin treatment represented in the literature search conducted here. While both treatments show initial promise for reducing the swallowing impairment, they require further research using well-controlled experimental

Systematic review of low-level laser therapy for adult androgenic alopecia.

Science.gov (United States)

Delaney, Sean W; Zhang, Paul

2017-12-29

Alopecia is a common disorder affecting over half of the world's population. Within this condition, androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in the possibility of using laser to stimulate hair growth. In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and qualitatively (quality of evidence, risk of bias). Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.

USING POWDERED ACTIVATED CARBON: A CRITICAL REVIEW

Science.gov (United States)

Because the performance of powdered activated carbon (PAC) for uses other than taste and odor control is poorly documented, the purpose of this article is to critically review uses that have been reported (i.e., pesticides and herbicides, synthetic organic chemicals, and trihalom...

Pediatric Critical Care Telemedicine Program: A Single Institution Review.

Science.gov (United States)

Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

2016-01-01

Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

Adult-acquired hidden penis in obese patients: a critical survey of the literature.

Science.gov (United States)

Cavayero, Chase T; Cooper, Meghan A; Harlin, Stephen L

2015-03-01

Hidden penis is anatomically defined by a lack of firm attachments of the skin and dartos fascia to the underlying Buck fascia. To critically appraise the research evidence that could support the most effective surgical techniques for adult-acquired hidden penis in obese patients. Studies investigating patients with a diagnosis of hidden penis were identified. Of these studies, only those with adult patients classified as overweight or obese (body mass index >25) were included in the review. Three reviewers examined the abstracts of the studies identified in the initial Medline search, and abstracts considered potentially relevant underwent full-text review. Studies that included patients with congenital, iatrogenic (eg, circumcision issues or aesthetic genital surgery), or traumatic causes of hidden penis were excluded. Studies that did not define the diagnostic criteria for hidden penis were excluded to minimize the risk of definition bias. The quality of evidence for each study was determined after considering the following sources of bias: method of allocation to study groups, data analysis, presence of baseline differences between groups, objectivity of outcome, and completeness of follow-up. Using these criteria, studies were then graded as high, moderate, or low in quality. Seven studies with a total of 119 patients met the inclusion criteria. All but 1 of the studies were nonrandomized. One study provided a clear presentation of results and appropriate statistical analysis. Six studies accounted for individual-based differences, and 1 study failed to account for baseline differences altogether. Four studies addressed follow-up. One study was of high quality, 2 were of moderate quality, and 4 were of low quality. Building a clinical practice guideline for the surgical management of hidden penis has proven difficult because of a lack of high-quality, statistically significant data in the research synthesis. The authors elucidate the challenges and epitomize

English language learning materials a critical review

CERN Document Server

Tomlinson

2010-01-01

This research collection presents a critical review of the materials used for learning English around the world. The first section includes a discussion of materials for specific learners and purposes, such as young learners, self-study, academic writing and general proficiency. The second section presents a detailed study of the materials used in Europe, Asia, North America, South America, Africa and Australia, and critically evaluates their effectiveness in the teaching of English to speakers of other languages. Taking both the teacher's and the learner's needs into consideration, the book m

More than Meets the Eye: Adult Education for Critical Consciousness in Luis Camnitzer's Art

Science.gov (United States)

Zorrilla, Ana Carlina

2012-01-01

The purpose of this study was to explore the connection between art and adult education for critical consciousness through the conceptual art of Luis Camnitzer. The theoretical framework grounding this research was critical public pedagogy, influenced by both critical theory and Stuart Hall's systems of representation (1997). This framework…

How do older adults experience and perceive socially assistive robots in aged care: a systematic review of qualitative evidence.

Science.gov (United States)

Vandemeulebroucke, Tijs; de Casterlé, Bernadette Dierckx; Gastmans, Chris

2018-02-01

The aim of this review was to gain a better understanding of how older adults experience, perceive, think, and feel about the use of socially assistive robots (SARs) in aged care settings. We conducted a literature search for studies that used a qualitative or a mixed-method approach having a significant qualitative element. Pubmed, Cinahl, Embase, Scopus, and Web of Science electronic databases were queried. Candidate articles published in journals and conference proceedings were considered for review. Two independent reviewers assessed the included studies for methodological quality using the Critical Appraisal Skills Program, after which data on subjects' self-reported opinions and perceptions were extracted and synthesized using thematic analyses. Seventeen studies producing 23 publications were included. Based on the opinions of older adults, four themes emerged in relation to the use of SARS: (1) roles of a SAR; (2) interaction between the older adult and the SAR, which could be further subdivided into (a) the technical aspect of the interaction and (b) the human aspect of the interaction; (3) appearance of the SAR; and (4) normative/ethical issues regarding the use of SARs in aged care. Older adults have clear positive and negative opinions about different aspects of SARs in aged care. Nonetheless, some opinions can be ambiguous and need more attention if SARs are to be considered for use in aged care. Understanding older adults' lived experiences with SARs creates the possibility of using an approach that embeds technological innovation into the care practice itself.

TWTF project criticality task force final review and assessment

International Nuclear Information System (INIS)

McKinley, K.B.; Cannon, J.W.; Wheeler, F.J.; Worle, H.A.

1980-11-01

The Transuranic Waste Treatment Facility (TWTF) is being developed to process transuranic waste, stored and buried at the Idaho National Engineering Laboratory, into a chemically inert, physically stable basalt-like residue acceptable at a federal repository. A task force was assembled by the TWTF Project Division to review and assess all aspects of criticality safety for the TWTF. This document presents the final review, assessments, and recommendations of this task force. The following conclusions were made: Additional criticality studies are needed for the entire envelope of feed compositions and temperature effects. Safe operating k/sub eff/'s need to be determined for process components. Criticality analyses validation experiments may also be required. SRP neutron interrogation should be replaced by DDT neutron interrogation. Accuracy studies need to be performed for the proposed assaying techniques. Time-correlated neutron monitoring needs to be mocked up for process components to prove feasibility and determine accuracy. The criticality control techniques developed for the TWTF conceptual design are in compliance with ERDAM 0530, including the Double Contingency Rule. Detailed procedures and controls need to be developed

The Role and Impact of Critical Review as Perceived by an Implementer

International Nuclear Information System (INIS)

Thegerstroem, Claes; Laarouchi Engstroem, Saida; Olsson, Olle

2006-01-01

The quality and success of a nuclear waste management programme is based on the amalgamation of the interests of a wide number of stakeholders, integration of many different scientific disciplines, and merging of scientific, technical, ethical and social issues. In this process, a broad and structured review of all aspects of the program is necessary and we find the process with submission and review by stakeholders, regulators and government every third year very useful. High-quality critical review of is always a real benefit to the implementer - as it gives the implementer the possibility to see where improvements can be made. However, a close dialogue and a dynamic reviewing process, where questions are raised throughout the process, are essential in order to optimize the quality of the final applications. Naturally, critical review should not be used for pushing specific general research interests or issues that belong to the political arena rather than nuclear waste management itself. Moreover, critical review provides additional insight and promotes confidence by the general public. However, sometimes the public might be confused and have difficulties in judging the importance and relevance of critical comments. The implementer and regulatory authorities have a special duty to provide an overall perspective of safety-related issues. Even if critical review is valuable, the implementer can not only rely on this. The implementers' own internal quality assurance practise, internal review process as well as its overall safety culture is all crucial. Indeed, a successful management of radio-active waste, including operational aspects as well as siting process, starts with the implementers' own wish to perform state-of-the art-work both in terms of technology and overall approach

The Role and Impact of Critical Review as Perceived by an Implementer

Energy Technology Data Exchange (ETDEWEB)

Thegerstroem, Claes; Laarouchi Engstroem, Saida; Olsson, Olle [Swedish Nuclear Fuel and Waste Management Co, Stockholm (Sweden)

2006-09-15

The quality and success of a nuclear waste management programme is based on the amalgamation of the interests of a wide number of stakeholders, integration of many different scientific disciplines, and merging of scientific, technical, ethical and social issues. In this process, a broad and structured review of all aspects of the program is necessary and we find the process with submission and review by stakeholders, regulators and government every third year very useful. High-quality critical review of is always a real benefit to the implementer - as it gives the implementer the possibility to see where improvements can be made. However, a close dialogue and a dynamic reviewing process, where questions are raised throughout the process, are essential in order to optimize the quality of the final applications. Naturally, critical review should not be used for pushing specific general research interests or issues that belong to the political arena rather than nuclear waste management itself. Moreover, critical review provides additional insight and promotes confidence by the general public. However, sometimes the public might be confused and have difficulties in judging the importance and relevance of critical comments. The implementer and regulatory authorities have a special duty to provide an overall perspective of safety-related issues. Even if critical review is valuable, the implementer can not only rely on this. The implementers' own internal quality assurance practise, internal review process as well as its overall safety culture is all crucial. Indeed, a successful management of radio-active waste, including operational aspects as well as siting process, starts with the implementers' own wish to perform state-of-the art-work both in terms of technology and overall approach.

A review of instruments to measure interprofessional collaboration for chronic disease management for community-living older adults.

Science.gov (United States)

Bookey-Bassett, Sue; Markle-Reid, Maureen; McKey, Colleen; Akhtar-Danesh, Noori

2016-01-01

It is acknowledged internationally that chronic disease management (CDM) for community-living older adults (CLOA) is an increasingly complex process. CDM for older adults, who are often living with multiple chronic conditions, requires coordination of various health and social services. Coordination is enabled through interprofessional collaboration (IPC) among individual providers, community organizations, and health sectors. Measuring IPC is complicated given there are multiple conceptualisations and measures of IPC. A literature review of several healthcare, psychological, and social science electronic databases was conducted to locate instruments that measure IPC at the team level and have published evidence of their reliability and validity. Five instruments met the criteria and were critically reviewed to determine their strengths and limitations as they relate to CDM for CLOA. A comparison of the characteristics, psychometric properties, and overall concordance of each instrument with salient attributes of IPC found the Collaborative Practice Assessment Tool to be the most appropriate instrument for measuring IPC for CDM in CLOA.

Consequences of child emotional abuse, emotional neglect and exposure to intimate partner violence for eating disorders: a systematic critical review.

Science.gov (United States)

Kimber, Melissa; McTavish, Jill R; Couturier, Jennifer; Boven, Alison; Gill, Sana; Dimitropoulos, Gina; MacMillan, Harriet L

2017-09-22

Child maltreatment and eating disorders are significant public health problems. Yet, to date, research has focused on the role of child physical and sexual abuse in eating-related pathology. This is despite the fact that globally, exposure to emotional abuse, emotional neglect and intimate partner violence are the three of the most common forms of child maltreatment. The objective of the present study is to systematically identify and critically review the literature examining the association between child emotional abuse (EA), emotional neglect (EN), and exposure to intimate partner violence (IPV) and adult eating-disordered behavior and eating disorders. A systematic search was conducted of five electronic databases: Medline, Embase, PsycINFO, CINAHL, and ERIC up to October 2015 to identify original research studies that investigated the association between EA, EN and children's exposure to IPV, with adult eating disorders or eating-disordered behavior using a quantitative research design. Database searches were complemented with forward and backward citation chaining. Studies were critically appraised using the Quality in Prognosis Studies (QUIPS) tool. A total of 5556 publications were screened for this review resulting in twenty-three articles included in the present synthesis. These studies focused predominantly on EA and EN, with a minority examining the role of child exposure to IPV in adult eating-related pathology. Prevalence of EA and EN ranged from 21.0% to 66.0%, respectively. No prevalence information was provided in relation to child exposure to IPV. Samples included predominantly White women. The methodological quality of the available literature is generally low. Currently, the available literature precludes the possibility of determining the extent to which EA, EN or child exposure to IPV have independent explanatory influence in adult eating-related pathology above what has been identified for physical and sexual abuse. While a large proportion

Activity trackers: a critical review.

Science.gov (United States)

Lee, Jeon; Finkelstein, Joseph

2014-01-01

The wearable consumer health devices can be mainly divided into activity trackers, sleep trackers, and stress management devices. These devices are widely advertised to provide positive effects on the user's daily behaviours and overall heath. However, objective evidence supporting these claims appears to be missing. The goal of this study was to review available evidence pertaining to performance of activity trackers. A comprehensive review of available information has been conducted for seven representative devices and the validity of marketing claims was assessed. The device assessment was based on availability of verified output metrics, theoretical frameworks, systematic evaluation, and FDA clearance. The review identified critical absence of supporting evidence of advertised functions and benefits for the majority of the devices. Six out of seven devices did not provide any information on sensor accuracy and output validity at all. Possible underestimation or overestimation of specific health indicators reported to consumers was not clearly disclosed to the public. Furthermore, significant limitations of these devices which can be categorized into user restrictions, user responsibilities and company disclaimers could not be easily found or comprehended by unsophisticated users and may represent a serious health hazard.

Music in Peacebuilding: A Critical Literature Review

Science.gov (United States)

Sandoval, Elaine

2016-01-01

The critical literature review summarizes and appraises studies that have been pursued by music scholars examining the contributions of music to peacebuilding as well as the role of music in violence. These two bodies of literature are rarely brought into dialogue, but I juxtapose them in order to confront the idea of music's exceptionalism as…

Social-Ecological Correlates in Adult Autism Outcome Studies: A Scoping Review.

Science.gov (United States)

Anderson, Kristy A; Roux, Anne M; Kuo, Alice; Shattuck, Paul T

2018-04-01

The transition into adulthood is a critical period in the life course that shapes later outcomes. Many adults on the autism spectrum fare poorly across a wide range of quality of life indicators. Understanding the multilevel factors that influence transition outcomes is necessary to develop strategies that promote better outcomes. In this scoping review, we characterize the use of social-ecological factors in adult autism outcome studies, identify understudied areas of research, and provide recommendations for future research. We conducted a literature search for studies in which the relationship between social-ecological factors and transition outcomes among transition-age youth with autism was assessed. We organized variables used in studies across 5 levels of influence: family-, interpersonal-, institutional-, community-, and policy-level factors. Our findings reveal that both breadth and depth of social-ecological factors usage in autism outcomes studies is limited because of the narrow inclusion of variables across social-ecological levels, the overreliance on a limited number of national data sets, and the overall lack of variation in research design. We propose 9 recommendations to inform the development of multilevel studies. Copyright © 2018 by the American Academy of Pediatrics.

Critical Discourse Analysis in Literacy Education: A Review of the Literature

Science.gov (United States)

Rogers, Rebecca; Schaenen, Inda

2014-01-01

This article is a critical, integrative literature review of scholarship in literacy studies from 2004 to 2012 that draws on critical discourse analysis (CDA). We discuss key issues, trends, and criticisms in the field. Our methodology was carried out in three stages. First, we searched educational databases to locate literacy-focused CDA…

Beethoven recordings reviewed: a systematic method for mapping the content of music performance criticism.

Science.gov (United States)

Alessandri, Elena; Williamson, Victoria J; Eiholzer, Hubert; Williamon, Aaron

2015-01-01

Critical reviews offer rich data that can be used to investigate how musical experiences are conceptualized by expert listeners. However, these data also present significant challenges in terms of organization, analysis, and interpretation. This study presents a new systematic method for examining written responses to music, tested on a substantial corpus of music criticism. One hundred critical reviews of Beethoven's piano sonata recordings, published in the Gramophone between August 1934 and July 2010, were selected using in-depth data reduction (qualitative/quantitative approach). The texts were then examined using thematic analysis in order to generate a visual descriptive model of expert critical review. This model reveals how the concept of evaluation permeates critical review. It also distinguishes between two types of descriptors. The first characterizes the performance in terms of specific actions or features of the musical sound (musical parameters, technique, and energy); the second appeals to higher-order properties (artistic style, character and emotion, musical structure, communicativeness) or assumed performer qualities (understanding, intentionality, spontaneity, sensibility, control, and care). The new model provides a methodological guide and conceptual basis for future studies of critical review in any genre.

Adherence to prescribed oral medication in adult patients undergoing chronic hemodialysis: A critical review of the literature

Directory of Open Access Journals (Sweden)

Schmid H

2009-06-01

Full Text Available Abstract Objective Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. While a few studies have been devoted to understanding patient nonadherence, their results were somewhat controversial. The goals of this review are to quantify nonadherence to certain oral medications, to raise awareness of factors that may cause problems in a patient's adherence to this treatment, and to describe strategies that may be used to improve adherence to prescribed pharmacotherapy. Methods A systematic literature review in the MEDLINE and PubMed database (1971-2008 was performed. Quantitative studies, which accurately indicated the total percentages of nonadherence to oral medication in adult patients receiving chronic hemodialysis, were identified. Results A total of 19 studies fulfilled the search criteria. Rates of nonadherence to the oral medication ranged from 3 - 80%. More than half of the included studies reported nonadherence rates of ≥ 50% (mean 67%. The use of phosphate binding therapy was the prevalent surveyed oral medication. Self reports, structured interviews, and predialysis serum phosphate levels were the most frequent assessment tools used to record adherence rates. Limitations of the reviewed studies included small patient cohorts, inconsistent definitions of adherence, and a lack of standardized methods for measuring nonadherence. Conclusions Nonadherence to oral medication in hemodialysis patients is still an underestimated, but life-threatening behaviour.

A review of criticality accidents

International Nuclear Information System (INIS)

Stratton, W.R.; Smith, D.R.

1989-03-01

Criticality accidents and the characteristics of prompt power excursions are discussed. Forty-one accidental power transients are reviewed. In each case where available, enough detail is given to help visualize the physical situation, the cause or causes of the accident, the history and characteristics of the transient, the energy release, and the consequences, if any, to personnel and property. Excursions associated with large power reactors are not included in this study, except that some information on the major accident at the Chernobyl reactor in April 1986 is provided in the Appendix. 67 refs., 21 figs., 2 tabs

PENERAPAN CRITICAL REVIEW ARTIKEL PEMBELAJARAN IPA UNTUK MENINGKATKAN KEMAMPUAN MAHASISWA DALAM MENYUSUN PROPOSAL SKRIPSI

Directory of Open Access Journals (Sweden)

Parmin -

2012-10-01

Full Text Available Penelitian bertujuan untuk meningkatkan kemampuan mahasiswa dalam menyusun proposal skripsi melalui penerapan critical review artikel ilmiah bersumber dari jurnal. Penelitian dirancang dengan metode penelitian tindakan kelas. Hasil penelitian menunjukkan 63% proposal skripsi mahasiswa pada mata kuliah Metodologi Penelitian mendapatkan nilai diatas 80. Berdasarkan hasil yang telah diperoleh dapat disimpulkan penerapan critical review atau kajian kritis terhadap artikel ilmiah dapat meningkatkan kemampuan mahasiswa dalam menyusun proposal penelitian.   The aims of this research is to improve students' ability in developing a proposal thesis by applying critical review of scientific articles come from journals. The research is designed by class action research. The results showed 63% of students thesis proposals on Research Methodology course scored above 80. Based on the results obtained it can be concluded that the application has been critical review or critical study of scientific articles can enhance students' ability in preparing research proposals.

Adult Craniopharyngioma: Case Series, Systematic Review, and Meta-Analysis.

Science.gov (United States)

Dandurand, Charlotte; Sepehry, Amir Ali; Asadi Lari, Mohammad Hossein; Akagami, Ryojo; Gooderham, Peter

2017-12-18

The optimal therapeutic approach for adult craniopharyngioma remains controversial. Some advocate for gross total resection (GTR), while others advocate for subtotal resection followed by adjuvant radiotherapy (STR + XRT). To conduct a systematic review and meta-analysis assessing the rate of recurrence in the follow-up of 3 yr in adult craniopharyngioma stratified by extent of resection and presence of adjuvant radiotherapy. MEDLINE (1946-July 1, 2016) and EMBASE (1980-June 30, 2016) were systematically reviewed. From1975 to 2013, 33 patients were treated with initial surgical resection for adult onset craniopharyngioma at our center and were reviewed for inclusion in this study. Data from 22 patients were available for inclusion as a case series in the systematic review. Eligible studies (n = 21) were identified from the literature in addition to a case series of our institutional experience. Three groups were available for analysis: GTR, STR + XRT, and STR. The rates of recurrence were 17%, 27%, and 45%, respectively. The risk of developing recurrence was significant for GTR vs STR (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.15-0.38) and STR + XRT vs STR (OR: 0.20, 95% CI: 0.10-0.41). Risk of recurrence after GTR vs STR + XRT did not reach significance (OR: 0.63, 95% CI: 0.33-1.24, P = .18). This is the first and largest systematic review focusing on the rate of recurrence in adult craniopharyngioma. Although the rates of recurrence are favoring GTR, difference in risk of recurrence did not reach significance. This study provides guidance to clinicians and directions for future research with the need to stratify outcomes per treatment modalities. Copyright © 2017 by the Congress of Neurological Surgeons

REVIEWS OF TOPICAL PROBLEMS: Critical opalescence

Science.gov (United States)

Zubkov, L. A.; Romanov, Vadim P.

1988-04-01

Studies of critical opalescence near phase transitions in different systems are reviewed. The fundamentals of the modern approach to the description of the propagation and scattering of light in media with large nonuniformities are presented. The experimental data on the coefficient of extinction and integrated intensity of the scattered light are analyzed and different models for the correlation function are discussed. Different methods for studying multiple scattering of light and methods for eliminating it from the measured intensity are examined. The kinetic properties of systems in the critical region are examined. Attention is devoted primarily to the experimental data obtained by the methods of correlation spectroscopy and to the comparison of these data with the predictions of different theoretical models. Significant attention is devoted to the study of phase transitions in liquids by the methods of light scattering as well as the problem of propagation and scattering of light in the nematic phase, where fluctuations of the director exhibit the same behavior as at the critical point. In conclusion, phase transformations in micellar solutions, to which a great deal of attention has been devoted in recent years, are studied.

Fission, critical mass and safety-a historical review

International Nuclear Information System (INIS)

Meggitt, Geoff

2006-01-01

Since the discovery of fission, the notion of a chain reaction in a critical mass releasing massive amounts of energy has haunted physicists. The possibility of a bomb or a reactor prompted much of the early work on determining a critical mass, but the need to avoid an accidental critical excursion during processing or transport of fissile material drove much that took place subsequently. Because of the variety of possible situations that might arise, it took some time to develop adequate theoretical tools for criticality safety and the early assessments were based on direct experiment. Some extension of these experiments to closely similar situations proved possible, but it was not until the 1960s that theoretical methods (and computers to run them) developed enough for them to become reliable assessment tools. Validating such theoretical methods remained a concern, but by the end of the century they formed the backbone of criticality safety assessment. This paper traces the evolution of these methods, principally in the UK and USA, and summarises some related work concerned with the nature of criticality accidents and their radiological consequences. It also indicates how the results have been communicated and used in ensuring nuclear safety. (review)

Overgeneral autobiographical memory and depression in older adults: a systematic review.

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Wilson, F C L; Gregory, J D

2018-05-01

Overgeneral autobiographical memory (OGM) is a well-researched phenomenon in working age adults with depression. However, the relevance and importance of OGM in older adult depression is not well established. The aim of this review was to synthesise existing literature on OGM and depressive symptoms in older adults under the framework of the Capture and Rumination, Functional Avoidance and Impaired Executive Control (CaR-FA-X) model. Literature searches were conducted using PsychINFO, PubMed and Web of Knowledge. Eighteen articles were reviewed. OGM is elevated in healthy older adults compared to adults of working age, and further elevated in older adults with depression. Evidence supports the role of impaired executive function as a mechanism for OGM in older adults with depression, but no studies measured other components of the CaR-FA-X model (i.e. functional avoidance and rumination). OGM is prevalent in older adults and more so for those with depression; however, there is no clear understanding of the underpinning mechanisms. It is recommended that future research looks at the role of functional avoidance and rumination, and at the use of memory specificity interventions being developed in the working age adult literature.

Transfusion in critically ill children

DEFF Research Database (Denmark)

Secher, E L; Stensballe, J; Afshari, A

2013-01-01

Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects...... of transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut-off values, and expert opinions, rather than...... evidence-based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors...

A review of factors that influence adult handwriting performance.

Science.gov (United States)

van Drempt, Nadege; McCluskey, Annie; Lannin, Natasha A

2011-10-01

Handwriting is an important activity for people of all ages. Handwriting is frequently affected after stroke and other neurological conditions. However, research on the handwriting of healthy adults is difficult to find. This review aims to advance the development of evidence-informed handwriting assessment and retraining. The aim of this paper was to review factors that influence the handwriting performance of unimpaired adults, some of which are amenable to intervention. Searches were conducted of eight electronic databases up to April 2009 and again in November 2010. Reference lists were also used to identify potential studies of interest. No limits were placed on study design.  Age: Younger adults write more legibly and faster than older adults. Gender: Women write faster and more legibly than men. Pengrip: Grips other than the traditional dynamic tripod are functional, producing legible text in an acceptable time. Pen pressure: Pressure varies with different letters, words, text size, speed and across a page of text. Error corrections and a mixed writing style occur in healthy adult handwriting. Research was inconclusive about the association between speed, pressure and upper limb movements on handwriting performance. Other factors able to predict adult handwriting legibility have been largely unexplored. A number of knowledge and research gaps about adult handwriting were identified, including the need for more contemporary normative data. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

Private prayer as a suitable intervention for hospitalised patients: a critical review of the literature.

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Hollywell, Claire; Walker, Jan

2009-03-01

This critical review seeks to identify if there is evidence that private (personal) prayer is capable of improving wellbeing for adult patients in hospital. The review was conducted in the belief that the spiritual needs of hospitalised patients may be enhanced by encouragement and support to engage in prayer. Systematic review. A systematic approach was used to gather evidence from published studies. In the absence of experimental research involving this type of population, evidence from qualitative and correlational studies was critically reviewed. Results. The findings indicate that private prayer, when measured by frequency, is usually associated with lower levels of depression and anxiety. Most of the studies that show positive associations between prayer and wellbeing were located in areas that have strong Christian traditions and samples reported a relatively high level of religiosity, church attendance and use of prayer. Church attenders, older people, women, those who are poor, less well educated and have chronic health problems appear to make more frequent use of prayer. Prayer appears to be a coping action that mediates between religious faith and wellbeing and can take different forms. Devotional prayers involving an intimate dialogue with a supportive God appear to be associated with improved optimism, wellbeing and function. In contrast, prayers that involve pleas for help may, in the absence of a pre-existing faith, be associated with increased distress and possibly poorer function. Future research needs to differentiate the effects of different types of prayer. Encouragement to engage in prayer should be offered only following assessment of the patient's faith and likely content and form of prayer to be used. Hospitalised patients who lack faith and whose prayers involve desperate pleas for help are likely to need additional support from competent nursing and chaplaincy staff.

Review of adult attention-deficit/hyperactivity disorder in South Africa.

Science.gov (United States)

Munasur-Naidoo, A P; Truter, I

2017-08-01

Recently, there has been a greater focus on adults with Attention-Deficit/Hyperactivity Disorder (ADHD) given that the symptoms persist in two-thirds of patients into adulthood. Areas covered: A systematic review of articles reporting on adult ADHD in SA was undertaken. From the database search, 1209 articles were identified, with 29 articles included in this analysis. Expert commentary: Fourteen of the 29 studies reviewed were exploratory, 10 were reviews/commentaries, four were developmental studies and one was a phenomenological study. More than half (58.62%) of the articles were published in local South African journals, 13.79% were published in African journals (excluding South Africa), and 27.59% of the articles were published in international journals. The impact factor for nine of the journals were not stated and the remaining 11 have impact factors ranging from 0.207 to 6.78. In 2004, only one article on adult ADHD was published in SA and by 2015, the number of publications increased to six. Adult ADHD is gaining interest in South Africa, however, there have been a limited number of studies conducted thus far. It is recommended that further studies are conducted in this new and developing field.

A review of the economics of adult congenital heart disease.

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Seckeler, Michael D; Thomas, Ian D; Andrews, Jennifer; Joiner, Keith; Klewer, Scott E

2016-01-01

Adults living with congenital heart disease (CHD) now outnumber children with the disease. Thanks to medical advances over the past 75 years, many of these fatal childhood heart problems have changed to chronic medical conditions. As the population of adults with CHD increases, they will require increasingly complex medical, surgical and catheter-based therapies. In addition, social burdens including education, employment and insurability, which increase the societal costs of adult CHD, are now being recognized for adults living with CHD. This review summarizes the available literature on the economics of adult CHD.

A Systematic Review of Psychosocial Interventions for Adults with Autism Spectrum Disorders

Science.gov (United States)

Bishop-Fitzpatrick, Lauren; Minshew, Nancy J.; Eack, Shaun M.

2013-01-01

Individuals with autism spectrum disorders (ASD) spend the majority of their lives as adults, and psychosocial interventions show promise for improving outcomes in this population. This research conducted a systematic review of all peer-review studies evaluating psychosocial interventions for adults with ASD. A total of 1,217 studies were…

White matter development and tobacco smoking in young adults: A systematic review with recommendations for future research.

Science.gov (United States)

Gogliettino, Alex R; Potenza, Marc N; Yip, Sarah W

2016-05-01

Adolescence and young adulthood are critical vulnerability periods for initiation of tobacco smoking. White matter development is ongoing during this time and may be influenced by exposure to nicotine. Synthesis of findings from diffusion tensor imaging (DTI) studies of adolescent and young adult smokers may be helpful in understanding the relationship between neurodevelopment and initiation and progression of tobacco-use behaviors and in guiding further research. A systematic literature review was conducted to identify DTI studies comparing adolescent and young adult (mean age adult studies. Directions for further research are also discussed. All identified studies reported increases in fractional anisotropy (FA) among adolescent/young adult smokers in comparison to non-smokers. Increased FA was most frequently reported in regions of the corpus callosum (genu, body and spenium), internal capsule and superior longitudinal fasciculus. Findings of increased FA among adolescent/young adult smokers are contrary to those from most adult studies and thus raise the possibility of differential effects of nicotine on white matter across the lifespan. Further research including multiple time points is needed to test this hypothesis. Other areas warranting further research include DTI studies of e-cigarette use and studies incorporating measures of pubertal stage. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparison of pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a protocol for a systematic review incorporating network meta-analyses.

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Burry, L D; Hutton, B; Guenette, M; Williamson, D; Mehta, S; Egerod, I; Kanji, S; Adhikari, N K; Moher, D; Martin, C M; Rose, L

2016-09-08

Delirium is characterized by acute changes in mental status including inattention, disorganized thinking, and altered level of consciousness, and is highly prevalent in critically ill adults. Delirium has adverse consequences for both patients and the healthcare system; however, at this time, no effective treatment exists. The identification of effective prevention strategies is therefore a clinical and research imperative. An important limitation of previous reviews of delirium prevention is that interventions were considered in isolation and only direct evidence was used. Our systematic review will synthesize all existing data using network meta-analysis, a powerful statistical approach that enables synthesis of both direct and indirect evidence. We will search Ovid MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science from 1980 to March 2016. We will search the PROSPERO registry for protocols and the Cochrane Library for published systematic reviews. We will examine reference lists of pertinent reviews and search grey literature and the International Clinical Trials Registry Platform for unpublished studies and ongoing trials. We will include randomized and quasi-randomized trials of critically ill adults evaluating any pharmacological, non-pharmacological, or multi-component intervention for delirium prevention, administered in or prior to (i.e., peri-operatively) transfer to the ICU. Two authors will independently screen search results and extract data from eligible studies. Risk of bias assessments will be completed on all included studies. To inform our network meta-analysis, we will first conduct conventional pair-wise meta-analyses for primary and secondary outcomes using random-effects models. We will generate our network meta-analysis using a Bayesian framework, assuming a common heterogeneity parameter across all comparisons, and accounting for correlations in multi-arm studies. We will perform analyses using WinBUGS software. This systematic review

A review of conceptualisation of expressed emotion in caregivers of older adults with dementia.

Science.gov (United States)

Li, Chao-Yin; Murray, MaryAnne

2015-02-01

To clarify the concept of 'expressed emotion' and its application to caregivers of older adults with dementia. Expressed emotion has been a useful construct for understanding the quality of family relationships affecting patients with mental illness and their caregivers. However, this concept has been developed without precisely defining 'expressed emotion' as it pertains to dementia patients. Clarity regarding expressed emotion will enable nurses to apply knowledge of expressed emotion and provide important information for the development of new clinical interventions for this specific population. Integrative review. A review of literature on expressed emotion by caregivers of older adults with dementia. The inclusion criteria were: (1) published in English or Chinese during 1970-2012; (2) included both research and theoretical review articles on expressed emotion in nursing and other disciplines such as psychology, psychiatry and sociology. Initially, 236 articles were screened, and finally, 32 articles were evaluated for this review. Emotional expression and expressed emotion were discussed to clarify the distinctions and address overlap between these two similar terms. In addition, expressed emotion was examined further from three different aspects: trait or state, social control and cross-cultural. Finally, the results of reviewed papers for expressed emotion on dementia patients were explored and synthesised. A conceptual definition and a theoretical framework for the concept of expressed emotion are urgently needed to further our understanding of this critical phenomenon. With increasing attention to caregiving for patients with dementia, including the concept of expressed emotion in the research of this field may accelerate understanding of the importance of the family dynamics in advanced ageing caregiving. The expressed emotion concept could guide much of current clinical practice and help professional nurses understand the family's experience and

Adult Children of Divorce and Intimate Relationships: A Review of the Literature.

Science.gov (United States)

Christensen, Teresa M.; Brooks, Morgan C.

2001-01-01

Reviews research specific to the effects of parental divorce on adults in terms of relationship issues. Specific purposes of this review are to (a) explore research specific to intimacy and marital attitudes in adult children of divorce, (b) inform couple and family counselors of effects of parental divorce, and (c) relay implications for…

Adult-Perpetrated Animal Abuse: A Systematic Literature Review.

Science.gov (United States)

Alleyne, Emma; Parfitt, Charlotte

2017-01-01

Adults perpetrate the majority of animal abuse incidents yet clinicians are left with very little evidence base to advance/enhance their practice. The purpose of this systematic review is to synthesize and evaluate the current literature on adult-perpetrated animal abuse and to identify the etiological factors related to this type of offending. Twenty-three studies met the specific inclusion criteria but most importantly, they examined the characteristics of adult perpetrators of animal abuse. The findings from this review were demarcated by sample type: (1) Participants were the perpetrators of the animal abuse or held offense-supportive attitudes and (2) participants were victims of intimate partner violence reporting incidents of animal abuse perpetrated by their partner. From the perpetrator perspective, there were key developmental (i.e., maladaptive parenting strategies), behavioral (such as varied offending behaviors), and psychological (e.g., callousness, empathy deficits) factors highlighted in the literature. Finally, in the context of intimate partner violence, findings indicated that perpetrators abuse animals to control, coerce, intimidate, and/or manipulate their victims (this effect is moderated by the victims' emotional attachment to their pet). This review inherently underlines treatment targets that could achieve greater clinical gains, but we also conclude that more empirical and theoretical work is needed in order to set an agenda that prioritizes future research and effective practice.

Radio-frequency glow discharge spectrometry: A critical review

International Nuclear Information System (INIS)

Winchester, Michael R.; Payling, Richard

2004-01-01

This paper presents a critical review of analytical radio frequency glow discharge spectrometry (rf-GDS). The historical foundations of rf-GDS are described, and current knowledge of the fundamental physics of analytical rf glow discharges is discussed. Additionally, instrumentation, methodologies, and applications of rf glow discharge optical emission spectrometry (rf-GDOES) and mass spectrometry (rf-GDMS) are reviewed. Although other rf-GDS techniques have appeared [e.g. rf glow discharge atomic absorption spectrophotometry (rf-GDAAS)], the emphasis is placed upon rf-GDOES and rf-GDMS, because they have received by far the most interest from analytical chemical metrologists. This review also provides explanations of some developments that are needed for further progress in the field of analytical rf-GDS

Older adults' perceptions of technologies aimed at falls prevention, detection or monitoring: a systematic review.

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Hawley-Hague, Helen; Boulton, Elisabeth; Hall, Alex; Pfeiffer, Klaus; Todd, Chris

2014-06-01

Over recent years a number of Information and Communication Technologies (ICTs) have emerged aiming at falls prevention, falls detection and alarms for use in case of fall. There are also a range of ICT interventions, which have been created or adapted to be pro-active in preventing falls, such as those which provide strength and balance training to older adults in the prevention of falls. However, there are issues related to the adoption and continued use of these technologies by older adults. This review provides an overview of older adults' perceptions of falls technologies. We undertook systematic searches of MEDLINE, EMBASE, CINAHL and PsychINFO, COMPENDEX and the Cochrane database. Key search terms included 'older adults', 'seniors', 'preference', 'attitudes' and a wide range of technologies, they also included the key word 'fall*'. We considered all studies that included older adults aged 50 and above. Studies had to include technologies related specifically to falls prevention, detection or monitoring. The Joanna Briggs Institute (JBI) tool and the Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project (EPHPP) were used. We identified 76 potentially relevant papers. Some 21 studies were considered for quality review. Twelve qualitative studies, three quantitative studies and 6 mixed methods studies were included. The literature related to technologies aimed at predicting, monitoring and preventing falls suggest that intrinsic factors related to older adults' attitudes around control, independence and perceived need/requirements for safety are important for their motivation to use and continue using technologies. Extrinsic factors such as usability, feedback gained and costs are important elements which support these attitudes and perceptions. Positive messages about the benefits of falls technologies for promoting healthy active ageing and independence are critical, as is ensuring that the technologies are simple

SRTC criticality safety technical review: Phase 1 criticality analysis for the 9972-9975 family of shipping casks: (SRT-CMA-940003)

International Nuclear Information System (INIS)

Rathbun, R.

1994-01-01

Review of SRT-CMA-940003, ''Phase I Criticality Analysis For The 9972-9975 Family Of Shipping Casks (U). (SRT-CMA-940003).'' January 22, 1994, has been performed by the SRTC Applied Physics Group. The NCSE is a criticality assessment of the 9972-9975 family of shipping casks. This work is a follow-on of a previous criticality safety evaluation, with the differences between this and the previous evaluation are that now wall tolerances are modeled and more sophisticated analytical methods are applied. The NCSE under review concludes that, with one exception, the previously specified plutonium and uranium mass limits for 9972-9975 family of shipping casks do ensure that WSRC Nuclear Criticality Safety Manual requirements (ref. 1) are satisfied. The one exception is that the plutonium mass limit for the 9974 cask had to be reduced from 4.4 to 4.3 kg. In contrast, the 7.5 kg uranium mass limit for the 9974 cask was raised to 14.5 kg, making the uranium mass identical for all casks in this family. This technical review consisted of an independent check of the methods and models employed, application of ANSI/ANS 8.1 and 8.15, and verification of WSRC Nuclear Criticality Safety Manual procedures

Technical review of WSRC-TR-93-614 criticality safety evaluation for disassembly basin sand filter

International Nuclear Information System (INIS)

Reed, R.L.

1994-01-01

The study documented in WSRC-TR-93-614 performed an evaluation of the criticality potential associated with the Disassembly Basin Sand Filter for K and L Areas. The document reviewed incorporated results of calculations documented in the engineering calculation N-CLC-K-00151. Analyses of the contents of disassembly basin sludge has indicated that the sludge contains fissile material in excess of subcritical mass limits as specified in ANSI/ANS standards. Previous studies had determined that the fissile material can not collect into a critical configuration in the basin. Since the sand filter is intended to remove suspended particles from the basin water and could serve as a mechanism to collect the fissile material into a critical configuration, the study examined conditions under which criticality could occur in the sand filter. The study shows that criticality is not considered possible in the sand filter. This review emphasized the technical accuracy and presentation of the evaluation. The evaluation was also examined for the elements required for NCSEs. The review was performed in accordance with the NRTSC technical review requirements and procedures and the E7 Manual technical review requirements. The technical review (per the E7 manual) of the engineering calculation (N-CLC-K-0 1 5 1) was previously performed by this reviewer

Critical factors for EIA implementation: literature review and research options.

Science.gov (United States)

Zhang, Jie; Kørnøv, Lone; Christensen, Per

2013-01-15

After decades of development, the gap between expectations of Environment Impact Assessments (EIA) and their practical performance remains significant. Research has been done to identify the critical factors for an effective implementation of EIA. However, this research, to a large extent, has not been cumulated and analysed comprehensively according to the stages of the EIA process. This paper contributes to the critical review of the literature on EIA implementation and effectiveness by cumulating mainly empirical findings in an implementation theoretical perspective. It focuses on the links between different critical factors and how they relate to different stages in the EIA and thus influence the decision making process. After reviewing 33 refereed journal articles published between 1999 and 2011, we identified 203 notions of critical factors. Of these, 102 related to different stages defined in our comprehensive EIA implementation model, and 101 were identified as general factors related to the whole EIA system. The number of notions of stage factors and general factors is thus about equal. An overlap between stage factors and general factors was found, which demonstrates that critical factors function differently in different cases. The function of the critical factors is complex and it is difficult to determine contingencies and causations. In the sources we examined, there is evidently an imbalance between in-depth empirical research and general knowledge, and the paper offers some suggestions for future research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Tracheal intubation in critically ill patients: a comprehensive systematic review of randomized trials.

Science.gov (United States)

Cabrini, Luca; Landoni, Giovanni; Baiardo Radaelli, Martina; Saleh, Omar; Votta, Carmine D; Fominskiy, Evgeny; Putzu, Alessandro; Snak de Souza, Cézar Daniel; Antonelli, Massimo; Bellomo, Rinaldo; Pelosi, Paolo; Zangrillo, Alberto

2018-01-20

We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years. Exclusion criteria were pre-hospital or operating theatre settings and simulation-based studies. Two investigators selected studies for the final analysis. Extracted data included first author, publication year, characteristics of patients and clinical settings, intervention details, comparators and relevant outcomes. The risk of bias was assessed with the Cochrane Collaboration's Risk of Bias tool. We identified 22 trials on use of a pre-procedure check-list (1 study), pre-oxygenation or apneic oxygenation (6 studies), sedatives (3 studies), neuromuscular blocking agents (1 study), patient positioning (1 study), video laryngoscopy (9 studies), and post-intubation lung recruitment (1 study). Pre-oxygenation with non-invasive ventilation (NIV) and/or high-flow nasal cannula (HFNC) showed a possible beneficial role. Post-intubation recruitment improved oxygenation , while ramped position increased the number of intubation attempts and thiopental had negative hemodynamic effects. No effect was found for use of a checklist, apneic oxygenation (on oxygenation and hemodynamics), videolaryngoscopy (on number and length of intubation attempts), sedatives and neuromuscular blockers (on hemodynamics). Finally, videolaryngoscopy was associated with severe adverse effects in multiple trials. The limited available

Critical Review of Membrane Bioreactor Models

DEFF Research Database (Denmark)

Naessens, W.; Maere, T.; Ratkovich, Nicolas Rios

2012-01-01

Membrane bioreactor technology exists for a couple of decades, but has not yet overwhelmed the market due to some serious drawbacks of which operational cost due to fouling is the major contributor. Knowledge buildup and optimisation for such complex systems can heavily benefit from mathematical...... modelling. In this paper, the vast literature on hydrodynamic and integrated modelling in MBR is critically reviewed. Hydrodynamic models are used at different scales and focus mainly on fouling and only little on system design/optimisation. Integrated models also focus on fouling although the ones...

Tank waste remediation system nuclear criticality safety program management review

International Nuclear Information System (INIS)

BRADY RAAP, M.C.

1999-01-01

This document provides the results of an internal management review of the Tank Waste Remediation System (TWRS) criticality safety program, performed in advance of the DOE/RL assessment for closure of the TWRS Nuclear Criticality Safety Issue, March 1994. Resolution of the safety issue was identified as Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-40-12, due September 1999

Predicting risk and outcomes for frail older adults: an umbrella review of frailty screening tools

Science.gov (United States)

Apóstolo, João; Cooke, Richard; Bobrowicz-Campos, Elzbieta; Santana, Silvina; Marcucci, Maura; Cano, Antonio; Vollenbroek-Hutten, Miriam; Germini, Federico; Holland, Carol

2017-01-01

EXECUTIVE SUMMARY Background A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. Objectives To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. Inclusion criteria Population Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals. Index test Available frailty measures in older adults. Reference test Cardiovascular Health Study phenotype model, the Canadian Study of Health and Aging cumulative deficit model, Comprehensive Geriatric Assessment or other reference tests. Diagnosis of interest Frailty defined as an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Types of studies Quantitative systematic reviews. Search strategy A three-step search strategy was utilized to find systematic reviews, available in English, published between January 2001 and October 2015. Methodological quality Assessed by two independent reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Data extraction Two independent reviewers extracted data using the standardized data extraction tool designed for umbrella reviews. Data synthesis Data were only presented in a narrative form due to the heterogeneity of included reviews. Results Five reviews with a total of 227,381 participants were included in this umbrella review. Two reviews focused on reliability, validity and diagnostic accuracy; two examined predictive ability for adverse health outcomes; and one investigated validity, diagnostic accuracy and predictive ability. In total, 26 questionnaires and brief assessments and eight frailty

Learning styles and critical thinking relationship in baccalaureate nursing education: a systematic review.

Science.gov (United States)

Andreou, Christos; Papastavrou, Evridiki; Merkouris, Anastasios

2014-03-01

Critical thinking is a desirable competency for contemporary nurses although there are growing concerns supporting a disturbing paucity in its achievement. Learning styles reflect habitual behaviors which determine distinct preferences within learning situations. Evidence suggests that critical thinking could evolve through learning processes. Variances in critical thinking achievement by nursing students might therefore be influenced by individual learning preferences. The concepts "learning styles" and "critical thinking" have been independently examined in the nursing literature. No reviews were found however exploring their association in nursing education. To identify the potential relationships between learning styles and critical thinking in baccalaureate nursing students. Systematic review. Eleven electronic databases were utilized without geographical and time publishing filters. Hand-searching journals and scanning references from retrieved studies were also performed. Databases were searched for descriptive correlational studies which considered the relationship between learning styles and critical thinking in baccalaureate nursing students. The authors independently progressed three stage screening. Retrieved articles were reviewed at title, abstract and full text levels according to predetermined criteria. All included studies were quality appraised using a rating tool for descriptive studies. Six studies were finally included. Findings were grouped under four key themes: predominant learning styles, critical thinking scoring, critical thinking evolution across academic progress and learning styles-critical thinking correlations. Learning styles' diversities, weak critical thinking and inconsistent evolution through academic progress were revealed across studies. Critical thinking differed significantly between learning styles. Commonly accepted models in nursing education were lacking in both learning styles and critical thinking. Within studies

Reproducibility of clinical research in critical care: a scoping review.

Science.gov (United States)

Niven, Daniel J; McCormick, T Jared; Straus, Sharon E; Hemmelgarn, Brenda R; Jeffs, Lianne; Barnes, Tavish R M; Stelfox, Henry T

2018-02-21

The ability to reproduce experiments is a defining principle of science. Reproducibility of clinical research has received relatively little scientific attention. However, it is important as it may inform clinical practice, research agendas, and the design of future studies. We used scoping review methods to examine reproducibility within a cohort of randomized trials examining clinical critical care research and published in the top general medical and critical care journals. To identify relevant clinical practices, we searched the New England Journal of Medicine, The Lancet, and JAMA for randomized trials published up to April 2016. To identify a comprehensive set of studies for these practices, included articles informed secondary searches within other high-impact medical and specialty journals. We included late-phase randomized controlled trials examining therapeutic clinical practices in adults admitted to general medical-surgical or specialty intensive care units (ICUs). Included articles were classified using a reproducibility framework. An original study was the first to evaluate a clinical practice. A reproduction attempt re-evaluated that practice in a new set of participants. Overall, 158 practices were examined in 275 included articles. A reproduction attempt was identified for 66 practices (42%, 95% CI 33-50%). Original studies reported larger effects than reproduction attempts (primary endpoint, risk difference 16.0%, 95% CI 11.6-20.5% vs. 8.4%, 95% CI 6.0-10.8%, P = 0.003). More than half of clinical practices with a reproduction attempt demonstrated effects that were inconsistent with the original study (56%, 95% CI 42-68%), among which a large number were reported to be efficacious in the original study and to lack efficacy in the reproduction attempt (34%, 95% CI 19-52%). Two practices reported to be efficacious in the original study were found to be harmful in the reproduction attempt. A minority of critical care practices with research published

Review of critical factors for SEA implementation

Energy Technology Data Exchange (ETDEWEB)

Zhang Jie, E-mail: jasmine@plan.aau.dk; Christensen, Per; Kornov, Lone

2013-01-15

The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it in practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The

Review of critical factors for SEA implementation

International Nuclear Information System (INIS)

Zhang Jie; Christensen, Per; Kørnøv, Lone

2013-01-01

The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it in practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The

"Theorizing Teacher Mobility": A Critical Review of Literature

Science.gov (United States)

Vagi, Robert; Pivovarova, Margarita

2017-01-01

In this critical review of literature, we summarize the major theoretical frameworks that have been used to study teacher mobility. In total we identified 40 teacher mobility studies that met our inclusion criteria. We conclude that relatively few theoretical frameworks have been used to study teacher mobility and those that have been used are…

A Theoretical Basis for Adult Learning Facilitation: Review of Selected Articles

Science.gov (United States)

Muneja, Mussa S.

2015-01-01

The aim of this paper is to synthesize a theoretical basis for adult learning facilitation in order to provide a valuable systematic resource in the field of adult education. The paper has reviewed 6 journal articles with topics ranging from theory of andragogy; the effect of globalization on adult learning; the contribution of Malcolm Knowles;…

Critical appraisal of nonrandomized studies-A review of recommended and commonly used tools.

Science.gov (United States)

Quigley, Joan M; Thompson, Juliette C; Halfpenny, Nicholas J; Scott, David A

2018-02-27

When randomized controlled trial data are limited or unavailable, or to supplement randomized controlled trial evidence, health technology assessment (HTA) agencies may rely on systematic reviews of nonrandomized studies (NRSs) for evidence of the effectiveness of health care interventions. NRS designs may introduce considerable bias into systematic reviews, and several methodologies by which to evaluate this risk of bias are available. This study aimed to identify tools commonly used to assess bias in NRS and determine those recommended by HTA bodies. Appraisal tools used in NRS were identified through a targeted search of systematic reviews (January 2013-March 2017; MEDLINE and EMBASE [OVID SP]). Recommendations for the critical appraisal of NRS by expert review groups and HTA bodies were reviewed. From the 686 studies included in the narrative synthesis, 48 critical appraisal tools were identified. Commonly used tools included the Newcastle-Ottawa Scale, the methodological index for NRS, and bespoke appraisal tools. Neither the Cochrane Handbook nor the Centre for Reviews and Dissemination recommends a particular instrument for the assessment of risk of bias in NRS, although Cochrane has recently developed their own NRS critical appraisal tool. Among HTA bodies, only the Canadian Agency for Drugs and Technologies in Health recommends use of a specific critical appraisal tool-SIGN 50 (for cohort or case-control studies). Several criteria including reporting, external validity, confounding, and power were examined. There is no consensus between HTA groups on the preferred appraisal tool. Reviewers should select from a suite of tools on the basis of the design of studies included in their review. © 2018 John Wiley & Sons, Ltd.

Development and validation of a risk model for identification of non-neutropenic, critically ill adult patients at high risk of invasive Candida infection: the Fungal Infection Risk Evaluation (FIRE) Study.

Science.gov (United States)

Harrison, D; Muskett, H; Harvey, S; Grieve, R; Shahin, J; Patel, K; Sadique, Z; Allen, E; Dybowski, R; Jit, M; Edgeworth, J; Kibbler, C; Barnes, R; Soni, N; Rowan, K

2013-02-01

There is increasing evidence that invasive fungal disease (IFD) is more likely to occur in non-neutropenic patients in critical care units. A number of randomised controlled trials (RCTs) have evaluated antifungal prophylaxis in non-neutropenic, critically ill patients, demonstrating a reduction in the risk of proven IFD and suggesting a reduction in mortality. It is necessary to establish a method to identify and target antifungal prophylaxis at those patients at highest risk of IFD, who stand to benefit most from any antifungal prophylaxis strategy. To develop and validate risk models to identify non-neutropenic, critically ill adult patients at high risk of invasive Candida infection, who would benefit from antifungal prophylaxis, and to assess the cost-effectiveness of targeting antifungal prophylaxis to high-risk patients based on these models. Systematic review, prospective data collection, statistical modelling, economic decision modelling and value of information analysis. Ninety-six UK adult general critical care units. Consecutive admissions to participating critical care units. None. Invasive fungal disease, defined as a blood culture or sample from a normally sterile site showing yeast/mould cells in a microbiological or histopathological report. For statistical and economic modelling, the primary outcome was invasive Candida infection, defined as IFD-positive for Candida species. Systematic review: Thirteen articles exploring risk factors, risk models or clinical decision rules for IFD in critically ill adult patients were identified. Risk factors reported to be significantly associated with IFD were included in the final data set for the prospective data collection. Data were collected on 60,778 admissions between July 2009 and March 2011. Overall, 383 patients (0.6%) were admitted with or developed IFD. The majority of IFD patients (94%) were positive for Candida species. The most common site of infection was blood (55%). The incidence of IFD

Comprehension of Critical News Items as Expressed by College Students and Adults in Business, Industry, and Religion.

Science.gov (United States)

Adams, Effie Kaye; Scott, Elois M.

College students were compared to adults for their reading comprehension of news items on two critical issues of national concern. The subjects were 109 adults and 97 college students who read ten short magazine articles on the Iran-United States hostage crisis and the U.S. energy problem. After reading the articles, the subjects' comprehension…

PHOTOPERIODIC CONTROL OF ADULT DIAPAUSE IN CHRYSOPERLA SINICA （TJEDER） （NEUROPTERA： CHRYSOPIDAE） -I. CRITICAL PHOTOPERIOD AND SENSITIVE STAGES OF ADULT DIAPAUSE INDUCTION

Institute of Scientific and Technical Information of China (English)

Yong-yuXu; Ji-yuanMu; CuiHu; Hong-gangWang

2004-01-01

Photoperiodic sensitivity for diapause induction of the green lacewing, Chrysoperla sinica (Tjeder) was examined at 22℃. The adult diapause of C. sinica was induced by short-day photoperiods, and the critical photoperiod for its induction was between 12.5L-11.5D and 13L-11D.Adults developed without diapause under long-day conditions, and entered diapause under short-day conditions. The adult stage was the uppermost sensitive stage for adult diapause induction, adults could go into diapause only when the emerging adults were under diapause-inducing short-day photoperiods. The short-day photoperiodic experience by transferring between 15L: 9D and 9L: 15D at preimaginal stages did not result in adult diapause under 15L: 9D photo regime, although some treatments extended the pre-oviposition period in adult stage. The results showed that the 3rd instar larvae and pre-pupae were more sensitive to the photoperiodic change from 15L: 9D to 9L: 15D photo regime than the other preimaginal stages.

BIOCHAR: PYROGENIC CARBON FOR AGRICULTURAL USE - A CRITICAL REVIEW

Directory of Open Access Journals (Sweden)

Etelvino Henrique Novotny

2015-04-01

Full Text Available Biochar (carbonized biomass for agricultural use has been used worldwide as soil amendment and is a technology of particular interest for Brazil, since its "inspiration" is from the historical Terra Preta de Índios(Amazon Dark Earth, and also because Brazil is the world's largest charcoal producer, generating enormous residue quantities in form of fine charcoal and due to the availability of different residual biomasses, mainly from agroindustry (e.g., sugar-cane bagasse; wood and paper-mill wastes; residues from biofuel industries; sewage sludge etc, that can be used for biochar production, making Brazil a key actor in the international scenario in terms of biochar research and utilization. In the last decade, numerous studies on biochar have been carried out and now a vast literature, and excellent reviews, are available. The objective of this paper is therefore to deliver a critical review with some highlights on biochar research, rather than an exhaustive bibliographic review. To this end, some key points considered critical and relevant were selected and the pertinent literature "condensed", with a view to guide future research, rather than analyze trends of the past.

Review on modeling and simulation of interdependent critical infrastructure systems

International Nuclear Information System (INIS)

Ouyang, Min

2014-01-01

Modern societies are becoming increasingly dependent on critical infrastructure systems (CISs) to provide essential services that support economic prosperity, governance, and quality of life. These systems are not alone but interdependent at multiple levels to enhance their overall performance. However, recent worldwide events such as the 9/11 terrorist attack, Gulf Coast hurricanes, the Chile and Japanese earthquakes, and even heat waves have highlighted that interdependencies among CISs increase the potential for cascading failures and amplify the impact of both large and small scale initial failures into events of catastrophic proportions. To better understand CISs to support planning, maintenance and emergency decision making, modeling and simulation of interdependencies across CISs has recently become a key field of study. This paper reviews the studies in the field and broadly groups the existing modeling and simulation approaches into six types: empirical approaches, agent based approaches, system dynamics based approaches, economic theory based approaches, network based approaches, and others. Different studies for each type of the approaches are categorized and reviewed in terms of fundamental principles, such as research focus, modeling rationale, and the analysis method, while different types of approaches are further compared according to several criteria, such as the notion of resilience. Finally, this paper offers future research directions and identifies critical challenges in the field. - Highlights: • Modeling approaches on interdependent critical infrastructure systems are reviewed. • I mainly review empirical, agent-based, system-dynamics, economic, network approaches. • Studies by each approach are sorted out in terms of fundamental principles. • Different approaches are further compared with resilience as the main criterion

Nutritional risk assessment in critically ill cancer patients: systematic review

Science.gov (United States)

Fruchtenicht, Ana Valéria Gonçalves; Poziomyck, Aline Kirjner; Kabke, Geórgia Brum; Loss, Sérgio Henrique; Antoniazzi, Jorge Luiz; Steemburgo, Thais; Moreira, Luis Fernando

2015-01-01

Objective To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature. Methods The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words “nutritional risk assessment”, “critically ill” and “cancer”. Results Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values < 87 were significantly associated with mortality. A high Prognostic Inflammatory and Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found. Conclusion None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic

The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review.

Science.gov (United States)

Benham, Brian; Hawley, Diane

2015-05-15

Students leave healthcare academic programs for a variety of reasons. When they attrite, it is disappointing for the student as well as their faculty. Advanced practice nursing and other healthcare professions require not only extensive academic preparation, but also the ability to critically evaluate patient care situations. The ability to critically evaluate a situation is not innate. Critical decision making skills are high level skills that are difficult to assess. For the purpose of this review, critical decision making and critical thinking skills refer to the same constructs and will be referred to globally as critical decision making skills. The objective of this review was to identify the effectiveness of tools used to evaluate critical decision making skills for applicants to healthcare graduate educational programs. Adult (18 years of age or older) applicants, students enrolled and/or recent graduates (within one year from completion) of healthcare graduate educational programs. Types of interventions: This review considered studies that evaluated the utilization of unique tools as well as standard tools, such as the Graduate Record Exam or grade point average, to evaluate critical decision making skills in graduate healthcare program applicants. Types of studies: Experimental and non-experimental studies were considered for inclusion. Types of outcomes: Successful quantitative evaluations based on specific field of study standards. The search strategy aimed to find both published and unpublished studies. Studies published in English after 1969 were considered for inclusion in this review. Databases that included both published and unpublished (grey) literature were searched. Additionally, reference lists from all articles retrieved were examined for articles for inclusion. Selected papers were assessed by two independent reviewers using standardized critical appraisal instruments from Joanna Briggs Institute. Any disagreement between reviewers was

Development of critical digital review procedure

International Nuclear Information System (INIS)

Huang Huiwen; Liao Benching; Tseng Maosheng; Chung Hsianghan; Cheng Tsungchieh; Chen Minghuei

2011-01-01

This paper describes the critical digital review (CDR) procedure, which was developed by Institute of Nuclear Energy Research (INER), and sponsored by Taiwan Power Company (TPC). A preliminary CDR application experience which was performed by INER, is also described in this paper. Currently, CDR becomes one of the policies for digital Instrumentation and Control (I and C) system replacement in TPC. The contents of this CDR procedure include: Scope, Responsibility, Operation Procedure, Operation Flow Chart, CDR review items. The 'CDR Review Items' chapter proposes optional review items, including the comparison of the design change, Software Verification and Validation (SV and V), Failure Mode and Effects Analysis (FMEA), Evaluation of Watchdog Timer, Evaluation of Electromagnetic Compatibility (EMC), Evaluation of Grounding for System/Component, Seismic Evaluation, HFE Evaluation, Witness and Inspection, Lessons Learnt from the Digital I and C Failure Events. Since CDR has become a TPC policy, Chin Shan Nuclear Power Plant (NPP) performed the CDR practice of Automatic Voltage Regulator (AVR) digital I and C replacement, even though the project had been on the half way. The major review items of this CDR were: the comparison of the design change, SV and V, FMEA, Evaluation of Watchdog Timer, Evaluation of Electromagnetic Compatibility (EMC), Evaluation of Grounding for System/ Component, Witness and Inspection, Lessons Learnt from the Digital I and C Failure Events. The experience of the CDR showed the importance of preparation of the documents by the vendor. This means the communication with the vendors for the bid preparation is crucial. (author)

PENERAPAN CRITICAL REVIEW ARTIKEL PEMBELAJARAN IPA UNTUK MENINGKATKAN KEMAMPUAN MAHASISWA DALAM MENYUSUN PROPOSAL SKRIPSI

Directory of Open Access Journals (Sweden)

p parmin

2016-02-01

Full Text Available The aims of this research is to improve students’ ability in develop- ing a proposal thesis by applying critical review of scientific articles come from journals. The research is designed by class action research. The results showed 63% of students thesis proposals on Research Methodology course scored above 80. Based on the results obtained it can be concluded that the application has been critical review or critical study of scientific articles can enhance students’ ability in preparing research proposals.

A CRITICAL REVIEW OF THE MODEL MINORITY STEREOTYPE SHIBBOLETH

Directory of Open Access Journals (Sweden)

Nicholas Daniel Hartlep

2012-04-01

Full Text Available The author conducted a thematic review of the literature on the model minority stereotype  (MMS.  MMS  writings  (n  =  246  included  peer-reviewed  and  non-peer-reviewed materials spanning from the 1960s to present. Writings were reviewed if their title included “model minority.”  The purpose  was to review the MMS critically.  Six major themes were found to recurrently appear in the MMS literature. Those themes were the following: (1 critiquing colorblindness, (2 countering meritocracy, (3 demystifying Asian  American  exceptionalism,  (4  uncovering  divide  and  conquer  stratagem,  (5 problematizing Asian American homogenization, and (6 unmasking the “yellow peril” stereotype. Implications for the education of Asian students in America and abroad are shared.

Adult Education, Social Change and Development in Post-Colonial Jamaica

Science.gov (United States)

Barrett, Shermaine Ann Marie

2014-01-01

The purpose of this qualitative case study was to demonstrate how adult education enabled the process of economic and social change, and national development in Jamaica through a critical review of two cases of adult education provisions in Jamaica since the country gained independence in 1962. Content analysis of various documents from primary…

Consumer sleep tracking devices: a critical review.

Science.gov (United States)

Lee, Jeon; Finkelstein, Joseph

2015-01-01

Consumer sleep tracking devices are widely advertised as effective means to monitor and manage sleep quality and to provide positive effects on overall heath. However objective evidence supporting these claims is not always readily available. The goal of this study was to perform a comprehensive review of available information on six representative sleep tracking devices: BodyMedia FIT, Fitbit Flex, Jawbone UP, Basis Band, Innovative Sleep Solutions SleepTracker, and Zeo Sleep Manager Pro. The review was conducted along the following dimensions: output metrics, theoretical frameworks, systematic evaluation, and FDA clearance. The review identified a critical lack of basic information about the devices: five out of six devices provided no supporting information on their sensor accuracy and four out of six devices provided no information on their output metrics accuracy. Only three devices were found to have related peer-reviewed articles. However in these articles wake detection accuracy was revealed to be quite low and to vary widely (BodyMedia, 49.9±3.6%; Fitbit, 19.8%; Zeo, 78.9% to 83.5%). No supporting evidence on how well tracking devices can help mitigate sleep loss and manage sleep disturbances in practical life was provided.

Critical thinking in nursing: Scoping review of the literature.

Science.gov (United States)

Zuriguel Pérez, Esperanza; Lluch Canut, Maria Teresa; Falcó Pegueroles, Anna; Puig Llobet, Montserrat; Moreno Arroyo, Carmen; Roldán Merino, Juan

2015-12-01

This article seeks to analyse the current state of scientific knowledge concerning critical thinking in nursing. The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January 1999 to June 2013 were identified, of which 90 met the inclusion criteria. The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest in the study of both its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals. Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting, independent of conceptual models, with a variety of instruments used for its measurement. We recommend (i) the investigation of critical thinking among working professionals, (ii) the designing of evaluative instruments linked to conceptual models and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care. © 2014 Wiley Publishing Asia Pty Ltd.

The Experience of Adolescents and Young Adults Treated for Cancer in an Adult Setting: A Review of the Literature.

Science.gov (United States)

Marshall, Steve; Grinyer, Anne; Limmer, Mark

2018-02-13

The purpose of this review is to explore the literature on the experience of adolescents and young adults (AYAs) having cancer treatment in an adult setting, rather than on a specialist adolescent cancer unit. The integrative review method was used to explore the current literature. Primary research on the topic was located systematically and then synthesized into a thematic narrative. The experience of AYAs undergoing treatment in an adult setting was generally negative. This can be attributed to three themes: feeling isolated in the adult setting; the lack of empathy from staff working in the adult setting; and the inappropriateness of the adult environment for this age group. As many AYAs with cancer will continue to have treatment in adult settings, staff working in this environment should be aware of the negative experience of this cohort and the impact this can have on a vulnerable group of patients. Staff could consider simple ways of improving the AYA experience, such as connecting AYA patients with their peers to reduce isolation; adapting their approach to take account of the unique emotional needs of this age group; and considering ways of making the environment more welcoming and age-appropriate.

Haloperidol for delirium in critically ill patients - protocol for a systematic review

DEFF Research Database (Denmark)

Barbateskovic, M; Kraus, S R; Collet, M O

2018-01-01

, relatives, and societies is considerable. The objective of this systematic review was to critically access the evidence of randomised clinical trials on the effects of haloperidol vs. placebo or any other agents for delirium in critically ill patients. METHODS: We will search for randomised clinical trials...... decision makers on the use of or future trials with haloperidol for the management of delirium in critically ill patients....

Gambling behavior and problems among older adults: a systematic review of empirical studies.

Science.gov (United States)

Tse, Samson; Hong, Song-Iee; Wang, Chong-Wen; Cunningham-Williams, Renee M

2012-09-01

With the rapid aging of the population and the increased availability of gambling facilities over the past three decades, older adults may gamble more and may be increasingly at risk for problem gambling (PG) or pathological gambling disorder (PGD). To facilitate a better understanding of gambling behavior among older adults that will inform preventive strategies, this article systematically examined empirical studies on issues related to older adults' gambling. This article reviewed 75 empirical studies including data on the distribution and determinants of PG and PGD and the outcomes of gambling. This review used the broad term of "disordered gambling" as a means to explain a continuum of problems caused by PG and PGD. The analyses covered seven topics concerning older adults' gambling behaviors: Participation rates for gambling, prevalence rates of disordered gambling, motivation for initially beginning to gamble, risk and protective factors for disordered gambling, and negative and positive health outcomes from gambling. Based on research gaps identified in the review, this article proposes six recommendations for future studies focusing on well-being of older adults who gamble, research method issues, and taking into account older adults' inspirations and adjustment to the aging process in the 21st century.

Social Workers' Attitudes toward Older Adults: A Review of the Literature

Science.gov (United States)

Wang, Donna; Chonody, Jill

2013-01-01

Ageist attitudes toward older adults have been recognized as barriers to recruiting and training competent social workers. This article provides a systematic review of the literature that focused on social workers' and social work students' attitudes toward older adults and working with older adults. The authors sought empirical studies…

Critical Review of NOAA's Observation Requirements Process

Science.gov (United States)

LaJoie, M.; Yapur, M.; Vo, T.; Templeton, A.; Bludis, D.

2017-12-01

NOAA's Observing Systems Council (NOSC) maintains a comprehensive database of user observation requirements. The requirements collection process engages NOAA subject matter experts to document and effectively communicate the specific environmental observation measurements (parameters and attributes) needed to produce operational products and pursue research objectives. User observation requirements documented using a structured and standardized manner and framework enables NOAA to assess its needs across organizational lines in an impartial, objective, and transparent manner. This structure provides the foundation for: selecting, designing, developing, acquiring observing technologies, systems and architectures; budget and contract formulation and decision-making; and assessing in a repeatable fashion the productivity, efficiency and optimization of NOAA's observing system enterprise. User observation requirements are captured independently from observing technologies. Therefore, they can be addressed by a variety of current or expected observing capabilities and allow flexibility to be remapped to new and evolving technologies. NOAA's current inventory of user observation requirements were collected over a ten-year period, and there have been many changes in policies, mission priorities, and funding levels during this time. In light of these changes, the NOSC initiated a critical, in-depth review to examine all aspects of user observation requirements and associated processes during 2017. This presentation provides background on the NOAA requirements process, major milestones and outcomes of the critical review, and plans for evolving and connecting observing requirements processes in the next year.

Critical review of directional neutron survey meters

Science.gov (United States)

Balmer, Matthew J. I.; Gamage, Kelum A. A.; Taylor, Graeme C.

2014-01-01

Having been overlooked for many years, research is now starting to take into account the directional distribution of the neutron work place field. The impact of not taking this into account has led to overly conservative estimates of dose in neutron workplace fields. This paper provides a critical review of this existing research into directional survey meters which could improve these estimates of dose. Instruments which could be adapted for use as directional neutron survey meters are also considered within this review. Using Monte-Carlo techniques, two of the most promising existing designs are evaluated; a boron-doped liquid scintillator and a multi-detector directional spectrometer. As an outcome of these simulations, possible adaptations to these instruments are suggested with a view to improving the portability of the instrument.

Critical Review of Directional Neutron Survey Meters

International Nuclear Information System (INIS)

Balmer, M.J.I.; Gamage, K.A.A.; Taylor, G.C.

2013-06-01

Having been overlooked for many years, research is now starting to take into account the directional distribution of the neutron work place field. The impact of not taking this into account has led to overly conservative estimates of dose in neutron workplace fields. This paper provides a critical review of this existing research into directional survey meters which could improve these estimates of dose. Instruments which could be adapted for use as directional neutron survey meters are also considered within this review. Using Monte-Carlo techniques, two of the most promising existing designs are evaluated; a boron-doped liquid scintillator and a multi-detector directional spectrometer. As an outcome of these simulations, possible adaptations to these instruments are suggested with a view to improving the portability of the instrument. (authors)

Health Benefits of Digital Videogames for Older Adults: A Systematic Review of the Literature.

Science.gov (United States)

Hall, Amanda K; Chavarria, Enmanuel; Maneeratana, Vasana; Chaney, Beth H; Bernhardt, Jay M

2012-12-01

This article is a systematic review conducted of the research literature on digital videogames played by older adults and health outcomes associated with game play. Findings from each study meeting the inclusion criteria were analyzed and summarized into emergent themes to determine the impact of digital games in promoting healthy behaviors among older adults. A systematic review of the research literature was conducted through multiple academic databases for works, published between the years 2000 and 2011, looking at digital videogame interventions with adults 65 years of age and older. Multiple combinations of search terms and Boolean operators relevant to digital videogames and older adults were queried. A criteria matrix was created to code and evaluate studies. Thirteen studies met specific criteria for inclusion and were analyzed in the final review. Significant mental, physical, and social health factors, type of digital game platform, study design, and measurements are among emergent themes summarized from the reviewed research literature. Significant mental health outcomes of digital game interventions were found in the majority of the reviewed studies, followed by physical and lastly social health outcomes in older adults. A majority of the studies revealed significant positive effects on health outcomes associated with digital videogame play among older adults. With current advancements in technology, including advanced motion sensing, digital game platforms have significant potential for positive health impact among older populations. More robust and rigorous research designs are needed to increase validity and reliability of results and establish stronger causal relationships on the health benefits of digital videogame play for older adults.

A Critical Review of the Literature on Electronic Records ...

African Journals Online (AJOL)

This article provides a critical review of existing articles addressing the management of electronic records in the Eastern and Southern African Regional Branch of the International Council on Archives (ESARBICA) region. The article argues that while the literature in developed countries has come up with practical solutions ...

Patient outcomes after critical illness: a systematic review of qualitative studies following hospital discharge.

Science.gov (United States)

Hashem, Mohamed D; Nallagangula, Aparna; Nalamalapu, Swaroopa; Nunna, Krishidhar; Nausran, Utkarsh; Robinson, Karen A; Dinglas, Victor D; Needham, Dale M; Eakin, Michelle N

2016-10-26

There is growing interest in patient outcomes following critical illness, with an increasing number and different types of studies conducted, and a need for synthesis of existing findings to help inform the field. For this purpose we conducted a systematic review of qualitative studies evaluating patient outcomes after hospital discharge for survivors of critical illness. We searched the PubMed, EMBASE, CINAHL, PsycINFO, and CENTRAL databases from inception to June 2015. Studies were eligible for inclusion if the study population was >50 % adults discharged from the ICU, with qualitative evaluation of patient outcomes. Studies were excluded if they focused on specific ICU patient populations or specialty ICUs. Citations were screened in duplicate, and two reviewers extracted data sequentially for each eligible article. Themes related to patient outcome domains were coded and categorized based on the main domains of the Patient Reported Outcomes Measurement Information System (PROMIS) framework. A total of 2735 citations were screened, and 22 full-text articles were eligible, with year of publication ranging from 1995 to 2015. All of the qualitative themes were extracted from eligible studies and then categorized using PROMIS descriptors: satisfaction with life (16 studies), including positive outlook, acceptance, gratitude, independence, boredom, loneliness, and wishing they had not lived; mental health (15 articles), including symptoms of post-traumatic stress disorder, anxiety, depression, and irritability/anger; physical health (14 articles), including mobility, activities of daily living, fatigue, appetite, sensory changes, muscle weakness, and sleep disturbances; social health (seven articles), including changes in friends/family relationships; and ability to participate in social roles and activities (six articles), including hobbies and disability. ICU survivors may experience positive emotions and life satisfaction; however, a wide range of mental

EPR and Bell's theorem: A critical review

International Nuclear Information System (INIS)

Stapp, H.P.

1991-01-01

The argument of Einstein, Podolsky, and Rosen is reviewed with attention to logical structure and character of assumptions. Bohr's reply is discussed. Bell's contribution is formulated without use of hidden variables, and efforts to equate hidden variables to realism are critically examined. An alternative derivation of nonlocality that makes no use of hidden variables, microrealism, counterfactual definiteness, or any other assumption alien to orthodox quantum thinking is described in detail, with particular attention to the quartet or broken-square question

Adult type granulosa cell tumor in adult testis: report of a case and review of the literature

Directory of Open Access Journals (Sweden)

Zhanyong Bing

2011-10-01

Full Text Available Granulosa cell tumors can be classified into juvenile and adult types and more commonly occur in ovaries. Adult testicular granulosa cell tumors are extremely rare and only 29 cases of adult type have previously been reported. We report here a 28-year-old Caucasian man with a left testicular adult type granulosa cell tumor. The tumor measured 2.6 x 2.6 x 2.5 cm and was mitotically active (10/10 HPF. Immunohistochemical stains showed the tumor diffusely positive for inhibin and vimentin, and negative for epithelial membrane antigen, cytokeratins, synaptophysin, HMB-45, OCT-4, placental-like alkaline phosphatase and lymphoid markers . The reported granulosa cell tumors in adult testis were briefly reviewed.

Interventions to reduce cognitive impairments following critical illness

DEFF Research Database (Denmark)

Nedergaard, H K; Jensen, H I; Toft, P

2017-01-01

and sleep quality improvement. Data were synthesized to provide an overview of interventions, quality, follow-up assessments and neuropsychological outcomes. CONCLUSION: None of the interventions had significant positive effects on cognitive impairments following critical illness. Quality was negatively......BACKGROUND: Critical illness is associated with cognitive impairments. Effective treatment or prevention has not been established. The aim of this review was to create a systematic summary of the current evidence concerning clinical interventions during intensive care admission to reduce cognitive...... impairments after discharge. METHODS: Medline, Embase, Cochrane Central, PsycInfo and Cinahl were searched. Inclusion criteria were studies assessing the effect of interventions during intensive care admission on cognitive function in adult patients. Studies were excluded if they were reviews or reported...

Standardizing communication from acute care providers to primary care providers on critically ill adults.

Science.gov (United States)

Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

2015-11-01

To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

Antidiabetic plant-derived nutraceuticals: a critical review.

Science.gov (United States)

Naveen, Jayapal; Baskaran, Vallikannan

2018-06-01

Diabetes mellitus (DM) is one of the major health problems in the world, especially amongst the urban population. Chemically synthesized drugs used to decrease the ill effects of DM and its secondary complications cause adverse side effects, viz., weight gain, gastrointestinal disturbances, and heart failure. Currently, various other approaches, viz., diet control, physical exercise and use of antidiabetic plant-derived molecules/foods are advocated to manage DM, as they are economical with fewer or no side effects. This review mainly focuses on antidiabetic plants, chemically characterized plant molecules and plant-based foods in the treatment of DM. Very little science-based evidence is available on the mechanism of action of plant-derived food molecules on the DM targets. Critical DM targets include α-amylase, α-glucosidase, DPP-IV, aldose reductase, PPAR-γ, AMP kinase and GLUT4. In-depth studies carried out on a few of those targets with specific mechanisms of action are addressed in this review. This review may help future researchers in identifying a right plant molecule to treat DM or to develop food formulations for DM management.

Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.

Science.gov (United States)

Barrows, Jennifer L; Fleury, Julie

2016-06-01

The benefits of physical activity are well established, yet few older adults engage in adequate physical activity to optimize health. While yoga may reduce the risk of cardiovascular disease, few studies have focused on the efficacy of yoga-based physical activity to promote cardiovascular health in older adults. The objective of this review is to provide an evaluation of yoga interventions to reduce cardiovascular risk in older adults. Four databases were searched for randomized controlled trials of yoga interventions in older adults. Studies with cardiovascular outcomes were included. Literature searches identified nine articles eligible for review. Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids. Yoga practices, participant characteristics, and outcome measures were variable. There was limited use of theory. Yoga is safe and feasible in older adults; additional research is warranted to examine the specific components of yoga interventions essential to reducing cardiovascular risk. © The Author(s) 2015.

Peer-to-Peer Teaching in Higher Education: A Critical Literature Review

Science.gov (United States)

Stigmar, Martin

2016-01-01

The aim of my critical literature review is to identify studies where students are engaged as partners in teaching in higher education and to analyze how tutors and tutees benefit from peer teaching. Thirty studies were included for review. Thirteen countries are represented and two thirds of the studies conducted in the United States of America…

Frailty in Older Adults Using Pre-hospital Care and the Emergency Department: A Narrative Review.

Science.gov (United States)

Goldstein, Judah P; Andrew, Melissa K; Travers, Andrew

2012-03-01

Older adults use more health-care services per capita than younger age groups and the older adult population varies greatly in its needs. Evidence suggests that there is a critical distinction between relative frailty and fitness in older adults. Here, we review how frailty is described in the pre-hospital literature and in the broader emergency medicine literature. PubMed was used as the primary database, but was augmented by searches of CINAHL and EMBASE. Articles were included if they focused on patients 60 years and older and implemented a definition of frailty or risk screening tool in the Emergency Medical Services (EMS) or Emergency Department setting. IN THE BROAD CLINICAL LITERATURE, THREE TYPES OF MEASURES CAN BE IDENTIFIED: frailty index measures, frailty scales, and a phenotypic definition. Each offers advantages and disadvantages for the EMS stakeholder. We identified no EMS literature on frailty conceptualization or management, although some risk measures from emergency medicine use terms that overlap with the frailty literature. There is a paucity of research on frailty in the Emergency Medical Services literature. No research was identified that specifically addressed frailty conceptualization or management in EMS patients. There is a compelling need for further research in this area.

Flavour preferences in youth versus adults: a review

Science.gov (United States)

Hoffman, Allison C; Salgado, Raydel Valdes; Dresler, Carolyn; Faller, Rachel Williams; Bartlett, Christopher

2016-01-01

Objective To understand the available evidence of how children and adults differ in their preferences for flavours that may be used in tobacco products. Data sources A total of 474 articles published between 1931 and August 2015 were retrieved through searches conducted in PubMed, EMBASE, Web of Science and PsycINFO. Study selection and extraction A 2-phase relevancy review process resulted in the identification of 59 articles and information was extracted by 2 independent reviewers. Data synthesis Findings were grouped by taste and smell preferences, which are important components of overall flavour. For taste, evidence is summarised in the following categories: sweet, salty, sour, bitter, umami and fat; within each of them, findings are organised by age categories. For smell, evidence is summarised as follows: fruit/herbal/spices, tobacco and coffee and other odours. Major findings from this search indicated that sweet preference in children and adolescents was higher than in adults. Examples of preferred food-related tastes and odours for young people included cherry, candy, strawberry, orange, apple and cinnamon. Currently, all these are used to flavour cigars, cartridges for electronic cigarettes, hookah (waterpipe) and smokeless tobacco products. Conclusions Infants and children exhibited elevated sweet and salty preference relative to adults. Age-related changes in bitter, sour, umami and fat taste were not clear and more research would be useful. ‘Sweet’ food odours were highly preferred by children. Tobacco products in flavours preferred by young people may impact tobacco use and initiation, while flavours preferred by adults may impact product switching or dual use. PMID:27633764

Motivation Measures in Sport: A Critical Review and Bibliometric Analysis

OpenAIRE

Clancy, Rachel B.; Herring, Matthew P.; Campbell, Mark J.

2017-01-01

Motivation is widely-researched, in both sport psychology and other fields. As rigorous measurement is essential to understanding this latent construct, a critical appraisal of measurement instruments is needed. Thus, the purpose of this review was to evaluate the six most highly cited motivation measures in sport. Peer-reviewed articles published prior to August 2016 were searched to identify the six most highly cited motivation questionnaires in sport: Sport Motivation Scale (SMS), Intrinsi...

Automatic Generation and Ranking of Questions for Critical Review

Science.gov (United States)

Liu, Ming; Calvo, Rafael A.; Rus, Vasile

2014-01-01

Critical review skill is one important aspect of academic writing. Generic trigger questions have been widely used to support this activity. When students have a concrete topic in mind, trigger questions are less effective if they are too general. This article presents a learning-to-rank based system which automatically generates specific trigger…

Most important needs of family members of critical patients in light of the critical care family needs inventory.

Science.gov (United States)

Padilla Fortunatti, Cristóbal Felipe

2014-01-01

This work sought to identify the most important needs for family members of adult critical patients as described in the literature pursuant to the dimensions established in the "Critical Care Family Needs Inventory" (CCFNI) by Molter and Leske. A literature review was carried out by using the CCFNI instrument. The databases used were: Pubmed, CINAHL, Proquest Nursing & Allied Health Source, Proquest Psychology Journals, LILACS, Science Direct, Ovid SP, PsyicINFO, and SciELO. The following limitations for the search were identified: adult patients, articles in English and Spanish, with abstract and complete text available and which had been published from 2003 to June 2013; 15 articles were included. The family's hope on desired results and sincere communication with the healthcare staff turned out to be the most relevant needs, while the least important were related to comfort and having support structures or systems. Most of the studies were conducted in Asia and North America revealing differences in the order of importance assigned to each necessity. Certain sociodemographic and cultural characteristics impact upon how family members rank their needs; this also occurs with the nature of the most important needs for the family and the factors determining their prioritization. The articles included in this review mention the frequent interaction with the family and their holistic view of the person beyond the illness, determine that nurses are the most appropriate professionals to know and satisfy the family needs of critical patients.

Most Important Needs of Family Members of Critical Patients in Light of the Critical Care Family Needs Inventory

Directory of Open Access Journals (Sweden)

Cristóbal Felipe Padilla Fortunatti

2014-07-01

Full Text Available Objective. This work sought to identify the most important needs for family members of adult critical patients as described in the literature pursuant to the dimensions established in the "Critical Care Family Needs Inventory" (CCFNI by Molter and Leske. Methodology. A literature review was carried out by using the CCFNI instrument. The databases used were: Pubmed, CINAHL, Proquest Nursing & Allied Health Source, Proquest Psychology Journals, LILACS, Science Direct, Ovid SP, PsyicINFO, and SciELO. The following limitations for the search were identified: adult patients, articles in English and Spanish, with abstract and complete text available and which had been published from 2003 to June 2013; 15 articles were included. Results. The family's hope on desired results and sincere communication with the healthcare staff turned out to be the most relevant needs, while the least important were related to comfort and having support structures or systems. Most of the studies were conducted in Asia and North America revealing differences in the order of importance assigned to each necessity. Certain sociodemographic and cultural characteristics impact upon how family members rank their needs; this also occurs with the nature of the most important needs for the family and the factors determining their prioritization. Conclusion. The articles included in this review mention the frequent interaction with the family and their holistic view of the person beyond the illness, determine that nurses are the most appropriate professionals to know and satisfy the family needs of critical patients.

A critical review on tablet disintegration.

Science.gov (United States)

Quodbach, Julian; Kleinebudde, Peter

2016-09-01

Tablet disintegration is an important factor for drug release and can be modified with excipients called tablet disintegrants. Tablet disintegrants act via different mechanisms and the efficacy of these excipients is influenced by various factors. In this review, the existing literature on tablet disintegration is critically reviewed. Potential disintegration mechanisms, as well as impact factors on the disintegration process will be discussed based on experimental evidence. Search terms for Scopus and Web of Science included "tablet disintegration", "mechanism tablet disintegration", "superdisintegrants", "disintegrants", "swelling force", "disintegration force", "disintegration mechanisms", as well as brand names of commonly applied superdisintegrants. References of identified papers were screened as well. Experimental data supports swelling and shape recovery as main mechanisms of action of disintegrants. Other tablet excipients and different manufacturing techniques greatly influence the disintegration process. The use of different excipients, experimental setups and manufacturing techniques, as well as the demand for original research led to a distinct patchwork of knowledge. Broader, more systematic approaches are necessary not only to structure the past but also future findings.

School Uniforms: A Critical Review of the Literature. From Inquiry to Practice.

Science.gov (United States)

Brunsma, David L.

The debate surrounding the effectiveness of school-uniform policies, as well as discussions concerning when and how to implement them, is rooted in anecdote. This review summarizes anecdotal literature on which the current debate is based and critically reviews the empirical literature, including theoretical underpinnings, findings, and…

Macronutrient intake and inadequacies of community-dwelling older adults, a systematic review

NARCIS (Netherlands)

Borg, ter S.J.; Verlaan, S.; Mijnarends, D.; Schols, J.M.G.A.; Groot, de C.P.G.M.; Luiking, Y.C.

2015-01-01

Background: Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. Summary: This systematic review provides a comprehensive overview of the energy

Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review.

Science.gov (United States)

Carden, Kelly A; Boiselle, Philip M; Waltz, David A; Ernst, Armin

2005-03-01

Tracheomalacia and tracheobronchomalacia are disorders that are encountered in both pediatric and adult medicine. Despite increasing recognition of these disease processes, there remains some uncertainty regarding their identification, causes, and treatment. This article is intended to be a comprehensive review of both the adult and pediatric forms of the diseases, and includes sections on the historical aspects of the disorders, and their classification, associated conditions, histopathology, and natural history. We also review the various modalities that are used for diagnosis as well as the state of the art of treatment, including airway stent placement and surgical intervention.

Epidemiology of bruxism in adults: a systematic review of the literature

NARCIS (Netherlands)

Manfredini, D.; Winocur, E.; Guarda-Nardini, L.; Paesani, D.; Lobbezoo, F.

2013-01-01

AIMS: To perform a systematic review of the literature dealing with the prevalence of bruxism in adult populations. METHODS: A systematic search of the medical literature was performed to identify all peer-reviewed English-language papers dealing with the prevalence assessment of either awake or

Evaluation of quality of life according to the nutritional status of the adult palliative patient: systematic review

Directory of Open Access Journals (Sweden)

Ester Aracil-Lavado

2017-10-01

Full Text Available Objective: To review the scientific literature related to the quality of life according to the nutritional status of the adult palliative patient. Method: Critical analysis of the documents recovered by systematic review. The data were obtained from the direct consultation and access, on the Internet, in the next bibliographic databases in the area of health sciences: MEDLINE (via PubMed, The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL, Web of Science and Latin American and Caribbean Literature in Health Sciences (LILACS. The use of the Descriptors “Quality of life”, “Nutritional status” and “Palliative care” were considered appropriate, using the filters: “Humans”, “Adults” and “Comparative Study” or “Clinical Trial”. Date of search: November 2016. Results: After applying the inclusion and exclusion criteria, 4 studies were accepted for review and critical analysis. To evaluate the quality of articles selected for review using the CONSORT questionnaire, scores ranged from 11 to 20 with a maximum score of 25. Conclusions: The nutritional monitoring of the patients was directly related to the improvement of the nutritional status, and corresponded to the increase of the quality of life. It would be desirable to use specific and validated questionnaires to evaluate the quality of life according to the nutritional status that will allow to minimize any type of subjectivity of the patient. Future studies, with an adequate population, would be necessary to clarify the direct relationship between nutritional status and quality of life in palliative patients.

Diffusion tensor imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review.

Science.gov (United States)

Asken, Breton Michael; DeKosky, Steven T; Clugston, James R; Jaffee, Michael S; Bauer, Russell M

2018-04-01

This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOhost, and Google Scholar, using a Boolean search string containing the following terms: "diffusion tensor imaging", "diffusion imaging", "DTI", "white matter", "concussion", "mild traumatic brain injury", "mTBI", "traumatic brain injury", and "TBI". We added studies not identified by this method that were found via manually-searched reference lists. We identified 86 eligible studies from English-language journals using, adult, human samples. Studies were evaluated based on duration between injury and DTI assessment, categorized as acute, subacute/chronic, remote mTBI, and repetitive brain trauma considerations. Since changes in brain structure after mTBI can also be affected by other co-occurring medical and demographic factors, we also briefly review DTI studies that have addressed socioeconomic status factors (SES), major depressive disorder (MDD), and attention-deficit hyperactivity disorder (ADHD). The review describes population-specific risks and the complications of clinical versus pathophysiological outcomes of mTBI. We had anticipated that the distinct population groups (civilian, military, and athlete) would require separate consideration, and various aspects of the study characteristics supported this. In general, study results suggested widespread but inconsistent differences in white matter diffusion metrics (primarily fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) following mTBI/concussion. Inspection of study designs and results revealed potential explanations for discrepant DTI findings, such as control group variability, analytic techniques, the manner in which regional differences were reported, and

A Review of Accident Modelling Approaches for Complex Critical Sociotechnical Systems

National Research Council Canada - National Science Library

Qureshi, Zahid H

2008-01-01

.... This report provides a review of key traditional accident modelling approaches and their limitations, and describes new system-theoretic approaches to the modelling and analysis of accidents in safety-critical systems...

Systematic review of the use of online questionnaires of older adults.

Science.gov (United States)

Remillard, Meegan L; Mazor, Kathleen M; Cutrona, Sarah L; Gurwitz, Jerry H; Tjia, Jennifer

2014-04-01

To describe methodological approaches to population targeting and sampling and to summarize limitations of Internet-based questionnaires in older adults. Systematic literature review. Studies using online questionnaires in older adult populations. English-language articles using search terms for geriatric, age 65 and over, Internet survey, online survey, Internet questionnaire, and online questionnaire in PubMed and EBSCO host between 1984 and July 2012. Inclusion criteria were study population mean age 65 and older and use of an online questionnaire for research. Review of 336 abstracts yielded 14 articles for full review by two investigators; 11 articles met inclusion criteria. Articles were extracted for study design and setting, participant characteristics, recruitment strategy, country, and study limitations. Eleven articles were published after 2001. Studies had populations with a mean age of 65 to 78, included descriptive and analytical designs, and were conducted in the United States, Australia, and Japan. Recruiting methods varied widely from paper fliers and personal e-mails to use of consumer marketing panels. Investigator-reported study limitations included the use of small convenience samples and limited generalizability. Online questionnaires are a feasible method of surveying older adults in some geographic regions and for some subsets of older adults, but limited Internet access constrains recruiting methods and often limits study generalizability. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

A Decade of Critical Information Literacy: A Review of the Literature

Directory of Open Access Journals (Sweden)

Eamon Tewell

2015-06-01

Full Text Available As information literacy continues in its centrality to many academic libraries’ missions, a line of inquiry has developed in response to ACRL’s charge to develop information literate citizens. The literature of critical information literacy questions widely held assumptions about information literacy and considers in what ways librarians may encourage students to engage with and act upon information’s complex and inherently political nature. This review explores the research into critical information literacy, including critical pedagogy and critiques of information literacy, in order to provide an entry point for this emerging and challenging approach to information literacy.

Older adults' perspectives on the process of becoming users of assistive technology: a qualitative systematic review and meta-synthesis.

Science.gov (United States)

Larsen, Stina Meyer; Mortensen, Rikke Falgreen; Kristensen, Hanne Kaae; Hounsgaard, Lise

2018-04-22

To identify, synthesize, and evaluate existing literature concerning the process of becoming a user of assistive technology (AT). A systematic review and meta-synthesis were carried out. Five bibliographic databases (MEDLINE via PubMed, CINAHL, Web of Science, PsycINFO and SocINDEX) were systematically searched up to 13 th of March 2017, using two sets of search terms: (i) elderly and synonyms and (ii) assistive technology and similar words, and combined with a qualitative research filter. Articles were screened, read and critically assessed. The meta-synthesis was guided by Ricoeur's theory of interpretation. Seventeen out of 4645 articles were included. Five phases emerged relating to the process of becoming a user of AT: phase A: Evaluating need, phase B: Acknowledging need, phase C: Incorporating the AT into daily life, phase D: Using the AT, and phase E: Future use. Three transitions, describing factors essential to moving from one phase to the next, were identified; from phase A-B: Valued activities are threatened, from phase B-C: Obtaining the AT and from phase C-D: Trust in the AT. No transition was identified from phase D-E. The meta-synthesis led to a deeper understanding of the process of older adults becoming users of AT, by exploring findings across the included articles. The identified phases and transitions in the systematic review serve as an analytical framework for understanding the process from the older adult's perspective. This review advocates for using a client-centred approach throughout the entire delivery process. Implications for rehabilitation The process of the older adult becoming a user of AT involves an individualized time factor, and this supports the practice of individualized follow-up. The process of becoming a user of AT is closely related to self-image; healthcare professionals should support not only the use of AT but also the older adult's emotional adjustment to a new self-image. The process is highly influenced by the older

A review of the neurobiological basis of dyslexia in the adult population.

Science.gov (United States)

Soriano-Ferrer, M; Piedra Martínez, E

Adult dyslexia affects about 4% of the population. However, studies on the neurobiological basis of dyslexia in adulthood are scarce compared to paediatric studies. This review investigates the neurobiological basis of dyslexia in adulthood. Using PsycINFO, a database of psychology abstracts, we identified 11 studies on genetics, 9 neurostructural studies, 13 neurofunctional studies and 24 neurophysiological studies. Results from the review show that dyslexia is highly heritable and displays polygenic transmission. Likewise, adult neuroimaging studies found structural, functional, and physiological changes in the parieto-occipital and occipito-temporal regions, and in the inferior frontal gyrus, in adults with dyslexia. According to different studies, aetiology in cases of adult dyslexia is complex. We stress the need for neurobiological studies of dyslexia in languages with transparent spelling systems. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative evidence-synthesis.

Science.gov (United States)

Jordan, Joanne; Rose, Louise; Dainty, Katie N; Noyes, Jane; Blackwood, Bronagh

2016-10-04

Prolonged mechanical ventilation is associated with a longer intensive care unit (ICU) length of stay and higher mortality. Consequently, methods to improve ventilator weaning processes have been sought. Two recent Cochrane systematic reviews in ICU adult and paediatric populations concluded that protocols can be effective in reducing the duration of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions. 1. To locate, appraise and synthesize qualitative evidence concerning the barriers and facilitators of the use of protocols for weaning critically-ill adults and children from mechanical ventilation;2. To integrate this synthesis with two Cochrane effectiveness reviews of protocolized weaning to help explain observed heterogeneity by identifying contextual factors that impact on the use of protocols for weaning critically-ill adults and children from mechanical ventilation;3. To use the integrated body of evidence to suggest the circumstances in which weaning protocols are most likely to be used. We used a range of search terms identified with the help of the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) mnemonic. Where available, we used appropriate methodological filters for specific databases. We searched the following databases: Ovid MEDLINE, Embase, OVID, PsycINFO, CINAHL Plus, EBSCOHost, Web of Science Core Collection, ASSIA, IBSS, Sociological Abstracts, ProQuest and LILACS on the 26th February 2015. In addition, we searched: the grey literature; the websites of professional associations for relevant publications; and the reference lists of all publications reviewed. We also contacted authors of

Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews.

Directory of Open Access Journals (Sweden)

Ania Zubala

Full Text Available While there is strong evidence that regular participation in physical activity (PA brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old.Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes.Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended. We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended.The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive

Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews.

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Zubala, Ania; MacGillivray, Stephen; Frost, Helen; Kroll, Thilo; Skelton, Dawn A; Gavine, Anna; Gray, Nicola M; Toma, Madalina; Morris, Jacqui

2017-01-01

While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old. Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes. Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended). The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies

A Critical Review of Recent Literature on Populism

Directory of Open Access Journals (Sweden)

John Abromeit

2017-12-01

Full Text Available This is a review article of the following five recent studies on populism: 1 Ruth Wodak’s The Politics of Fear: What Right-Wing Populist Discourses Mean (Sage, 2015; 2 Benjamin Moffitt’s The Global Rise of Populism: Performance, Political Style and Representation (Stanford University Press, 2016; 3 Cas Mudde and Cristóbal Rovira Kaltwasser’s Populism: A Very Short Introduction (Oxford University Press, 2017; 4 Jan-Werner Müller’s What is Populism? (University of Pennsylvania Press, 2016; and 5 John B. Judis’ The Populist Explosion: How the Great Recession Transformed American and European Politics (Columbia Global Reports, 2016. The review argues for a return to early Frankfurt School Critical Theory to address some of the shortcomings of these studies.

A Critical Review of Low Back Pain Guidelines.

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Chetty, Laran

2017-09-01

Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.

Bridging the Gap between Human Resource Development and Adult Education: Part Two, the Critical Turn

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Hatcher, Tim; Bowles, Tuere

2014-01-01

Human resource development (HRD) as a scholarly endeavor and as a practice is often criticized in the adult education (AE) literature and by AE scholars as manipulative and oppressive and, through training and other interventions, controlling workers for strictly economic ends (Baptiste, 2001; Cunningham, 2004; Schied, 2001; Welton, 1995). The…

Exercise improves depressive symptoms in older adults: An umbrella review of systematic reviews and meta-analyses.

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Catalan-Matamoros, Daniel; Gomez-Conesa, Antonia; Stubbs, Brendon; Vancampfort, Davy

2016-10-30

Late-life depression is a growing public health concern. Exercise may be of added value but the literature remains equivocal. We conducted a systematic overview of meta-analyses and an exploratory pooled analysis of previous meta-analyses to determine the effect of exercise on depression in older adults. Two independent researchers searched Pubmed, CINAHL, Cochrane Plus, PsycArticles, and PsycInfo for meta-analyses on exercise in late-life depression. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. We pooled effect sizes from previous meta-analyses of randomized controlled trials to determine the effect of exercise on depression in older adults. The systematic review yielded 3 meta-analyses. In total, 16 unique cohorts of 1487 participants were included. The quality of the three included meta-analyses was considered as "moderate" according to AMSTAR scores. No serious adverse events were reported. Compared to controls (n=583), those exercising (n=541) significantly reduced depressive symptoms. Our umbrella review indicates that exercise is safe and efficacious in reducing depressive symptoms in older people. Since exercise has many other known health benefits, it should be considered as a core intervention in the multidisciplinary treatment of older adults experiencing depression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Social media use of older adults: a mini-review.

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Leist, Anja K

2013-01-01

Maintaining social relationships has been defined as a core element of aging well. With a considerable amount of older adults living alone, social media provides the possibility to engage in meaningful social contact, e.g. by joining online social networks and online discussion forums. The review encompasses current knowledge of prerequisites in social media use of older adults such as functional capacity, information and communications technology-related knowledge, and favorable attitudes towards social media. Then, the potential of social media use for clinical practice and possible negative consequences are outlined. Literature on social media use from a gerontological perspective was reviewed in July and August 2012. Online communities are suitable for providing and receiving social support when confronted with a difficult life situation, regardless of geographical location or time. From a practitioner's perspective, social media can be used to advance health-related knowledge such as information on prevention, diagnosis, and treatment of specific conditions and disorders. Further positive consequences have been shown to be overcoming loneliness, relieving stress, and raising feelings of control and self-efficacy. Possible negative consequences could be misuse of personal data as well as the distribution and uncritical adoption of potentially harmful information via online communities. The potential of social media in clinical practice is reflected in a wide range of intervention possibilities for older adults. However, with the rise of social media, new threats emerge for older adults as well. Copyright © 2013 S. Karger AG, Basel.

Initial qualifications of adult educators – a comparative view

DEFF Research Database (Denmark)

Milana, Marcella; Larson, Anne; Søgaard Lund, Lise

General adult education, vocationally oriented adult education and liberal education often represent separated fields of public intervention. Each of these sectors is characterized by organizational features and a financial structure that support the pursuing of specific educational goals....... These distinctions are reflected not only in the provision of adult education opportunities but also in public policies on adult learning. Consequently, initial education and training of adult educators as well as the policy on qualification of adult education professionals differs both between countries and between......, the paper will critically review current public policies in the field and problematise the role of existing education and training opportunities in providing those willing to teach adults in general adult education, vocationally oriented adult education or liberal education with the qualifications required...

Fear of Falling in Older Adults: Comprehensive Review

Directory of Open Access Journals (Sweden)

Dukyoo Jung, PhD, RN

2008-12-01

Full Text Available Fear of falling has been reported in a high percentage of community-dwelling elderly who both do and don't have a history of falling. The aims of this review are to: (a elucidate the definition of fear of falling; (b clarify measurements of fear of falling based on its definition; and (c describe the risk factors for fear of falling. Despite the importance of the percentage and the consequences of fear of falling, its definition is still vague and warrants clarification. Based on a literature review, major fear of falling measurements involve the evaluation of fear of falling and use of a fall efficacy scale. Using a correct definition of fear of falling, nurses working close with older adults need to identify the different definitions of fear of falling and fall efficacy scale. In addition, nurses who work closely with older adults should encourage them to increase or maintain modifiable factors by maximizing their basic health status and enhancing their physical activity to decrease fear of falling.

Management of sleep bruxism in adults: a qualitative systematic literature review

NARCIS (Netherlands)

Manfredini, D.; Ahlberg, J.; Winocur, E.; Lobbezoo, F.

2015-01-01

This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509-23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio-video (AV) recordings, or with

Smoking Initiation Among Young Adults in the United States and Canada, 1998-2010: A Systematic Review

OpenAIRE

Freedman, Kit S.; Nelson, Nanette M.; Feldman, Laura L.

2011-01-01

Introduction Young adults have the highest smoking rate of any age group in the United States and Canada, and recent data indicate that they often initiate smoking as young adults. The objective of this study was to systematically review peer-reviewed articles on cigarette smoking initiation and effective prevention efforts among young adults. Methods We searched 5 databases for research articles published in English between 1998 and 2010 on smoking initiation among young adults (aged 18-25) ...

A narrative review on cervical interventions in adults with chronic whiplash-associated disorder

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Yeung, Euson; Tong, Tiffany; Reed, Nick

2018-01-01

Introduction Whiplash injuries are common in society, but clinical interventions are inconclusive on the most effective treatment. Research and reviews have been completed with the goal of determining clinical interventions that are effective for whiplash injuries and disorders, but literature has not recently been summarised on best practices for cervical spine interventions for adults with chronic whiplash. Purpose The objective of this narrative review is to update and expand on previous works, to provide recommendations for clinical interventions and future research in the area of cervical spine rehabilitation for adults with chronic whiplash-associated disorder. Method The Arskey and O’Malley methodology was used for this narrative review. CINHAL, EMBASE, Medline, PsychInfo, Scopus, Web of Science, as well as grey literature, were searched from 2003 to April 2017. Two reviewers screened titles and abstracts for relevance to the review, and content analysis summarised the study findings. A total of 14 citations were included in the final review. Findings Exercise-based interventions targeted at the cervical spine appear most beneficial for adults with chronic whiplash-associated disorder (WAD). Invasive interventions still require more rigorous studies to deem their effectiveness for this population. Conclusion Further research is required to investigate and determine clinically relevant results for cervical spine intervention in patients with chronic WAD. PMID:29719724

Learning from critical case reviews: emergent themes and their impact on practice.

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Crofts, Linda

2006-12-01

This paper describes the process of conducting critical case reviews as part of a leadership programme for critical care. Forty-five cases were reviewed over 2 years in five different hospitals and permission was sought from local research ethics committees and research and development committees for the discussions to be treated as research data. Typically the cases presented were patients with complex needs whose trajectory of care had not gone smoothly. Key themes to emerge from the case reviews were: The case reviews themselves were: Communication failures between professional groups, between professional themselves, between staff and families, between wards and departments and between different hospitals. Documentation was also often less than satisfactory. Teams often had problems in working together as a team and different professionals often had different expectations of other members of the team. Individual action may compensate for weaknesses in formal clinical risk system. The case reviews themselves were showcases of the difficulties the health service faces every day and the challenges of communicating effectively. The case reviews provided an effective medium to both resolve those difficulties and model a means through which teams could effectively manage and communicate patient care issues. Furthermore their strength as a learning tool was attributed to team learning as a powerful catalyst for change.

Psychosocial Interventions for Women with HIV/AIDS: A Critical Review

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Hernandez, Julieta P.; Macgowan, Mark J.

2015-01-01

Objective: Recent research on psychosocial interventions addressing the well-being of women with HIV/AIDS has brought new options for practitioners. This study critically reviews the treatment features, methodological quality, and efficacy of these interventions. Methods: A comprehensive search between 2000 and 2011 identified 19 studies employing…

Household Air Pollution and Acute Lower Respiratory Infections in Adults: A Systematic Review.

Directory of Open Access Journals (Sweden)

Hannah Jary

Full Text Available Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities.Ten bibliographic databases were searched to identify studies of household air pollution and adult acute lower respiratory infection. Data were extracted from eligible studies using standardised forms.From 4617 titles, 513 abstracts and 72 full-text articles were reviewed. Eight studies met the inclusion criteria of which 2 found a significant adjusted increased risk of acute lower respiratory infection, 2 identified a univariate association whilst 4 found no significant association. Study quality was generally limited. Heterogeneity in methods and findings precluded meta-analysis.A systematic review of the literature found limited evidence for an association between household air pollution and risk of acute lower respiratory infection in adults. Additional research, with carefully defined exposure and outcome measures, is required to complete the risk profile caused by household air pollution in adults.CRD42015028042.

Household Air Pollution and Acute Lower Respiratory Infections in Adults: A Systematic Review.

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Jary, Hannah; Simpson, Hope; Havens, Deborah; Manda, Geoffrey; Pope, Daniel; Bruce, Nigel; Mortimer, Kevin

2016-01-01

Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities. Ten bibliographic databases were searched to identify studies of household air pollution and adult acute lower respiratory infection. Data were extracted from eligible studies using standardised forms. From 4617 titles, 513 abstracts and 72 full-text articles were reviewed. Eight studies met the inclusion criteria of which 2 found a significant adjusted increased risk of acute lower respiratory infection, 2 identified a univariate association whilst 4 found no significant association. Study quality was generally limited. Heterogeneity in methods and findings precluded meta-analysis. A systematic review of the literature found limited evidence for an association between household air pollution and risk of acute lower respiratory infection in adults. Additional research, with carefully defined exposure and outcome measures, is required to complete the risk profile caused by household air pollution in adults. CRD42015028042.

Bruxism and prosthetic treatment: a critical review.

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Johansson, Anders; Omar, Ridwaan; Carlsson, Gunnar E

2011-07-01

Based on the findings from available research on bruxism and prosthetic treatment published in the dental literature, an attempt was made to draw conclusions about the existence of a possible relationship between the two, and its clinical relevance. MEDLINE/PubMed searches were conducted using the terms 'bruxism' and 'prosthetic treatment', as well as combinations of these and related terms. The few studies judged to be relevant were critically reviewed, in addition to papers found during an additional manual search of reference lists within selected articles. Bruxism is a common parafunctional habit, occurring both during sleep and wakefulness. Usually it causes few serious effects, but can do so in some patients. The etiology is multifactorial. There is no known treatment to stop bruxism, including prosthetic treatment. The role of bruxism in the process of tooth wear is unclear, but it is not considered a major cause. As informed by the present critical review, the relationship between bruxism and prosthetic treatment is one that relates mainly to the effect of the former on the latter. Bruxism may be included among the risk factors, and is associated with increased mechanical and/or technical complications in prosthodontic rehabilitation, although it seems not to affect implant survival. When prosthetic intervention is indicated in a patient with bruxism, efforts should be made to reduce the effects of likely heavy occlusal loading on all the components that contribute to prosthetic structural integrity. Failure to do so may indicate earlier failure than is the norm. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

The impact of transitional care programs on health services utilization in community-dwelling older adults: a systematic review.

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Weeks, Lori E; Macdonald, Marilyn; Martin-Misener, Ruth; Helwig, Melissa; Bishop, Andrea; Iduye, Damilola F; Moody, Elaine

2018-02-01

The objective was to identify and synthesize the best available evidence on the impact of transitional care programs on various forms of health services utilization in community-dwelling older adults. There is growing evidence that transitional care programs can help address important challenges facing health care systems and our increasing older adult population in many countries by reducing unnecessary health service utilization. There is a need for a systematic review of the research evaluating the impact of transitional care programs on hospital and other health service usage. The review included studies on community-dwelling adults age 60 and over with at least one medical diagnosis, and which evaluated the outcomes of transitional care programs on health system utilization of older adults. The outcomes for this review were hospital usage including admissions and readmissions, emergency department usage, primary care/physician usage, nursing home usage, and home health care usage. The review considered experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, and case-control studies. A three-step search was utilized to find published and unpublished studies conducted in any country but reported in English. Six electronic databases were searched from inception of the database to May, 2016. A search for unpublished studies was also conducted. Methodological quality was assessed independently by two reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Quantitative data were extracted from included studies independently by the two reviewers using the standardized Joanna Briggs Institute data extraction tools. Due to the methodological heterogeneity of the included studies, a comprehensive meta-analysis for all outcomes was not possible

Glucose monitoring as a guide to diabetes management. Critical subject review.

OpenAIRE

Koch, B.

1996-01-01

PURPOSE: To encourage a balanced approach to blood glucose monitoring in diabetes by a critical review of the history, power and cost of glucose testing. DATA SOURCES: The Cambridge Data Base was searched and was supplemented by a random review of other relevant sources, including textbooks, company pamphlets, and laboratory manuals. STUDY SELECTION: Keywords used were "glucosuria diagnosis," "blood glucose self-monitoring," "glycosylated hemoglobin," and "fructosamine" for the 10-year period...

Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis.

Science.gov (United States)

Walklet, Elaine; Muse, Kate; Meyrick, Jane; Moss, Tim

2016-08-30

Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.

Management of language discordance in clinical nursing practice--A critical review.

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Probst, Sebastian; Imhof, Lorenz

2016-05-01

Language plays an essential role in the provision of nursing care, since successful communication is a vital prerequisite to being able to provide appropriate nursing care efficiently and effectively. It is not known what kinds of interventions are effective in overcoming language discordance in nursing practice. This critical review aimed to examine the interventions that are most successfully used to overcome language discordance in nursing. A critical review of the literature was performed and 24 relevant research papers were included. A search was carried out between January 2004 and September 2014 in MEDLINE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychinfo, Germanistic online, Pragmatis and Linguistic & Language Behaviour Abstracts (LLBA). Both authors independently screened the titles (n=299), abstracts and full texts to decide which articles should be chosen. The inclusion criteria were: (1) articles examine the problem of language discordance in various health care settings and (2) articles published in English, German, French or Italian. Articles were included irrespective of their design. Data were analysed using the Critical Appraisal Skills Program Tool (CASP). In total, 24 publications met the inclusion criteria. Most of the studies (n=20) were focused on the nursing intervention of using an interpreter and three were describing the nursing assessment. The study designs of the included studies were mainly non-experimental studies, qualitative studies or reviews. The only suggested intervention described in the articles is the use of ad-hoc or professional interpreters for communicating with patients who do not speak the local language. Health care institutions should provide more strategies for clinical practice to overcome language discordance. Copyright © 2015 Elsevier Inc. All rights reserved.

Adults surviving lung cancer two or more years: A systematic review.

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Rhea, Deborah J; Lockwood, Suzy

Lung cancer has had a low survival rate throughout the years. Some studies have shown that psychological variables such as hardiness and resiliency may play a role in the meaningfulness of survival among lung cancer patients. The objective of this systematic review was to synthesize the best available evidence on the experiences of surviving lung cancer (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) in adults over the age of 18, two or more years after diagnosis. The review considered adults (18 years and older) who have survived lung cancer two or more years post diagnosis.The review included studies that examined the experiences (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) of surviving lung cancer two or more years post diagnosis.The review considered patients' experiences of surviving lung cancer post two years diagnosis, including the examination of specific psychological/affective well-being aspects such as resiliency, optimism, quality of life and coping strategies.The review included quantitative descriptive studies and qualitative studies. A search for published and unpublished studies in English language from January 1999 through December 2010 was undertaken in multiple databases including MEDLINE, CINAHL, ProQuest and Psyc INFO. Assessment of methodological quality of studies was undertaken using critical appraisal tools from the Joanna Briggs Institute. Data was extracted using the Joanna Briggs Institute Data Extraction forms. Results were presented in a narrative format as the synthesis of qualitative or quantitative data was not appropriate. 13 studies were included in the review: one mixed methods study (including a qualitative research component) and 12 quantitative studies.The qualitative component of the included mixed methods study identified five findings related to the meaningfulness

Blood parasites of penguins: a critical review.

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Vanstreels, Ralph Eric Thijl; Braga, Érika Martins; Catão-Dias, José Luiz

2016-07-01

Blood parasites are considered some of the most significant pathogens for the conservation of penguins, due to the considerable morbidity and mortality they have been shown to produce in captive and wild populations of these birds. Parasites known to occur in the blood of penguins include haemosporidian protozoans (Plasmodium, Leucocytozoon, Haemoproteus), piroplamid protozoans (Babesia), kinetoplastid protozoans (Trypanosoma), spirochete bacteria (Borrelia) and nematode microfilariae. This review provides a critical and comprehensive assessment of the current knowledge on these parasites, providing an overview of their biology, host and geographic distribution, epidemiology, pathology and implications for public health and conservation.

Music Appreciation after Cochlear Implantation in Adult Patients: A Systematic Review.

Science.gov (United States)

Riley, Phoebe E; Ruhl, Douglas S; Camacho, Macario; Tolisano, Anthony M

2018-06-01

Objective The cochlear implant (CI) improves quality of life for people who are severely and profoundly deafened, allowing implantees to perceive speech at levels similar to those of individuals with normal hearing. However, patients with CIs generally report a reduced appreciation of music after implantation. We aimed to systematically review the English-language literature for studies evaluating music enjoyment and perception among adult patients with CIs. Data Sources A systematic review of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library. Review Methods The PRISMA statement was utilized to identify English-language studies reporting music appreciation among adults with CIs. Two independent reviewers performed searches through May 2017. Included studies investigated parameters related to music enjoyment and music perception, including (1) pitch and timbre perception, (2) noise-canceling algorithms, and (3) the presence of dissonant chords, lyrics, or visual cues. Results A total of 508 articles were screened for relevance. Forty-one full-text articles were evaluated, and 18 met final inclusion criteria. Studies used heterogeneous methods of outcome measurement for identifying music appreciation. The outcome measures suggest that rhythm and lyrics are important components of enjoyment. Patients with CIs had difficulty with pitch and timbre perception. Conclusion The heterogeneous outcome measures identified in this systematic review suggest that rhythm and lyrics are important components of enjoyment, while patients with CIs had difficulty with pitch and timbre perception. Because there is no standardized reporting metric for music appreciation among adult patients with CIs, a standardized validated outcome-measuring tool is warranted.

Radiopharmaceuticals drug interactions: a critical review

International Nuclear Information System (INIS)

Santos-Oliveira, Ralph; Smith, Sheila W.; Carneiro-Leao, Ana Maria A.

2008-01-01

Radiopharmaceuticals play a critical role in modern medicine primarily for diagnostic purposes, but also for monitoring disease progression and response to treatment. As the use of image has been increased, so has the use of prescription medications. These trends increase the risk of interactions between medications and radiopharmaceuticals. These interactions which have an impact on image by competing with the radiopharmaceutical for binding sites for example can lead to false negative results. Drugs that accelerate the metabolism of the radiopharmaceutical can have a positive impact (i.e. speeding its clearance) or, if repeating image is needed, a negative impact. In some cases, for example in cardiac image among patients taking doxirubacin, these interactions may have a therapeutic benefit. The incidence of drug-radiopharmaceuticals adverse reactions is unknown, since they may not be reported or even recognized. Here, we compiled the medical literature, using the criteria of a systematic review established by the Cochrane Collaboration, on pharmaceutical-drug interactions to provide a summary of documented interactions by organ system and radiopharmaceuticals. The purpose is to provide a reference on drug interactions that could inform the nuclear medicine staff in their daily routine. Efforts to increase adverse event reporting, and ideally consolidate reports worldwide, can provide a critically needed resource for prevention of drug-radiopharmaceuticals interactions. (author)

Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews.

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Halter, Mary; Pelone, Ferruccio; Boiko, Olga; Beighton, Carole; Harris, Ruth; Gale, Julia; Gourlay, Stephen; Drennan, Vari

2017-01-01

Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

A systematic review on critical thinking in medical education.

Science.gov (United States)

Chan, Zenobia C Y

2016-04-18

Critical thinking is the ability to raise discriminating questions in an attempt to search for better ideas, a deeper understanding and better solutions relating to a given issue. This systematic review provides a summary of efforts that have been made to enhance and assess critical thinking in medical education. Nine databases [Ovid MEDLINE(R), AMED, Academic Search Premier, ERIC, CINAHL, Web of Science, JSTOR, SCOPUS and PsycINFO] were searched to identify journal articles published from the start of each database to October 2012. A total of 41 articles published from 1981 to 2012 were categorised into two main themes: (i) evaluation of current education on critical thinking and (ii) development of new strategies about critical thinking. Under each theme, the teaching strategies, assessment tools, uses of multimedia and stakeholders were analysed. While a majority of studies developed teaching strategies and multimedia tools, a further examination of their quality and variety could yield some insights. The articles on assessment placed a greater focus on learning outcomes than on learning processes. It is expected that more research will be conducted on teacher development and students' voices.

Understanding Monitoring Technologies for Adults With Pain: Systematic Literature Review.

Science.gov (United States)

Rodríguez, Iyubanit; Herskovic, Valeria; Gerea, Carmen; Fuentes, Carolina; Rossel, Pedro O; Marques, Maíra; Campos, Mauricio

2017-10-27

Monitoring of patients may decrease treatment costs and improve quality of care. Pain is the most common health problem that people seek help for in hospitals. Therefore, monitoring patients with pain may have significant impact in improving treatment. Several studies have studied factors affecting pain; however, no previous study has reviewed the contextual information that a monitoring system may capture to characterize a patient's situation. The objective of this study was to conduct a systematic review to (1) determine what types of technologies have been used to monitor adults with pain, and (2) construct a model of the context information that may be used to implement apps and devices aimed at monitoring adults with pain. A literature search (2005-2015) was conducted in electronic databases pertaining to medical and computer science literature (PubMed, Science Direct, ACM Digital Library, and IEEE Xplore) using a defined search string. Article selection was done through a process of removing duplicates, analyzing title and abstract, and then reviewing the full text of the article. In the final analysis, 87 articles were included and 53 of them (61%) used technologies to collect contextual information. A total of 49 types of context information were found and a five-dimension (activity, identity, wellness, environment, physiological) model of context information to monitor adults with pain was proposed, expanding on a previous model. Most technological interfaces for pain monitoring were wearable, possibly because they can be used in more realistic contexts. Few studies focused on older adults, creating a relevant avenue of research on how to create devices for users that may have impaired cognitive skills or low digital literacy. The design of monitoring devices and interfaces for adults with pain must deal with the challenge of selecting relevant contextual information to understand the user's situation, and not overburdening or inconveniencing users with

Theory based interventions for caries related sugar intake in adults: systematic review.

Science.gov (United States)

Al Rawahi, Said Hartih; Asimakopoulou, Koula; Newton, Jonathon Timothy

2017-07-25

Theories of behavior change are essential in the design of effective behaviour change strategies. No studies have assessed the effectiveness of interventions based on psychological theories to reduce sugar intake related to dental caries. The study assessed the effect of interventions based on Social Congition Models (SCMs) on sugar intake in adults, when compared with educational interventions or no intervention. A range of papers were considered: Systematic review Systematic Reviews with or without Meta Analyses; Randomised Controlled Trials; Controlled Clinical Trials and Before and after studies, of interventions based on Social Cognition Models aimed at dietary intake of sugar in adults. The Cochrane database including: Oral Health Group's Trials Register (2015), MEDLINE (from 1966 to September 2015), EMBASE (from 1980 to September 2015), PsycINFO (from 1966 to September 2015) were searched. No article met the full eligibility criteria for the current systematic review so no articles were included. There is a need for more clinical trials to assess the effectiveness of interventions based on psychological theory in reducing dietary sugar intake among adults. PROSPERO: CRD42015026357 .

Critical illness among adults with cystic fibrosis in Texas, 2004-2013: Patterns of ICU utilization, characteristics, and outcomes.

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Lavi Oud

Full Text Available Available reports on critically ill adults with cystic fibrosis (CF suggest improving short-term outcomes. However, there is marked heterogeneity in reported findings, with studies mostly based on single-centered data, limiting generalizability. We sought to examine population-level patterns of demand for critical care resources, and the characteristics, resource utilization, and outcomes of ICU-managed adults with CF.We used the Texas Inpatient Public Use Data File to identify ICU admissions with CF aged ≥18 years in Texas between 2004-2013. We examined ICU utilization at population level (using CF Foundation annual reports and, among ICU admissions, socio-demographic characteristics, burden of comorbidities, organ failure, life-support utilization and hospital disposition. Linear regression and multilevel logistic regression were used to examine temporal trends and predictors of short-term mortality (hospital death and discharge to hospice, respectively.Of 9,579 hospitalizations of adults with CF, 1,249 (13% were admitted to ICU. The incidence of ICU admission among adults with CF in Texas increased between 2004-2005 and 2012-2013 from 16.7 to 19.2 per 100 person-years (p = 0.0181, with ICU admissions aged ≥30 years accounting for 80.3% of the change. Among ICU admissions the following changes were noted between 2004-2005 and 2012-2013: any organ failure 30.2% vs. 56.3% (p = 0.0004, mechanical ventilation 11.5% vs. 19.2% (p = 0.0216, and hemodialysis 1.0% vs. 8.1% (p = 0.0007. Short-term mortality for the whole cohort and for those with mechanical ventilation was 11.4% and 41.8%, respectively, with corresponding home discharge among survivors 84% and 62.1%, respectively. Key predictors (adjusted odds ratios [aOR (95% CI] of short-term mortality included age ≥45 years (2.051 [1.231-3.415], female gender (1.907 [1.237-2.941], and mechanical ventilation (7.982 [5.001-12.739].Adults with CF had high and rising population-level burden of

Critical illness among adults with cystic fibrosis in Texas, 2004-2013: Patterns of ICU utilization, characteristics, and outcomes.

Science.gov (United States)

Oud, Lavi

2017-01-01

Available reports on critically ill adults with cystic fibrosis (CF) suggest improving short-term outcomes. However, there is marked heterogeneity in reported findings, with studies mostly based on single-centered data, limiting generalizability. We sought to examine population-level patterns of demand for critical care resources, and the characteristics, resource utilization, and outcomes of ICU-managed adults with CF. We used the Texas Inpatient Public Use Data File to identify ICU admissions with CF aged ≥18 years in Texas between 2004-2013. We examined ICU utilization at population level (using CF Foundation annual reports) and, among ICU admissions, socio-demographic characteristics, burden of comorbidities, organ failure, life-support utilization and hospital disposition. Linear regression and multilevel logistic regression were used to examine temporal trends and predictors of short-term mortality (hospital death and discharge to hospice), respectively. Of 9,579 hospitalizations of adults with CF, 1,249 (13%) were admitted to ICU. The incidence of ICU admission among adults with CF in Texas increased between 2004-2005 and 2012-2013 from 16.7 to 19.2 per 100 person-years (p = 0.0181), with ICU admissions aged ≥30 years accounting for 80.3% of the change. Among ICU admissions the following changes were noted between 2004-2005 and 2012-2013: any organ failure 30.2% vs. 56.3% (p = 0.0004), mechanical ventilation 11.5% vs. 19.2% (p = 0.0216), and hemodialysis 1.0% vs. 8.1% (p = 0.0007). Short-term mortality for the whole cohort and for those with mechanical ventilation was 11.4% and 41.8%, respectively, with corresponding home discharge among survivors 84% and 62.1%, respectively. Key predictors (adjusted odds ratios [aOR (95% CI)]) of short-term mortality included age ≥45 years (2.051 [1.231-3.415]), female gender (1.907 [1.237-2.941]), and mechanical ventilation (7.982 [5.001-12.739]). Adults with CF had high and rising population-level burden of critical

Reminiscence and adaptation to critical life events in older adults with mild to moderate depressive symptoms

NARCIS (Netherlands)

Korte, J.; Bohlmeijer, Ernst Thomas; Westerhof, Gerben Johan; Pot, Anne Margriet

2011-01-01

Objectives: The role of reminiscence as a way of adapting to critical life events and chronic medical conditions was investigated in older adults with mild to moderate depressive symptoms. Reminiscence is the (non)volitional act or process of recollecting memories of one's self in the past. Method:

A Review of Critical Conditions for the Onset of Nonlinear Fluid Flow in Rock Fractures

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Liyuan Yu

2017-01-01

Full Text Available Selecting appropriate governing equations for fluid flow in fractured rock masses is of special importance for estimating the permeability of rock fracture networks. When the flow velocity is small, the flow is in the linear regime and obeys the cubic law, whereas when the flow velocity is large, the flow is in the nonlinear regime and should be simulated by solving the complex Navier-Stokes equations. The critical conditions such as critical Reynolds number and critical hydraulic gradient are commonly defined in the previous works to quantify the onset of nonlinear fluid flow. This study reviews the simplifications of governing equations from the Navier-Stokes equations, Stokes equation, and Reynold equation to the cubic law and reviews the evolutions of critical Reynolds number and critical hydraulic gradient for fluid flow in rock fractures and fracture networks, considering the influences of shear displacement, normal stress and/or confining pressure, fracture surface roughness, aperture, and number of intersections. This review provides a reference for the engineers and hydrogeologists especially the beginners to thoroughly understand the nonlinear flow regimes/mechanisms within complex fractured rock masses.

Not the Sum of Its Parts: A Critical Review of the MacDonald Triad.

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Parfitt, Charlotte Hannah; Alleyne, Emma

2018-01-01

The MacDonald triad posits that animal cruelty, fire setting, and bed wetting in childhood is indicative of later aggressive and violent behavior in adults. Researchers refer to this phenomenon as a precursor to later antisocial behaviors including serial and sexual murder; while practitioners cite the triad in clinical formulations and risk assessments. However, there is yet to be a critical review and consolidation of the literature that establishes whether there is empirical support. This article explores the validity of the triad. We conducted a narrative review of the relevant studies examining the MacDonald triad and its individual constituents. There is evidence that any one of the triad behaviors could predict future violent offending, but it is very rare to find all three behaviors together as predictors. Thus, the empirical research on the MacDonald triad does not fully substantiate its premise. Rather, it would appear that the triad, or its individual constituents, is better used as an indicator of dysfunctional home environments, or poor coping skills in children. Future research is needed with robust and rigorous methodologies (e.g., adequate control groups, longitudinal designs) to fully establish the MacDonald triad's validity. Finally, further consideration is needed as to whether the triad behaviors are more indicative of other problematic outcomes (e.g., maladaptive coping to life stressors).

A missing ethical competency? A review of critical reflection in health promotion.

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Tretheway, Rebecca; Taylor, Jane; O'Hara, Lily; Percival, Nikki

2015-12-01

There is increasing emphasis in the health promotion literature on the ethical imperative for the profession to move towards critical practice. A key challenge for health promotion is that critical practice appears both under-developed and under-practiced. This is evident in the omission of critical reflection from Australian and international competencies for health promotion practitioners. A narrative literature review was undertaken to explore the current use of critical reflection in health promotion. Critical reflection models relevant to health promotion were identified and critiqued. There was a dearth of literature on critical reflection within health promotion, despite recognition of its potential to support critical practice. The discipline of critical social work provided literature on the use, effect and outcome of critical reflection in practice. The interdisciplinary critical reflection model was identified as the model most applicable to health promotion. Underpinned by critical theory, this model emphasises both critical and ethical practice. Critical reflection is a core competency for health promotion practitioners to address the ethical imperative to move towards critical practice. There is a need to explore the application of a critical reflection model in health promotion to determine how it may support critical and ethical practice. So what? If health promotion is to meet its ethical responsibilities, then critical reflection needs to be articulated as a core health promotion competency and a model for its application in health promotion developed.

Accuracy of subcutaneous continuous glucose monitoring in critically ill adults: improved sensor performance with enhanced calibrations.

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Leelarathna, Lalantha; English, Shane W; Thabit, Hood; Caldwell, Karen; Allen, Janet M; Kumareswaran, Kavita; Wilinska, Malgorzata E; Nodale, Marianna; Haidar, Ahmad; Evans, Mark L; Burnstein, Rowan; Hovorka, Roman

2014-02-01

Accurate real-time continuous glucose measurements may improve glucose control in the critical care unit. We evaluated the accuracy of the FreeStyle(®) Navigator(®) (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration. In a randomized trial, paired CGM and reference glucose (hourly arterial blood glucose [ABG]) were collected over a 48-h period from 24 adults with critical illness (mean±SD age, 60±14 years; mean±SD body mass index, 29.6±9.3 kg/m(2); mean±SD Acute Physiology and Chronic Health Evaluation score, 12±4 [range, 6-19]) and hyperglycemia. In 12 subjects, the CGM device was calibrated at variable intervals of 1-6 h using ABG. In the other 12 subjects, the sensor was calibrated according to the manufacturer's instructions (1, 2, 10, and 24 h) using arterial blood and the built-in point-of-care glucometer. In total, 1,060 CGM-ABG pairs were analyzed over the glucose range from 4.3 to 18.8 mmol/L. Using enhanced calibration median (interquartile range) every 169 (122-213) min, the absolute relative deviation was lower (7.0% [3.5, 13.0] vs. 12.8% [6.3, 21.8], P<0.001), and the percentage of points in the Clarke error grid Zone A was higher (87.8% vs. 70.2%). Accuracy of the Navigator CGM device during critical illness was comparable to that observed in non-critical care settings. Further significant improvements in accuracy may be obtained by frequent calibrations with ABG measurements.

Reproducing Gender Inequality: A Critical Discourse Analysis of a Turkish Adult Literacy Textbook. Research Brief #7

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Gungor, Ramazan; Prins, Esther

2011-01-01

Adult education curricula such as literacy textbooks present blueprints for living, including different ways of being and relating as men and women. However, educators and scholars seldom consider the underlying assumptions about gender in literacy workbooks, especially in international settings. This study used Critical Discourse Analysis (CDA)…

Adult Learning for Social Change in Museums: An Exploration of Sociocultural Learning Approaches to Community Engagement

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Kim, Junghwan; You, Jieun; Yeon Park, Soo

2016-01-01

This integrative literature review critically examined how scholars were articulating the work of museums to make a space for "adult learning for social change through community engagement". We applied sociocultural adult learning theories (situated learning and cultural-historical activity theory), to 25 theoretical and empirical…

Green Adsorbents for Wastewaters: A Critical Review

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George Z. Kyzas

2014-01-01

Full Text Available One of the most serious environmental problems is the existence of hazardous and toxic pollutants in industrial wastewaters. The major hindrance is the simultaneous existence of many/different types of pollutants as (i dyes; (ii heavy metals; (iii phenols; (iv pesticides and (v pharmaceuticals. Adsorption is considered to be one of the most promising techniques for wastewater treatment over the last decades. The economic crisis of the 2000s led researchers to turn their interest in adsorbent materials with lower cost. In this review article, a new term will be introduced, which is called “green adsorption”. Under this term, it is meant the low-cost materials originated from: (i agricultural sources and by-products (fruits, vegetables, foods; (ii agricultural residues and wastes; (iii low-cost sources from which most complex adsorbents will be produced (i.e., activated carbons after pyrolysis of agricultural sources. These “green adsorbents” are expected to be inferior (regarding their adsorption capacity to the super-adsorbents of previous literature (complex materials as modified chitosans, activated carbons, structurally-complex inorganic composite materials etc., but their cost-potential makes them competitive. This review is a critical approach to green adsorption, discussing many different (maybe in some occasions doubtful topics such as: (i adsorption capacity; (ii kinetic modeling (given the ultimate target to scale up the batch experimental data to fixed-bed column calculations for designing/optimizing commercial processes and (iii critical techno-economical data of green adsorption processes in order to scale-up experiments (from lab to industry with economic analysis and perspectives of the use of green adsorbents.

Green Adsorbents for Wastewaters: A Critical Review

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Kyzas, George Z.; Kostoglou, Margaritis

2014-01-01

One of the most serious environmental problems is the existence of hazardous and toxic pollutants in industrial wastewaters. The major hindrance is the simultaneous existence of many/different types of pollutants as (i) dyes; (ii) heavy metals; (iii) phenols; (iv) pesticides and (v) pharmaceuticals. Adsorption is considered to be one of the most promising techniques for wastewater treatment over the last decades. The economic crisis of the 2000s led researchers to turn their interest in adsorbent materials with lower cost. In this review article, a new term will be introduced, which is called “green adsorption”. Under this term, it is meant the low-cost materials originated from: (i) agricultural sources and by-products (fruits, vegetables, foods); (ii) agricultural residues and wastes; (iii) low-cost sources from which most complex adsorbents will be produced (i.e., activated carbons after pyrolysis of agricultural sources). These “green adsorbents” are expected to be inferior (regarding their adsorption capacity) to the super-adsorbents of previous literature (complex materials as modified chitosans, activated carbons, structurally-complex inorganic composite materials etc.), but their cost-potential makes them competitive. This review is a critical approach to green adsorption, discussing many different (maybe in some occasions doubtful) topics such as: (i) adsorption capacity; (ii) kinetic modeling (given the ultimate target to scale up the batch experimental data to fixed-bed column calculations for designing/optimizing commercial processes) and (iii) critical techno-economical data of green adsorption processes in order to scale-up experiments (from lab to industry) with economic analysis and perspectives of the use of green adsorbents. PMID:28788460

Activity and participation characteristics of adults with learning disabilities--a systematic review.

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Kineret Sharfi

Full Text Available BACKGROUND: 'Learning disabilities' (LD refer to a wide group of neurological disorders caused by deficits in the central nervous system which influence the individual's ability to maintain-, process or convey information to others in an efficient way. A worldwide discussion about the definitions of LD continues while a conceptual framework for studying the diverse life outcomes of adults with LD is still missing. OBJECTIVE: The aim was to review the literature on the activity and participation of adults with LD based on the International Classification of Functioning, Disability and Health (ICF concepts. METHODS: "PsychInfo", "Eric" and "PubMed" were searched for relevant literature according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA. After a three-stage process, 62 articles relevant for domains of activity and participation of adults with LD were included in the review. RESULTS: Thirty-two articles focused on the domain of major life areas of education, work and employment and twelve articles focused on the domain of learning and applying knowledge. Limitations in activity and participation of the population with LD in these domains are recognized and discussed. Eighteen additional articles demonstrated that adults with LD confront difficulties in various life domains (e.g., communication, interpersonal interactions, mobility, and domestic life, however literature concerning these domains is scarce. CONCLUSIONS: The ICF can be useful for further exploration of activity and participation characteristics of adults with LD in various life domains. Such exploration is required in order to gain a wider perspective of their functional characteristics and daily needs.

A Systematic Review of Research on Social Networks of Older Adults.

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Ayalon, Liat; Levkovich, Inbar

2018-01-29

There has been a substantial interest in life course/life span changes in older adults' social networks and in the relationship between social networks and health and wellbeing. The study embarked on a systematic review to examine the existing knowledgebase on social network in the field of gerontology. Our focus was on studies in which both ego (respondents) and his or her alters (network members) are queried about their social ties. We searched for studies published in English before September, 2017, relied on quantitative methods to obtain data from both ego (60 years of age and older) and alters and provided a quantitative account of the social network properties. We searched the following data sets: APA Psychnet, Pubmed, Sociological abstracts, and Ageline. This was followed by a snowball search of relevant articles using Google Scholar. Titles and abstracts were reviewed and selected articles were extracted independently by two reviewers. A total of 5,519 records were retrieved. Of these, 3,994 records remained after the removal of duplicates. Ten records reporting on five original samples were kept for the systematic review. One study described a social network of community dwelling older adults and the remaining studies described social networks of institutional older adults. The present study points to a lacuna in current understanding of social networks in the field of gerontology. It provides a useful review and possible tools for the design of future studies to address current shortcomings in the field. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of using Nintendo Wii™ exergames in older adults: a review of the literature.

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Chao, Ying-Yu; Scherer, Yvonne K; Montgomery, Carolyn A

2015-04-01

The purpose of this review is to summarize and synthesize the impact of using the Nintendo Wii™ exergames in older adults. A database search was conducted to identify relevant studies. The search was limited to empirical studies, with particular attention paid to the effects of Wii exergames intervention on cognition, physical function, and psychosocial outcomes in older adults. A total of 22 empirical studies met inclusion criteria and were included in this review. Positive effects included improving physical function, decreasing depression, and increasing cognition and quality of life in older adults. Improved socialization and motivation to exercise were also reported. Using Wii exergames does show promise as an intervention to improve physical function, cognition, and psychosocial outcomes in older adults. Evidence supports that Wii exergames is a safe and feasible tool to encourage older adults to engage in exercise. © The Author(s) 2014.

The effectiveness of concept mapping on development of critical thinking in nursing education: A systematic review and meta-analysis.

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Yue, Meng; Zhang, Meng; Zhang, Chunmei; Jin, Changde

2017-05-01

As an essential skill in daily clinical nursing practice, critical thinking ability has been an important objective in nursing education. Concept mapping enables nursing students connect new information to existing knowledge and integrates interdisciplinary knowledge. However, there is a lack of evidence related to critical thinking ability and concept mapping in nursing education. The purpose of this systematic review and meta-analysis was to assess the effect of concept mapping in developing critical thinking in nursing education. This systematic review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A search was conducted in PubMed, Web of science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health (CINAHL) and China National Knowledge Infrastructure (CNKI). Randomized controlled trials (RCT) comparing concept mapping and traditional teaching method were retrieved. Data were collected by two reviewers according to the data extraction tables. The methodological quality of included studies was assessed by other two reviewers. The results of meta-analysis were presented using mean difference (MD). Thirteen trials were summarized in the systematic review and eleven trials were included in the meta-analysis. The pooled effect size showed that, comparing with traditional methods, concept mapping could improve subjects' critical thinking ability measured by California Critical Thinking Disposition Inventory (CCTDI), California Critical Thinking Skill Test (CCTST) and Critical Thinking Scale (CTS). The subgroup analyses showed that concept mapping improved the score of all subscales. The result of this review indicated that concept mapping could affect the critical thinking affective dispositions and critical thinking cognitive skills. Further high quality research using uniform evaluation is required. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Evidence-Based Approach to Adult-Onset Idiopathic Nephrotic Syndrome.

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Canetta, Pietro A A; Radhakrishnan, Jai

2015-01-01

Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

Assistive technology for communication of older adults: a systematic review.

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Pedrozo Campos Antunes, Thaiany; Souza Bulle de Oliveira, Acary; Hudec, Robert; Brusque Crocetta, Tania; Ferreira de Lima Antão, Jennifer Yohanna; de Almeida Barbosa, Renata Thais; Guarnieri, Regiani; Massetti, Thais; Garner, David M; de Abreu, Luiz Carlos

2018-02-16

Describe the use of assistive technology to enhance communication opportunities for older adults. A systematic review was conducted in two databases, PubMed and Web of Science, by using two different searches in each. The search was limited to original articles, in English language, including people aged 60 years and older that used any type of assistive technology for communication. The articles found in the initial search were filtered by title, abstracts and the remaining articles were fully read. Eighteen studies were included in this review after the reading of full-texts. Most of the studies included apparently healthy participants with communication limitations due to aging related changes and the others included people with some pathology that prevent them from normal communication. Four categories of assistive technology were identified: assistive technology for people with speech problems; robot or videoconferencing systems; Information and Communication Technologies and, other types of assistive technology for communication, such as hearing aids and scrapbooks. Assistive technology for communication of older adults is not only used by people with disabilities that prevent them from usual communication. They are mostly for older adults without a pathological communication problem.

Computerized cognitive training with older adults: a systematic review.

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Alexandra M Kueider

Full Text Available A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer's disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.

Reviewing the Evidence on How Adult Students Learn: An Examination of Knowles' Model of Andragogy

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McGrath, Valerie

2009-01-01

While there may be similarities between adults and children in how they learn (such as language, interaction and communication), many writers argue that adult learners are different from child learners in a number of ways. This article aims to review how adults learn through examining one particular theory of adult learning. Two conflicting…

A critical review of the literature on early rehabilitation of patients with post-traumatic amnesia in acute care

DEFF Research Database (Denmark)

Langhorn, Leanne; Sorensen, Jens C; Pedersen, Preben U

2010-01-01

A critical review of the literature on early rehabilitation of patients with post-traumatic amnesia in acute care......A critical review of the literature on early rehabilitation of patients with post-traumatic amnesia in acute care...

[Prediabetes as a riskmarker for stress-induced hyperglycemia in critically ill adults].

Science.gov (United States)

García-Gallegos, Diego Jesús; Luis-López, Eliseo

2017-01-01

It is not known if patients with prediabetes, a subgroup of non-diabetic patients that usually present hyperinsulinemia, have higher risk to present stress-induced hyperglycemia. The objective was to determine if prediabetes is a risk marker to present stress-induced hyperglycemia. Analytic, observational, prospective cohort study of non-diabetic critically ill patients of a third level hospital. We determined plasmatic glucose and glycated hemoglobin (HbA1c) at admission to diagnose stress-induced hyperglycemia (glucose ≥ 140 mg/dL) and prediabetes (HbA1c between 5.7 and 6.4%), respectively. We examined the proportion of non-prediabetic and prediabetic patients that developed stress hyperglycemia with contingence tables and Fisher's exact test for nominal scales. Of 73 patients studied, we found a proportion of stress-induced hyperglycemia in 6.6% in those without prediabetes and 61.1% in those with prediabetes. The Fisher's exact test value was 22.46 (p Prediabetes is a risk marker for stress-induced hyperglycemia in critically ill adults.

Critical thinking dispositions of nursing students in Asian and non-Asian countries: a literature review.

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Salsali, Mahvash; Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad

2013-09-26

Critical thinking disposition represents an inclination of a person to use possessed skills in relation to critical thinking. The trend of critical thinking has been described as inner motivation to solve problems and make decisions by thinking. In nursing as a practical profession, the concept of critical thinking dispositions is important component in helping to manage complex health situations and to deal with patient issues effectively. Willingness to think critically is a prerequisite for safe and subtly performance. The results of studies show critical thinking dispositions of nursing students in Asian countries are different from non-Asian countries. Aim of this literature review was to compare critical thinking dispositions of nursing students in Asian and non-Asian countries. Literature review was done in English and Persian databases. The results showed of the 795 articles published in English and Persian language that studied critical thinking, 73 ones studied critical thinking skills and dispositions in nursing education, and relationship between teaching methods and critical thinking skills and dispositions in nursing education of different countries. Fifteen of seventy three articles assessed critical thinking dispositions in nursing students. Limited studies showed that the Asian nursing students had mostly undermining score of the critical thinking dispositions, while non-Asian countries tend to positive scores. The reasons for these differences could be due to issues such as environmental, educational methods and cultural differences. However, future studies should measure critical thinking disposition by discipline-based tools.

Critical Thinking Dispositions of Nursing Students in Asian and Non-Asian Countries: A Literature Review

Science.gov (United States)

Salsali, Mahvash; Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad

2013-01-01

Critical thinking disposition represents an inclination of a person to use possessed skills in relation to critical thinking. The trend of critical thinking has been described as inner motivation to solve problems and make decisions by thinking. In nursing as a practical profession, the concept of critical thinking dispositions is important component in helping to manage complex health situations and to deal with patient issues effectively. Willingness to think critically is a prerequisite for safe and subtly performance. The results of studies show critical thinking dispositions of nursing students in Asian countries are different from non-Asian countries. Aim of this literature review was to compare critical thinking dispositions of nursing students in Asian and non-Asian countries. Literature review was done in English and Persian databases. The results showed of the 795 articles published in English and Persian language that studied critical thinking, 73 ones studied critical thinking skills and dispositions in nursing education, and relationship between teaching methods and critical thinking skills and dispositions in nursing education of different countries. Fifteen of seventy three articles assessed critical thinking dispositions in nursing students. Limited studies showed that the Asian nursing students had mostly undermining score of the critical thinking dispositions, while non-Asian countries tend to positive scores. The reasons for these differences could be due to issues such as environmental, educational methods and cultural differences. However, future studies should measure critical thinking disposition by discipline-based tools. PMID:24171885

Toothbrush Contamination: A Review of the Literature

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Michelle R. Frazelle

2012-01-01

Full Text Available Toothbrushes are commonly used in hospital settings and may harbor potentially harmful microorganisms. A peer-reviewed literature review was conducted to evaluate the cumulative state of knowledge related to toothbrush contamination and its possible role in disease transmission. A systematic review was conducted on adult human subjects through three distinct searches. The review resulted in seven experimental and three descriptive studies which identified multiple concepts related to toothbrush contamination to include contamination, methods for decontamination, storage, design, and environmental factors. The selected studies found that toothbrushes of healthy and oral diseased adults become contaminated with pathogenic bacteria from the dental plaque, design, environment, or a combination of factors. There are no studies that specifically examine toothbrush contamination and the role of environmental factors, toothbrush contamination, and vulnerable populations in the hospital setting (e.g., critically ill adults and toothbrush use in nursing clinical practice.

Patient-important outcomes in randomized controlled trials in critically ill patients: a systematic review.

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Gaudry, Stéphane; Messika, Jonathan; Ricard, Jean-Damien; Guillo, Sylvie; Pasquet, Blandine; Dubief, Emeline; Boukertouta, Tanissia; Dreyfuss, Didier; Tubach, Florence

2017-12-01

Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. Literature search was conducted to identify eligible trials indexed from January to December 2013. Articles were eligible if they reported an RCT involving critically ill adult patients. We excluded phase II, pilot and physiological crossover studies. We assessed study characteristics. All primary and secondary outcomes were collected, described and classified using six categories of outcomes including patient-important outcomes (involving mortality at any time on the one hand and quality of life, functional/cognitive/neurological outcomes assessed after ICU discharge on the other). Of the 716 articles retrieved in 2013, 112 RCTs met the inclusion criteria. Most common topics were mechanical ventilation (27%), sepsis (19%) and nutrition (17%). Among the 112 primary outcomes, 27 (24%) were patient-important outcomes (mainly mortality, 21/27) but only six (5%) were patient-important outcomes besides mortality assessed after ICU discharge (functional disability = 4; quality of life = 2). Among the 598 secondary outcomes, 133 (22%) were patient-important outcomes (mainly mortality, 92/133) but only 41 (7%) were patient-important outcomes besides mortality assessed after ICU discharge (quality of life = 20, functional disability = 14; neurological/cognitive performance = 5; handicap = 1; post-traumatic stress = 1). Seventy-three RCTs (65%) reported at least one patient-important outcome but only 11 (10%) reported at least one patient-important outcome besides mortality assessed after ICU discharge. Patient-important outcomes are rarely primary

Entropy in the Critical Zone: A Comprehensive Review

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Juan Quijano

2014-06-01

Full Text Available Thermodynamic entropy was initially proposed by Clausius in 1865. Since then it has been implemented in the analysis of different systems, and is seen as a promising concept to understand the evolution of open systems in non-equilibrium conditions. Information entropy was proposed by Shannon in 1948, and has become an important concept to measure information in different systems. Both thermodynamic entropy and information entropy have been extensively applied in different fields related to the Critical Zone, such as hydrology, ecology, pedology, and geomorphology. In this study, we review the most important applications of these concepts in those fields, including how they are calculated, and how they have been utilized to analyze different processes. We then synthesize the link between thermodynamic and information entropies in the light of energy dissipation and organizational patterns, and discuss how this link may be used to enhance the understanding of the Critical Zone.

Measures of Wellness in Young Adult College Students: An Integrative Review.

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Nair, Julie McCulloh

2018-04-01

Wellness behaviors typically form during the college years, making wellness evaluation crucial during this time frame. Instruments often assess health rather than wellness. Thus, the purpose of this integrative review is to identify and evaluate instruments measuring wellness among young adult college students. Google Scholar, CINAHL, PubMed, MEDLINE, PsycINFO, ERIC, and other databases were searched yielding 350 studies initially. Seven studies met inclusion criteria and were retained for this review. Reliability and validity is reported in each study with ongoing analysis. Homogeneous samples were reported in each study, and administering concurrent instruments created feasibility issues. A summary of instruments measuring wellness in young adult college students is provided. However, few wellness instruments exist in this population. Thus, further development is needed.

Online counseling: a narrative and critical review of the literature.

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Richards, Derek; Viganó, Noemi

2013-09-01

This article aimed to critically review the literature on online counseling. Database and hand-searches were made using search terms and eligibility criteria, yielding a total of 123 studies. The review begins with what characterizes online counseling. Outcome and process research in online counseling is reviewed. Features and cyberbehaviors of online counseling such as anonymity and disinhibition, convenience, time-delay, the loss of social signaling, and writing behavior in cyberspace are discussed. Ethical behavior, professional training, client suitability, and clients' and therapists' attitudes and experiences of online counseling are reviewed. A growing body of knowledge to date is positive in showing that online counseling can have a similar impact and is capable of replicating the facilitative conditions as face-to-face encounters. A need remains for stronger empirical evidence to establish efficacy and effectiveness and to understand better the unique mediating and facilitative variables. © 2013 Wiley Periodicals, Inc.

A critical review of the nursing shortage in Malaysia.

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Barnett, T; Namasivayam, P; Narudin, D A A

2010-03-01

This paper describes and critically reviews steps taken to address the nursing workforce shortage in Malaysia. To address the shortage and to build health care capacity, Malaysia has more than doubled its nursing workforce over the past decade, primarily through an increase in the domestic supply of new graduates. Government reports, policy documents and ministerial statements were sourced from the Ministry of Health Malaysia website and reviewed and analysed in the context of the scholarly literature published about the health care workforce in Malaysia and more generally about the global nursing shortage. An escalation in student numbers and the unprecedented number of new graduates entering the workforce has been associated with other impacts that have been responded to symptomatically rather than through workplace reform. Whilst growing the domestic supply of nurses is a critical key strategy to address workforce shortages, steps should also be taken to address structural and other problems of the workplace to support both new graduates and the retention of more experienced staff. Nursing shortages should not be tackled by increasing the supply of new graduates alone. The creation of a safe and supportive work environment is important to the long-term success of current measures taken to grow the workforce and retain nurses within the Malaysian health care system.

Tablet Use in Schools: A Critical Review of the Evidence for Learning Outcomes

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Haßler, B.; Major, L.; Hennessy, S.

2016-01-01

The increased popularity of tablets in general has led to uptake in education. We critically review the literature reporting use of tablets by primary and secondary school children across the curriculum, with a particular emphasis on learning outcomes. The systematic review methodology was used, and our literature search resulted in 33 relevant…

Critical Discourse Analysis in Education: A Review of the Literature, 2004 to 2012

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Rogers, Rebecca; Schaenen, Inda; Schott, Christopher; O'Brien, Kathryn; Trigos-Carrillo, Lina; Starkey, Kim; Chasteen, Cynthia Carter

2016-01-01

This article reviews critical discourse analysis scholarship in education research from 2004 to 2012. Our methodology was carried out in three stages. First, we searched educational databases. Second, we completed an analytic review template for each article and encoded these data into a digital spreadsheet to assess macro-trends in the field.…

Resistance Training in Children and Young Adults: A Critical Review

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Rami Shenouda

2017-01-01

Full Text Available Resistance training is a method used by many athletes to increase their levels of performance. The benefits of this method are known to be increased strength, power and endurance. Resistance training in children has been a topic that has been long debated and there are some widely accepted beliefs and principles that guide clinicians involved in the discipline of sport and exercise medicine. While weight training is a form of resistance training that has proven beneficial effects on health and wellbeing, powerlifting and heavy weight training should be avoided, as lifting maximal weights through various ranges of motion as fast as possible can lead to serious limb injuries. In order to determine the risks and benefits of resistance training in children and adolescents, it is important to review the literature to find a clear consensus. Further prospective research should be completed to determine the long-term sequelae of resistance training in children in comparison to the general population.

A Systematic Review of the Role of Gender in Securing and Maintaining Employment Among Youth and Young Adults with Disabilities.

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Lindsay, Sally; Cagliostro, Elaine; Albarico, Mikhaela; Srikanthan, Dilakshan; Mortaji, Neda

2018-06-01

Purpose There is a critical need for gender-specific vocational supports for young adults with disabilities as they transition to employment. We conducted a systematic review to explore the role of gender in securing and maintaining employment. Methods Systematic searches of seven databases identified 48 studies meeting our inclusion criteria. Using a narrative synthesis approach, these studies were analyzed in terms of the characteristics of the participants, methodology, results, and quality of the evidence. Results Among the 48 studies, 112,473 participants (56% male), mean age (of the total sample) was 21, represented across ten countries. Twenty-one studies reported that young men with disabilities had better employment outcomes than women with disabilities. Eight studies showed that females with disabilities had better employment outcomes than males. Five studies reported that there were no gender differences in employment outcomes for youth with various disabilities. With regards to maintaining employment, men with disabilities often work more hours and have better wages compared to women with disabilities. There are several gender-related barriers and facilitators to maintaining employment including social supports and gender role expectations. Conclusions Our findings highlight that there is a critical need for gender-specific vocational supports for young adults with disabilities.

A critical review of regional economic integration in China

OpenAIRE

Wang RUI

2015-01-01

Under the circumstances of economic globalization, regional economic integration has become the mainstream of current economic development for each country, so China has to pay more attention to it. The critical review on regional economic integration in China can lay a certain foundation and provide experience for the in-depth research. Main contents of regional economic integration are refined according to the previous studies and realities, including the integration of regional economic re...

Activity and Participation Characteristics of Adults with Learning Disabilities - A Systematic Review

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Sharfi, Kineret; Rosenblum, Sara

2014-01-01

Background ‘Learning disabilities’ (LD) refer to a wide group of neurological disorders caused by deficits in the central nervous system which influence the individual's ability to maintain-, process or convey information to others in an efficient way. A worldwide discussion about the definitions of LD continues while a conceptual framework for studying the diverse life outcomes of adults with LD is still missing. Objective The aim was to review the literature on the activity and participation of adults with LD based on the International Classification of Functioning, Disability and Health (ICF) concepts. Methods “PsychInfo”, “Eric” and “PubMed” were searched for relevant literature according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After a three-stage process, 62 articles relevant for domains of activity and participation of adults with LD were included in the review. Results Thirty-two articles focused on the domain of major life areas of education, work and employment and twelve articles focused on the domain of learning and applying knowledge. Limitations in activity and participation of the population with LD in these domains are recognized and discussed. Eighteen additional articles demonstrated that adults with LD confront difficulties in various life domains (e.g., communication, interpersonal interactions, mobility, and domestic life), however literature concerning these domains is scarce. Conclusions The ICF can be useful for further exploration of activity and participation characteristics of adults with LD in various life domains. Such exploration is required in order to gain a wider perspective of their functional characteristics and daily needs. PMID:25184315

Epidemiology of constipation in children and adults: A systematic review

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Mugie, Suzanne M.; Benninga, Marc A.; Di Lorenzo, Carlo

2011-01-01

We aimed to review the published literature regarding the epidemiology of constipation in the general paediatric and adult population and to assess its geographic, gender and age distribution, and associated factors. A search of the Medline database was performed. Study selection criteria included:

Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

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Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

2010-10-01

The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

The evidence-based approach to adult-onset idiopathic nephrotic syndrome

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Pietro A. Canetta

2015-09-01

Full Text Available Adult-onset nephrotic syndrome differs from its pediatric counterpart in several important ways. Most importantly, nephrotic syndrome in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histologic diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult nephrotic syndrome has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

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

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

2018-01-10

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

Young adults' perspectives on living with kidney failure: a systematic review and thematic synthesis of qualitative studies.

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Bailey, Phillippa K; Hamilton, Alexander J; Clissold, Rhian L; Inward, Carol D; Caskey, Fergus J; Ben-Shlomo, Yoav; Owen-Smith, Amanda

2018-01-10

Young adults fare worse than younger adolescents or older adults on a broad range of health indicators. Those with a chronic illness such as renal failure are a particularly vulnerable group, who experience poor outcomes compared with both children and older adults. Understanding how being in receipt of renal replacement therapy (RRT) affects the lives of young adults might help us to better prepare and support these individuals for and on RRT, and improve outcomes. This study aimed to synthesise research describing young adults' experiences of the psychosocial impact of kidney failure and RRT. A systematic literature review identified qualitative research reporting the perspectives of people aged 16-30 years receiving RRT on the psychosocial impact of renal failure. Electronic databases (including Medline/EMBASE/PsycINFO/ASSIA) were searched to November 2017 for full-text papers. The transparency of reporting of each study was assessed using the Consolidated Criteria for Reporting Qualitative Health Research (COREQ) framework. Quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. An inductive thematic synthesis was undertaken. Seven studies from five different countries were included, comprising 123 young adults receiving RRT. Comprehensiveness of reporting was variable: studies reported 9-22 of the 32 COREQ-checklist items.Three global themes about the impact of kidney failure on young adults were identified: (1) difference desiring normality, (2) thwarted or moderated dreams and ambitions, and (3) uncertainty and liminality. These reflected five organising themes: (1) physical appearance and body image, (2) activity and participation, (3) educational disruption and underachievement, (4) career ambitions and employment difficulties, and (5) social isolation and intimate relationships. Across different countries and different healthcare settings, young adults on RRT experience difference and liminality, even after

A Cross-Industry Review of B2B Critical Success Factors.

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Eid, Riyad; Trueman, Myfanwy; Ahmed, Abdel Moneim

2002-01-01

Presents a comprehensive review of B2B (business-to- business) international Internet marketing and identifies 21 critical success factors in five categories: marketing strategy, including management support, strategic goals, and collaboration; Web site factors, including Web site design; global factors, including multilanguage sites and cultural…

Research Review: A Critical Review of Studies on the Developmental Trajectories of Antisocial Behavior in Females

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Fontaine, Nathalie; Carbonneau, Rene; Vitaro, Frank; Barker, Edward D.; Tremblay, Richard E.

2009-01-01

Background: Knowledge on the onset and the development of antisocial behavior in females is limited, because most of the research in this domain is based on males. Methods: We critically reviewed 46 empirical studies that examined developmental trajectories of antisocial behavior in females, notably to help determine whether or not an…

Critical review: medical students' motivation after failure.

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Holland, Chris

2016-08-01

About 10 % of students in each years' entrants to medical school will encounter academic failure at some stage in their programme. The usual approach to supporting these students is to offer them short term remedial study programmes that often enhance approaches to study that are orientated towards avoiding failure. In this critical review I will summarise the current theories about student motivation that are most relevant to this group of students and describe how they are enhanced or not by various contextual factors that medical students experience during their programme. I will conclude by suggesting ways in which support programmes for students who have encountered academic failure might be better designed and researched in the future.

A critical review of advance directives in Germany: attitudes, use and healthcare professionals’ compliance

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Evans, N.; Bausewein, C.; Meñaca, A.; Andrew, E.V.W.; Higginson, I.J.; Harding, R.; Pool, R.; Gysels, M.

2012-01-01

Objective Recent legal changes in Germany make non-compliance with advance directives (ADs) a criminal offence. This article assesses the evidence on attitudes towards, use of, and physician compliance with ADs in Germany. Methods Critical review: studies on ADs, identified from a systematic review

Strategies used for the promotion of critical thinking in nursing undergraduate education: A systematic review.

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Carvalho, Diana P S R P; Azevedo, Isabelle C; Cruz, Giovanna K P; Mafra, Gabriela A C; Rego, Anna L C; Vitor, Allyne F; Santos, Viviane E P; Cogo, Ana L P; Ferreira Júnior, Marcos A

2017-10-01

Identifying the strategies used to promote critical thinking (CT) during undergraduate education in nursing courses. Systematic review. Five electronic databases were searched without language, publication time or geographic filters. A systematic review of the literature. Including experimental studies that considered at least one teaching strategy to promote critical thinking of undergraduate students in Nursing courses. The search for studies occurred in three phases: title and summary review, complete text and implementation of a clinical form of selection according to predetermined criteria. All included studies were assessed for quality through a classification tool for experimental studies. Six studies were selected. The results were grouped into three key themes: an evaluation of the quality of the selected studies, characterization of the studies and the strategies used to promote critical thinking. All selected studies were in English, with significant conceptual similarity of Critical Thinking and dominance in choosing the approached theme during strategies in clinical nursing education with an emphasis on the nursing process. The most widely used teaching intervention was Problem-Based Learning. Nursing education mediated by strategies that stimulate CT is considered a positive difference in undergraduate curriculums. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Systematic Review of Transitional Care for Emerging Adults with Diabetes.

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Findley, Mary K; Cha, EunSeok; Wong, Eugene; Faulkner, Melissa Spezia

2015-01-01

The prevalence of diabetes and prediabetes in adolescents is increasing. A systematic review of 31 research articles focusing on transitional care for adolescents or emerging adults with diabetes or prediabetes was completed. Studies focused on those with type 1 diabetes, not type 2 diabetes or prediabetes, and were primarily descriptive. Major findings and conclusions include differences in pediatric versus adult care delivery and the importance of structured transitional programs using established recommendations of leading national organizations. Implications include future research on program development, implementation, and evaluation that is inclusive of adolescents and emerging adults, regardless of diabetes type, or prediabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews.

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Schultz, Timothy J; Roupas, Peter; Wiechula, Richard; Krause, Debra; Gravier, Susan; Tuckett, Anthony; Hines, Sonia; Kitson, Alison

2016-08-01

Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people. This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions. The participants were older adults, 60 years of age or older, living in the community. The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education. This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews). The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status. The phenomena of interestwere the qualitative perceptions and experiences of participants. We developed an iterative search strategy for nine bibliometric databases and gray literature. Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified. Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute

A Critical Review of Instructional Design Process of Distance Learning System

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Chaudry, Muhammad Ajmal; ur-Rahman, Fazal

2010-01-01

Instructional design refers to planning, development, delivery and evaluation of instructional system. It is an applied field of study aiming at the application of descriptive research outcomes in regular instructional settings. The present study was designed to critically review the process of instructional design at Allama Iqbal Open University…

International entrepreneurship research in emerging economies : A critical review and research agenda

NARCIS (Netherlands)

Kiss, A.N.; Danis, W.D.; Cavusgil, S.T.

This article systematically reviews and critically examines international entrepreneurship research in emerging economies (IEEE research), and articulates its importance, timeliness and relevance in consideration of the growing influence of emerging markets in the global economy. A systematic

Physical activity and cognitive function among older adults in China: A systematic review

Directory of Open Access Journals (Sweden)

Jiaojiao Lü

2016-09-01

Conclusion: This systematic review provides initial evidence that PA may benefit cognition in older Chinese adults. Further studies of individuals with cognitive impairments and prospective and RCT studies having high scientific rigor are needed to corroborate the findings reported in this review.

Critical Care Organizations: Business of Critical Care and Value/Performance Building.

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Leung, Sharon; Gregg, Sara R; Coopersmith, Craig M; Layon, A Joseph; Oropello, John; Brown, Daniel R; Pastores, Stephen M; Kvetan, Vladimir

2018-01-01

New, value-based regulations and reimbursement structures are creating historic care management challenges, thinning the margins and threatening the viability of hospitals and health systems. The Society of Critical Care Medicine convened a taskforce of Academic Leaders in Critical Care Medicine on February 22, 2016, during the 45th Critical Care Congress to develop a toolkit drawing on the experience of successful leaders of critical care organizations in North America for advancing critical care organizations (Appendix 1). The goal of this article was to provide a roadmap and call attention to key factors that adult critical care medicine leadership in both academic and nonacademic setting should consider when planning for value-based care. Relevant medical literature was accessed through a literature search. Material published by federal health agencies and other specialty organizations was also reviewed. Collaboratively and iteratively, taskforce members corresponded by electronic mail and held monthly conference calls to finalize this report. The business and value/performance critical care organization building section comprised of leaders of critical care organizations with expertise in critical care administration, healthcare management, and clinical practice. Two phases of critical care organizations care integration are described: "horizontal," within the system and regionalization of care as an initial phase, and "vertical," with a post-ICU and postacute care continuum as a succeeding phase. The tools required for the clinical and financial transformation are provided, including the essential prerequisites of forming a critical care organization; the manner in which a critical care organization can help manage transformational domains is considered. Lastly, how to achieve organizational health system support for critical care organization implementation is discussed. A critical care organization that incorporates functional clinical horizontal and

Nurses' attitudes towards older people care: An integrative review.

Science.gov (United States)

Rush, Kathy L; Hickey, Stormee; Epp, Sheila; Janke, Robert

2017-12-01

To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes. © 2017 John Wiley & Sons Ltd.

The personal active aging strategies of older adults in Europe: a systematic review of qualitative evidence.

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Klugar, Miloslav; Čáp, Juraj; Klugarová, Jitka; Marečková, Jana; Roberson, Donald N; Kelnarová, Zuzana

2016-05-01

There is a consensus that the aging population is beginning to impact on many facets of our life. They have more medical problems and the potential to "drain" the focus of the medical community, as well as national budgets with their accompanying medical bills. Personal strategies related to active aging will help us to better understand and identify how older adults in Europe prepare themselves for the natural process of aging and what are their personal approaches to active aging. The objective of this review was to synthesize the best available evidence regarding the older adult's perspective on the personal strategies related to active aging among older adults in Europe. This review considered studies that included older adults (age over 55 years) who live in Europe. This review considered studies that investigated older adults' perspectives on (any) personal strategies related to active aging. Europe (considering "some similarity" in health care systems and retirement policies). This review considered any qualitative designs. A three-step search strategy was used to identify published and unpublished studies. The extensive search process was conducted in October 2014 and considered published and unpublished studies from the inception of databases until October 2014. Studies published in any language which had an abstract in English, Czech and Slovak languages were considered for inclusion in this review. Studies were appraised for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the papers included in the review by two independent reviewers using the standardized JBI-QARI data extraction tool. Data synthesis was performed using the meta-aggregation approach of meta-synthesis recommended by the Joanna Briggs Institute. Fourteen studies were included in this systematic review. From these 14 studies, 42 findings were extracted; findings were

A review of costing methodologies in critical care studies.

Science.gov (United States)

Pines, Jesse M; Fager, Samuel S; Milzman, David P

2002-09-01

Clinical decision making in critical care has traditionally been based on clinical outcome measures such as mortality and morbidity. Over the past few decades, however, increasing competition in the health care marketplace has made it necessary to consider costs when making clinical and managerial decisions in critical care. Sophisticated costing methodologies have been developed to aid this decision-making process. We performed a narrative review of published costing studies in critical care during the past 6 years. A total of 282 articles were found, of which 68 met our search criteria. They involved a mean of 508 patients (range, 20-13,907). A total of 92.6% of the studies (63 of 68) used traditional cost analysis, whereas the remaining 7.4% (5 of 68) used cost-effectiveness analysis. None (0 of 68) used cost-benefit analysis or cost-utility analysis. A total of 36.7% (25 of 68) used hospital charges as a surrogate for actual costs. Of the 43 articles that actually counted costs, 37.2% (16 of 43) counted physician costs, 27.9% (12 of 43) counted facility costs, 34.9% (15 of 43) counted nursing costs, 9.3% (4 of 43) counted societal costs, and 90.7% (39 of 43) counted laboratory, equipment, and pharmacy costs. Our conclusion is that despite considerable progress in costing methodologies, critical care studies have not adequately implemented these techniques. Given the importance of financial implications in medicine, it would be prudent for critical care studies to use these more advanced techniques. Copyright 2002, Elsevier Science (USA). All rights reserved.

Evidence analysis library review of best practices for performing indirect calorimetry in healthy and non-critically ill individuals.

Science.gov (United States)

Fullmer, Susan; Benson-Davies, Sue; Earthman, Carrie P; Frankenfield, David C; Gradwell, Erica; Lee, Peggy S P; Piemonte, Tami; Trabulsi, Jillian

2015-09-01

When measurement of resting metabolic rate (RMR) by indirect calorimetry is necessary, following evidence-based protocols will ensure the individual has achieved a resting state. The purpose of this project was to update the best practices for measuring RMR by indirect calorimetry in healthy and non-critically ill adults and children found the Evidence Analysis Library of the Academy of Nutrition and Dietetics. The Evidence Analysis process described by the Academy of Nutrition and Dietetics was followed. The Ovid database was searched for papers published between 2003 and 2012 using key words identified by the work group and research consultants, studies used in the previous project were also considered (1980 to 2003), and references were hand searched. The work group worked in pairs to assign papers to specific questions; however, the work group developed evidence summaries, conclusion statements, and recommendations as a group. Only 43 papers were included to answer 21 questions about the best practices to ensure an individual is at rest when measuring RMR in the non-critically ill population. In summary, subjects should be fasted for at least 7 hours and rest for 30 minutes in a thermoneutral, quiet, and dimly lit room in the supine position before the test, without doing any activities, including fidgeting, reading, or listening to music. RMR can be measured at any time of the day as long as resting conditions are met. The duration of the effects of nicotine and caffeine and other stimulants is unknown, but lasts longer than 140 minutes and 240 minutes, respectively. The duration of the effects of various types of exercise on RMR is unknown. Recommendations for achieving steady state, preferred gas-collection devices, and use of respiratory quotient to detect measurement errors are also given. Of the 21 conclusions statements developed in this systemic review, only 5 received a grade I or II. One limitation is the low number of studies available to address the

Organ donation in adults: a critical care perspective.

Science.gov (United States)

Citerio, Giuseppe; Cypel, Marcelo; Dobb, Geoff J; Dominguez-Gil, Beatriz; Frontera, Jennifer A; Greer, David M; Manara, Alex R; Shemie, Sam D; Smith, Martin; Valenza, Franco; Wijdicks, Eelco F M

2016-03-01

The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.

Review of the role of probiotics in gastrointestinal diseases in adults.

Science.gov (United States)

Sebastián Domingo, Juan José

Probiotics may act as biological agents that modify the intestinal microbiota and certain cytokine profiles, which can lead to an improvement in certain gastrointestinal diseases. To conduct a review of the evidence of the role of probiotics in certain gastrointestinal diseases in adults. Review conducted using appropriate descriptors, filters and limits in the PubMed database (MEDLINE). The MeSH terms used were Probiotics [in the title] AND Gastrointestinal Diseases, with the following limits or filters: Types of study: Systematic Reviews, Meta-Analysis, Guideline, Practice Guideline, Consensus Development Conference (and Consensus Development Conference NIH), Randomized Controlled Trial, Controlled Clinical Trial and Clinical Trial; age: adults (19 or older); language: English and Spanish; in humans, and with at least one abstract. Full texts of all the Systematic Reviews and meta-analyses directly related to the review's objective were obtained, as well as the Randomised Controlled Trials of the studies that were considered relevant and of sufficient quality for this review. Certain probiotics, different for each process, have proven to be effective and beneficial in cases of acute infectious diarrhoea, antibiotic-associated diarrhoea, Clostridium difficile-associated diarrhoea, pouchitis and Helicobacter pylori infection eradication. Although some probiotics have not demonstrated any benefit, there are certain gastrointestinal diseases in which the use of probiotics, true biological agents, can be recommended. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

An integrated review of the correlation between critical thinking ability and clinical decision-making in nursing.

Science.gov (United States)

Lee, Daphne Sk; Abdullah, Khatijah Lim; Subramanian, Pathmawathi; Bachmann, Robert Thomas; Ong, Swee Leong

2017-12-01

To explore whether there is a correlation between critical thinking ability and clinical decision-making among nurses. Critical thinking is currently considered as an essential component of nurses' professional judgement and clinical decision-making. If confirmed, nursing curricula may be revised emphasising on critical thinking with the expectation to improve clinical decision-making and thus better health care. Integrated literature review. The integrative review was carried out after a comprehensive literature search using electronic databases Ovid, EBESCO MEDLINE, EBESCO CINAHL, PROQuest and Internet search engine Google Scholar. Two hundred and 22 articles from January 1980 to end of 2015 were retrieved. All studies evaluating the relationship between critical thinking and clinical decision-making, published in English language with nurses or nursing students as the study population, were included. No qualitative studies were found investigating the relationship between critical thinking and clinical decision-making, while 10 quantitative studies met the inclusion criteria and were further evaluated using the Quality Assessment and Validity Tool. As a result, one study was excluded due to a low-quality score, with the remaining nine accepted for this review. Four of nine studies established a positive relationship between critical thinking and clinical decision-making. Another five studies did not demonstrate a significant correlation. The lack of refinement in studies' design and instrumentation were arguably the main reasons for the inconsistent results. Research studies yielded contradictory results as regard to the relationship between critical thinking and clinical decision-making; therefore, the evidence is not convincing. Future quantitative studies should have representative sample size, use critical thinking measurement tools related to the healthcare sector and evaluate the predisposition of test takers towards their willingness and ability to think

Exploring the Group Prenatal Care Model: A Critical Review of the Literature

Science.gov (United States)

Thielen, Kathleen

2012-01-01

Few studies have compared perinatal outcomes between individual prenatal care and group prenatal care. A critical review of research articles that were published between 1998 and 2009 and involved participants of individual and group prenatal care was conducted. Two middle range theories, Pender’s health promotion model and Swanson’s theory of caring, were blended to enhance conceptualization of the relationship between pregnant women and the group prenatal care model. Among the 17 research studies that met inclusion criteria for this critical review, five examined gestational age and birth weight with researchers reporting longer gestations and higher birth weights in infants born to mothers participating in group prenatal care, especially in the preterm birth population. Current evidence demonstrates that nurse educators and leaders should promote group prenatal care as a potential method of improving perinatal outcomes within the pregnant population. PMID:23997549

Beverage Consumption and Adult Weight Management: A Review

OpenAIRE

Dennis, Elizabeth A.; Flack, Kyle D.; Davy, Brenda M.

2009-01-01

Total energy consumption among United States adults has increased in recent decades, and energy-containing beverages are a significant contributor to this increase. Because beverages are less satiating than solid foods, consumption of energy-containing beverages may increase energy intake and lead to weight gain; trends in food and beverage consumption coinciding with increases in overweight and obesity support this possibility. The purpose of this review is to present what is known about the...

Factors affecting caregiver burden of terminally ill adults in the home setting - A systematic review.

Science.gov (United States)

He Leow, Mabel Qi; Wai Chi Chan, Sally

Background: Terminally ill people have complex physical and psychological needs. As a result, their caregivers may experience high levels of burden, and some caregivers are unable to cope with the burden. Thus, it is important to determine the various factors that may influence caregiver burden, so that healthcare professionals may implement strategies to reduce caregiver burden. In this review, "caregiver burden" was expanded to include "caregiver stress" and "caregiver strain", as the two terms were related to caregiver burden. The objective of this systematic review was to identify the factors that may influence caregiver burden of a terminally ill adult in the home setting. Types of participants: This review considered adult participants (above age 18) who were the main caregivers of a terminally ill adult in the home setting, and providing care for the terminally ill person at the point of participation in the study.Types of intervention: There was no specific intervention of interest for the study.Types of outcomes: The focus of study was the factors that affected caregiver burden of the terminally ill person.Types of studies: Quantitative studies such as randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time series (ITSs), controlled before after designs (CBAs), observational design (cohort, case-control), and descriptive surveys were included in the study. This review was limited to papers in English and Mandarin. A literature search from the inception of the database to October 2010 was conducted using major electronic databases. The databases used were CINAHL, MEDLINE, PsycINFO (Ovid), Scopus, SpringerLink, ScienceDirect, Web of Science, Mosby's Nursing Consult, Mednar: Deep web medical search, Proquest Dissertations and Theses and China Journal Net.Methodological quality: The quality of the potential studies was assessed by two independent reviewers using the critical appraisal checklists for descriptive/case studies

Psychologic adjustment to irreversible vision loss in adults: a systematic review.

Science.gov (United States)

Senra, Hugo; Barbosa, Fernando; Ferreira, Patrícia; Vieira, Cristina R; Perrin, Paul B; Rogers, Heather; Rivera, Diego; Leal, Isabel

2015-04-01

To summarize relevant evidence investigating the psychologic adjustment to irreversible vision loss (IVL) in adults. Irreversible vision loss entails a challenging medical condition in which rehabilitation outcomes are strongly dependent on the patient's psychologic adjustment to illness and impairment. So far, no study has systematically reviewed the psychologic adjustment to IVL in adults. We reviewed all articles examining the psychologic adjustment to IVL in adults. We included articles published in English in peer-reviewed journals. We performed a keyword literature search using 4 databases (PubMed, EBSCO, Cochrane Library, and Science Direct) for all years through July 2014. We assessed risk of bias of selected studies using the RTI Item Bank for Assessing Risk of Bias and Confounding for Observational Studies of Interventions or Exposures and the Cochrane risk of bias tool for randomized controlled trials. Of a total of 3948 citations retrieved, we selected 52 eligible studies published between 1946 and 2014. The majority of studies were observational and cross-sectional in nature. Our review suggests that high levels of depression occur during the adjustment to IVL. Better adjustment to IVL was associated with greater acceptance of vision loss and use of instrumental coping, good social support, positivity, and use of assistive aids. The overall findings indicate that IVL often has negative effects on patients' quality of life and mental health and that such effects tend to remain over time. Specific factors and variables associated with the adjustment to IVL need to be clarified through further in-depth and longitudinal research. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Measuring culture: a critical review of acculturation and health in Asian immigrant populations.

Science.gov (United States)

Salant, Talya; Lauderdale, Diane S

2003-07-01

The number of studies examining how acculturation affects the health of Asian immigrants has increased in recent years. The proliferation of studies reflects the growing size and heterogeneity of Asian immigrant populations in the United States, Canada, Australia, New Zealand, and the United Kingdom. This paper compares various approaches to acculturation within the health literature on Asian immigrants by reviewing the literature in three-health domains (1) mental health (2) physical health and (3) health services use. The review critically examines the conceptualizations and measures of acculturation in these three domains and presents major findings. We observe that measurement difficulties posed by the experiences of heterogeneous Asian groups compound theoretical and disciplinary disparities between acculturation instruments. The extent to which conceptual and methodological critiques of acculturation studies in Hispanic populations apply to studies of Asian populations is also discussed. The critical review thus provides insights into the diverse ways that the relationship between culture and health is measured in this complicated and growing literature.

Ultra-low-volume space sprays in mosquito control: a critical review.

Science.gov (United States)

Bonds, J A S

2012-06-01

The availability of tools to control mosquito (Diptera:Culicidae) vectors that transmit disease is often limited by a variety of economic, environmental and social issues. In emergency conditions (epidemics, hurricanes, floods etc.), the application of pesticides as space sprays (either by ground or air) is the common method of choice in order to rapidly limit adult local mosquito production in the affected area. Space spray application now employs ultra-low-volume technology for the control of adult mosquitoes. However, the use of space sprays often raises social and environmental concerns by the general public that is served. This review will define and illustrate modern ultra-low-volume technology for the purpose of application as a space spray, as well as describing the engineering controls that have been developed to minimize the environmental impact. The primary social concern is validity and efficacy of application. To address this point, the review will attempt to synthesize the global literature to address the effectiveness of space sprays to significantly impact mosquito vectors in relation to human disease. © 2012 The Author. Medical and Veterinary Entomology © 2012 The Royal Entomological Society.

Critical Review of rate constants for reacitons of hydrated electrons

International Nuclear Information System (INIS)

Buxton, G.V.; Greenstock, C.L.; Phillips Helman, W.; Ross, A.B.

1988-01-01

Kinetic data for the radicals Hx and xOH in aqueous solution,and the corresponding radical anions, xO - and e/sub =/, have been critically reviewed. Reactions of the radicals in aqueous solution have been studied by pulse radiolysis, flash photolysis and other methods. Rate constants for over 3500 reaction are tabulated, including reaction with molecules, ions and other radicals derived from inorganic and organic solutes

Knowledge Management : Review of the Critical Success Factors and Development of a Conceptual Classification Model

NARCIS (Netherlands)

Sedighi, M.; Zand, F.

2012-01-01

Knowledge management is a critical issue in today's business world. Knowledge is considered as one of the most strategic resources of the firm and sources of competitive advantage. This research provides a comprehensive review of the literature on the Critical Success Factors (CSFs) and identifies

Rationing in health systems: A critical review.

Science.gov (United States)

Keliddar, Iman; Mosadeghrad, Ali Mohammad; Jafari-Sirizi, Mehdi

2017-01-01

Background: It is difficult to provide health care services to all those in need of such services due to limited resources and unlimited demands. Thus, priority setting and rationing have to be applied. This study aimed at critically examining the concept of rationing in health sector and identifying its purposes, influencing factors, mechanisms, and outcomes. Methods: The critical interpretive synthesis methodology was used in this study. PubMed, Cochrane, and Proquest databases were searched using the related key words to find related documents published between 1970 and 2015. In total, 161 published reports were reviewed and included in the study. Thematic content analysis was applied for data analysis. Results: Health services rationing means restricting the access of some people to useful or potentially useful health services due to budgetary limitation. The inherent features of the health market and health services, limited resources, and unlimited needs necessitate health services rationing. Rationing can be applied in 4 levels: health care policy- makers, health care managers, health care providers, and patients. Health care rationing can be accomplished through fixed budget, benefit package, payment mechanisms, queuing, copayments, and deductibles. Conclusion: This paper enriched our understanding of health services rationing and its mechanisms at various levels and contributed to the literature by broadly conceptualizing health services rationing.

Young adult cancer survivors and work: a systematic review.

Science.gov (United States)

Stone, Dawn S; Ganz, Patricia A; Pavlish, Carol; Robbins, Wendie A

2017-12-01

Sixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established. The purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings. A narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English. Twenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors. More research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care. While young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of occupation, employment appears to enhance overall quality of life.

A Review of Criticality Accidents 2000 Revision

Energy Technology Data Exchange (ETDEWEB)

Thomas P. McLaughlin; Shean P. Monahan; Norman L. Pruvost; Vladimir V. Frolov; Boris G. Ryazanov; Victor I. Sviridov

2000-05-01

Criticality accidents and the characteristics of prompt power excursions are discussed. Sixty accidental power excursions are reviewed. Sufficient detail is provided to enable the reader to understand the physical situation, the chemistry and material flow, and when available the administrative setting leading up to the time of the accident. Information on the power history, energy release, consequences, and causes are also included when available. For those accidents that occurred in process plants, two new sections have been included in this revision. The first is an analysis and summary of the physical and neutronic features of the chain reacting systems. The second is a compilation of observations and lessons learned. Excursions associated with large power reactors are not included in this report.

A Review of Criticality Accidents 2000 Revision

International Nuclear Information System (INIS)

McLaughlin, Thomas P.; Monahan, Shean P.; Pruvost, Norman L.; Frolov, Vladimir V.; Ryazanov, Boris G.; Sviridov, Victor I.

2000-01-01

Criticality accidents and the characteristics of prompt power excursions are discussed. Sixty accidental power excursions are reviewed. Sufficient detail is provided to enable the reader to understand the physical situation, the chemistry and material flow, and when available the administrative setting leading up to the time of the accident. Information on the power history, energy release, consequences, and causes are also included when available. For those accidents that occurred in process plants, two new sections have been included in this revision. The first is an analysis and summary of the physical and neutronic features of the chain reacting systems. The second is a compilation of observations and lessons learned. Excursions associated with large power reactors are not included in this report

Clinical Pharmacology Studies in Critically Ill Children

Science.gov (United States)

Thakkar, Nilay; Salerno, Sara; Hornik, Christoph P.; Gonzalez, Daniel

2016-01-01

Developmental and physiological changes in children contribute to variation in drug disposition with age. Additionally, critically ill children suffer from various life-threatening conditions that can lead to pathophysiological alterations that further affect pharmacokinetics (PK). Some factors that can alter PK in this patient population include variability in tissue distribution caused by protein binding changes and fluid shifts, altered drug elimination due to organ dysfunction, and use of medical interventions that can affect drug disposition (e.g., extracorporeal membrane oxygenation and continuous renal replacement therapy). Performing clinical studies in critically ill children is challenging because there is large inter-subject variability in the severity and time course of organ dysfunction; some critical illnesses are rare, which can affect subject enrollment; and critically ill children usually have multiple organ failure, necessitating careful selection of a study design. As a result, drug dosing in critically ill children is often based on extrapolations from adults or non-critically ill children. Dedicated clinical studies in critically ill children are urgently needed to identify optimal dosing of drugs in this population. This review will summarize the effect of critical illness on pediatric PK, the challenges associated with performing studies in this vulnerable subpopulation, and the clinical PK studies performed to date for commonly used drugs. PMID:27585904

Resilience and the rehabilitation of adult spinal cord injury survivors: A qualitative systematic review.

Science.gov (United States)

Kornhaber, Rachel; Mclean, Loyola; Betihavas, Vasiliki; Cleary, Michelle

2018-01-01

To synthesize the qualitative research evidence that explored how survivors of adult spinal cord injury experience and make sense of resilience. Spinal cord injury is often a sudden and unexpected life-changing event requiring complex and long-term rehabilitation. The development of resilience is essential in determining how spinal cord injury survivors negotiate this injury and rehabilitation. A qualitative systematic review and thematic synthesis of the research evidence. CINAHL, PubMed, Embase, Scopus and PsycINFO were searched, no restriction dates were used. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist. Thematic synthesis focused on how survivors of adult spinal cord injury experience and make sense of resilience. Six qualitative research articles reported the experiences of 84 spinal cord injury survivors. Themes identified were: uncertainty and regaining independence; prior experiences of resilience; adopting resilient thinking; and strengthening resilience through supports. Recovery and rehabilitation following spinal cord survivors is influenced by the individual's capacity for resilience. Resilience may be influenced by previous life experiences and enhanced by supportive nursing staff encouraging self-efficacy. Survivors identified the need for active involvement in decision-making about their care to enable a sense of regaining control of their lives. This has the potential to have a significant impact on their self-efficacy and in turn health outcomes. © 2017 John Wiley & Sons Ltd.

Motivational interviewing for older adults in primary care: a systematic review.

Science.gov (United States)

Purath, Janet; Keck, Annmarie; Fitzgerald, Cynthia E

2014-01-01

Chronic disease is now the leading cause of death and disability in United States. Many chronic illnesses experienced by older adults can be prevented or managed through behavior change, making patient counseling an essential component of disease prevention and management. Motivational Interviewing (MI), a type of conversational method, has been effective in eliciting health behavior changes in people in a variety of settings and may also be a useful tool to help older adults change. This review of the literature analyzes current research and describes potential biases of MI interventions that have been conducted in primary care settings with older adults. MI shows promise as a technique to elicit health behavior change among older adults. However, further study with this population is needed to evaluate efficacy of MI interventions in primary care settings. Copyright © 2014 Mosby, Inc. All rights reserved.

Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) in adults-a case report and literature review.

Science.gov (United States)

Yuan, Junliang; Yang, Shuna; Wang, Shuangkun; Qin, Wei; Yang, Lei; Hu, Wenli

2017-05-25

Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare clinico-radiological entity characterized by the magnetic resonance imaging (MRI) finding of a reversible lesion in the corpus callosum, sometimes involved the symmetrical white matters. Many cases of child-onset MERS with various causes have been reported. However, adult-onset MERS is relatively rare. The clinical characteristics and pathophysiologiccal mechanisms of adult-onset MERS are not well understood. We reviewed the literature on adult-onset MERS in order to describe the characteristics of MERS in adults and to provide experiences for clinician. We reported a case of adult-onset MERS with acute urinary retension and performed literature search from PubMed and web of science databases to identify other adult-onset MERS reports from Januarary 2004 to March 2016. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed on selection process. And then we summarized the clinico-radiological features of adult-onset MERS. Twenty-nine adult-onset MERS cases were reviewed from available literature including the case we have. 86.2% of the cases (25/29) were reported in Asia, especially in Japan. Ages varied between 18 and 59 years old with a 12:17 female-to-male ratio. The major cause was infection by virus or bacteria. Fever and headache were the most common clinical manifestation, and acute urinary retention was observed in 6 patients. All patients recovered completely within a month. Adult-onset MERS is an entity with a broad clinico-radiological spectrum because of the various diseases and conditions. There are similar characteristics between MERS in adults and children, also some differences.

Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review

Science.gov (United States)

Abramovitch, Amitai; Dar, Reuven; Mittelman, Andrew; Wilhelm, Sabine

2015-01-01

Abstract The concept of comorbidity between attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) has been discussed for two decades. No review, however, has examined this question in light of the stark contrast in disorder-specific phenomenology and neurobiology. We review reported prevalence rates and the methodological, phenomenological, and theoretical issues concerning concomitant ADHD-OCD. Reported co-occurrence rates are highly inconsistent in the literature. Studies aimed at examining the potential for comorbidity have suffered from various methodological problems, including the existence of very few community samples, highly variable exclusionary criteria, and possible clinical misinterpretation of symptoms. Despite numerous studies suggesting an ADHD-OCD comorbidity, thus far etiological (i.e., genetic) backing has been provided only for a pediatric comorbidity. Additionally, inflated rates of ADHD-OCD co-occurrence may be mediated by the presence of tic disorders, and evidence of impaired neuronal maturational processes in pediatric OCD may lead to possibly transient phenotypical expressions that resemble ADHD symptomatology. Thus, clinicians are encouraged to consider the possibility that ADHD-like symptoms resulting from OCD-specific symptomatology may be misdiagnosed as ADHD. This suggestion may account for the lower co-occurrence rates reported in adolescents and adults and for the lack of a theoretical account for comorbidity in these age groups. Existing literature is summarized and critically reviewed, and recommendations are made for future research. PMID:26052877

Integration of Mobile Health Technology in the Treatment of Chronic Pain: A Critical Review.

Science.gov (United States)

Sundararaman, Lalitha V; Edwards, Robert R; Ross, Edgar L; Jamison, Robert N

This article provides a critical overview and best-evidence synthesis of the use of mobile health (mHealth) technology among persons with chronic pain and their health care providers and examines the future benefits and barriers of implementing mHealth technology in clinical care. We critically review articles about electronic pain diaries, pain assessment programs, text messaging, and smartphone pain apps for management of persons with pain. Also presented are findings on the utility of activity trackers and use of telehealth to deliver cognitive behavioral therapy. Finally, barriers, study gaps, and future challenges of incorporating mobile technology for chronic pain are discussed. Although the future of mHealth technology and telemedicine in clinical practice is promising, this critical review highlights the need for rigorous studies to establish an association of the use of mHealth technology with improved quality of life, functional autonomy, and decreased hospital use.

On critical reflection : A review of Mezirow’s theory and its operationalization

NARCIS (Netherlands)

Lundgren, H.; Poell, R.F.

2016-01-01

In this article, we review empirical studies that research critical reflection based on Mezirow’s definition. The concepts of content, process, and premise reflection have often been cited, and operationalizing Mezirow’s high-level transformative learning theory and its components has been the

Antifungal Prevention of Systemic Candidiasis in Immunocompetent ICU Adults: Systematic Review and Meta-Analysis of Clinical Trials.

Science.gov (United States)

Dupont, Hervé; Mahjoub, Yazine; Chouaki, Taieb; Lorne, Emmanuel; Zogheib, Elie

2017-11-01

The aim of this study was to identify the impact of antifungal prevention in critically ill immunocompetent adult patients on mortality and subsequent infection. A systematic review and meta-analysis of randomized controlled trials comparing any antifungal use versus placebo to prevent candidiasis in ICU patients were performed. Searches were performed on PubMed, Embase, Scopus, main conference proceedings, and ClinicalTrials.gov, as well as reference lists. The primary outcomes were mortality and invasive candidiasis. The secondary outcome was the rate of Candida albicans and nonalbicans strains after treatment. A random effect model was used, and sensitivity analysis was performed for both outcomes. Results are expressed as risk ratios and their 95% CIs. Nineteen trials (10 with fluconazole, four with ketoconazole, one with itraconazole, three with micafungin, and one with caspofungin) including 2,792 patients were identified. No individual trial showed a decreased mortality rate. Combined analysis showed that preventive antifungal did not decrease mortality (risk ratio, 0.88; 95% CI, 0.74-1.04; p = 0.14) but significantly decreased secondary fungal infections by 50% (risk ratio, 0.49; 95% CI, 0.35-0.68; p = 0.0001). No shift across nonalbicans strains was observed during treatment (risk ratio, 0.62; 95% CI, 0.19-1.97; p = 0.42). However, publication biases preclude any definite conclusions for prevention of infection. Antifungal prevention of systemic candidiasis in immunocompetent critically ill adults did not reduce mortality and may have decreased secondary fungal infection rates. However, significant publication bias was present.

Review of studies on criticality safety evaluation and criticality experiment methods

International Nuclear Information System (INIS)

Naito, Yoshitaka; Yamamoto, Toshihiro; Misawa, Tsuyoshi; Yamane, Yuichi

2013-01-01

Since the early 1960s, many studies on criticality safety evaluation have been conducted in Japan. Computer code systems were developed initially by employing finite difference methods, and more recently by using Monte Carlo methods. Criticality experiments have also been carried out in many laboratories in Japan as well as overseas. By effectively using these study results, the Japanese Criticality Safety Handbook was published in 1988, almost the intermediate point of the last 50 years. An increased interest has been shown in criticality safety studies, and a Working Party on Nuclear Criticality Safety (WPNCS) was set up by the Nuclear Science Committee of Organisation Economic Co-operation and Development in 1997. WPNCS has several task forces in charge of each of the International Criticality Safety Benchmark Evaluation Program (ICSBEP), Subcritical Measurement, Experimental Needs, Burn-up Credit Studies and Minimum Critical Values. Criticality safety studies in Japan have been carried out in cooperation with WPNCS. This paper describes criticality safety study activities in Japan along with the contents of the Japanese Criticality Safety Handbook and the tasks of WPNCS. (author)

Social Marketing Interventions Aiming to Increase Physical Activity among Adults: A Systematic Review

Science.gov (United States)

Kubacki, Krzysztof; Ronti, Rimante; Lahtinen, Ville; Pang, Bo; Rundle-Thiele, Sharyn

2017-01-01

Purpose: A significant proportion of the world's adult population is insufficiently active. One approach used to overcome barriers and facilitate participation in physical activity is social marketing. The purpose of this paper are twofold: first, this review seeks to provide a contemporary review of social marketing's effectiveness in changing…

Silver (Ag) Transport Mechanisms in TRISO coated particles: A Critical Review

Energy Technology Data Exchange (ETDEWEB)

I J van Rooyen; J H Neethling; J A A Engelbrecht; P M van Rooyen; G Strydom

2012-10-01

Transport of 110mAg in the intact SiC layer of TRISO coated particles has been studied for approximately 30 years without arriving at a satisfactory explanation of the transport mechanism. In this paper the possible mechanisms postulated in previous experimental studies, both in-reactor and out-of reactor research environment studies are critically reviewed and of particular interest are relevance to very high temperature gas reactor operating and accident conditions. Among the factors thought to influence Ag transport are grain boundary stoichiometry, SiC grain size and shape, the presence of free silicon, nano-cracks, thermal decomposition, palladium attack, transmutation products, layer thinning and coated particle shape. Additionally new insight to nature and location of fission products has been gained via recent post irradiation electron microscopy examination of TRISO coated particles from the DOE’s fuel development program. The combined effect of critical review and new analyses indicates a direction for investigating possible the Ag transport mechanism including the confidence level with which these mechanisms may be experimentally verified.

Silver (Ag) transport mechanisms in TRISO coated particles: A critical review

Energy Technology Data Exchange (ETDEWEB)

Rooyen, I.J. van, E-mail: isabella.vanrooyen@inl.gov [Idaho National Laboratory, Idaho Falls, ID 83415-6188 (United States); Dunzik-Gougar, M.L. [Department of Nuclear Engineering, Idaho State University, ID (United States); Rooyen, P.M. van [Philip M. van Rooyen Network Consultants, Midlands Estates (South Africa)

2014-05-01

Transport of {sup 110m}Ag in the intact SiC layer of TRISO coated particles has been studied for approximately 30 years without arriving at a satisfactory explanation of the transport mechanism. In this paper the possible mechanisms postulated in previous experimental studies, both in-reactor and out-of reactor research environment studies are critically reviewed and of particular interest are relevance to very high temperature gas reactor operating and accident conditions. Among the factors thought to influence Ag transport are grain boundary stoichiometry, SiC grain size and shape, the presence of free silicon, nano-cracks, thermal decomposition, palladium attack, transmutation products, layer thinning and coated particle shape. Additionally new insight to nature and location of fission products has been gained via recent post irradiation electron microscopy examination of TRISO coated particles from the DOE's fuel development program. The combined effect of critical review and new analyses indicates a direction for investigating possible the Ag transport mechanism including the confidence level with which these mechanisms may be experimentally verified.

Computerized tomography and schizophrenia: critical review of the literature

International Nuclear Information System (INIS)

Krakauer Huebner, C.V.; Gattaz, W.F.

1988-01-01

A critical review of the literature regarding structural brain abnormalities in Schizophrenia is presented. It is reported that the prevalence and the localization of the abnormalities vary widely among studies. These differences might stem from samples heterogeneity, from the choice of the computer tomographic (CT) parameter to be investigated and from the use of different criteria for defining abnormalities. It seems established that at least one subgroup of Schizophrenia patients shows mild or moderate brain atrophy, in spite of some contradictory findings. (M.A.C.)

A critical review of the neuroimaging literature on synesthesia.

Directory of Open Access Journals (Sweden)

Jean-Michel eHupé

2015-03-01

Full Text Available Synesthesia refers to additional sensations experienced by some people for specific stimulations, such as the systematic arbitrary association of colors to letters for the most studied type. Here we review all the studies (based mostly on functional and structural MRI that have searched for the neural correlates of this subjective experience, as well as structural differences related to synesthesia. Most differences claimed for synesthetes are unsupported, due mainly to low statistical power, statistical errors and methodological limitations. Our critical review therefore casts some doubts on whether any neural correlate of the synesthetic experience has been established yet. Rather than being a neurological condition (i.e., a structural or functional brain anomaly, synesthesia could be reconsidered as a special kind of childhood memory, whose signature in the brain may be out of reach with present brain imaging techniques.

The Reasons Requirement in International Investment Arbitration: Critical Case Studies (book review)

DEFF Research Database (Denmark)

Tang, Yi Shin

2008-01-01

3. In the article, the Researcher reviews the work of Professors Guillermo A. Alvarez and W. Michael Reisman from Yale Law School, regarding the mechanisms of international investment arbitration and their importance for developing countries. The article provides a critical perspective on the aut...

Openness in Adoption: What We Know So Far--A Critical Review of the Literature

Science.gov (United States)

Wolfgram, Susan M.

2008-01-01

What are the factors that keep adoptive parents and birth parents connected and sustain their kinship relationships over time? This is the central research question critically reviewed across studies dating from 1987 to 2000. A preliminary review of the literature revealed 15 to 20 studies within this 13-year scope limited to the perspective of…

Constructive staff-family relationships in the care of older adults in the institutional setting: A systematic review.

Science.gov (United States)

Haesler, Emily; Bauer, Michael; Nay, Rhonda

2004-01-01

Modern health care philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's wellbeing. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family imvolvement in the health care of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the health care environment to benefit from the involvement of their family members, health care professionals need an understanding of the issues surrounding family presence in the health care environement and the strategies to best support it. The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the health care setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family & Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO, and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference

Review of criticality safety benchmark data of plutonium solution in ICSBEP handbook

International Nuclear Information System (INIS)

Yamamoto, Toshihiro; Miyoshi, Yoshinori; Okubo, Kiyoshi

2003-01-01

The criticality data of plutonium solutions published in the ICSBEP Handbook were reviewed. Criticality data for lower plutonium concentration and higher 240 Pu content, which correspond to a reprocessing process condition, are very scarce and hence the criticality data in this area are desired. While the calculated k eff 's with ENDF/B-V show the dependence of the plutonium concentration, the dependence has been corrected in JENDL-3.3 because of energy distribution of the capture cross section of 239 Pu. Based on the generalized perturbation theory, the sensitivity coefficient of k eff with respect to fission and capture cross section in plutonium solutions were obtained. In a plutonium solution with a lower concentration, cross sections in the thermal energy less than 0.1 eV have significant effects on the criticality. On the other hand, the criticality of higher concentration plutonium solutions is mostly dominated by cross sections in the energy range larger than 0.1 eV. Regarding the effect of 240 Pu on criticality, the capture cross section 240 Pu around the resonance peak near 1 eV is dominant regardless of the concentration. (author)

Multiple health behavior change in adults with or at risk for cancer: a systematic review.

Science.gov (United States)

Green, Amanda C; Hayman, Laura L; Cooley, Mary E

2015-05-01

To identify components of efficacious interventions for multiple health behavior change (MHBC) in adult cancer survivors or adults at high risk for cancer. A systematic review of MHBC interventions was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Ten studies met inclusion criteria. Most studies changed at least 2 health behaviors. Diet, exercise, and smoking cessation were consistently changed with in-person interventions. Longer duration interventions using phone or mail contact had a positive association with changing diet and exercise. MHBC interventions positively influenced behavior change in adults with cancer and those at high risk for cancer. Future studies should focus on increasing dissemination and implementation of efficacious interventions.

Childhood socioeconomic position and adult leisure-time physical activity: a systematic review.

Science.gov (United States)

Elhakeem, Ahmed; Cooper, Rachel; Bann, David; Hardy, Rebecca

2015-07-03

Regular leisure-time physical activity (LTPA) benefits health and is thought to be less prevalent in lower socioeconomic groups. Evidence suggests that childhood socioeconomic circumstances can impact on adult health and behaviour however, it is unclear if this includes an influence on adult LTPA. This review tested the hypothesis that a lower childhood socioeconomic position (SEP) is associated with less frequent LTPA during adulthood. Studies were located through a systematic search of MEDLINE, Embase, PsycINFO, CINAHL and SPORTDiscus and by searching reference lists. Eligible studies were English-language publications testing the association between any indicator of childhood SEP and an LTPA outcome measured during adulthood. Forty-five papers from 36 studies, most of which were European, were included. In most samples, childhood SEP and LTPA were self-reported in midlife. Twenty-two studies found evidence to support the review's hypothesis and thirteen studies found no association. Accounting for own adult SEP partly attenuated associations. There was more evidence of an association in British compared with Scandinavian cohorts and in women compared with men. Results did not vary by childhood SEP indicator or age at assessment of LTPA. This review found evidence of an association between less advantaged childhood SEP and less frequent LTPA during adulthood. Understanding how associations vary by gender and place could provide insights into underlying pathways.

A critical review of "internet addiction" criteria with suggestions for the future

NARCIS (Netherlands)

A.J. van Rooij (Antonius); N. Prause (Nicole)

2014-01-01

textabstractAims: In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome.

Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial.

Science.gov (United States)

van den Boogaard, Mark; Slooter, Arjen J C; Brüggemann, Roger J M; Schoonhoven, Lisette; Beishuizen, Albertus; Vermeijden, J Wytze; Pretorius, Danie; de Koning, Jan; Simons, Koen S; Dennesen, Paul J W; Van der Voort, Peter H J; Houterman, Saskia; van der Hoeven, J G; Pickkers, Peter; van der Woude, Margaretha C. E.; Besselink, Anna; Hofstra, Lieuwe S; Spronk, Peter E; van den Bergh, Walter; Donker, Dirk W; Fuchs, Malaika; Karakus, Attila; Koeman, M; van Duijnhoven, Mirella; Hannink, Gerjon

2018-02-20

Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium. To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days. Randomized, double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands. Patients without delirium whose expected ICU stay was at least a day were included. Recruitment was from July 2013 to December 2016 and follow-up was conducted at 90 days with the final follow-up on March 1, 2017. Patients received prophylactic treatment 3 times daily intravenously either 1 mg (n = 350) or 2 mg (n = 732) of haloperidol or placebo (n = 707), consisting of 0.9% sodium chloride. The primary outcome was the number of days that patients survived in 28 days. There were 15 secondary outcomes, including delirium incidence, 28-day delirium-free and coma-free days, duration of mechanical ventilation, and ICU and hospital length of stay. All 1789 randomized patients (mean, age 66.6 years [SD, 12.6]; 1099 men [61.4%]) completed the study. The 1-mg haloperidol group was prematurely stopped because of futility. There was no difference in the median days patients survived in 28 days, 28 days in the 2-mg haloperidol group vs 28 days in the placebo group, for a difference of 0 days (95% CI, 0-0; P = .93) and a hazard ratio of 1.003 (95% CI, 0.78-1.30, P=.82). All of the 15 secondary outcomes were not statistically different. These included delirium incidence (mean difference, 1.5%, 95% CI, -3.6% to 6.7%), delirium-free and coma-free days (mean difference, 0 days, 95% CI, 0-0 days), and duration of mechanical ventilation, ICU, and hospital length of stay (mean difference

The benefits associated with volunteering among seniors: a critical review and recommendations for future research.

Science.gov (United States)

Anderson, Nicole D; Damianakis, Thecla; Kröger, Edeltraut; Wagner, Laura M; Dawson, Deirdre R; Binns, Malcolm A; Bernstein, Syrelle; Caspi, Eilon; Cook, Suzanne L

2014-11-01

There is an urgent need to identify lifestyle activities that reduce functional decline and dementia associated with population aging. The goals of this article are to review critically the evidence on the benefits associated with formal volunteering among older adults, propose a theoretical model of how volunteering may reduce functional limitations and dementia risk, and offer recommendations for future research. Database searches identified 113 papers on volunteering benefits in older adults, of which 73 were included. Data from descriptive, cross-sectional, and prospective cohort studies, along with 1 randomized controlled trial, most consistently reveal that volunteering is associated with reduced symptoms of depression, better self-reported health, fewer functional limitations, and lower mortality. The extant evidence provides the basis for a model proposing that volunteering increases social, physical, and cognitive activity (to varying degrees depending on characteristics of the volunteer placement) which, through biological and psychological mechanisms, leads to improved functioning; we further propose that these volunteering-related functional improvements should be associated with reduced dementia risk. Recommendations for future research are that studies (a) include more objective measures of psychosocial, physical, and cognitive functioning; (b) integrate qualitative and quantitative methods in prospective study designs; (c) explore further individual differences in the benefits associated with volunteering; (d) include occupational analyses of volunteers' specific jobs in order to identify their social, physical, and cognitive complexity; (e) investigate the independent versus interactive health benefits associated with volunteering relative to engagement in other forms of activity; and (f) examine the relationship between volunteering and dementia risk. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Neurobiological findings associated with high cognitive performance in older adults: a systematic review.

Science.gov (United States)

Borelli, Wyllians Vendramini; Schilling, Lucas Porcello; Radaelli, Graciane; Ferreira, Luciana Borges; Pisani, Leonardo; Portuguez, Mirna Wetters; da Costa, Jaderson Costa

2018-04-18

ABSTRACTObjectives:to perform a comprehensive literature review of studies on older adults with exceptional cognitive performance. We performed a systematic review using two major databases (MEDLINE and Web of Science) from January 2002 to November 2017. Quantitative analysis included nine of 4,457 studies and revealed that high-performing older adults have global preservation of the cortex, especially the anterior cingulate region, and hippocampal volumes larger than normal agers. Histological analysis of this group also exhibited decreased amyloid burden and neurofibrillary tangles compared to cognitively normal older controls. High performers that maintained memory ability after three years showed reduced amyloid positron emission tomography at baseline compared with high performers that declined. A single study on blood plasma found a set of 12 metabolites predicting memory maintenance of this group. Structural and molecular brain preservation of older adults with high cognitive performance may be associated with brain maintenance. The operationalized definition of high-performing older adults must be carefully addressed using appropriate age cut-off and cognitive evaluation, including memory and non-memory tests. Further studies with a longitudinal approach that include a younger control group are essential.

Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review protocol.

Science.gov (United States)

Muellmann, Saskia; Forberger, Sarah; Möllers, Tobias; Zeeb, Hajo; Pischke, Claudia R

2016-03-16

It is known that regular physical activity (PA) is associated with improvements in physical, psychological, cognitive, and functional health outcomes. The World Health Organization recommends 150 min of moderate exercise per week for older adults to achieve these health benefits. However, only 20-60 % of adults aged 60 years and above currently meet these recommendations for exercise. The widespread use of the internet and mobile phones among older adults may open new opportunities to promote PA in this population. Findings of previous reviews suggest that eHealth interventions are effective in promoting PA in adults of various ages. However, to date, none of these reviews have provided a differentiated picture of engagement in such interventions and effects on PA among older adults. Also, we are unaware of any studies comparing effects of participation in eHealth vs. traditional paper-and-pencil interventions on PA in this population. The aim of this systematic review and meta-analysis is to compare the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with either a non-eHealth PA intervention or a group that is not exposed to any intervention. Eight electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, PEI, PsycINFO, Web of Science, and OpenGrey) will be searched to identify experimental and quasi-experimental studies examining the effectiveness of eHealth interventions for PA promotion in adults aged 55 years and above. Two authors will independently select and review references, extract data, and assess the quality of the included studies by using the Cochrane Collaboration's risk of bias tool. Disagreements between authors will be resolved by discussion involving a third author. If feasible, a meta-analysis will be conducted. Narrative synthesis using harvest plots will be performed, should a meta-analysis not be feasible. The proposed systematic review will be the first review that compares the effectiveness of e

What is bizarre in bizarre delusions? A critical review

DEFF Research Database (Denmark)

Cermolacce, Michel René Joseph; Jensen, Lars Meldgaard Sass; Parnas, J

2010-01-01

or incomprehensible. Then, we provide a critical review of contemporary studies on the reliability of BD and their methodological and conceptual limitations. Current approaches have focused intensely on BD's reliability and have defined BD strictly in terms of delusional content--mainly in terms of the physical...... to delusional contents alone and requires taking into account the subjective side of BD (how altered experience manifests itself) as well as the conditions of intersubjective encounter (how BD are expressed to and experienced by the clinician). The notion of "bizarreness" in schizophrenia is not purely...

Novel sensing technology in fall risk assessment in older adults: a systematic review.

Science.gov (United States)

Sun, Ruopeng; Sosnoff, Jacob J

2018-01-16

Falls are a major health problem for older adults with significant physical and psychological consequences. A first step of successful fall prevention is to identify those at risk of falling. Recent advancement in sensing technology offers the possibility of objective, low-cost and easy-to-implement fall risk assessment. The objective of this systematic review is to assess the current state of sensing technology on providing objective fall risk assessment in older adults. A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Twenty-two studies out of 855 articles were systematically identified and included in this review. Pertinent methodological features (sensing technique, assessment activities, outcome variables, and fall discrimination/prediction models) were extracted from each article. Four major sensing technologies (inertial sensors, video/depth camera, pressure sensing platform and laser sensing) were reported to provide accurate fall risk diagnostic in older adults. Steady state walking, static/dynamic balance, and functional mobility were used as the assessment activity. A diverse range of diagnostic accuracy across studies (47.9% - 100%) were reported, due to variation in measured kinematic/kinetic parameters and modelling techniques. A wide range of sensor technologies have been utilized in fall risk assessment in older adults. Overall, these devices have the potential to provide an accurate, inexpensive, and easy-to-implement fall risk assessment. However, the variation in measured parameters, assessment tools, sensor sites, movement tasks, and modelling techniques, precludes a firm conclusion on their ability to predict future falls. Future work is needed to determine a clinical meaningful and easy to interpret fall risk diagnosis utilizing sensing technology. Additionally, the gap between functional evaluation and user experience to technology should be addressed.

Mental health implications for older adults after natural disasters--a systematic review and meta-analysis.

Science.gov (United States)

Parker, Georgina; Lie, David; Siskind, Dan J; Martin-Khan, Melinda; Raphael, Beverly; Crompton, David; Kisely, Steve

2016-01-01

Natural disasters affect the health and well-being of adults throughout the world. There is some debate in the literature as to whether older persons have increased risk of mental health outcomes after exposure to natural disasters when compared with younger adults. To date, no systematic review has evaluated this. We aimed to synthesize the available evidence on the impact of natural disasters on the mental health and psychological distress experienced by older adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified six papers with sufficient data for a random effects meta-analysis. Older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults. Given the global rise in the number of older adults affected by natural disasters, mental health services need to be prepared to meet their needs following natural disasters, particularly around the early detection and management of PTSD.

An integrative review of the literature on the teaching of the history of nursing in pre-registration adult nursing education in the UK.

Science.gov (United States)

Kelly, Jacinta; Watson, Roger

2015-02-01

To present an integrative review of literature on the teaching of nursing history in pre-registration adult nursing education. Despite successive reconfigurations in healthcare systems and education policy, the teaching of the history of nursing remains contested in pre-registration curricula. Recent curriculum reviews acknowledge the need for systematic study of nursing education. To date in the UK, there has been no systematic review of the literature on the teaching of nursing history in pre-registration training programmes. An integrative review of the literature. A search of the electronic databases of CINAHL (1982-2013), HMIC (1979-2013), BNI (1994-2013) and MEDLINE (Pub Med) (1966-2013) was concluded in January 2014, using the keywords 'adult nursing', 'history' 'pre-registration', 'education' and 'teaching'. An integrative literature review was conducted. Identified titles and abstracts were screened separately by researchers for relevance and eligibility and papers were independently assessed for inclusion. Data were abstracted from included papers and quality evaluation of included papers was conducted. The papers were analysed and reported in a narrative synthesis. Twelve papers were selected for review. The majority of articles were discursive papers and there was a paucity of empirical reports. Content indicated concerns for teaching nursing history in regard to curriculum policy and methods of teaching and assessment. Substantial support exists for mandatory inclusion of the teaching of historical literacy in nursing centred on the themes of health and disease, hegemony, nursing work and image and ideology. Due to space and teaching expertise issues this could ideally be achieved through the use of nursing museum visits, the usefulness of which could be critically explored in future research. Published by Elsevier Ltd.

Teaching Critical Thinking Skills in Higher Education: A Review of the Literature

Science.gov (United States)

Behar-Horenstein, Linda S.; Niu, Lian

2011-01-01

The authors reviewed 42 empirical studies of teaching of critical thinking skills in postsecondary education published between 1994 and 2009. The instructional intervention, test measure, and research design of the studies were analyzed. Study results suggest that: (1) the same instructional interventions can lead to different results, depending…

Explaining Differences in Age at Autism Spectrum Disorder Diagnosis: A Critical Review

Science.gov (United States)

Daniels, Amy M.; Mandell, David S.

2014-01-01

The diagnosis of autism is often delayed, which translates into a missed opportunity to provide treatment during a critical developmental period. This study reviews studies that assessed factors associated with age at autism spectrum disorder diagnosis and provides recommendations on future research, programs, and policies to improve early…

Do spatiotemporal parameters and gait variability differ across the lifespan of healthy adults? A systematic review.

Science.gov (United States)

Herssens, Nolan; Verbecque, Evi; Hallemans, Ann; Vereeck, Luc; Van Rompaey, Vincent; Saeys, Wim

2018-06-12

Aging is often associated with changes in the musculoskeletal system, peripheral and central nervous system. These age-related changes often result in mobility problems influencing gait performance. Compensatory strategies are used as a way to adapt to these physiological changes. The aim of this review is to investigate the differences in spatiotemporal and gait variability measures throughout the healthy adult life. This systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (no. CRD42017057720). Databases MEDLINE (Pubmed), Web of Science (Web of Knowledge), Cochrane Library and ScienceDirect were systematically searched until March 2018. Eighteen of the 3195 original studies met the eligibility criteria and were included in this review. The majority of studies reported spatiotemporal and gait variability measures in adults above the age of 65, followed by the young adult population, information of middle-aged adults is lacking. Spatiotemporal parameters and gait variability measures were extracted from 2112 healthy adults between 18 and 98 years old and, in general, tend to deteriorate with increasing age. Variability measures were only reported in an elderly population and show great variety between studies. The findings of this review suggest that most spatiotemporal parameters significantly differ across different age groups. Elderly populations show a reduction of preferred walking speed, cadence, step and stride length, all related to a more cautious gait, while gait variability measures remain stable over time. A preliminary framework of normative reference data is provided, enabling insights into the influence of aging on spatiotemporal parameters, however spatiotemporal parameters of middle-aged adults should be investigated more thoroughly. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of 2 intravenous insulin protocols: Glycemia variability in critically ill patients.

Science.gov (United States)

Gómez-Garrido, Marta; Rodilla-Fiz, Ana M; Girón-Lacasa, María; Rodríguez-Rubio, Laura; Martínez-Blázquez, Anselmo; Martínez-López, Fernando; Pardo-Ibáñez, María Dolores; Núñez-Marín, Juan M

2017-05-01

Glycemic variability is an independent predictor of mortality in critically ill patients. The objective of this study was to compare two intravenous insulin protocols in critically ill patients regarding the glycemic variability. This was a retrospective observational study performed by reviewing clinical records of patients from a Critical Care Unit for 4 consecutive months. First, a simpler Scale-Based Intravenous Insulin Protocol (SBIIP) was reviewed and later it was compared for the same months of the following year with a Sliding Scale-Based Intravenous Insulin Protocol (SSBIIP). All adult patients admitted to the unit during the referred months were included. Patients in whom the protocol was not adequately followed were excluded. A total of 557 patients were reviewed, of whom they had needed intravenous insulin 73 in the first group and 52 in the second group. Four and two patients were excluded in each group respectively. Glycemic variability for both day 1 (DS1) and total stay (DST) was lower in SSBIIP patients compared to SBIIP patients: SD1 34.88 vs 18.16 and SDT 36.45 vs 23.65 (P<.001). A glycemic management protocol in critically ill patients based on sliding scales decreases glycemic variability. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

The policy challenges of tradable credits: A critical review of eight markets

International Nuclear Information System (INIS)

Sovacool, Benjamin K.

2011-01-01

This article offers a critical review of eight tradable permit markets: water permits at Fox River, Wisconsin; the U.S. leaded gasoline phase-out; sulfur dioxide credits under the U.S. Clean Air Act Amendments of 1990; the Regional Clean Air Incentives Market (RECLAIM) for controlling ozone and acid rain in Southern California; renewable energy credit trading at the regional level in the United States; individual transferrable quotas for fisheries at the national level in New Zealand; carbon credits traded under the European Union-Emissions Trading Scheme; and carbon offsets permitted under the Clean Development Mechanism of the Kyoto Protocol. By 'critical' the article does not fully weigh the costs and benefits of each tradable credit scheme and instead identifies key challenges and problems. By 'review' the author relied exclusively on secondary data from an interdisciplinary review of the academic literature. Rather than performing as economic theory suggests, the article shows that in many cases credit markets are prone to compromises in program design, transaction costs, price volatility, leakage, and environmental degradation. The article concludes by discussing the implications of these problems for those seeking to design more equitable and effective public policies addressing environmental degradation and climate change. - Research Highlights: →This study reviews eight tradable credit markets. →It finds that markets are prone to common problems. →It concludes that tradable permit markets are political instruments as much as they are economic ones.

Social science research of HIV in Vietnam: A critical review and future directions

OpenAIRE

Dao, Amy; Hirsch, Jennifer; Giang, Le Minh; Parker, Richard G.

2013-01-01

Social science research, with theoretical and methodological tools that are well suited to capture the complexities of Vietnam’s rapidly changing social and political context, could contribute important insights that would enhance the response to Vietnam’s growing HIV epidemic. The present paper reviews the published, peer-reviewed English-language social science literature on HIV in Vietnam in order to identify critical theoretical and substantive gaps and lay the groundwork for future resea...

Managing Osteoarthritis Pain with Medicines: A Review of the Research for Adults

Science.gov (United States)

Managing Osteoarthritis Pain With Medicines A Review of the Research for Adults Is This Summary Right for Me? Yes, if: „ „ A doctor* said you have osteoarthritis (pronounced ah-stee-oh- arth-RYE-tis). Osteoarthritis ...

A review of health utilities across conditions common in paediatric and adult populations

Directory of Open Access Journals (Sweden)

Hopkins Robert B

2010-01-01

Full Text Available Abstract Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI or EuroQoL-5Dimensions (EQ-5D questionnaires or using time trade off (TTO or standard gamble (SG techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL. Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25, cancer (n = 23, diabetes mellitus (n = 11, skin diseases (n = 19 or chronic diseases (n = 2, with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33, EQ-5D (n = 26, TTO (n = 12, and SG (n = 14, with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin

Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.

Science.gov (United States)

Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip

2016-11-01

This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be

A Review of Physiological and Psychological Changes in Aging and Their Implications for Teachers of Adults.

Science.gov (United States)

Hand, Samuel E.

This review of literature on the aging process points out primary physiological and psychological changes in maturing adults which have implications for teachers of adults. Visual acuity and hearing decline during adult years and there is a general slowing down process of most bodily activities. Teachers should be aware of the need for good…

Virtual reality using games for improving physical functioning in older adults: a systematic review.

Science.gov (United States)

Molina, Karina Iglesia; Ricci, Natalia Aquaroni; de Moraes, Suzana Albuquerque; Perracini, Monica Rodrigues

2014-11-15

The use of virtual reality through exergames or active video game, i.e. a new form of interactive gaming, as a complementary tool in rehabilitation has been a frequent focus in research and clinical practice in the last few years. However, evidence of their effectiveness is scarce in the older population. This review aim to provide a summary of the effects of exergames in improving physical functioning in older adults. A search for randomized controlled trials was performed in the databases EMBASE, MEDLINE, PsyInfo, Cochrane data base, PEDro and ISI Web of Knowledge. Results from the included studies were analyzed through a critical review and methodological quality by the PEDro scale. Thirteen studies were included in the review. The most common apparatus for exergames intervention was the Nintendo Wii gaming console (8 studies), followed by computers games, Dance video game with pad (two studies each) and only one study with the Balance Rehabilitation Unit. The Timed Up and Go was the most frequently used instrument to assess physical functioning (7 studies). According to the PEDro scale, most of the studies presented methodological problems, with a high proportion of scores below 5 points (8 studies). The exergames protocols and their duration varied widely, and the benefits for physical function in older people remain inconclusive. However, a consensus between studies is the positive motivational aspect that the use of exergames provides. Further studies are needed in order to achieve better methodological quality, external validity and provide stronger scientific evidence.

A critical review of simulation-based medical education research: 2003-2009.

Science.gov (United States)

McGaghie, William C; Issenberg, S Barry; Petrusa, Emil R; Scalese, Ross J

2010-01-01

This article reviews and critically evaluates historical and contemporary research on simulation-based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit. This qualitative synthesis of SBME research and scholarship was carried out in two stages. Firstly, we summarised the results of three SBME research reviews covering the years 1969-2003. Secondly, we performed a selective, critical review of SBME research and scholarship published during 2003-2009. The historical and contemporary research synthesis is reported to inform the medical education community about 12 features and best practices of SBME: (i) feedback; (ii) deliberate practice; (iii) curriculum integration; (iv) outcome measurement; (v) simulation fidelity; (vi) skill acquisition and maintenance; (vii) mastery learning; (viii) transfer to practice; (ix) team training; (x) high-stakes testing; (xi) instructor training, and (xii) educational and professional context. Each of these is discussed in the light of available evidence. The scientific quality of contemporary SBME research is much improved compared with the historical record. Development of and research into SBME have grown and matured over the past 40 years on substantive and methodological grounds. We believe the impact and educational utility of SBME are likely to increase in the future. More thematic programmes of research are needed. Simulation-based medical education is a complex service intervention that needs to be planned and practised with attention to organisational contexts.

A critical review of objective personality inventories with sex offenders.

Science.gov (United States)

Davis, Karen M; Archer, Robert P

2010-12-01

This review provides a critical analysis of the ability of multiscale inventories to distinguish between sex offender and nonoffender control groups, as well as to discriminate sex offenders from other types of offenders. In addition to expanding upon previous reviews that examined the utility of the Minnesota Multiphasic Personality Inventory (MMPI) with this population (e.g., Levin & Stava, 1987), the current review included studies that utilized other multiscale inventories commonly used in forensic practice (i.e., MMPI-2, Millon Clinical Multiaxial Inventory-III [MCMI-III], Personality Assessment Inventory) and, when possible, provides effect sizes to evaluate group differences. Based on the review, the various forms of the MMPI and MCMI are clearly the most widely used instruments in sex offender populations. The MMPI Pd scale has shown moderate to large effect sizes when distinguishing between sex offender and nonsex offender groups, but this relationship may be reflective of antisocial behavior in general rather than traits specific to sex offenders. Recommendations to standardize future research classification strategies and more effectively utilize these instruments when assessing sex offenders are also provided. © 2010 Wiley Periodicals, Inc.

School effectiveness research: a review of criticisms and some proposals to address them.

Directory of Open Access Journals (Sweden)

Andres Sandoval-Hernandez

2008-03-01

Full Text Available Based on Lakato’s notion of research programmes, the paper analyses the structure of the School Effectiveness Research (SER programme and reviews the main criticisms that have arisen, stressing those regarding its objectivity and theoretical limitations. Then, some proposals are made to address these criticisms, namely: to adopt a critical realist approach to the study of SE and an Abductive Theory of Scientific Method that lead to the development of sound theory in the field. Based on this analysis the paper concludes that, in terms of Lakatos, a movement towards a new research programme is needed in order to ensure that the main objectives originally set for SER can be eventually reached.

Anticonvulsant pharmacotherapy for generalized and localized vulvodynia : a critical review of the literature

NARCIS (Netherlands)

Spoelstra, Symen K.; Borg, Charmaine; Schultz, Willibrord C. M. Weijmar

Anticonvulsant therapy has occasionally been recommended to treat vulvodynia. However, convincing evidence to support this therapeutic option is lacking. The goal of this study was to critically review studies published on the effectiveness of anticonvulsants for the treatment of vulvodynia.

Photodesorption: a critical review

International Nuclear Information System (INIS)

Lichtman, D.; Shapira, Y.

1975-01-01

A critical review of the literature in the field of photodesorption is presented. Material is covered through December 1975. Although it is impossible to include every paper ever published which is in some way related to photodesorption, it is felt that the material covered is sufficiently complete to permit reasonable conclusions to be reached. The literature naturally falls into two basic categories, namely, papers involved with metal substrates and those involved with semiconductor substrates. Since the effects on these two kinds of surfaces are very different, they are each considered in separate sections. Photodesorption from metals seems to be an extremely inefficient process if it occurs at all. That is, cross sections are equal to or less than 10 -23 cm 2 . The reason for this extremely low cross section is not yet well understood. Photodesorption from semiconductors seems to be a very efficient process with cross sections as high as 10 -17 cm 2 . On most substrates studied, e.g. ZnO, TiO 2 , CdS, the chrome oxide surface of stainless steel, etc., impurity carbon atoms play a very significant role. On all these materials, the single or dominant process involves chemisorption of molecular oxygen onto the impurity carbon surface atoms. Electrons are captured from the conduction band to produce a chemisorbed CO 2 - complex. The application of band gap and higher energy radiation produces electron-hole pairs. Some of the photogenerated holes migrate to the surface where they combine with the negative ion complex. The resulting physisorbed CO 2 is then thermally desorbed

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

Science.gov (United States)

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

2017-07-10

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

A Critical Review on the Concept of Social Technology

Directory of Open Access Journals (Sweden)

Bettina Leibetseder

2013-08-01

Full Text Available Purpose—A critical analysis of the term social technology from a social science point of view.Design/Methodology/Approach—Review of the term “social technology” from a social science point of perspective in connection to the study of governmentality and power in a Foucauldian way.Findings—The article covers the perspective that social technology provides social science knowledge for a purpose. Such a notion allows an in depth debate about the meaning of social order in modern societies. Establishing distinctive techniques now forms the basis of the modern state and governance. Social technology forms the basis of governmental decisions; it allows for a use of social theories and methods for a purpose in politics and introduces a specific conception of power between the individual and public powers. Therefore, it alters government in three ways: It provides expert power to define solutions for social problems based on social science knowledge. It transforms government. Social technology exemplifies a support system for an ordered method of the way of government, it allows for the conduct of others and self based on scientific expertise. It can define new areas of problems in need of a change of government.Research limitations/implications—Consequently, social technology requests a critical analysis using a governmental approach. Such an approach focuses on problems on the governed subject and how governing works and why it has evolved in that way towards the subject and what kind of ideas and thinking lies within the discourse.Research type—general review.

Does preoperative physiotherapy improve postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty? A systematic review.

Science.gov (United States)

Chesham, Ross Alexander; Shanmugam, Sivaramkumar

2017-01-01

Knee osteoarthritis (OA) is a leading cause of disability in older adults (≥60) in the UK. If nonsurgical management fails and if OA severity becomes too great, knee arthroplasty is a preferred treatment choice. Preoperative physiotherapy is often offered as part of rehabilitation to improve postoperative patient-based outcomes. Systematically review whether preoperative physiotherapy improves postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty (TKA) and compare study interventions to best-practice guidelines. A literature search of Randomized Controlled Trials (RCTs), published April 2004-April 2014, was performed across six databases. Individual studies were evaluated for quality using the PEDro Scale. Ten RCTs met the full inclusion/exclusion criteria. RCTs compared control groups versus: preoperative exercise (n = 5); combined exercise and education (n = 2); combined exercise and acupuncture (n = 1); neuromuscular electrical stimulation (NMES; n = 1); and acupuncture versus exercise (n = 1). RCTs recorded many patient-based outcomes including knee strength, ambulation, and pain. Minimal evidence is presented that preoperative physiotherapy is more effective than no physiotherapy or usual care. PEDro Scale and critical appraisal highlighted substantial methodological quality issues within the RCTs. There is insufficient quality evidence to support the efficacy of preoperative physiotherapy in older adults who undergo total knee arthroplasty.

Timing of the initiation of parenteral nutrition in critically ill children.

Science.gov (United States)

Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P

2017-05-01

To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.

Hope and Mental Health in Young Adult College Students: An Integrative Review.

Science.gov (United States)

Griggs, Stephanie

2017-02-01

One in five young adults are diagnosed with a mental illness and many experience psychological distress during their first year of college due to new pressures in academia. The purpose of the current integrative review was to describe and synthesize hope and mental health in young adults in college. PubMed, CINAHL, and PsycINFO were searched for articles published in peer-reviewed journals from 2011-2016. Twenty empirical works were selected for inclusion and five themes emerged: (a) Hope is Associated With Improved Coping, (b) Hope is Associated With Improved Well-Being, (c) Hope is a Moderator Between Depression and Negative Life Events, (d) Hope is a Protective Factor in Suicide, and (e) Hope is a Factor in Healthy Behavior Engagement. Hope may be a protective factor in suicide and negative, self-deprecatory thinking. Further research is needed to determine if increasing hope in young adult college students will decrease the risk of suicide and non-suicidal self-injury, increase healthy behavior engagement, and improve coping and well-being. [Journal of Psychosocial Nursing and Mental Health Services, 55(2), 28-35.]. Copyright 2017, SLACK Incorporated.

Stress ulcer prophylaxis versus placebo or no prophylaxis in critically ill patients. A systematic review of randomised clinical trials with meta-analysis and trial sequential analysis

DEFF Research Database (Denmark)

Krag, Mette; Perner, Anders; Wetterslev, Jørn

2014-01-01

PURPOSE: To assess the effects of stress ulcer prophylaxis (SUP) versus placebo or no prophylaxis on all-cause mortality, gastrointestinal (GI) bleeding and hospital-acquired pneumonia in adult critically ill patients in the intensive care unit (ICU). METHODS: We performed a systematic review using...... meta-analysis and trial sequential analysis (TSA). Eligible trials were randomised clinical trials comparing proton pump inhibitors or histamine 2 receptor antagonists with either placebo or no prophylaxis. Two reviewers independently assessed studies for inclusion and extracted data. The Cochrane...... of bias. There was no statistically significant difference in mortality (fixed effect: RR 1.00, 95% CI 0.84-1.20; P = 0.87; I(2) = 0%) or hospital-acquired pneumonia (random effects: RR 1.23, 95% CI 0.86-1.78; P = 0.28; I(2) = 19%) between SUP patients and the no prophylaxis/placebo patients...

Older adults and mobile phones for health: a review.

Science.gov (United States)

Joe, Jonathan; Demiris, George

2013-10-01

To report on the results of a review concerning the use of mobile phones for health with older adults. PubMed and CINAHL were searched for articles using "older adults" and "mobile phones" along with related terms and synonyms between 1965 and June 2012. Identified articles were filtered by the following inclusion criteria: original research project utilizing a mobile phone as an intervention, involve/target adults 60 years of age or older, and have an aim emphasizing the mobile phone's use in health. Twenty-one different articles were found and categorized into ten different clinical domains, including diabetes, activities of daily life, and dementia care, among others. The largest group of articles focused on diabetes care (4 articles), followed by COPD (3 articles), Alzheimer's/dementia Care (3 articles) and osteoarthritis (3 articles). Areas of interest studied included feasibility, acceptability, and effectiveness. While there were many different clinical domains, the majority of studies were pilot studies that needed more work to establish a stronger base of evidence. Current work in using mobile phones for older adult use are spread across a variety of clinical domains. While this work is promising, current studies are generally smaller feasibility studies, and thus future work is needed to establish more generalizable, stronger base of evidence for effectiveness of these interventions. Copyright © 2013 Elsevier Inc. All rights reserved.

Who should be responsible for supporting individuals with mental health problems? A critical literature review.

Science.gov (United States)

Pope, Megan A; Malla, Ashok K; Iyer, Srividya N

2018-05-01

Individuals with mental health problems have many support needs that are often inadequately met; however, perceptions of who should be responsible for meeting these needs have been largely unexplored. Varying perceptions may influence whether, how, and to what extent relevant stakeholders support individuals with mental health problems. To critically evaluate the literature to determine who different stakeholders believe should be responsible for supporting individuals with mental health problems, what factors shape these perceptions, and how they relate to one another. A critical literature review was undertaken. Following an extensive literature search, the conceptual contributions of relevant works were critically evaluated. A concept map was created to build a conceptual framework of the topic. Views of individual versus societal responsibility for need provision and health; the morality of caring; and attributions of responsibility for mental illness offered valuable understandings of the review questions. Creating a concept map revealed that various interrelated factors may influence perceptions of responsibility. Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to unmet support needs among this group. Our critical review helps build a much-needed conceptual framework of factors influencing perceptions of responsibility. Such a framework is essential as these views iteratively shape and reflect the complex divisions of mental healthcare roles and responsibilities. Understanding these perceptions can help define relevant stakeholders' roles more clearly, which can improve mental health services and strengthen stakeholder accountability.

Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.

Science.gov (United States)

Tayyib, Nahla; Coyer, Fiona

2016-12-01

Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.

The meaningfulness of participating in Support Groups for informal caregives of older adults with dementia: A Systematic Review Protocol

DEFF Research Database (Denmark)

Lauritzen, Jette; Pedersen, Preben Ulrich; Bjerrum, Merete Bender

2013-01-01

of the disease and the duration of care. The informal caregiver is mainly seen as a family member and care must be performed at home. The review will not differentiate between studies involving subsets of informal caregivers (e.g. based on specific ethnicity, gender and/or specific morbidities of dementia among......Review question/objective The objective of this review is to identify the meaningfulness of participating in support groups for informal caregivers of older adults with dementia living in their own home. More specifically, the review question is: How do informal caregivers of older adults...... with dementia, living in urban and rural settings, perceive the meaningfulness of participating in support groups? Inclusion Criteria Types of participant(s) This review will consider studies that include informal caregivers of older adults aged 65 years and older with dementia, regardless of the severity...

Sensitivity and Specificity of the Comfort Scale to Assess Pain in Ventilated Critically Ill Adult Patients in Intensive Care Unit

OpenAIRE

Wahyuningsih, Indah Sri; Prasetyo, Awal; Utami, Reni Sulung

2017-01-01

Background: Pain is a common phenomenon experienced by ventilated and critically ill adult patients. It is urgent to measure the pain among these patients since they are unable to report their pain verbally. Comfort Scale is one of the instruments used to measure pain in adult patients. The scale is used to measure pain among children patients with fairly high sensitivity and specificity.Purpose: This study aimed to examine the sensitivity and specificity of the Comfort Scale to measure pain ...

Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions

Science.gov (United States)

White Hughto, Jaclyn M.; Reisner, Sari L.; Pachankis, John E.

2015-01-01

Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. PMID:26599625

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

Directory of Open Access Journals (Sweden)

Amna Umer

2017-08-01

Full Text Available Abstract Background Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Methods Studies were included if they met the following criteria: (1 longitudinal and cohort studies (including case-cohort, (2 childhood exposure and adult outcomes collected on the same individual over time, (3 childhood obesity, as defined by the original study authors, (4 English-language articles, (5 studies published up to June, 2015, (6 one or more of the following CVD risk factors [systolic blood pressure (SBP, diastolic blood pressure (DBP, total cholesterol (TC, high-density lipoprotein cholesterol (HDL, low-density lipoprotein cholesterol (LDL, non-high-density lipoprotein cholesterol (non-HDL, and triglycerides (TG], (7 outcome(s not self-reported, and (8 exposure measurements (child’s adiposity assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher’s r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Results Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and

Hormonal Signaling Cascade during an Early-Adult Critical Period Required for Courtship Memory Retention in Drosophila.

Science.gov (United States)

Lee, Sang Soo; Ding, Yike; Karapetians, Natalie; Rivera-Perez, Crisalejandra; Noriega, Fernando Gabriel; Adams, Michael E

2017-09-25

Formation and expression of memories are critical for context-dependent decision making. In Drosophila, a courting male rejected by a mated female subsequently courts less avidly when paired with a virgin female, a behavioral modification attributed to "courtship memory." Here we show the critical role of hormonal state for maintenance of courtship memory. Ecdysis-triggering hormone (ETH) is essential for courtship memory through regulation of juvenile hormone (JH) levels in adult males. Reduction of JH levels via silencing of ETH signaling genes impairs short-term courtship memory, a phenotype rescuable by the JH analog methoprene. JH-deficit-induced memory impairment involves rapid decay rather than failure of memory acquisition. A critical period governs memory performance during the first 3 days of adulthood. Using sex-peptide-expressing "pseudo-mated" trainers, we find that robust courtship memory elicited in the absence of aversive chemical mating cues also is dependent on ETH-JH signaling. Finally, we find that JH acts through dopaminergic neurons and conclude that an ETH-JH-dopamine signaling cascade is required during a critical period for promotion of social-context-dependent memory. Copyright © 2017 Elsevier Ltd. All rights reserved.

Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials

Science.gov (United States)

Innes, Kim E.; Selfe, Terry Kit

2016-01-01

A growing body of evidence suggests yogic practices may benefit adults with type 2 diabetes (DM2). In this systematic review, we evaluate available evidence from prospective controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management. To identify qualifying studies, we searched nine databases and scanned bibliographies of relevant review papers and all identified articles. Controlled trials that did not target adults with diabetes, included only adults with type 1 diabetes, were under two-week duration, or did not include quantitative outcome data were excluded. Study quality was evaluated using the PEDro scale. Thirty-three papers reporting findings from 25 controlled trials (13 nonrandomized, 12 randomized) met our inclusion criteria (N = 2170 participants). Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition. More limited data suggest that yoga may also lower oxidative stress and blood pressure; enhance pulmonary and autonomic function, mood, sleep, and quality of life; and reduce medication use in adults with DM2. However, given the methodological limitations of existing studies, additional high-quality investigations are required to confirm and further elucidate the potential benefits of yoga programs in populations with DM2. PMID:26788520

Review and compilation of criticality accidents in nuclear fuel processing facilities outside of Japan

International Nuclear Information System (INIS)

Watanabe, Norio; Tamaki, Hitoshi

2000-04-01

On September 30, 1999, a criticality accident occurred at the Tokai-mura uranium processing plant operated by JCO Co., Ltd., which resulted in the first nuclear accident involving a fatality, in Japan, and forced the residents in the vicinity of the site to be evacuated and be sheltered indoors. There have now been 21 criticality accidents reported in nuclear fuel processing facilities in foreign countries: seven in the United States, one in the United Kingdom and thirteen in Russia. Most of them occurred during the period from mid-1950's to mid-1960's, but one criticality accident tool place in Russian in 1997. This report reviews and compiles the published information on these accidents, including the latest information, focusing on the event sequence, the consequence of accident, and the cause of accident. The observations from the reviews are summarized as follows: Twenty of the 21 accidents occurred with the fissile material in a liquid. Twenty of the 21 accidents occurred in vessels/tanks with unfavorable geometry but one occurred in the vessel with favorable geometry. There were seven fatalities that were involved in five accidents. Three accidents involved a re-criticality condition caused by inadequate operator actions and two of them led to the death of the operators. One accident reached a re-criticality condition several hours after the first excursion was terminated by injecting borated water into the affected vessel. This accident implies the possibility that the borated water injection might not be effective to the criticality termination due to solubility of boric acid. Mechanisms of the criticality termination vary as follows: ejection or splashing of the solution at the time of power excursion, boiling or evaporation, addition of neutron poisons, or manual draining of solutions. (author)

Review and compilation of criticality accidents in nuclear fuel processing facilities outside of Japan

Energy Technology Data Exchange (ETDEWEB)

Watanabe, Norio [Planning and Analysis Division, Nuclear Safety Research Center, Tokai Research Establishment, Japan Atomic Energy Research Institute, Tokai, Ibaraki (Japan); Tamaki, Hitoshi [Department of Safety Research Technical Support, Tokai Research Establishment, Japan Atomic Energy Research Institute, Tokai, Ibaraki (Japan)

2000-04-01

On September 30, 1999, a criticality accident occurred at the Tokai-mura uranium processing plant operated by JCO Co., Ltd., which resulted in the first nuclear accident involving a fatality, in Japan, and forced the residents in the vicinity of the site to be evacuated and be sheltered indoors. There have now been 21 criticality accidents reported in nuclear fuel processing facilities in foreign countries: seven in the United States, one in the United Kingdom and thirteen in Russia. Most of them occurred during the period from mid-1950's to mid-1960's, but one criticality accident tool place in Russian in 1997. This report reviews and compiles the published information on these accidents, including the latest information, focusing on the event sequence, the consequence of accident, and the cause of accident. The observations from the reviews are summarized as follows: Twenty of the 21 accidents occurred with the fissile material in a liquid. Twenty of the 21 accidents occurred in vessels/tanks with unfavorable geometry but one occurred in the vessel with favorable geometry. There were seven fatalities that were involved in five accidents. Three accidents involved a re-criticality condition caused by inadequate operator actions and two of them led to the death of the operators. One accident reached a re-criticality condition several hours after the first excursion was terminated by injecting borated water into the affected vessel. This accident implies the possibility that the borated water injection might not be effective to the criticality termination due to solubility of boric acid. Mechanisms of the criticality termination vary as follows: ejection or splashing of the solution at the time of power excursion, boiling or evaporation, addition of neutron poisons, or manual draining of solutions. (author)

Psychotropic Drug Use in Physically Restrained, Critically Ill Adults Receiving Mechanical Ventilation.

Science.gov (United States)

Guenette, Melanie; Burry, Lisa; Cheung, Alexandra; Farquharson, Tara; Traille, Marlene; Mantas, Ioanna; Mehta, Sangeeta; Rose, Louise

2017-09-01

Restraining therapies (physical or pharmacological) are used to promote the safety of both patients and health care workers. Some guidelines recommend nonpharmacological or pharmacological interventions be used before physical restraints in critically ill patients. To characterize psychotropic drug interventions before and after use of physical restraints in critically ill adults receiving mechanical ventilation. A single-center, prospective, observational study documenting psychotropic drug use and Sedation-Agitation Scale (SAS) scores in the 2 hours before and the 6 hours after application of physical restraints. Ninety-three patients were restrained for a median of 21 hours (interquartile range, 9-70 hours). Thirty percent of patients did not receive a psychotropic drug or had a drug stopped or decreased before physical restraints were applied. More patients received a psychotropic drug intervention after use of physical restraints than before (86% vs 56%, P = .001). Administration of opioids was more common after the use of physical restraints (54% vs 20% of patients, P = .001) and accounted for more drug interventions (45% vs 29%, P = .001). Fifty patients had SAS scores from both time periods; 16% remained oversedated, 24% were appropriately sedated, and 16% remained agitated in both time periods. Patients became oversedated (20%), more agitated (10%), less agitated (8%), and less sedated (6%) after restraint use. Psychotropic drug interventions (mostly using opioids) were more common after use of physical restraints. Some patients may be physically restrained for anticipated treatment interference without consideration of pharmacological options and without documented agitation. ©2017 American Association of Critical-Care Nurses.

Factors associated with smoking in Asian American adults: a systematic review.

Science.gov (United States)

Zhang, Jing; Wang, Zhongmiao

2008-05-01

This review systematically examined the factors associated with smoking in Asian American adults (aged > or =17 years). A total of 21 quantitative studies published in peer-reviewed journals from 1997 to 2006 were reviewed and abstracted using the matrix method. Statistically significant factors reported by the studies were summarized. Methodological quality of the studies also was assessed (maximum possible score = 10). Acculturation and education were the most frequently reported factors (n = 10, 47.6%). Acculturation was negatively associated with men's smoking but was positively associated with women's smoking. Education was uniformly found to be negatively related to smoking. Age was reported to have either a positive or a negative relationship with smoking (n = 9, 42.9%). Men were more likely to smoke than women (n = 7, 33.3%). The mean methodological score of the reviewed studies was 4.14 (on a scale of 1-10 points; SD = 1.62; range = 2-8). Health promotion professionals need to consider the summarized factors associated with Asian American adults' smoking behavior when planning smoking prevention programs and when recruiting participants for smoking cessation programs. When addressing acculturation, program planners should design different health education materials and use different strategies for men and women. To identify, understand, and incorporate essential factors into effective interventions, future studies should aim at higher methodological quality by using longitudinal design and increasing the use of theory, the test of data validity and reliability, and the report of effect sizes.

Systematic review and meta-analysis of Saccharomyces boulardii in adult patients.

Science.gov (United States)

McFarland, Lynne V

2010-05-14

This article reviews the evidence for efficacy and safety of Saccharomyces boulardii (S. boulardii) for various disease indications in adults based on the peer-reviewed, randomized clinical trials and pre-clinical studies from the published medical literature (Medline, Clinical Trial websites and meeting abstracts) between 1976 and 2009. For meta-analysis, only randomized, blinded controlled trials unrestricted by language were included. Pre-clinical studies, volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis, but included in the systematic review. Of 31 randomized, placebo-controlled treatment arms in 27 trials (encompassing 5029 study patients), S. boulardii was found to be significantly efficacious and safe in 84% of those treatment arms. A meta-analysis found a significant therapeutic efficacy for S. boulardii in the prevention of antibiotic-associated diarrhea (AAD) (RR = 0.47, 95% CI: 0.35-0.63, P boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea. Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Helicobacter pylori treatment-related symptoms. S. boulardii shows promise for the prevention of C. difficile disease recurrences; treatment of irritable bowel syndrome, acute adult diarrhea, Crohn's disease, giardiasis, human immunodeficiency virus-related diarrhea; but more supporting evidence is recommended for these indications. The use of S. boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.

Integrative Review of the Relationship Between Sleep Disturbances and Episodic Memory in Older Adults.

Science.gov (United States)

Yeh, An-Yun; Pressler, Susan J; Giordani, Bruno J; Pozehl, Bunny J; Berger, Ann M

2018-07-01

Impaired episodic memory in older adults has been linked to many factors. One of these factors is sleep disturbances, which are reported by more than 50% of older adults. The relationship between episodic memory and sleep disturbances remains unclear, however, because of the multiple types of measures of sleep and episodic memory used in previous studies. The purpose of this integrative literature review was to integrate and compare findings on this relationship in adults aged 65 years. An electronic search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Medline for material published from the inception of the databases to December 2016. The literature search produced 13 data-based, peer-reviewed, and primary research articles that met eligibility criteria. The synthesized results from these articles provide evidence that older adults with 6-8 hr of self-reported total sleep time had better episodic memory than older adults with ≤5 hr or ≥9 hr of total sleep time. Shorter length and lower percentage of slow-wave sleep were associated with reduced episodic memory in older adults, but the results were controversial. Selection of different measurements and inconsistent variables across studies increased the difficulty of synthesizing and comparing the results. The diversity of covariates controlled in the included articles raise questions regarding which covariates should be controlled in such studies of sleep and episodic memory in older adults. The numerous study limitations were thus major barriers to understanding the relationship between sleep disturbances and episodic memory.

A Year of Progress: NASA's Space Launch System Approaches Critical Design Review

Science.gov (United States)

Askins, Bruce; Robinson, Kimberly

2015-01-01

NASA's Space Launch System (SLS) made significant progress on the manufacturing floor and on the test stand in 2014 and positioned itself for a successful Critical Design Review in mid-2015. SLS, the world's only exploration-class heavy lift rocket, has the capability to dramatically increase the mass and volume of human and robotic exploration. Additionally, it will decrease overall mission risk, increase safety, and simplify ground and mission operations - all significant considerations for crewed missions and unique high-value national payloads. Development now is focused on configuration with 70 metric tons (t) of payload to low Earth orbit (LEO), more than double the payload of the retired Space Shuttle program or current operational vehicles. This "Block 1" design will launch NASA's Orion Multi-Purpose Crew Vehicle (MPCV) on an uncrewed flight beyond the Moon and back and the first crewed flight around the Moon. The current design has a direct evolutionary path to a vehicle with a 130t lift capability that offers even more flexibility to reduce planetary trip times, simplify payload design cycles, and provide new capabilities such as planetary sample returns. Every major element of SLS has successfully completed its Critical Design Review and now has hardware in production or testing. In fact, the SLS MPCV-to-Stage-Adapter (MSA) flew successfully on the Exploration Flight Test (EFT) 1 launch of a Delta IV and Orion spacecraft in December 2014. The SLS Program is currently working toward vehicle Critical Design Review in mid-2015. This paper will discuss these and other technical and programmatic successes and challenges over the past year and provide a preview of work ahead before the first flight of this new capability.

A critical review of classical bouncing cosmologies

Energy Technology Data Exchange (ETDEWEB)

Battefeld, Diana, E-mail: dbattefe@astro.physik.uni-goettingen.de [Institut for Astrophysics, University of Goettingen, Friedrich-Hund Platz 1, D-37077 (Germany); Peter, Patrick, E-mail: peter@iap.fr [Institut d’Astrophysique de Paris, UMR 7095-CNRS, Université Pierre et Marie Curie, 98 bis boulevard Arago, 75014 Paris (France)

2015-04-01

Given the proliferation of bouncing models in recent years, we gather and critically assess these proposals in a comprehensive review. The PLANCK data shows an unmistakably red, quasi scale-invariant, purely adiabatic primordial power spectrum and no primary non-Gaussianities. While these observations are consistent with inflationary predictions, bouncing cosmologies aspire to provide an alternative framework to explain them. Such models face many problems, both of the purely theoretical kind, such as the necessity of violating the NEC and instabilities, and at the cosmological application level, as exemplified by the possible presence of shear. We provide a pedagogical introduction to these problems and also assess the fitness of different proposals with respect to the data. For example, many models predict a slightly blue spectrum and must be fine-tuned to generate a red spectral index; as a side effect, large non-Gaussianities often result. We highlight several promising attempts to violate the NEC without introducing dangerous instabilities at the classical and/or quantum level. If primordial gravitational waves are observed, certain bouncing cosmologies, such as the cyclic scenario, are in trouble, while others remain valid. We conclude that, while most bouncing cosmologies are far from providing an alternative to the inflationary paradigm, a handful of interesting proposals have surfaced, which warrant further research. The constraints and lessons learned as laid out in this review might guide future research.

Historical and Critical Review on Biophysical Economics

Science.gov (United States)

Adigüzel, Yekbun

2016-07-01

Biophysical economics is initiated with the long history of the relation of economics with ecological basis and biophysical perspectives of the physiocrats. It inherently has social, economic, biological, environmental, natural, physical, and scientific grounds. Biological entities in economy like the resources, consumers, populations, and parts of production systems, etc. could all be dealt by biophysical economics. Considering this wide scope, current work is a “biophysical economics at a glance” rather than a comprehensive review of the full range of topics that may just be adequately covered in a book-length work. However, the sense of its wide range of applications is aimed to be provided to the reader in this work. Here, modern approaches and biophysical growth theory are presented after the long history and an overview of the concepts in biophysical economics. Examples of the recent studies are provided at the end with discussions. This review is also related to the work by Cleveland, “Biophysical Economics: From Physiocracy to Ecological Economics and Industrial Ecology” [C. J. Cleveland, in Advances in Bioeconomics and Sustainability: Essay in Honor of Nicholas Gerogescu-Roegen, eds. J. Gowdy and K. Mayumi (Edward Elgar Publishing, Cheltenham, England, 1999), pp. 125-154.]. Relevant parts include critics and comments on the presented concepts in a parallelized fashion with the Cleveland’s work.

Feasibility and reliability of frailty assessment in the critically ill: a systematic review.

Science.gov (United States)

Pugh, Richard J; Ellison, Amy; Pye, Kate; Subbe, Christian P; Thorpe, Chris M; Lone, Nazir I; Clegg, Andrew

2018-02-26

For healthcare systems, an ageing population poses challenges in the delivery of equitable and effective care. Frailty assessment has the potential to improve care in the intensive care setting, but applying assessment tools in critical illness may be problematic. The aim of this systematic review was to evaluate evidence for the feasibility and reliability of frailty assessment in critical care. Our primary search was conducted in Medline, Medline In-process, EMBASE, CINAHL, PsycINFO, AMED, Cochrane Database of Systematic Reviews, and Web of Science (January 2001 to October 2017). We included observational studies reporting data on feasibility and reliability of frailty assessment in the critical care setting in patients 16 years and older. Feasibility was assessed in terms of timing of evaluation, the background, training and expertise required for assessors, and reliance upon proxy input. Reliability was assessed in terms of inter-rater reliability. Data from 11 study publications are included, representing 8 study cohorts and 7761 patients. Proxy involvement in frailty assessment ranged from 58 to 100%. Feasibility data were not well-reported overall, but the exclusion rate due to lack of proxy availability ranged from 0 to 45%, the highest rate observed where family involvement was mandatory and the assessment tool relatively complex (frailty index, FI). Conventional elements of frailty phenotype (FP) assessment required modification prior to use in two studies. Clinical staff tended to use a simple judgement-based tool, the clinical frailty scale (CFS). Inter-rater reliability was reported in one study using the CFS and although a good level of agreement was observed between clinician assessments, this was a small and single-centre study. Though of unproven reliability in the critically ill, CFS was the tool used most widely by critical care clinical staff. Conventional FP assessment required modification for general application in critical care, and an FI

High-flow nasal cannula therapy for adult patients

Science.gov (United States)

Zhang, Jian; Lin, Ling; Pan, Konghan; Zhou, Jiancang

2016-01-01

High-flow nasal cannula (HFNC) oxygen therapy has several physiological advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure in the pharynx, increasing alveolar recruitment in the lungs, humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. Recently, the use of HFNC in treating adult critical illness patients has significantly increased, and it is now being used in many patients with a range of different disease conditions. However, there are no established guidelines to direct the safe and effective use of HFNC for these patients. This review article summarizes the available published literature on the positive physiological effects, mechanisms of action, and the clinical applications of HFNC, compared with traditional oxygen therapy devices. The available literature suggests that HFNC oxygen therapy is an effective modality for the early treatment of critically adult patients. PMID:27698207

Developmental Counseling: The Young Adult Period. Critical Issues in Young Adult Development.

Science.gov (United States)

Beaty, Lee A.

In this paper, development during the adolescent period is considered from a counseling perspective. Although many of the issues of young adults continue to confront older adults, this paper discusses the issues that are special to this age group. It suggests that the emotional and social domain is best represented by the theory of Erikson, which…

Scales for the Identification of Adults with Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review

Science.gov (United States)

Taylor, Abigail; Deb, Shoumitro; Unwin, Gemma

2011-01-01

Attention deficit hyperactivity disorder (ADHD) is prevalent in the adult population. The associated co-morbidities and impairments can be relieved with treatment. Therefore, several rating scales have been developed to identify adults with ADHD who may benefit from treatment. No systematic review has yet sought to evaluate these scales in more…

Impact of vitamin D supplementation on endothelial and inflammatory markers in adults: A systematic review.

Science.gov (United States)

Agbalalah, Tari; Hughes, Stephen F; Freeborn, Ellen J; Mushtaq, Sohail

2017-10-01

This systematic review aims to evaluate randomised controlled trials (RCTs) investigating the effect of vitamin D supplementation on endothelial function and inflammation in adults. An electronic search of published randomised controlled trials, using Cochrane, Pubmed and Medline databases was conducted, with the search terms related to vitamin D and endothelial function. Inclusion criteria were RCTs in adult humans with a measure of vitamin D status using serum/plasma 25(OH)D and studies which administered the intervention through the oral route. Among the 1107 studies retrieved, 29 studies met the full inclusion criteria for this systematic review. Overall, 8 studies reported significant improvements in the endothelial/inflammatory biomarkers/parameters measured. However, in 2 out of the 8 studies, improvements were reported at interim time points, but improvements were absent post-intervention. The remaining 21 trial studies did not show significant improvements in the markers of interest measured. Evidence from the studies included in this systematic review did not demonstrate that vitamin D supplementation in adults, results in an improvement in circulating inflammatory and endothelial function biomarkers/parameters. This systematic review does not therefore support the use of vitamin D supplementation as a therapeutic or preventative measure for CVD in this respect. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Vocational Support Approaches in Autism Spectrum Disorder: A Synthesis Review of the Literature

Science.gov (United States)

Nicholas, David B.; Attridge, Mark; Zwaigenbaum, Lonnie; Clarke, Margaret

2015-01-01

This synthesis-based analysis identifies and reviews studies evaluating vocational resources for adults with autism spectrum disorder. It is based on a larger systematic review of intervention studies in autism spectrum disorder, from which a critical interpretive synthesis was conducted on studies related to vocation and autism spectrum disorder.…

Understanding unskilled work as a condition for participation in adult education and training

DEFF Research Database (Denmark)

Kondrup, Sissel

2015-01-01

This article discusses how to comprehend why people working unskilled jobs are less likely than other groups to position themselves as educable subjects and engage in adult education and training. This article outlines how different research traditions examining recruitment to and participation...... in adult education and training reveal and explain distinctive participation patterns. These traditions are critically reviewed in order to identify how they provide certain understandings and entail certain blind spots. The review reveals a striking absence of research into unskilled work and thus...... a tendency to overlook how engagement in specific kinds of work condition people’s perception of adult education and training. It is finally argued that future research must pay closer attention to people’s specific work-life and examine how engagement in specific historical, social and material (changing...

Intelligence Assessment Instruments in Adult Prison Populations: A Systematic Review.

Science.gov (United States)

van Esch, A Y M; Denzel, A D; Scherder, E J A; Masthoff, E D M

2017-10-01

Detection of intellectual disability (ID) in the penitentiary system is important for the following reasons: (a) to provide assistance to people with ID in understanding their legal rights and court proceedings; (b) to facilitate rehabilitation programs tailored to ID patients, which improves the enhancement of their quality of life and reduces their risk of reoffending; and (c) to provide a reliable estimate of the risk of offence recidivism. It requires a short assessment instrument that provides a reliable estimation of a person's intellectual functioning at the earliest possible stage of this process. The aim of this systematic review is (a) to provide an overview of recent short assessment instruments that provide a full-scale IQ score in adult prison populations and (b) to achieve a quality measurement of the validation studies regarding these instruments to determine which tests are most feasible in this target population. The Preferred Reporting Items for Systematic reviews and Meta-Analyses Statement is used to ensure reliability. The Satz-Mögel, an item-reduction short form of the Wechsler Adult Intelligence Scale, shows the highest correlation with the golden standard and is described to be most reliable. Nevertheless, when it comes to applicability in prison populations, the shorter and less verbal Quick Test can be preferred over others. Without affecting these conclusions, major limitations emerge from the present systematic review, which give rise to several important recommendations for further research.

A systematic review of interventions to improve outcomes for young adults with Type 1 diabetes.

LENUS (Irish Health Repository)

O'Hara, M C

2016-10-20

Many young adults with Type 1 diabetes experience poor outcomes. The aim of this systematic review was to synthesize the evidence regarding the effectiveness of interventions aimed at improving clinical, behavioural or psychosocial outcomes for young adults with Type 1 diabetes.

Contending Claims to Causality: A Critical Review of Mediation Research in HRD

Science.gov (United States)

Ghosh, Rajashi; Jacobson, Seth

2016-01-01

Purpose: The purpose of this paper is to conduct a critical review of the mediation studies published in the field of Human Resource Development (HRD) to discern if the study designs, the nature of data collection and the choice of statistical methods justify the causal claims made in those studies. Design/methodology/approach: This paper conducts…

Early enteral nutrition in critically ill patients with hemodynamic instability: an evidence-based review and practical advice.

Science.gov (United States)

Yang, Shuofei; Wu, Xingjiang; Yu, Wenkui; Li, Jieshou

2014-02-01

Early enteral nutrition (EEN) in critically ill patients is associated with significant benefit as well as elevated risk of complications. Concomitant use of EEN with vasopressors has been associated with nonocclusive bowel necrosis in critically ill patients with hemodynamic instability. The decision when to initiate enteral nutrition in hemodynamically unstable patients that require vasoactive substances remains a clinical dilemma. This review summarizes the effect of EEN and vasoactive agents on gastrointestinal blood flow and perfusion in critically ill patients, based on current evidence. Animal and clinical data involving simultaneous administration of EEN and vasoactive agents for hemodynamic instability are reviewed, and the factors related to the safety and effectiveness of EEN support in this patient population are analyzed. Moreover, practical recommendations are provided. Additional randomized clinical trials are warranted to provide cutting-edge evidence-based guidance about this issue for practitioners of critical care.

The chemistry and behaviour of antimony in the soil environment with comparisons to arsenic: A critical review

International Nuclear Information System (INIS)

Wilson, Susan C.; Lockwood, Peter V.; Ashley, Paul M.; Tighe, Matthew

2010-01-01

This article provides a critical review of the environmental chemistry of inorganic antimony (Sb) in soils, comparing and contrasting findings with those of arsenic (As). Characteristics of the Sb soil system are reviewed, with an emphasis on speciation, sorption and phase associations, identifying differences between Sb and As behaviour. Knowledge gaps in environmentally relevant Sb data for soils are identified and discussed in terms of the limitations this imposes on understanding the fate, behaviour and risks associated with Sb in environmental soil systems, with particular reference to mobility and bioavailability. - A critical and comparative review of Sb and As chemistry and associations in soil systems identifies research directions needed for better understanding of risks.

Pre-treatment risk stratification of prostate cancer patients: A critical review.

Science.gov (United States)

Rodrigues, George; Warde, Padraig; Pickles, Tom; Crook, Juanita; Brundage, Michael; Souhami, Luis; Lukka, Himu

2012-04-01

The use of accepted prostate cancer risk stratification groups based on prostate-specific antigen, T stage and Gleason score assists in therapeutic treatment decision-making, clinical trial design and outcome reporting. The utility of integrating novel prognostic factors into an updated risk stratification schema is an area of current debate. The purpose of this work is to critically review the available literature on novel pre-treatment prognostic factors and alternative prostate cancer risk stratification schema to assess the feasibility and need for changes to existing risk stratification systems. A systematic literature search was conducted to identify original research publications and review articles on prognostic factors and risk stratification in prostate cancer. Search terms included risk stratification, risk assessment, prostate cancer or neoplasms, and prognostic factors. Abstracted information was assessed to draw conclusions regarding the potential utility of changes to existing risk stratification schema. The critical review identified three specific clinically relevant potential changes to the most commonly used three-group risk stratification system: (1) the creation of a very-low risk category; (2) the splitting of intermediate-risk into a low- and high-intermediate risk groups; and (3) the clarification of the interface between intermediate- and high-risk disease. Novel pathological factors regarding high-grade cancer, subtypes of Gleason score 7 and percentage biopsy cores positive were also identified as potentially important risk-stratification factors. Multiple studies of prognostic factors have been performed to create currently utilized prostate cancer risk stratification systems. We propose potential changes to existing systems.

A critical scoping review of external uses of comfrey (Symphytum spp.).

Science.gov (United States)

Frost, R; MacPherson, H; O'Meara, S

2013-12-01

External preparations of the herb comfrey (most commonly Symphytum officinale L.) are widely available for over-the-counter, practitioner and healthcare professional usage. Traditional practice suggests comfrey can be used to treat musculoskeletal disorders, wounds and various other conditions; however a full and critical coverage of the evidence base has not yet been undertaken. A critical scoping review was undertaken. Six bibliographic databases, 10 grey literature databases and nine trials registers were searched plus reference lists of included studies and a descriptive overview of comfrey. Randomised or non-randomised clinical trials assessing the external use of comfrey for any indication were included and methodological and reporting quality were assessed. Observational studies were included only in the assessment of adverse events. Studies were grouped and summarised according to the type of indication treated. Of 1348 identified records, 64 full texts were screened for inclusion and 26 were included in the review - 13 RCTs, 5 non-randomised controlled trials and 8 observational studies evaluating treatments for ankle distortion, back pain, abrasion wounds, venous leg ulcers and osteoarthritis. The majority of included trials had an overall unclear risk of bias due to poor quality of reporting. Few adverse events were reported. Individual clinical trials showed evidence of benefit for ankle distortion, back pain, abrasion wounds and osteoarthritis. Topical application appears to be safe but further rigorous assessment is needed. Systematic reviews focussing on particular indications may clarify the treatment effect and safety of external comfrey preparations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Best Practices for Chiropractic Care for Older Adults: A Systematic Review and Consensus Update.

Science.gov (United States)

Hawk, Cheryl; Schneider, Michael J; Haas, Mitchell; Katz, Paul; Dougherty, Paul; Gleberzon, Brian; Killinger, Lisa Z; Weeks, John

2017-05-01

The purpose of this study was to update evidence-based recommendations on the best practices for chiropractic care of older adults. The project consisted of a systematic literature review and a consensus process. The following were searched from October 2009 through January 2016: MEDLINE, Index to Chiropractic Literature, CINAHL (Cumulative Index to Nursing and Allied Health Literature), AMED (Allied and Complementary Medicine Database), Alt HealthWatch, Cochrane Database of Systematic Reviews, and Cochrane Registry of Controlled Trials. Search terms were: (manipulation, spinal OR manipulation, chiropractic OR chiropract*) AND (geriatric OR "older adult*"). Two reviewers independently screened articles and abstracts using inclusion and exclusion criteria. The systematic review informed the project steering committee, which revised the previous recommendations. A multidisciplinary panel of experts representing expertise in practice, research, and teaching in a variety of health professions serving older adults rated the revised recommendations. The RAND Corporation/University of California, Los Angeles methodology for a modified Delphi consensus process was used. A total of 199 articles were found; after exclusion criteria were applied, 6 articles about effectiveness or efficacy and 6 on safety were added. The Delphi process was conducted from April to June 2016. Of the 37 Delphi panelists, 31 were DCs and 6 were other health care professionals. Three Delphi rounds were conducted to reach consensus on all 45 statements. As a result, statements regarding the safety of manipulation were strengthened and additional statements were added recommending that DCs advise patients on exercise and that manipulation and mobilization contribute to general positive outcomes beyond pain reduction only. This document provides a summary of evidence-informed best practices for doctors of chiropractic for the evaluation, management, and manual treatment of older adult patients

Nutritional determinants of frailty in older adults: A systematic review.

Science.gov (United States)

Lorenzo-López, Laura; Maseda, Ana; de Labra, Carmen; Regueiro-Folgueira, Laura; Rodríguez-Villamil, José L; Millán-Calenti, José C

2017-05-15

Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults. PubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles. Of the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty. This systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty

A systematic review of interventions aiming to improve involvement in physical activity among adults with intellectual disability.

Science.gov (United States)

Brooker, Katie; van Dooren, Kate; McPherson, Lyn; Lennox, Nick; Ware, Robert

2015-03-01

Evidence suggests that most adults with intellectual disability do not participate in sufficient amounts of physical activity (PA). A systematic review of peer-reviewed studies that reported an intervention aiming to improve PA levels of adults with intellectual disability was conducted. Keywords related to intellectual disability and physical activity were used to search relevant databases. Studies were excluded if they did not measure PA as an outcome for adults with intellectual disability, were non-English, and were not peer-reviewed. All relevant studies were included in the review regardless of methodological quality and design. Six articles met the inclusion criteria. These included health education or health promotion programs with PA, nutrition, and weight loss components. The quality of studies included in this review was generally poor. Most studies used a prepost design, sample sizes were small, and measurement tools were used that are not valid and reliable for the population assessed. PA interventions have the potential to improve the health and wellbeing of people with intellectual disability, a vulnerable group who require attention from public health practitioners and researchers. Given the health inequities that exist, public health researchers should target efforts to improve PA levels among this group.

Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions.

Science.gov (United States)

White Hughto, Jaclyn M; Reisner, Sari L; Pachankis, John E

2015-12-01

Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. This critical review aims to integrate the literature on stigma towards transgender people in the U.S. This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review 1

Science.gov (United States)

Rodrigues, Maria Cristina Soares; de Oliveira, Cesar

2016-01-01

ABSTRACT Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps. PMID:27598380

Alcoholic beverage preference and dietary habits: a systematic literature review

NARCIS (Netherlands)

Sluik, D.; Bezemer, R.A.; Sierksma, A.; Feskens, E.J.M.

2016-01-01

Introduction: The aim of this review is to systematically and critically evaluate the existing literature into the association between alcoholic beverage preference and dietary habits in adults. Methods: A literature search was conducted in the databases of Medline (Pubmed), ISI Web of Knowledge,

A critical review of simulation-based mastery learning with translational outcomes.

Science.gov (United States)

McGaghie, William C; Issenberg, Saul B; Barsuk, Jeffrey H; Wayne, Diane B

2014-04-01

This article has two objectives. Firstly, we critically review simulation-based mastery learning (SBML) research in medical education, evaluate its implementation and immediate results, and document measured downstream translational outcomes in terms of improved patient care practices, better patient outcomes and collateral effects. Secondly, we briefly address implementation science and its importance in the dissemination of innovations in medical education and health care. This is a qualitative synthesis of SBML with translational (T) science research reports spanning a period of 7 years (2006-2013). We use the 'critical review' approach proposed by Norman and Eva to synthesise findings from 23 medical education studies that employ the mastery learning model and measure downstream translational outcomes. Research in SBML in medical education has addressed a range of interpersonal and technical skills. Measured outcomes have been achieved in educational laboratories (T1), and as improved patient care practices (T2), patient outcomes (T3) and collateral effects (T4). Simulation-based mastery learning in medical education can produce downstream results. Such results derive from integrated education and health services research programmes that are thematic, sustained and cumulative. The new discipline of implementation science holds promise to explain why medical education innovations are adopted slowly and how to accelerate innovation dissemination. © 2014 John Wiley & Sons Ltd.

Life Cycle Assessment Application to the Wine Sector: A Critical Review

Directory of Open Access Journals (Sweden)

Carmen Ferrara

2018-02-01

Full Text Available Life Cycle Assessment (LCA is a powerful tool that allows evaluation of the environmental performances of a product, service or process considering the whole life cycle or a part of it. In the wine sector, the application of LCA has grown significantly in recent years and several studies have been carried out about this topic that are similar to other research fields. Nowadays, LCA is an important and acknowledged environmental assessment tool but its application to the wine sector is still in a developing phase. For this reason, the present study proposes a critical review of papers dealing with both the wine sector and LCA. The critical review points out that the main wine hotspots are the viticulture phase (mainly due to fuel, fertilizer and pesticides consumption and the wine primary packaging production (due to glass bottles. Furthermore, the papers taken into consideration have a wide variability in the system boundaries definition as well as a shortage of availability of original and site-specific inventory data. Such key factors are sensitive aspects that have a huge influence on the results of a study and they are also affected by a wide variability: these issues need further scientific contribution through future studies.

The "sequence of prevention" for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature.

Science.gov (United States)

Kilic, Ozgur; Kemler, Ellen; Gouttebarge, Vincent

2018-02-02

To gather epidemiological information related to all steps of Van Mechelen's "sequence of prevention" for musculoskeletal injuries among adult recreational football players. A systematic review of the scientific literature was conducted in Medline via Pubmed. Therefore, two highly sensitive search strategies based on three groups of keywords (and related search terms) were used. In total, 33 relevant original studies were included in our systematic review. The results of our systematic review showed that the incidence of musculoskeletal injuries among recreational adult football players ranged from 9.6 to 15.8 injuries per 1000 exposure hours. These injuries are especially located in the ankle, knee, groin and hamstring, being associated with previous injury and match exposure. The FIFA11 + injury prevention programme and the Nordic Hamstring Exercise (NHE) were found to be effective for the reduction or prevention of musculoskeletal injuries among adult recreational football players. Our systematic review showed that musculoskeletal injuries are common among recreational adult football players, while effective preventive programmes are available. Further studies should focus on the identification and understanding of the key factors responsible for the optimal adoption, implementation and maintenance of these measures. Copyright © 2018 Elsevier Ltd. All rights reserved.

A systematic review of social networking sites: innovative platforms for health research targeting adolescents and young adults.

Science.gov (United States)

Park, Bu Kyung; Calamaro, Christina

2013-09-01

To review the evidence to determine if social networking sites (SNS) are effective tools for health research in the adolescent and young adult populations. Systematic review of published research articles focused on use of SNS for youth health research. Seventeen articles were selected that met the following criteria: used SNS at any stage of study, participants between 13 and 25 years of age, English language, and both international and national studies. Reviewers categorized selected studies based on the way SNS were used. Utilization of SNS for effectively implementing research with adolescents and young adults include (a) recruitment, (b) intervention, and (c) measurement. Four findings about advantages of using SNS apparent in this review are (a) ease of access to youth, (b) cost effectiveness in recruitment, (c) ease of intervention, and (d) reliable screening venue of mental status and high-risk behaviors. Although this literature review showed relatively minimal research to date on the use of SNS for research targeting adolescents and young adults, the impact of using SNS for health research is of considerable importance for researchers as well as participants. With careful focus, SNS can become a valuable platform to access, recruit, and deliver health interventions in a cost-effective manner to youth populations as well as hard-to-reach minority or underserved populations. The evidence demonstrates the usefulness of SNS as innovative platforms for health promotion among adolescents and young adults. © 2013 Sigma Theta Tau International.

Knowledge mobilisation in healthcare: a critical review of health sector and generic management literature.

Science.gov (United States)

Ferlie, Ewan; Crilly, Tessa; Jashapara, Ashok; Peckham, Anna

2012-04-01

The health policy domain has displayed increasing interest in questions of knowledge management and knowledge mobilisation within healthcare organisations. We analyse here the findings of a critical review of generic management and health-related literatures, covering the period 2000-2008. Using 29 pre-selected journals, supplemented by a search of selected electronic databases, we map twelve substantive domains classified into four broad groups: taxonomic and philosophical (e.g. different types of knowledge); theoretical discourse (e.g. critical organisational studies); disciplinary fields (e.g. organisational learning and Information Systems/Information Technology); and organisational processes and structures (e.g. organisational form). We explore cross-overs and gaps between these traditionally separate literature streams. We found that health sector literature has absorbed some generic concepts, notably Communities of Practice, but has not yet deployed the performance-oriented perspective of the Resource Based View (RBV) of the Firm. The generic literature uses healthcare sites to develop critical analyses of power and control in knowledge management, rooted in neo-Marxist/labour process and Foucauldian approaches. The review generates three theoretically grounded statements to inform future enquiry, by: (a) importing the RBV stream; (b) developing the critical organisational studies perspective further; and (c) exploring the theoretical argument that networks and other alternative organisational forms facilitate knowledge sharing. Copyright © 2012 Elsevier Ltd. All rights reserved.

Teaching Community Survival Skills to Mentally Retarded Adults: A Review and Analysis.

Science.gov (United States)

Martin, James E.; And Others

1982-01-01

The article reviews research on training mentally retarded adults in the following community survival skills: travel training, money management, meal preparation, clothing and personal care, telephone skill, housekeeping, self-medication, leisure skills, social skills, and conversation. Results are said to indicate the value of behavioral…

A critical review on the scaling theory of dispersion

Science.gov (United States)

Zech, Alraune; Mai, Juliane; Attinger, Sabine; Dietrich, Peter; Teutsch, Georg; Fiori, Aldo; Rubin, Yoram

2014-05-01

The phenomenon of dispersive mixing of solutes in aquifers is subject of research since decades. The characterization of dispersivity at a particular field site is a prerequisite to predict the movement and spreading of a contaminant plume. Experimental investigations have shown, that field-scale dispersivities vary over orders of magnitude, which apparently depends on the scale of measurement. Gelhar et al. [1992] and Schulze-Makuch [2005] have reviewed a large number of transport experiments reported in the literature. Based on that data Schulze-Makuch [2005] performed a trend analysis of longitudinal dispersivity, fostering the empirical relationship of a power law between dispersivities and the scale of measurement without an upper bound. The goal of our study is to critically revisit not only the data used for the trend analysis but the power-law scale dependence of longitudinal dispersivity (e.g. Neuman [1990], Xu and Eckstein [1995]). Our particular focus is on the reported dispersivities of large amount (larger than 100m) and large measurement scales (in the order of kilometers). We aim to evaluate current theories of transport against a critical "mass" of field experiments and to bracket the conditions of their applicability. We further aim to evaluate the adequacy of the field sampling techniques that were employed from the perspective of more than 30 years development in modeling and field characterization. Given the tremendous progress in field data acquisition techniques and new insights gained, it is reasonable to expect that interpretations of past experiments may be flawed due to the limitations or inadequacy of field sampling techniques. Gelhar, L.W., C. Welty, and K.R. Rehfeldt, 1992, A critical review of data on field-scale dispersion in aquifers, Water Resources Research 28, No. 7: 1955-1974. Schulze-Makuch, D., 2005, Longitudinal dispersivity data and implications for scaling behavior, Ground Water, Vol. 43, No. 3, 443-456. Neuman, S.P., 1990

The Costs and Benefits of Employing an Adult with Autism Spectrum Disorder: A Systematic Review.

Directory of Open Access Journals (Sweden)

Andrew Jacob

Full Text Available Despite an ambition from adults with Autism Spectrum Disorder (ASD to be employed, there are limited opportunities for competitive employment for this group. Employment is not only an entitlement enjoyed by others in society, but employing adults with ASD also has economic benefits by decreasing lost productivity and resource costs for this group. Few studies have explored the cost-benefit ratio for employing adults with ASD and even fewer have taken the viewpoint of the employer, particularly applying this situation to ASD. Until such study occurs, employers may continue to be reluctant to employ adults from this group.This review aimed to examine the costs, benefits and the cost-benefit ratio of employing adults with ASD, from a societal perspective and from the perspective of employers.Eight databases were searched for scientific studies within defined inclusion criteria. These databases included CINAHL Plus, Cochrane Library, Emerald, Ovid Medline, ProQuest, PsycINFO, Scopus and Web of Science.Enhancing the opportunities for adults with ASD to join the workforce is beneficial from a societal perspective, not only from an inclusiveness viewpoint, but also from a strict economic standpoint. Providing supported employment services for adults with ASD does not only cut the cost compared with providing standard care, it also results in better outcomes for adults with ASD. Despite the fact that ASD was the most expensive group to provide vocational rehabilitation services for, adults with ASD have a strong chance of becoming employed once appropriate measures are in place. Hence, rehabilitation services could be considered as a worthwhile investment. The current systematic review uncovered the fact that very few studies have examined the benefits, the costs and the cost-benefit ratio of employing an adult with ASD from the perspective of employers indicating a need for this topic to be further explored.

Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature

International Nuclear Information System (INIS)

Majchrzak, Ewa; Szybiak, Bartosz; Wegner, Anna; Pienkowski, Piotr; Pazdrowski, Jakub; Luczewski, Lukasz; Sowka, Marcin; Golusinski, Pawel; Malicki, Julian; Golusinski, Wojciech

2014-01-01

Head and neck squamous cell carcinoma (HNSCC) is a disease of middle-aged to elderly adults. However, an increased incidence of HNSCC in young people under 45 years of age has been reported recently. In the present review, we focused on the epidemiology and aetiology of HNSCC in adults under 45 years of age. We reviewed literature related to HNSCC in adult patients less than 45 years of age and discussed current treatment options and prognosis. HNSCC in young adults is associated with a higher incidence rate in nonsmokers, lower female-to-male ratio, a higher percentage of oral cavity and oropharynx tumours, and fewer second primary tumours. However, aside from traditional risk factors of tobacco and alcohol exposure, the causes of these cancers in young adults remain unclear. Agents that might contribute to risk include infection with high-risk human papillomavirus subtypes as well as genetic factors or immunodeficiency status. The expected increase in incidence and mortality of the young with HNSCC may become a major public health concern if current trends persist, particularly lifestyle habits that may contribute to this disease. Given the younger age and potential long-term adverse sequelae of traditional HNSCC treatments, young adults should be treated on a case-by-case basis and post-therapy quality of life must be considered in any treatment-decision making process

Formative Review of the Critical Television Viewing Skills Curriculum for Secondary Schools. Volume I: Final Report. Volume II: Teacher's Guide: Reviewers' Suggested Revisions.

Science.gov (United States)

Wheeler, Patricia; And Others

This formative review of a project designed to help high school students become more discriminating television viewers (1) presents a description of the curriculum designed during the project to foster critical television viewing in teenagers, (2) outlines the major tasks involved in the formative review of the curriculum, and (3) presents and…

Adult Stem Cells and Diseases of Aging

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Lisa B. Boyette

2014-01-01

Full Text Available Preservation of adult stem cells pools is critical for maintaining tissue homeostasis into old age. Exhaustion of adult stem cell pools as a result of deranged metabolic signaling, premature senescence as a response to oncogenic insults to the somatic genome, and other causes contribute to tissue degeneration with age. Both progeria, an extreme example of early-onset aging, and heritable longevity have provided avenues to study regulation of the aging program and its impact on adult stem cell compartments. In this review, we discuss recent findings concerning the effects of aging on stem cells, contributions of stem cells to age-related pathologies, examples of signaling pathways at work in these processes, and lessons about cellular aging gleaned from the development and refinement of cellular reprogramming technologies. We highlight emerging therapeutic approaches to manipulation of key signaling pathways corrupting or exhausting adult stem cells, as well as other approaches targeted at maintaining robust stem cell pools to extend not only lifespan but healthspan.

Developments in solar still desalination systems: A critical review

KAUST Repository

Ayoub, George M.

2012-10-01

Solar still desalination uses a sustainable and pollution-free source to produce high-quality water. The main limitation is low productivity and this has been the focus of intensive research. A major concern while increasing productivity is to maintain economic feasibility and simplicity. The authors present a critical review of the research work conducted on solar stills development. Studies addressing each parameter of concern are grouped together and results compared. Novelty in design and newly introduced features are presented. Modeling efforts of flow circulation within the still and methods to estimate internal heat transfer coefficients are discussed and future research needs are outlined. © 2012 Taylor & Francis Group, LLC.

Critical Factors of E-Learning Adoption and Acceptance in Pakistan: A Literature Review

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F. Kanwal

2017-08-01

Full Text Available This review paper examines the prior studies on critical factors of e-learning adoption in Pakistan. The search terms identified 40 papers reporting 25 conceptual and qualitative and 15 quantitative evidence about the e-learning adoption and critical factors that may influence the adoption of e-learning in Pakistan. The findings revealed that modern paradigm shift requires the in-depth analysis of government policies, institutional and management role, students and faculty attitude, social norms, cultural values as well as technological advancement. These factors may directly or indirectly affect the intention of students towards e-learning adoption. The lack of quantitative evidences illustrate that policy makers, practitioners and researchers need to pay attention for further research of identifying and analyzing the critical factors which enhances the e-learning adoption in Pakistan.

Prescriber barriers and enablers to minimising potentially inappropriate medications in adults: a systematic review and thematic synthesis.

Science.gov (United States)

Anderson, Kristen; Stowasser, Danielle; Freeman, Christopher; Scott, Ian

2014-12-08

To synthesise qualitative studies that explore prescribers' perceived barriers and enablers to minimising potentially inappropriate medications (PIMs) chronically prescribed in adults. A qualitative systematic review was undertaken by searching PubMed, EMBASE, Scopus, PsycINFO, CINAHL and INFORMIT from inception to March 2014, combined with an extensive manual search of reference lists and related citations. A quality checklist was used to assess the transparency of the reporting of included studies and the potential for bias. Thematic synthesis identified common subthemes and descriptive themes across studies from which an analytical construct was developed. Study characteristics were examined to explain differences in findings. All healthcare settings. Medical and non-medical prescribers of medicines to adults. Prescribers' perspectives on factors which shape their behaviour towards continuing or discontinuing PIMs in adults. 21 studies were included; most explored primary care physicians' perspectives on managing older, community-based adults. Barriers and enablers to minimising PIMs emerged within four analytical themes: problem awareness; inertia secondary to lower perceived value proposition for ceasing versus continuing PIMs; self-efficacy in regard to personal ability to alter prescribing; and feasibility of altering prescribing in routine care environments given external constraints. The first three themes are intrinsic to the prescriber (eg, beliefs, attitudes, knowledge, skills, behaviour) and the fourth is extrinsic (eg, patient, work setting, health system and cultural factors). The PIMs examined and practice setting influenced the themes reported. A multitude of highly interdependent factors shape prescribers' behaviour towards continuing or discontinuing PIMs. A full understanding of prescriber barriers and enablers to changing prescribing behaviour is critical to the development of targeted interventions aimed at deprescribing PIMs and reducing the

Potentially inappropriate prescribing and the risk of adverse drug reactions in critically ill older adults

Directory of Open Access Journals (Sweden)

Galli TB

2016-12-01

Full Text Available Background: Potentially inappropriate medication (PIM use in the elderly is associated with increased risk of adverse drug reactions (ADRs, but there is limited information regarding PIM use in the intensive care unit (ICU setting. Objective: The aim of the study is to describe the prevalence and factors associated with the use of PIM and the occurrence of PIM-related adverse reactions in the critically ill elderly. Methods: This study enrolled all critically ill older adults (60 years or more admitted to medical or cardiovascular ICUs between January and December 2013, in a large tertiary teaching hospital. For all patients, clinical pharmacists listed the medications given during the ICU stay and data on drugs were analyzed using 2012 Beers Criteria, to identify the prevalence of PIM. For each identified PIM the medical records were analyzed to evaluate factors associated with its use. The frequency of ADRs and, the causal relationship between PIM and the ADRs identified were also evaluated through review of medical records. Results: According to 2012 Beers Criteria, 98.2% of elderly patients used at least one PIM (n=599, of which 24.8% were newly started in the ICUs. In 29.6% of PIMs, there was a clinical circumstance that justified their prescription. The number of PIMs was associated with ICU length of stay and total number of medications. There was at least one ADR identified in 17.8% of patients; more than 40% were attributed to PIM, but there was no statistical association. Conclusions: There is a high prevalence of PIM used in acutely ill older people, but they do not seem to be the major cause of adverse drug reactions in this population. Although many PIMs had a clinical circumstance that led to their prescription during the course of ICU hospitalization, many were still present upon hospital discharge. Therefore, prescription of PIMs should be minimized to improve the safety of elderly patients.

Self-management interventions for adults with chronic kidney disease: a scoping review.

Science.gov (United States)

Donald, Maoliosa; Kahlon, Bhavneet Kaur; Beanlands, Heather; Straus, Sharon; Ronksley, Paul; Herrington, Gwen; Tong, Allison; Grill, Allan; Waldvogel, Blair; Large, Chantel A; Large, Claire L; Harwood, Lori; Novak, Marta; James, Matthew T; Elliott, Meghan; Fernandez, Nicolas; Brimble, Scott; Samuel, Susan; Hemmelgarn, Brenda R

2018-03-22

To systematically identify and describe self-management interventions for adult patients with chronic kidney disease (CKD). Community-based. Adults with CKD stages 1-5 (not requiring kidney replacement therapy). Self-management strategies for adults with CKD. Using a scoping review, electronic databases and grey literature were searched in October 2016 to identify self-management interventions for adults with CKD stages 1-5 (not requiring kidney replacement therapy). Randomised controlled trials (RCTs), non-RCTs, qualitative and mixed method studies were included and study selection and data extraction were independently performed by two reviewers. Outcomes included behaviours, cognitions, physiological measures, symptoms, health status and healthcare. Fifty studies (19 RCTs, 7 quasi-experimental, 5 observational, 13 pre-post intervention, 1 mixed method and 5 qualitative) reporting 45 interventions were included. The most common intervention topic was diet/nutrition and interventions were regularly delivered face to face. Interventions were administered by a variety of providers, with nursing professionals the most common health professional group. Cognitions (ie, changes in general CKD knowledge, perceived self-management and motivation) were the most frequently reported outcome domain that showed improvement. Less than 1% of the interventions were co-developed with patients and 20% were based on a theory or framework. There was a wide range of self-management interventions with considerable variability in outcomes for adults with CKD. Major gaps in the literature include lack of patient engagement in the design of the interventions, with the majority of interventions not applying a behavioural change theory to inform their development. This work highlights the need to involve patients to co-developed and evaluate a self-management intervention based on sound theories and clinical evidence. © Article author(s) (or their employer(s) unless otherwise stated in the

Non-traumatic acute abdomen in the adult: a critical review of imaging modalities

International Nuclear Information System (INIS)

Buitrago-Tellez, C.; Boos, S.; Heinemann, F.; Wenz, W.

1992-01-01

Two different series collected at the University Hospital of Freiburg are presented as a basis for the critical appraisal of available imaging tests and their correlation with anatomic pain sites. The first series comprises 284 patients of non-traumatic acute abdomen admitted to the emergency department during 1990. The radiological approach revealed an increased use of immediate ultrasound (58%) followed by plain film radiography (53%), contrast studies (15%), and computed tomography (9.8%). Five groups of entities were identified according to the diagnostic imaging procedure prior to surgery. In a second series, the clinical presentation, the distribution and the efficacy of imaging studies for the confirmation of acute mesenteric ischemia were evaluated in 55 patients over a period of 14 years. A reduced mortality rate emphasizes the value of early and agressive diagnosis and angiographic management. (orig.)

Health promotion and psychological interventions for adolescent and young adult cancer survivors: A systematic literature review.

Science.gov (United States)

Bradford, Natalie Katrina; Chan, Raymond Javan

2017-04-01

The effects of cancer and treatment have severe and long lasting negative impacts on quality of life. Adolescents and Young Adults (AYA) have high survival rates but may not reach their full life potential because of these consequences. This review aims to identify, appraise and synthesise the effects of health promotion and psychological interventions for AYA after cancer treatment. The review was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Included studies were identified though a range of electronic databases through to May 2016. Studies were critically appraised using the Cochrane Risk of Bias tool. Seventeen studies, comprising a total of 2314 participants aged 13-39years were included in this review. Participants in 15 studies were survivors of childhood cancer, with only two studies specifically recruiting survivors of cancer diagnosed during young adulthood. Ten studies were randomised controlled trials (RCTs); the remaining seven were before and after studies. The quality of studies was variable across all appraised domains; risk of bias was evident in regards to recruitment, measures of exposure and outcomes, confounding factors, attrition and lost-to follow-up. Studies evaluated a range of health promotion and psychological interventions to improve health related and process outcomes. Eleven studies reported modest positive outcomes, with psychological and physical activity interventions achieving greater success compared to general health promotion interventions. This review highlights the lack of high-quality studies for optimising the health and well-being of AYA cancer survivors. No conclusive evidence favouring specific interventions were identified, although recommendations for future studies are made. Interventions delivered face-to-face and those that facilitate peer-to-peer support hold promise. Harnessing social media and technology to deliver interventions is likely to increase and these

Restraint use in older adults in home care: A systematic review.

Science.gov (United States)

Scheepmans, Kristien; Dierckx de Casterlé, Bernadette; Paquay, Louis; Milisen, Koen

2018-03-01

To get insight into restraint use in older adults receiving home care and, more specifically, into the definition, prevalence and types of restraint, as well as the reasons for restraint use and the people involved in the decision-making process. Systematic review. Four databases (i.e. Pubmed, CINAHL, Embase, Cochrane Library) were systematically searched from inception to end of April 2017. The study encompassed qualitative and quantitative research on restraint use in older adults receiving home care that reported definitions of restraint, prevalence of use, types of restraint, reasons for use or the people involved. We considered publications written in English, French, Dutch and German. One reviewer performed the search and made the initial selection based on titles and abstracts. The final selection was made by two reviewers working independently; they also assessed study quality. We used an integrated design to synthesise the findings. Eight studies were reviewed (one qualitative, seven quantitative) ranging in quality from moderate to high. The review indicated there was no single, clear definition of restraint. The prevalence of restraint use ranged from 5% to 24.7%, with various types of restraint being used. Families played an important role in the decision-making process and application of restraints; general practitioners were less involved. Specific reasons, other than safety for using restraints in home care were noted (e.g. delay to nursing home admission; to provide respite for an informal caregiver). Contrary to the current socio demographical evolutions resulting in an increasing demand of restraint use in home care, research on this subject is still scarce and recent. The limited evidence however points to the challenging complexity and specificity of home care regarding restraint use. Given these serious challenges for clinical practice, more research about restraint use in home care is urgently needed. Copyright © 2017. Published by Elsevier

Some notes on critical appraisal of prevalence studies: Comment on: "The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence".

Science.gov (United States)

Harder, Thomas

2014-10-01

Decisions in healthcare should be based on information obtained according to the principles of Evidence-Based Medicine (EBM). An increasing number of systematic reviews are published which summarize the results of prevalence studies. Interpretation of the results of these reviews should be accompanied by an appraisal of the methodological quality of the included data and studies. The critical appraisal tool for prevalence studies developed and tested by Munn et al. comprises 10 items and aims at targeting all kinds of prevalence studies. This comment discusses the pros and cons of different designs of quality appraisal tools and highlights their importance for systematic reviews of prevalence studies. Beyond piloting, which has been performed in the study by Munn et al., it is suggested here that the validity of the tool should be tested, including reproducibility and inter-rater reliability. It is concluded that studies as the one by Munn et al. will help to establish a critical understanding of methodological quality and will support the use of systematic reviews of non-intervention studies for health policy making.

A critical review of histopathological findings associated with endocrine and non-endocrine hepatic toxicity in fish models.

Science.gov (United States)

Wolf, Jeffrey C; Wheeler, James R

2018-04-01

Although frequently examined as a target organ for non-endocrine toxicity, histopathological evaluation of the liver is becoming a routine component of endocrine disruption studies that utilize various fish species as test subjects. However, the interpretation of microscopic liver findings can be challenging, especially when attempting to distinguish adverse changes associated with endocrine disrupting substances from those caused by systemic or direct hepatic toxicity. The purpose of this project was to conduct a critical assessment of the available peer-reviewed and grey literature concerning the histopathologic effects of reproductive endocrine active substances (EAS) and non-endocrine acting substances in the livers of fish models, and to determine if liver histopathology can be used to reliably distinguish endocrine from non-endocrine etiologies. The results of this review suggest that few compound-specific histopathologic liver effects have been identified, among which are estrogen agonist-induced increases in hepatocyte basophilia and proteinaceous intravascular fluid in adult male teleosts, and potentially, decreased hepatocyte basophilia in female fish exposed to substances that possess androgenic, anti-estrogenic, or aromatase inhibitory activity. This review also used published standardized methodology to assess the credibility of the histopathology data in each of the 117 articles that reported liver effects of treatment, and consequently it was determined that in only 37% of those papers were the data considered either highly credible or credible. The outcome of this work highlights the value of histopathologic liver evaluation as an investigative tool for EAS studies, and provides information that may have implications for EAS hazard assessment. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

Critical review of the literature on the corrosion of copper by water

International Nuclear Information System (INIS)

King, Fraser

2010-12-01

The conventional belief that copper is thermodynamically stable in oxygen-free water has been questioned by a research group from the Royal Inst. of Technology, Stockholm lead by Dr. Gunnar Hultquist. A critical review of the literature both in support of the proposed mechanism and that which argues against it has been conducted. The critical review has been supported by supplementary analyses, with particular focus on the scientific validity of the reported observations and their significance for the corrosion of a copper canister. It is found that: - the scientific evidence in support of the suggestion that water oxidises copper is not conclusive and there are many aspects which are unclear and contradictory, - despite a number of attempts, no other researchers have been able to reproduce the observations of Hultquist and co-workers, - even if correct, the mechanism is not important for copper canisters in a repository, both because of differences in the environmental conditions and because, even if corrosion did occur by this mechanism, it would quickly stop, and - there is no adverse impact on the lifetime of copper canisters due to this proposed, but unproven, mechanism

Critical review of the literature on the corrosion of copper by water

Energy Technology Data Exchange (ETDEWEB)

King, Fraser (Integrity Corrosion Consulting Limited (Canada))

2010-12-15

The conventional belief that copper is thermodynamically stable in oxygen-free water has been questioned by a research group from the Royal Inst. of Technology, Stockholm lead by Dr. Gunnar Hultquist. A critical review of the literature both in support of the proposed mechanism and that which argues against it has been conducted. The critical review has been supported by supplementary analyses, with particular focus on the scientific validity of the reported observations and their significance for the corrosion of a copper canister. It is found that: - the scientific evidence in support of the suggestion that water oxidises copper is not conclusive and there are many aspects which are unclear and contradictory, - despite a number of attempts, no other researchers have been able to reproduce the observations of Hultquist and co-workers, - even if correct, the mechanism is not important for copper canisters in a repository, both because of differences in the environmental conditions and because, even if corrosion did occur by this mechanism, it would quickly stop, and - there is no adverse impact on the lifetime of copper canisters due to this proposed, but unproven, mechanism

Acute symptomatic calcific discitis in adults: a case report and review of literature

International Nuclear Information System (INIS)

Shah, A.; Botchu, R.; Davies, A.M.; James, S.L.; Grainger, M.F.

2015-01-01

Symptomatic calcific discitis has been reported in the paediatric population but is a rare entity in adults with only eight cases reported in the English literature. We present a case of adult calcific discitis presenting with acute onset back pain. Radiographs and CT demonstrated central T11-T12 disc calcification with diffuse marrow oedema on subsequent MRI. The patient was referred to our spinal oncology unit due to the extensive marrow oedema as a possible underlying primary bone tumour. Review of the CT confirmed an end-plate defect with herniated calcific nucleus pulposus with no underlying bone lesion. Features were in keeping with acute calcific discitis. The patient was treated symptomatically and made an uneventful recovery. We discuss the characteristic imaging features seen on radiograph, CT and MRI and review the current literature. Calcific discitis is a self-limiting pathology requiring symptomatic management only. Radiologists need to be aware of this rare entity as it can occur in adults and may be mistaken for a more sinister pathology such as infective discitis or a bone tumour and lead to further unnecessary imaging or invasive procedures. (orig.)

ETHICS OF SMART HOUSE WELFARE TECHNOLOGY FOR OLDER ADULTS: A SYSTEMATIC LITERATURE REVIEW.

Science.gov (United States)

Sánchez, Veralia Gabriela; Taylor, Ingrid; Bing-Jonsson, Pia Cecilie

2017-01-01

The University College of Southeast Norway has an on-going project to develop a smart house welfare system to allow older adults and people with disabilities to remain in their homes for as long as they wish in safe, dignified, living conditions. This article reviews reported ethical challenges to implementing smart houses for older adults. A systematic literature review identified twenty-four articles in English, French, Spanish, and Norwegian, which were analyzed and synthesized using Hofmann's question list to investigate the reported ethical challenges. Smart houses offer a promising way to improve access to home care for older adults and people with disabilities. However, important ethical challenges arise when implementing smart houses, including cost-effectiveness, privacy, autonomy, informed consent, dignity, safety, and trust. The identified ethical challenges are important to consider when developing smart house systems. Due to the limitations of smart house technology, designers and users should be mindful that smart houses can achieve a safer and more dignified life-style but cannot solve all the challenges related to ageing, disabilities, and disease. At some point, smart houses can no longer help persons as they develop needs that smart houses cannot meet.

Acute symptomatic calcific discitis in adults: a case report and review of literature

Energy Technology Data Exchange (ETDEWEB)

Shah, A.; Botchu, R.; Davies, A.M.; James, S.L. [Royal Orthopaedic Hospital, Department of Musculoskeletal Radiology, Birmingham (United Kingdom); Grainger, M.F. [Royal Orthopaedic Hospital, Department of Spinal Oncology, Birmingham (United Kingdom)

2015-12-15

Symptomatic calcific discitis has been reported in the paediatric population but is a rare entity in adults with only eight cases reported in the English literature. We present a case of adult calcific discitis presenting with acute onset back pain. Radiographs and CT demonstrated central T11-T12 disc calcification with diffuse marrow oedema on subsequent MRI. The patient was referred to our spinal oncology unit due to the extensive marrow oedema as a possible underlying primary bone tumour. Review of the CT confirmed an end-plate defect with herniated calcific nucleus pulposus with no underlying bone lesion. Features were in keeping with acute calcific discitis. The patient was treated symptomatically and made an uneventful recovery. We discuss the characteristic imaging features seen on radiograph, CT and MRI and review the current literature. Calcific discitis is a self-limiting pathology requiring symptomatic management only. Radiologists need to be aware of this rare entity as it can occur in adults and may be mistaken for a more sinister pathology such as infective discitis or a bone tumour and lead to further unnecessary imaging or invasive procedures. (orig.)

A review of shear wave splitting in the crack-critical crust

Science.gov (United States)

Crampin, Stuart; Chastin, Sebastien

2003-10-01

Over the last 15 years, it has become established that crack-induced stress-aligned shear wave splitting, with azimuthal anisotropy, is an inherent characteristic of almost all rocks in the crust. This means that most in situ rocks are pervaded by fluid-saturated microcracks and consequently are highly compliant. The evolution of such stress-aligned fluid-saturated grain-boundary cracks and pore throats in response to changing conditions can be calculated, in some cases with great accuracy, using anisotropic poro-elasticity (APE). APE is tightly constrained with no free parameters, yet dynamic modelling with APE currently matches a wide range of phenomena concerning anisotropy, stress, shear waves and cracks. In particular, APE has allowed the anisotropic response of a reservoir to injection to be calculated (predicted with hindsight), and the time and magnitude of an earthquake to be correctly stress-forecast. The reason for this calculability and predictability is that the microcracks in the crust are so closely spaced that they form critical systems. This crack-critical crust leads to a new style of geophysics that has profound implications for almost all aspects of pre-fracturing deformation of the crust and for solid-earth geophysics and geology. We review past, present and speculate about the future of shear wave splitting in the crack-critical crust. Shear wave splitting is seen to be a dynamic measure of the deformation of the rock mass. There is some good news and some bad news for conventional geophysics. Many accepted phenomena are no longer valid at high spatial and temporal resolution. A major effect is that the detailed crack geometry changes with time and varies from place to place in response to very small previously negligible changes. However, at least in some circumstances, the behaviour of the rock in the highly complex inhomogeneous Earth may be calculated and the response predicted, opening the way to possible control by feedback. The need is

Book Review: Critical Condition: Replacing Critical Thinking with Creativity by Patrick Finn

OpenAIRE

Matthews, Jodie

2016-01-01

In Critical Condition: Replacing Critical Thinking with Creativity, Patrick Finn expands upon his 2011 TEDx Talk, ‘Loving Communication’, to suggest that critical thinking implies disapproval and unnecessary judgement originating from a particular mode of Classical thought. Jodie Matthews argues that Finn’s discussion is dependent upon a crudely drawn straw man and neglects to consider thinking critically as a necessary corollary, rather than antithesis, to thinking creatively.

Microfinance institutions' failure to address poverty: A narrative critical literature review

OpenAIRE

Guðjónsson, Sigurður

2017-01-01

This critical literature review begins by giving a short introduction to the microfinance industry. Microfinance institutions (MFIs) are explained and an account is given of their dual performance goals of financial performance (‘financial sustainability’) and social performance (‘outreach’). While MFIs’ social performance is directly aimed at poverty reduction, it is noteworthy that often they fail to address poverty (i.e., they fail to deliver outreach). The aim of the paper is to answer th...

Relevance of collagen piezoelectricity to "Wolff's Law": a critical review.

Science.gov (United States)

Ahn, Andrew C; Grodzinsky, Alan J

2009-09-01

According to "Wolff's Law", bone is deposited and reinforced at areas of greatest stress. From a clinical perspective, this "law" is supported by the strong association between bone density and physical activity. From a mechanistic standpoint, however, the law presents a challenge to scientists seeking to understand how osteocytes and osteoblasts sense the mechanical load. In the 1960s, collagen piezoelectricity was invoked as a potential mechanism by which osteocytes could detect areas of greater stress but piezoelectricity diminished in importance as more compelling mechanisms, such as streaming potential, were identified. In addition, accumulating evidence for the role of fluid-related shear stress in osteocyte's mechanosensory function has made piezoelectricity seemingly more obsolete in bone physiology. This review critically evaluates the role of collagen piezoelectricity (if any) in Wolff's Law--specifically, the evidence regarding its involvement in strain-generated potentials, existing alternate mechanisms, the present understanding of bone mechanosensation, and whether piezoelectricity serves an influential role within the context of this newly proposed mechanism. In addition to reviewing the literature, this review generates several hypotheses and proposes future research to fully address the relevance of piezoelectricity in bone physiology.

Developing critical practitioners: A review of teaching methods in the Bachelor of Radiography and Medical Imaging

International Nuclear Information System (INIS)

Mc Inerney, J.; Baird, M.

2016-01-01

Background: The capacity to apply critical thinking clinically is no longer an option for radiographers. Radiographers are obliged by their registration board to embrace a contemporary and integrated conceptualisation of competence, including the capacity to think critically and reflectively to resolve clinical challenges. The study examines the complexity of critical thinking, identifies the skill set and personal traits necessary to enact it practically. Methods: Third and final year radiography students' perceptions of three teaching approaches used within the undergraduate course were explored using peer reviewed survey instruments. Thematic analysis and descriptive analyses were applied to the data to make sense of the responses. Conclusions: Students are exhibiting the capacity to formulate, evaluate and revise their own work practices through critical thinking. Educational activities that have been proven effective in empowering students with the skills necessary to meet professional standards and the personal traits required to enact them should be prioritised in curricula. The study has shown that establishment of an audit trail for the educational activities in use within radiography programs can facilitate the acquisition of evidence-based and reflective practice skills amongst students. An assessment of student's perceptions of the learning activities they engage with is an important step on this trail, though a before and after measure could be applied. - Highlights: • Examines the concept of critical thinking including the personal traits required to enact it. • Reviews three teaching activities aimed at teaching critical thinking. • Assesses student perceptions of the activities in facilitating critical thinking skills. • Students who acquire critical thinking skills can undergo transformative learning. • Establishing an audit trail can ensure teaching activities are having desired effect.

Web 2.0 chronic disease self-management for older adults: a systematic review.

Science.gov (United States)

Stellefson, Michael; Chaney, Beth; Barry, Adam E; Chavarria, Enmanuel; Tennant, Bethany; Walsh-Childers, Kim; Sriram, P S; Zagora, Justin

2013-02-14

Participatory Web 2.0 interventions promote collaboration to support chronic disease self-management. Growth in Web 2.0 interventions has led to the emergence of e-patient communication tools that enable older adults to (1) locate and share disease management information and (2) receive interactive healthcare advice. The evolution of older e-patients contributing to Web 2.0 health and medical forums has led to greater opportunities for achieving better chronic disease outcomes. To date, there are no review articles investigating the planning, implementation, and evaluation of Web 2.0 chronic disease self-management interventions for older adults. To review the planning, implementation, and overall effectiveness of Web 2.0 self-management interventions for older adults (mean age ≥ 50) with one or more chronic disease(s). A systematic literature search was conducted using six popular health science databases. The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and compute a study quality score (SQS) for 15 reviewed articles. Most interventions were adopted for delivery by multidisciplinary healthcare teams and tested among small samples of white females with diabetes. Studies indicated that Web 2.0 participants felt greater self-efficacy for managing their disease(s) and benefitted from communicating with health care providers and/or website moderators to receive feedback and social support. Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication

Instrumented Measurement of Balance and Postural Control in Individuals with Lower Limb Amputation: A Critical Review

Science.gov (United States)

Jayakaran, Prasath; Johnson, Gillian M.; Sullivan, S. John; Nitz, Jennifer C.

2012-01-01

Measurement of balance and postural performance that underpins activities of daily living is important in the rehabilitation of individuals with a lower limb amputation (LLA), and there are a number of methods and strategies available for this purpose. To provide an evidence-based choice of approach, this review aims to critically review the tasks…

Notes on critical care-review of seminal management and leadership papers in the United Kingdom.

Science.gov (United States)

Coombs, Maureen

2009-06-01

Review of recent critical care provision reveals substantial changes in clinical unit operating, and policy drivers influencing international critical care delivery. Practitioners who have worked in healthcare environments over this time, will have witnessed substantial shifts in healthcare policy, changes in professional body guidance and greater service evaluation have impacted on critical care management and leadership. This paper offers a personal perspective on seminal management and leadership papers published in the critical care literature over the past decade. Presenting a range of national and international work that utilise diverse approaches, ten key papers are highlighted that have impacted in the United Kingdom setting. Through this, the influence of the modernisation agenda, the increasing significance of outcome studies, and the need for flexible, interdependent practice emerges. A key message to surface from this paper is the need for all in critical care to engage with, and understand the wider implications of management and leadership change for critical care delivery.