AstroCom NYC: Equity, Inclusion, and the Next Generation of Astrophysicists

Science.gov (United States)

Paglione, Timothy; Ford, Saavik; Robbins, Dennis; Agueros, Marcel A.; Mac Low, Mordecai-Mark

2017-01-01

AstroCom NYC is an undergraduate mentoring program designed to improve urban minority student access to opportunities in astrophysical research by greatly enhancing partnerships between research astronomers in New York City (City University of New York - an MSI, American Museum of Natural History, and Columbia). AstroCom NYC provides centralized, personalized mentoring as well as financial and academic support, to CUNY undergraduates throughout their studies, plus the resources and opportunities to further CUNY faculty research with students. The goal is that students’ residency at AMNH helps them build a sense of belonging in the field, and readies and inspires them for graduate study. AstroCom NYC provides a rigorous Methods of Scientific Research course developed specifically to this purpose, a laptop, research and career mentors, outreach activities, scholarships and stipends, Metrocards, and regular assessment for maximum effectiveness. The goal of this support is to remove barriers to access and success. AMNH serves as the central hub for our faculty and students, who are otherwise dispersed among all five boroughs of the City. We welcomed our fourth cohort last year, along with 25 additional students through a NASA community college initiative. Our advanced AstroCom NYC students earned external summer internships at REU sites, and we had our first graduate school acceptance. We review plans for Year 5, when we have a number of graduate school applicants, and our deepening participation and leadership within partner activities.

An evidence-based review: distracted driver.

Science.gov (United States)

Llerena, Luis E; Aronow, Kathy V; Macleod, Jana; Bard, Michael; Salzman, Steven; Greene, Wendy; Haider, Adil; Schupper, Alex

2015-01-01

Cell phone use and texting are prevalent within society and have thus pervaded the driving population. This technology is a growing concern within the confines of distracted driving, as all diversions from attention to the road have been shown to increase the risk of crashes. Adolescent, inexperienced drivers, who have the greatest prevalence of texting while driving, are at a particularly higher risk of crashes because of distraction. Members of the Injury Control Violence Prevention Committee of the Eastern Association for the Surgery of Trauma performed a PubMed search of articles related to distracted driving and cell phone use as a distractor of driving between 2000 and 2013. A total of 19 articles were found to merit inclusion as evidence in the evidence-based review. These articles provided evidence regarding the relationship between distracted driving and crashes, cell phone use contributing to automobile accidents, and/or the relationship between driver experience and automobile accidents. (Adjust methods/results sections to the number of articles that correctly corresponds to the number of references, as well as the methodology for reference inclusion.) Based on the evidence reviewed, we can recommend the following. All drivers should minimize all in-vehicle distractions while on the road. All drivers should not text or use any touch messaging system (including the use of social media sites such as Facebook and Twitter) while driving. Younger, inexperienced drivers should especially not use cell phones, texting, or any touch messaging system while driving because they pose an increased risk for death and injury caused by distractions while driving.

ASTRO's 2007 Core Physics Curriculum for Radiation Oncology Residents

International Nuclear Information System (INIS)

Klein, Eric E.; Gerbi, Bruce J.; Price, Robert A.; Balter, James M.; Paliwal, Bhudatt; Hughes, Lesley; Huang, Eugene

2007-01-01

In 2004, American Society for Therapeutic Radiology and Oncology (ASTRO) published a curriculum for physics education. The document described a 54-hour course. In 2006, the committee reconvened to update the curriculum. The committee is composed of physicists and physicians from various residency program teaching institutions. Simultaneously, members have associations with American Association of Physicists in Medicine, ASTRO, Association of Residents in Radiation Oncology, American Board of Radiology, and American College of Radiology. Representatives from the latter two organizations are key to provide feedback between the examining organizations and ASTRO. Subjects are based on Accreditation Council for Graduate Medical Education requirements (particles and hyperthermia), whereas the majority of subjects and appropriated hours/subject were developed by consensus. The new curriculum is 55 hours, containing new subjects, redistribution of subjects with updates, and reorganization of core topics. For each subject, learning objectives are provided, and for each lecture hour, a detailed outline of material to be covered is provided. Some changes include a decrease in basic radiologic physics, addition of informatics as a subject, increase in intensity-modulated radiotherapy, and migration of some brachytherapy hours to radiopharmaceuticals. The new curriculum was approved by the ASTRO board in late 2006. It is hoped that physicists will adopt the curriculum for structuring their didactic teaching program, and simultaneously, American Board of Radiology, for its written examination. American College of Radiology uses the ASTRO curriculum for their training examination topics. In addition to the curriculum, the committee added suggested references, a glossary, and a condensed version of lectures for a Postgraduate Year 2 resident physics orientation. To ensure continued commitment to a current and relevant curriculum, subject matter will be updated again in 2 years

Book Review: Deployment Psychology: Evidence-based strategies ...

African Journals Online (AJOL)

Book Review: Deployment Psychology: Evidence-based strategies to promote mental health in the Military. AB Adler, PD Bliese, CA Castro. Abstract. Washington, DC: American Psychological Association 2011 294 pages ISBN-13: 978-1-4338-0881-4. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

AstroWeb -- Internet Resources for Astronomers

Science.gov (United States)

Jackson, R. E.; Adorf, H.-M.; Egret, D.; Heck, A.; Koekemoer, A.; Murtagh, F.; Wells, D. C.

AstroWeb is a World Wide Web (WWW) interface to a collection of Internet accessible resources aimed at the astronomical community. The collection currently contains more than 1000 WWW, Gopher, Wide Area Information System (WAIS), Telnet, and Anonymous FTP resources, and it is still growing. AstroWeb provides the additional value-added services: categorization of each resource; descriptive paragraphs for some resources; searchable index of all resource information; 3 times daily search for ``dead'' or ``unreliable'' resources.

AstroCappella: Songs of the Universe

Science.gov (United States)

Boyd, P. T.; Smale, A. P.; Smale, K. M.

2008-11-01

The AstroCappella Project is a classroom-ready collection of upbeat pop songs, lesson plans, and background information, all rich in science content. It was developed as a collaboration between working research astronomers, educators, and a contemporary vocal band, The Chromatics. A multimedia music CD, ``AstroCappella 2.0,'' has been produced containing 13 astronomically correct songs with original lyrics and music. Song topics range from the Sun, Moon, planets and small bodies of the Solar System, through the Doppler shift, the nearest stars, and extra-solar planets, to radio and X-ray astronomy. The CD also contains extensive CD-ROM materials including science background information, curriculum notes, lesson plans and activities for each song, images, movies, and slide shows. The songs and accompanying information have been extensively field-tested, and align to the K--12 National Science Education Standards. The AstroCappella materials are in widespread use in classrooms and homes across the U.S., and are supplemented with frequent live performances and teacher workshops.

ASTRO's core physics curriculum for radiation oncology residents

International Nuclear Information System (INIS)

Klein, Eric E.; Balter, James M.; Chaney, Edward L.; Gerbi, Bruce J.; Hughes, Lesley

2004-01-01

In 2002, the Radiation Physics Committee of the American Society of Therapeutic Radiology and Oncology (ASTRO) appointed an Ad-hoc Committee on Physics Teaching to Medical Residents. The main initiative of the committee was to develop a core curriculum for physics education. Prior publications that have analyzed physics teaching have pointed to wide discrepancies among teaching programs. The committee was composed of physicists or physicians from various residency program based institutions. Simultaneously, members had associations with the American Association of Physicists in Medicine (AAPM), ASTRO, Association of Residents in Radiation Oncology (ARRO), American Board of Radiology (ABR), and the American College of Radiology (ACR). The latter two organizations' representatives were on the physics examination committees, as one of the main agendas was to provide a feedback loop between the examining organizations and ASTRO. The document resulted in a recommended 54-h course. Some of the subjects were based on American College of Graduate Medical Education (ACGME) requirements (particles, hyperthermia), whereas the majority of the subjects along with the appropriated hours per subject were devised and agreed upon by the committee. For each subject there are learning objectives and for each hour there is a detailed outline of material to be covered. Some of the required subjects/h are being taught in most institutions (i.e., Radiation Measurement and Calibration for 4 h), whereas some may be new subjects (4 h of Imaging for Radiation Oncology). The curriculum was completed and approved by the ASTRO Board in late 2003 and is slated for dissemination to the community in 2004. It is our hope that teaching physicists will adopt the recommended curriculum for their classes, and simultaneously that the ABR for its written physics examination and the ACR for its training examination will use the recommended curriculum as the basis for subject matter and depth of

AstroCom NYC: A National Model for Urban Minority Engagement

Science.gov (United States)

Paglione, Timothy; Ford, Saavik; Robbins, Dennis; Mac Low, Mordecai-Mark; Agueros, Marcel A.

2016-01-01

AstroCom NYC is an undergraduate mentoring program designed to improve urban minority student access to opportunities in astrophysical research by greatly enhancing partnerships between research astronomers in New York City (City University of New York - an MSI, American Museum of Natural History, and Columbia). AstroCom NYC provides centralized, personalized mentoring as well as financial and academic support, to CUNY undergraduates throughout their studies, plus the resources and opportunities to further CUNY faculty research with students. The goal is that students' residency at AMNH helps them build a sense of belonging in the field, and readies and inspires them for graduate study. AstroCom NYC provides a rigorous Methods of Scientific Research course developed specifically to this purpose, a laptop, research and career mentors, outreach activities, scholarships and stipends, Metrocards, and regular assessment for maximum effectiveness. The goal of this support is to remove barriers to access and success. AMNH serves as the central hub for our faculty and students, who are otherwise dispersed among all five boroughs of the City. We welcomed our third and largest cohort last year, along with 13 additional students through a NASA community college initiative. We review plans for Year 4, when we expect all of our interns to compete for external summer REUs, and our growing participation and leadership within partner activities.

Montessori education: a review of the evidence base

Science.gov (United States)

Marshall, Chloë

2017-10-01

The Montessori educational method has existed for over 100 years, but evaluations of its effectiveness are scarce. This review paper has three aims, namely to (1) identify some key elements of the method, (2) review existing evaluations of Montessori education, and (3) review studies that do not explicitly evaluate Montessori education but which evaluate the key elements identified in (1). The goal of the paper is therefore to provide a review of the evidence base for Montessori education, with the dual aspirations of stimulating future research and helping teachers to better understand whether and why Montessori education might be effective.

AstroMadrid: Astrophysics and technological developments in Comunidad de Madrid

Science.gov (United States)

Mas-Hesse, J. M.

2011-11-01

AstroMadrid is a network constituted by different research groups in the Comunidad de Madrid area, with the objective of coordinating the activities related to the development of astronomical instrumentation in the various centres. AstroMadrid is a multidisciplinar team which benefits from the synergies provided by the different participating groups, optimizing our capabilities to develop instrumentation, and minimizing the problems related to the geographical dispersion within our region. AstroMadrid is also participated by several aerospace industries, which complement the capabilities and facilities available in the research centres. In addition to optimizing the development of instrumentation, AstroMadrid plays an essential role in the formation of new engineers and scientists, by actively contributing to some Master degree courses organized by different Universities in Madrid.

Introducing AstroGen: The Astronomy Genealogy Project

OpenAIRE

Tenn, Joseph S.

2016-01-01

The Astronomy Genealogy Project ("AstroGen"), a project of the Historical Astronomy Division of the American Astronomical Society (AAS), will soon appear on the AAS website. Ultimately, it will list the world's astronomers with their highest degrees, theses for those who wrote them, academic advisors (supervisors), universities, and links to the astronomers or their obituaries, their theses when on-line, and more. At present the AstroGen team is working on those who earned doctorates with ast...

The Astro Learning Design Player

NARCIS (Netherlands)

Sharples, Paul; Wilson, Scott; Popat, Kris; Griffiths, David; Beauvoir, Phillip

2010-01-01

Sharples, Paul Wilson, S., Popat, K., Griffiths, D., Beauvoir, P. (2009) The Astro Learning Design Player. This software is distributed under the three clause BSD license, copyright TENCompetence Foundation

AstroGrid: AstroGrid: Powering the virtual universe

Science.gov (United States)

Walton, N. A.

2002-02-01

Nic Walton describes a programme to break down wavelength barriers and empower astronomers, as well as making full use of astronomical archives. The full potential of the data from the major new observational facilities (e.g. VISTA) available to the community will only be realized if inclusive, rich, data access and manipulation mechanisms are provided. Astronomical endeavour will be further leveraged if these mechanisms enable ``science-driven'' research programmes benefiting from access to multiple data sources. I describe here the reasons and resources behind AstroGrid.

Wavelength calibration with PMAS at 3.5 m Calar Alto Telescope using a tunable astro-comb

Science.gov (United States)

Chavez Boggio, J. M.; Fremberg, T.; Bodenmüller, D.; Sandin, C.; Zajnulina, M.; Kelz, A.; Giannone, D.; Rutowska, M.; Moralejo, B.; Roth, M. M.; Wysmolek, M.; Sayinc, H.

2018-05-01

On-sky tests conducted with an astro-comb using the Potsdam Multi-Aperture Spectrograph (PMAS) at the 3.5 m Calar Alto Telescope are reported. The proposed astro-comb approach is based on cascaded four-wave mixing between two lasers propagating through dispersion optimized nonlinear fibers. This approach allows for a line spacing that can be continuously tuned over a broad range (from tens of GHz to beyond 1 THz) making it suitable for calibration of low- medium- and high-resolution spectrographs. The astro-comb provides 300 calibration lines and his line-spacing is tracked with a wavemeter having 0.3 pm absolute accuracy. First, we assess the accuracy of Neon calibration by measuring the astro-comb lines with (Neon calibrated) PMAS. The results are compared with expected line positions from wavemeter measurement showing an offset of ∼5-20 pm (4%-16% of one resolution element). This might be the footprint of the accuracy limits from actual Neon calibration. Then, the astro-comb performance as a calibrator is assessed through measurements of the Ca triplet from stellar objects HD3765 and HD219538 as well as with the sky line spectrum, showing the advantage of the proposed astro-comb for wavelength calibration at any resolution.

Songs of the Universe - The AstroCappella Project

Science.gov (United States)

Boyd, P. T.; Smale, K. M.; Smale, A. P.

2004-12-01

The AstroCappella Project is a classroom-ready collection of upbeat pop songs, lesson plans, and background information, all rich in science content. It was developed as a collaboration between working research astronomers, educators, and a contemporary vocal band. A multimedia music CD ("AstroCappella 2.0") has been produced containing 13 astronomically correct songs with original lyrics and music. Song topics range from the Sun, Moon, planets and small bodies of the Solar System, through the Doppler shift, the nearest stars, and extra-solar planets, to radio astronomy, X-ray astronomy, and the Hubble Space Telescope and Swift astronomy satellites. The CD also contains extensive CD-ROM materials including science background information, curriculum notes, lesson plans and activities for each song, images, movies, and slide shows. The songs and accompanying information have been extensively field-tested, and align to the K-12 National Science Education Standards. The AstroCappella materials are in widespread use in classrooms and homes across the US, and are supplemented with frequent live performances and teacher workshops. We describe here the history, content, and educational strategy behind the AstroCappella Project, and the plans for its future development.

Integrative review of implementation strategies for translation of research-based evidence by nurses.

Science.gov (United States)

Wuchner, Staci S

2014-01-01

The purpose of this review was to synthesize and critique experimental and/or quasi-experimental research that has evaluated implementation strategies for translation of research-based evidence into nursing practice. Successfully implementing evidence-based research can improve patient outcomes. Identifying successful implementation strategies is imperative to move research-based evidence into practice. As implementation science gains popularity, it is imperative to understand the strategies that most effectively translate research-based evidence into practice. The review used the CINAHL and MEDLINE (Ovid) databases. Articles were included if they were experimental and/or quasi-experimental research designs, were written in English, and measured nursing compliance to translation of research-based evidence. An independent review was performed to select and critique the included articles. A wide array of interventions were completed, including visual cues, audit and feedback, educational meetings and materials, reminders, outreach, and leadership involvement. Because of the complex multimodal nature of the interventions and the variety of research topics, comparison across interventions was difficult. Many difficulties exist in determining what implementation strategies are most effective for translation of research-based evidence into practice by nurses. With these limited findings, further research is warranted to determine which implementation strategies most successfully translate research-based evidence into practice.

Management of REM sleep behavior disorder: An evidence based review.

Science.gov (United States)

Devnani, Preeti; Fernandes, Racheal

2015-01-01

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG) while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.

Management of REM sleep behavior disorder: An evidence based review

Directory of Open Access Journals (Sweden)

Preeti Devnani

2015-01-01

Full Text Available Rapid eye movement (REM sleep behavior disorder (RBD is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.

Astro 4 - a sounding rocket programme of the X-ray astronomy

International Nuclear Information System (INIS)

Henkel, R.; Pechstein, H.

1980-01-01

The 'Astro 4' program is part of the German Astronomy Sounding Rocket Program and was divided into two different tasks. The 'Astro 4/1' project had the task to perform X-ray spectroscopic investigations and imaging of solar coronal active regions by means of zone-plate cameras, a Rowland spectrograph and a KAP crystal spectrometer aboard of a three-axis stabilized payload. The 'Astro 4/2' project had the task to take investigations of the X-ray sources Puppis A and the Crab Nebula by means of a Wolter Telescope, equipped with a position-sensitive proportional counter. Up to now the three-axis stabilized payload 'Astro 4/2' has been the longest Skylark payload. (Auth.)

Barriers to evidence-based medicine: a systematic review.

Science.gov (United States)

Sadeghi-Bazargani, Homayoun; Tabrizi, Jafar Sadegh; Azami-Aghdash, Saber

2014-12-01

Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM. Different database searching methods and also manual search were employed in this study using the search words ('evidence-based' or 'evidence-based medicine' or 'evidence-based practice' or 'evidence-based guidelines' or 'research utilization') and (barrier* or challenge or hinder) in the following databases: PubMed, Scopus, Web of Knowledge, Cochrane library, Pro Quest, Magiran, SID. Out of 2592 articles, 106 articles were finally identified for study. Research barriers, lack of resources, lack of time, inadequate skills, and inadequate access, lack of knowledge and financial barriers were found to be the most common barriers to EBM. Examples of these barriers were found in primary care, hospital/specialist care, rehabilitation care, medical education, management and decision making. The most common barriers to research utilization were research barriers, cooperation barriers and changing barriers. Lack of resources was the most common barrier to implementation of guidelines. The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled. © 2014 John Wiley & Sons, Ltd.

ASTROS: A multidisciplinary automated structural design tool

Science.gov (United States)

Neill, D. J.

1989-01-01

ASTROS (Automated Structural Optimization System) is a finite-element-based multidisciplinary structural optimization procedure developed under Air Force sponsorship to perform automated preliminary structural design. The design task is the determination of the structural sizes that provide an optimal structure while satisfying numerous constraints from many disciplines. In addition to its automated design features, ASTROS provides a general transient and frequency response capability, as well as a special feature to perform a transient analysis of a vehicle subjected to a nuclear blast. The motivation for the development of a single multidisciplinary design tool is that such a tool can provide improved structural designs in less time than is currently needed. The role of such a tool is even more apparent as modern materials come into widespread use. Balancing conflicting requirements for the structure's strength and stiffness while exploiting the benefits of material anisotropy is perhaps an impossible task without assistance from an automated design tool. Finally, the use of a single tool can bring the design task into better focus among design team members, thereby improving their insight into the overall task.

Initial Development and Pilot Study Design of Interactive Lecture Demonstrations for ASTRO 101

Science.gov (United States)

Schwortz, Andria C.; French, D. A; Gutierrez, Joseph V; Sanchez, Richard L; Slater, Timothy F.; Tatge, Coty

2014-06-01

Interactive lecture demonstrations (ILDs) have repeatedly shown to be effective tools for improving student achievement in the context of learning physics. As a first step toward systematic development of interactive lecture demonstrations in ASTRO 101, the introductory astronomy survey course, a systematic review of education research, describing educational computer simulations (ECSs) reveals that initial development requires a targeted study of how ASTRO 101 students respond to ECSs in the non-science majoring undergraduate lecture setting. In this project we have adopted the process by which ILDs were designed, pilot-tested, and successfully implemented in the context of physics teaching (Sokoloff & Thornton, 1997; Sokoloff & Thornton, 2004). We have designed the initial pilot-test set of ASTRO 101 ILD instructional materials relying heavily on ECSs. Both an instructor’s manual and a preliminary classroom-ready student workbook have been developed, and we are implementing a pilot study to explore their effectiveness in communicating scientific content, and the extent to which they might enhance students’ knowledge of and perception about astronomy and science in general. The study design uses a pre-/post-test quasi-experimental study design measuring students’ normalized gain scores, calculated as per Hake (1998) and Prather (2009), using a slightly modified version of S. Slater’s (2011) Test Of Astronomy STandards TOAST combined with other instruments. The results of this initial study will guide the iterative development of ASTRO 101 ILDs that are intended to both be effective at enhancing student achievement and easy for instructors to successfully implement.

Introducing AstroGen: the Astronomy Genealogy Project

Science.gov (United States)

Tenn, Joseph S.

2016-12-01

The Astronomy Genealogy Project (AstroGen), a project of the Historical Astronomy Division of the American Astronomical Society (AAS), will soon appear on the AAS website. Ultimately, it will list the world's astronomers with their highest degrees, theses for those who wrote them, academic advisors (supervisors), universities, and links to the astronomers or their obituaries, their theses when online, and more. At present the AstroGen team is working on those who earned doctorates with astronomy-related theses. We show what can be learned already, with just ten countries essentially completed.

The Astro-E/XRS Blocking Filter Calibration

Science.gov (United States)

Audley, Michael D.; Arnaud, Keith A.; Gendreau, Keith C.; Boyce, Kevin R.; Fleetwood, Charles M.; Kelley, Richard L.; Keski-Kuha, Ritva A.; Porter, F. Scott; Stahle, Caroline K.; Szymkowiak, Andrew E.

1999-01-01

We describe the transmission calibration of the Astro-E XRS blocking filters. The XRS instrument has five aluminized polyimide blocking filters. These filters are located at thermal stages ranging from 200 K to 60 mK. They are each about 1000 A thick. XRS will have high energy resolution which will enable it to see some of the extended fine structure around the oxygen and aluminum K edges of these filters. Thus, we are conducting a high spectral resolution calibration of the filters near these energies to resolve out extended flue structure and absorption lines.

AstroBlend: Visualization package for use with Blender

Science.gov (United States)

Naiman, J. P.

2015-12-01

AstroBlend is a visualization package for use in the three dimensional animation and modeling software, Blender. It reads data in via a text file or can use pre-fab isosurface files stored as OBJ or Wavefront files. AstroBlend supports a variety of codes such as FLASH (ascl:1010.082), Enzo (ascl:1010.072), and Athena (ascl:1010.014), and combines artistic 3D models with computational astrophysics datasets to create models and animations.

Pharmacists performing quality spirometry testing: an evidence based review.

Science.gov (United States)

Cawley, Michael J; Warning, William J

2015-10-01

The scope of pharmacist services for patients with pulmonary disease has primarily focused on drug related outcomes; however pharmacists have the ability to broaden the scope of clinical services by performing diagnostic testing including quality spirometry testing. Studies have demonstrated that pharmacists can perform quality spirometry testing based upon international guidelines. The primary aim of this review was to assess the published evidence of pharmacists performing quality spirometry testing based upon American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines. In order to accomplish this, the description of evidence and type of outcome from these services were reviewed. A literature search was conducted using five databases [PubMed (1946-January 2015), International Pharmaceutical Abstracts (1970 to January 2015), Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews] with search terms including pharmacy, spirometry, pulmonary function, asthma or COPD was conducted. Searches were limited to publications in English and reported in humans. In addition, Uniform Resource Locators and Google Scholar searches were implemented to include any additional supplemental information. Eight studies (six prospective multi-center trials, two retrospective single center studies) were included. Pharmacists in all studies received specialized training in performing spirometry testing. Of the eight studies meeting inclusion and exclusion criteria, 8 (100%) demonstrated acceptable repeatability of spirometry testing based upon standards set by the ATS/ERS guidelines. Acceptable repeatability of seven studies ranged from 70 to 99% consistent with published data. Available evidence suggests that quality spirometry testing can be performed by pharmacists. More prospective studies are needed to add to the current evidence of quality spirometry testing performed by

Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

Science.gov (United States)

Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

2018-04-01

The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

The Evolution of Spacelab Ultraviolet Astronomy Missions from OSS-3 through -7 to Astro-1

Science.gov (United States)

Gull, Theodore

2018-01-01

In the 1960s and 1970s, NASA was building towards a robust program in space astronomy. An evolutionary step from ground-based astronomy to space astronomy was human operation of space telescopes as astronomy in general evolved from astronomers directly at the telescope to application of computers and long distance communications to control to operate remote telescopes. Today ground-based telescopes and space observatories from cubesats to the Hubble Space Telescope and soon the James Webb Space Telescope are routinely operated remotely.In response to the Spacelab Announcement of Opportunity in the early 1980s, three ultraviolet experiments – the Hopkins Ultraviolet Telescope, the Ultraviolet Imaging Telescope and the Wisconsin Ultraviolet PhotoPolarimetry Experiment -- all instruments derived from multiple sounding rocket flights--were selected to fly as an integrated payload attached to a space shuttle. The justification for professional astronomers, both as Mission Specialists from the astronaut cadre and Payload Specialists from the instrument teams, was built to ensure key technical skills both of the science and the instruments. Bundled together as OSS-3 through -7 flights focused on Comet Halley, the experiments went through many changes and delays as a pathfinder for an anticipated series of attached astronomy payloads.By 1986, the five-flight mission had evolved into two missions, Astro-1 dedicated primarily to observe Halley’s Comet in early March 1986 and Astro-2 to fly about one year later. Due to the Challenger disaster 35 days before scheduled launch of Astro-1, the mission went through an initial cancellation and then re-scheduling once the instrument complement of Astro-1 was expanded to include Broad Band X-ray Telescope with emphasis on studying SN1987A. Ultimately Astro-1 flew in December 1990 partnered with an X-ray experiment focused on SN1987A.The nine-day mission was mostly successful despite multiple technical issues overcome by the NASA

AstroNet-II International Final Conference

CERN Document Server

Masdemont, Josep

2016-01-01

These are the proceedings of the "AstroNet-II International Final Conference". This conference was one of the last milestones of the Marie-Curie Research Training Network on Astrodynamics "AstroNet-II", that has been funded by the European Commission under the Seventh Framework Programme. The aim of the conference, and thus this book, is to communicate work on astrodynamics problems to an international and specialised audience. The results are presented by both members of the network and invited specialists. The topics include: trajectory design and control, attitude control, structural flexibility of spacecraft and formation flying. The book addresses a readership across the traditional boundaries between mathematics, engineering and industry by offering an interdisciplinary and multisectorial overview of the field.

The development and application of the AstroFit program for complementary dark matter studies

International Nuclear Information System (INIS)

Nguyen, Ngoc-Lan Nelly

2013-02-01

This doctoral thesis describes the development and application of the AstroFit program. Many studies have shown the existence of dark matter (DM), a mass component that constitutes over eighty percent of the entire matter in the Universe. From historical astrophysical evidence to latest reconstructions with sophisticated methods, the gravitational effect of DM can be shown, but its nature remains unknown. Many theoretical explanations aim at describing DM, for example as weakly interacting massive particles (WIMPs), within particular frameworks. The majority of these frameworks extend the existing standard model of particle physics (SM), so that new particles are added to the known set of elementary particles. One of these frameworks is the constrained supersymmetric standard model (CMSSM) that naturally introduces a DM candidate in form of the lightest supersymmetric particle(LSP). Searches for DM particles are undertaken in three different ways. First, directly with fixed-target experiments that measure WIMPs coming towards the Earth with nuclei of the target material. Second, indirectly by reconstructing DM signatures in particle spectra of known particles observed with ground-based telescopes, spaceborne satellites or balloon-borne experiments. And third, indirectly via direct production of DM at particle colliders such as the Large Hadron Collider (LHC) and energy reconstructions where missing transverse energy is presumably carried away by the DM particles. Global fit programs used in particle physics, such as Fittino, are designed to fit parameters of theories beyond the SM simultaneously that are in accordance with the experimental and observed data in order to probe models and constrain the parameter space. To explore complementarity in DM research, the AstroFit interface program has been developed to combine all available information from direct and indirect searches for DM as well as collider searches for new physics in such global fits. To demonstrate

The development and application of the AstroFit program for complementary dark matter studies

Energy Technology Data Exchange (ETDEWEB)

Nguyen, Ngoc-Lan Nelly

2013-02-15

This doctoral thesis describes the development and application of the AstroFit program. Many studies have shown the existence of dark matter (DM), a mass component that constitutes over eighty percent of the entire matter in the Universe. From historical astrophysical evidence to latest reconstructions with sophisticated methods, the gravitational effect of DM can be shown, but its nature remains unknown. Many theoretical explanations aim at describing DM, for example as weakly interacting massive particles (WIMPs), within particular frameworks. The majority of these frameworks extend the existing standard model of particle physics (SM), so that new particles are added to the known set of elementary particles. One of these frameworks is the constrained supersymmetric standard model (CMSSM) that naturally introduces a DM candidate in form of the lightest supersymmetric particle(LSP). Searches for DM particles are undertaken in three different ways. First, directly with fixed-target experiments that measure WIMPs coming towards the Earth with nuclei of the target material. Second, indirectly by reconstructing DM signatures in particle spectra of known particles observed with ground-based telescopes, spaceborne satellites or balloon-borne experiments. And third, indirectly via direct production of DM at particle colliders such as the Large Hadron Collider (LHC) and energy reconstructions where missing transverse energy is presumably carried away by the DM particles. Global fit programs used in particle physics, such as Fittino, are designed to fit parameters of theories beyond the SM simultaneously that are in accordance with the experimental and observed data in order to probe models and constrain the parameter space. To explore complementarity in DM research, the AstroFit interface program has been developed to combine all available information from direct and indirect searches for DM as well as collider searches for new physics in such global fits. To demonstrate

Management of REM sleep behavior disorder: An evidence based review

OpenAIRE

Preeti Devnani; Racheal Fernandes

2015-01-01

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, ...

Social Workers' Attitudes toward Peer-Reviewed Literature: The Evidence Base

Science.gov (United States)

Knight, Carolyn

2013-01-01

Social workers from one state chapter of the National Association of Social Workers were surveyed to assess their use of and attitudes toward the peer-reviewed literature and their engagement in evidence-based practice. Results reveal that, in general, the practitioners in this study did not read the peer-reviewed literature, particularly articles…

From evidence based medicine to mechanism based medicine : Reviewing the role of pharmacogenetics

NARCIS (Netherlands)

Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van der Zee, Anke-Hilse; Deneer, Vera

Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its

From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics

NARCIS (Netherlands)

Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van der Zee, Anke-Hilse; Deneer, Vera

Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its

Expert Images for All Audiences: The AstroPix Archive

Science.gov (United States)

Hurt, Robert; Llamas, Jacob; Wyatt, Ryan Jason; Christensen, Lars

2018-01-01

The AstroPix project provides one-stop-shopping for an extensive collection of the finest astronomical imagery, sourced from some of the world’s most prominent observatories. The archive is made possible by a grassroots effort to tag publicly-released imagery using the Astronomical Visualization Metadata (AVM) standard, which captures rich contextual information for each image. While the site has been in development for many years, it is now supported under NASA’s Universe of Learning collaboration, and AstroPix has been updated and deployed to cloud services. The AVM tags provide many unique features including spectral color assignments, sky context (using AAS WorldWide Telescope APIs), and direct links to the original source material on the web. The 7,000+ assets currently include imagery provided by Chandra, ESO, GALEX, Herschel, Hubble, NuSTAR, Spitzer, and WISE. The assets are also provided for use in the planetarium community by supporting the Data2Dome (D2D) initiative. AstroPix imagery is designed to be used in a variety of unique ways that benefit formal and informal education as well as astronomers and the general public. Observatories can add their own image archives to AstroPix by tagging their assets and providing a simple XML feed, increasing the value of their data to the community at large.

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

Science.gov (United States)

Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-03-01

The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

The role of ASTRO and the radiation oncologist in preparedness

International Nuclear Information System (INIS)

Daly, N.

2003-01-01

The events on September 11, 2001 were unpredictable and tragic, however it is not inconceivable that a similar terrorist event could occur again, this time involving radiologic or nuclear material. In order to prepare for this American Society for Therapeutic Radiology and Oncology (ASTRO) convened a task force. Initially the task force worked with the American College of Radiology (ACR)and the American Society of Physicists in Medicine (AAPM)to publish a PRIMER entitled 'Disaster Preparedness for Radiology Professionals'. The PRIMER serve as a quick reference in the event of a radiation disaster and is available on the ASTRO Web site (www.astro.org). The task force has also developed a detailed and extensive training program, in partnership with the U.S. Department of Energy's Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge (TN), that will equip radiation oncologists with the necessary expertise to train hospital radiation oncology departments and other healthcare personnel who are responsible for implementing and carrying out hospital planning for disasters involving radioactive materials. This presentation will outline the effort ASTRO has been involved with since September 11, 2001 to prepare the professional community it represent in the event of a radiation/nuclear disaster

Fractionation for Whole Breast Irradiation: An American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

International Nuclear Information System (INIS)

Smith, Benjamin D.; Bentzen, Soren M.; Correa, Candace R.; Hahn, Carol A.; Hardenbergh, Patricia H.; Ibbott, Geoffrey S.; McCormick, Beryl; McQueen, Julie R.; Pierce, Lori J.; Powell, Simon N.; Recht, Abram; Taghian, Alphonse G.; Vicini, Frank A.; White, Julia R.; Haffty, Bruce G.

2011-01-01

Purpose: In patients with early-stage breast cancer treated with breast-conserving surgery, randomized trials have found little difference in local control and survival outcomes between patients treated with conventionally fractionated (CF-) whole breast irradiation (WBI) and those receiving hypofractionated (HF)-WBI. However, it remains controversial whether these results apply to all subgroups of patients. We therefore developed an evidence-based guideline to provide direction for clinical practice. Methods and Materials: A task force authorized by the American Society for Radiation Oncology weighed evidence from a systematic literature review and produced the recommendations contained herein. Results: The majority of patients in randomized trials were aged 50 years or older, had disease Stage pT1-2 pN0, did not receive chemotherapy, and were treated with a radiation dose homogeneity within ±7% in the central axis plane. Such patients experienced equivalent outcomes with either HF-WBI or CF-WBI. Patients not meeting these criteria were relatively underrepresented, and few of the trials reported subgroup analyses. For patients not receiving a radiation boost, the task force favored a dose schedule of 42.5 Gy in 16 fractions when HF-WBI is planned. The task force also recommended that the heart should be excluded from the primary treatment fields (when HF-WBI is used) due to lingering uncertainty regarding late effects of HF-WBI on cardiac function. The task force could not agree on the appropriateness of a tumor bed boost in patients treated with HF-WBI. Conclusion: Data were sufficient to support the use of HF-WBI for patients with early-stage breast cancer who met all the aforementioned criteria. For other patients, the task force could not reach agreement either for or against the use of HF-WBI, which nevertheless should not be interpreted as a contraindication to its use.

Implementing Prehospital Evidence-Based Guidelines: A Systematic Literature Review.

Science.gov (United States)

Fishe, Jennifer N; Crowe, Remle P; Cash, Rebecca E; Nudell, Nikiah G; Martin-Gill, Christian; Richards, Christopher T

2018-01-19

As prehospital research advances, more evidence-based guidelines (EBGs) are implemented into emergency medical services (EMS) practice. However, incomplete or suboptimal prehospital EBG implementation may hinder improvement in patient outcomes. To inform future efforts, this study's objective was to review existing evidence pertaining to prehospital EBG implementation methods. This study was a systematic literature review and evaluation following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. PubMed, EMBASE, Scopus, and Google Advanced Search were searched without language or publication date filters for articles addressing prehospital EBG implementation. Conference proceedings, textbooks, and non-English articles were excluded. GRADE was applied to the remaining articles independently by three of five study investigators. Study characteristics and salient findings from the included articles are reported. The systematic literature review identified 1,367 articles, with 41 meeting inclusion criteria. Most articles described prehospital EBG implementation (n = 24, 59%), or implementation barriers (n = 13, 32%). Common study designs were statement documents (n = 12, 29%), retrospective cohort studies (n = 12, 29%), and cross-sectional studies (n = 9, 22%). Using GRADE, evidence quality was rated low (n = 18, 44%), or very low (n = 23, 56%). Salient findings from the articles included: (i) EBG adherence and patient outcomes depend upon successful implementation, (ii) published studies generally lack detailed implementation methods, (iii) EBG implementation takes longer than planned (mostly for EMS education), (iv) EMS systems' heterogeneity affects EBG implementation, and (v) multiple barriers limit successful implementation (e.g., financial constraints, equipment purchasing, coordination with hospitals, and regulatory agencies). This review found no direct evidence for best prehospital EBG implementation practices. There

Evidence-based information needs of public health workers: a systematized review.

Science.gov (United States)

Barr-Walker, Jill

2017-01-01

This study assessed public health workers' evidence-based information needs, based on a review of the literature using a systematic search strategy. This study is based on a thesis project conducted as part of the author's master's in public health coursework and is considered a systematized review. Four databases were searched for English-language articles published between 2005 and 2015: PubMed, Web of Science, Library Literature & Information Science Index, and Library, Information Science & Technology Abstracts (LISTA). Studies were excluded if there was no primary data collection, the population in the study was not identified as public health workers, "information" was not defined according to specific criteria, or evidence-based information and public health workers were not the major focus. Studies included in the final analysis underwent data extraction, critical appraisal using CASP and STROBE checklists, and thematic analysis. Thirty-three research studies were identified in the search, including twenty-one using quantitative methods and twelve using qualitative methods. Critical appraisal revealed many potential biases, particularly in the validity of research. Thematic analysis revealed five common themes: (1) definition of information needs, (2) current information-seeking behavior and use, (3) definition of evidence-based information, (4) barriers to information needs, and (5) public health-specific issues. Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers' information needs.

Towards Evidence-Based Initial Teacher Education in Singapore: A Review of Current Literature

Science.gov (United States)

Low, Ee-Ling; Hui, Chenri; Taylor, Peter G.; Ng, Pak Tee

2012-01-01

Initial teacher education (ITE) in Singapore is shifting towards evidence-based practice. Despite a clear policy orientation, ITE in Singapore has not yet produced the evidence base that it is anticipating. This paper presents an analytical review of previous research into ITE in Singapore and makes comparisons to the larger international context.…

Child debriefing: a review of the evidence base.

Science.gov (United States)

Pfefferbaum, Betty; Jacobs, Anne K; Nitiéma, Pascal; Everly, George S

2015-06-01

Debriefing, a controversial crisis intervention delivered in the early aftermath of a disaster, has not been well evaluated for use with children and adolescents. This report constitutes a review of the child debriefing evidence base. A systematic search of selected bibliographic databases (EBM Reviews, EMBASE, ERIC, Medline, Ovid, PILOTS, PubMed, and PsycINFO) was conducted in the spring of 2014 using search terms related to psychological debriefing. The search was limited to English language sources and studies of youth, aged 0 to 18 years. No time limit was placed on date of publication. The search yielded 713 references. Titles and abstracts were reviewed to select publications describing scientific studies and clinical reports. Reference sections of these publications, and of other literature known to the authors that was not generated by the search, were used to locate additional materials. Review of these materials generated 187 publications for more thorough examination; this assessment yielded a total of 91 references on debriefing in children and adolescents. Only 15 publications on debriefing in children and adolescents described empirical studies. Due to a lack of statistical analysis of effectiveness data with youth, and some articles describing the same study, only seven empirical studies described in nine papers were identified for analysis for this review. These studies were evaluated using criteria for assessment of methodological rigor in debriefing studies. Children and adolescents included in the seven empirical debriefing studies were survivors of motor-vehicle accidents, a maritime disaster, hostage taking, war, or peer suicides. The nine papers describing the seven studies were characterized by inconsistency in describing the interventions and populations and by a lack of information on intervention fidelity. Few of the studies used randomized design or blinded assessment. The results described in the reviewed studies were mixed in regard to

Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations.

Science.gov (United States)

Rudmik, Luke; Hoy, Monica; Schlosser, Rodney J; Harvey, Richard J; Welch, Kevin C; Lund, Valerie; Smith, Timothy L

2013-04-01

Topical therapies have become an integral component in the management plan for chronic rhinosinusitis (CRS). Several topical therapy strategies have been evaluated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence-based approach for the utilization of topical therapies in the management of CRS. A systematic review of the literature was performed and the guidelines for development of an evidence-based review with recommendations were followed. Study inclusion criteria were: adult population >18 years old; chronic rhinosinusitis (CRS) based on published diagnostic criteria; and clearly defined primary clinical end-point. We focused on reporting higher-quality studies (level 2b or higher), but reported on lower-level studies if the topic contained insufficient evidence. We excluded drug-eluting spacer and stent therapy from this review. This review identified and evaluated the literature on 5 topical therapy strategies for CRS: saline irrigation, topical steroid, topical antibiotic, topical antifungal, and topical alternatives (surfactant, manuka honey, and xylitol irrigations). Based on the available evidence, sinonasal saline irrigation and standard topical nasal steroid therapy are recommended in the topical treatment of CRS. Nonstandard (off-label) topical sinonasal steroid therapies can be an option for managing CRS. The evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using nebulized and spray techniques in routine cases of CRS. There is insufficient clinical research to provide recommendations for alternative therapies or topical antibiotic therapy delivered using other delivery methods (eg, irrigations). © 2013 ARS-AAOA, LLC.

Observing Compact Stars with AstroSat

Indian Academy of Sciences (India)

25

... of the Crab pulsar and an X-ray binary system GX 301-2 are presented to illustrate some of the capabilities of the mission. ...... vided online at the web portal of the AstroSat Science. Support Cell1. ... Library, Springer, 440, 61. [4] Bhalerao,V.

Nonablative Fractional Laser Resurfacing in Skin of Color: Evidence-based Review.

Science.gov (United States)

Kaushik, Shivani B; Alexis, Andrew F

2017-06-01

Background: Nonablative laser resurfacing represents one of the major advances in procedural dermatology over the past decade. However, its use in darker skin types is limited by safety concerns and a relative lack of available data. Aim: To provide evidence-based recommendations for the use of fractional lasers in darker skin types. Evidence review: A broad literature search of PubMed/Medline database was conducted in April 2016 using the term fractional lasers. A free text search of keywords including fractional resurfacing, nonablative lasers, skin type, skin of color, ethnic skin, Fitzpatrick skin type, Asian skin, African Americans, Afro-Caribbean, and Hispanics was also executed. An in-depth review of all the relevant articles fitting the authors' inclusion/exclusion criteria was performed. Thereafter, each study was assigned levels of evidence per the Modified Criteria by Oxford Center of Evidence Based Medicine. A recommendation was made for a specific treatment based on the presence of at least one Level 1 study or more than three Level 2 or 3 studies that had concordant results. Findings: The available evidence strongly suggests that fractional lasers are a favorable treatment option for a variety of dermatological diseases in Fitzpatrick skin phototypes IV to VI. Level 1 evidence was found for the use of fractional lasers for treating acne, striae and skin rejuvenation. Level 2 evidence was found for their use in acne scars, melasma, and surgical/traumatic scars. Conclusion: Fractional resurfacing is a safe and efficacious treatment option for various dermatological disorders in darker skin types; however, there is a paucity of high-quality studies involving skin types V and VI.

Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review

Science.gov (United States)

Besag, Frank; Ettinger, Alan B.; Mula, Marco; Gobbi, Gabriella; Comai, Stefano; Aldenkamp, Albert P.; Steinhoff, Bernhard J.

2016-01-01

Antiepileptic drugs (AEDs) have many benefits but also many side effects, including aggression, agitation, and irritability, in some patients with epilepsy. This article offers a comprehensive summary of current understanding of aggressive behaviors in patients with epilepsy, including an evidence-based review of aggression during AED treatment. Aggression is seen in a minority of people with epilepsy. It is rarely seizure related but is interictal, sometimes occurring as part of complex psychiatric and behavioral comorbidities, and it is sometimes associated with AED treatment. We review the common neurotransmitter systems and brain regions implicated in both epilepsy and aggression, including the GABA, glutamate, serotonin, dopamine, and noradrenaline systems and the hippocampus, amygdala, prefrontal cortex, anterior cingulate cortex, and temporal lobes. Few controlled clinical studies have used behavioral measures to specifically examine aggression with AEDs, and most evidence comes from adverse event reporting from clinical and observational studies. A systematic approach was used to identify relevant publications, and we present a comprehensive, evidence-based summary of available data surrounding aggression-related behaviors with each of the currently available AEDs in both adults and in children/adolescents with epilepsy. A psychiatric history and history of a propensity toward aggression/anger should routinely be sought from patients, family members, and carers; its presence does not preclude the use of any specific AEDs, but those most likely to be implicated in these behaviors should be used with caution in such cases. PMID:27255267

Two virtual astro refresher courses on the world-wide-web

International Nuclear Information System (INIS)

Goldwein, Joel W.

1997-01-01

Purpose/Objective: The Internet offers a novel venue for providing educational material to radiation oncologists. This exhibit demonstrates its utility for providing the complete content of two past ASTRO refresher courses. Materials and Methods: The audio recording, handout and slides from the 1995 ASTRO refresher course entitled 'Radiation Therapy for Pediatric Brain Tumors; Standards of Care, Current Clinical Trials and New Directions' and the 1996 ASTRO refresher course entitled 'Internet-based communications in Radiation Oncology' were digitized and placed on an Internet World-Wide-Web site. The Web address was posted on the refresher course handout and in the meeting book ('http://goldwein 1.xrt.upenn.edu/brain95.html' and 'http://goldwein 1.xrt.upenn.edu/astro96/'). The computer distributing this material is an Intel-based 486 DEC50 personal computer with a 50 Mhz processor running Windows NT 3.51 workstation. Software utilized to distribute the material is in the public domain and includes EWMAC's 'httpd', and Progressive Network's 'RealAudio Server' and 'Encoder'. The University's dedicated Internet connection is used to 'serve' this material. Results: The two approximately 100 minute lectures have been encoded into several 'RealAudio' files totaling 10 Megabytes in size. These files are accessible with moderate to excellent quality and speed utilizing as little as a 14.4k modem connection to the Internet. Use of 'streaming' technology provides a means for playing the audio files over the Internet after downloading only a small portion of the files. The time required to digitize the material has been approximately 40 hours, with most time related to digitizing slides from a Powerpoint presentation. Not all slides have been digitized as of this time. To date, approximately 400 accesses to this resource have been logged on the system. Seven electronic comment forms for the second course have all rated it as 'superior'. Pitfalls include the difficulty

Evaluation of radiation tolerance of FETs used for Astro-E2 hard X-ray detector (HXD-II)

International Nuclear Information System (INIS)

Itoh, Takeshi; Niko, Hisako; Kokubun, Motohide; Makishima, Kazuo; Kawaharada, Madoka; Takahashi, Isao; Miyasaka, Hiromasa

2005-01-01

We evaluated the radiation tolerance of three types of metal-can MOS Field Effect Transistors (FETs). They are candidates for flight electronics of the Hard X-ray Detector (HXD-II) experiment which is onboard the cosmic X-ray satellite Astro-E2 scheduled for launch in 2005. We irradiated FETs with a Co60γ-ray source under several different experimental conditions, and measured changes in their I-V characteristic curves. After a 10krad irradiation during which the gate voltage is set at 0V, all types showed a decrease in the switching voltage by ∼0.2-0.4V. In addition, the gate conductance increased under some irradiation conditions. These experimental results may be explained in terms of trapped charges and boundary levels in the oxide layer beneath the gate electrode. We have confirmed that at least two types of FETs can be used in our satellite-borne experiment, one as relay-driving FETs and the other in TTL-ECL conversion circuits

Developing evidence-based dentistry skills: how to interpret randomized clinical trials and systematic reviews.

Science.gov (United States)

Kiriakou, Juliana; Pandis, Nikolaos; Madianos, Phoebus; Polychronopoulou, Argy

2014-10-30

Decision-making based on reliable evidence is more likely to lead to effective and efficient treatments. Evidence-based dentistry was developed, similarly to evidence-based medicine, to help clinicians apply current and valid research findings into their own clinical practice. Interpreting and appraising the literature is fundamental and involves the development of evidence-based dentistry (EBD) skills. Systematic reviews (SRs) of randomized controlled trials (RCTs) are considered to be evidence of the highest level in evaluating the effectiveness of interventions. Furthermore, the assessment of the report of a RCT, as well as a SR, can lead to an estimation of how the study was designed and conducted.

AstroCV: Astronomy computer vision library

Science.gov (United States)

González, Roberto E.; Muñoz, Roberto P.; Hernández, Cristian A.

2018-04-01

AstroCV processes and analyzes big astronomical datasets, and is intended to provide a community repository of high performance Python and C++ algorithms used for image processing and computer vision. The library offers methods for object recognition, segmentation and classification, with emphasis in the automatic detection and classification of galaxies.

AstroCom NYC: A Partnership Between Astronomers at CUNY, AMNH, and Columbia University

Science.gov (United States)

Paglione, Timothy; Ford, K. S.; Robbins, D.; Mac Low, M.; Agueros, M. A.

2014-01-01

AstroCom NYC is a new program designed to improve urban minority student access to opportunities in astrophysical research by greatly enhancing partnerships between research astronomers in New York City. The partners are minority serving institutions of the City University of New York, and the astrophysics research departments of the American Museum of Natural History and Columbia. AstroCom NYC provides centralized, personalized mentoring as well as financial and academic support, to CUNY undergraduates throughout their studies, plus the resources and opportunities to further CUNY faculty research with students. The goal is that students’ residency at AMNH helps them build a sense of belonging in the field, and inspires and prepares them for graduate study. AstroCom NYC prepares students for research with a rigorous Methods of Scientific Research course developed specifically to this purpose, a laptop, a research mentor, career mentor, involvement in Columbia outreach activities, scholarships and stipends, Metrocards, and regular assessment for maximum effectiveness. Stipends in part alleviate the burdens at home typical for CUNY students so they may concentrate on their academic success. AMNH serves as the central hub for our faculty and students, who are otherwise dispersed among all five boroughs of the City. With our first cohort we experienced the expected challenges from their diverse preparedness, but also far greater than anticipated challenges in scheduling, academic advisement, and molding their expectations. We review Year 1 operations and outcomes, as well as plans for Year 2, when our current students progress to be peer mentors.

Low level laser therapy and hair regrowth: an evidence-based review.

Science.gov (United States)

Zarei, Mina; Wikramanayake, Tongyu C; Falto-Aizpurua, Leyre; Schachner, Lawrence A; Jimenez, Joaquin J

2016-02-01

Despite the current treatment options for different types of alopecia, there is a need for more effective management options. Recently, low-level laser therapy (LLLT) was evaluated for stimulating hair growth. Here, we reviewed the current evidence on the LLLT effects with an evidence-based approach, focusing more on randomized controlled studies by critically evaluating them. In order to investigate whether in individuals presenting with hair loss (male pattern hair loss (MPHL), female pattern hair loss (FPHL), alopecia areata (AA), and chemotherapy-induced alopecia (CIA)) LLLT is effective for hair regrowth, several databases including PubMed, Google Scholar, Medline, Embase, and Cochrane Database were searched using the following keywords: Alopecia, Hair loss, Hair growth, Low level laser therapy, Low level light therapy, Low energy laser irradiation, and Photobiomodulation. From the searches, 21 relevant studies were summarized in this review including 2 in vitro, 7 animal, and 12 clinical studies. Among clinical studies, only five were randomized controlled trials (RCTs), which evaluated LLLT effect on male and female pattern hair loss. The RCTs were critically appraised using the created checklist according to the Critical Appraisal for Therapy Articles Worksheet created by the Center of Evidence-Based Medicine, Oxford. The results demonstrated that all the performed RCTs have moderate to high quality of evidence. However, only one out of five studies performed intention-to-treat analysis, and only another study reported the method of randomization and subsequent concealment of allocation clearly; all other studies did not include this very important information in their reports. None of these studies reported the treatment effect of factors such as number needed to treat. Based on this review on all the available evidence about effect of LLLT in alopecia, we found that the FDA-cleared LLLT devices are both safe and effective in patients with MPHL and FPHL

Pedagogical strategies to teach bachelor students evidence-based practice: A systematic review.

Science.gov (United States)

Aglen, B

2016-01-01

The aim of this study is to review international scientific articles about pedagogical strategies to teach nursing students at bachelor degree evidence-based practice (EBP). A literature review including peer reviewed, original, empirical articles describing pedagogical interventions aimed at teaching bachelor's degree nursing students EBP in the period 2004-2014. Theories of discretion, knowledge transfer and cognitive maturity development are used as analytical perspectives. The main challenge teaching evidence based practice is that the students fail to see how research findings contribute to nursing practice. The pedagogical strategies described are student active learning methods to teach the students information literacy and research topics. Information literacy is mainly taught according to the stages of EBP. These stages focus on how to elaborate evidence from research findings for implementation into nursing practice. The articles reviewed mainly use qualitative, descriptive designs and formative evaluations of the pedagogical interventions. Although a considerable effort in teaching information literacy and research topics, nursing students still struggle to see the relevance evidence for nursing practice. Before being introduced to information literacy and research topics, students need insight into knowledge transfer and their own epistemic assumptions. Knowledge transfer related to clinical problems should be the learning situations prioritized when teaching EBP at bachelor level. Theoretical perspectives of cognitive maturity development, knowledge transfer and discretion in professional practice give alternative ways of designing pedagogical strategies for EBP. More research is needed to develop and test pedagogical strategies for EBP in light of these theories. Copyright © 2015. Published by Elsevier Ltd.

What are the effects of teaching evidence-based health care (EBHC? Overview of systematic reviews.

Directory of Open Access Journals (Sweden)

Taryn Young

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

Beyond Astro 101: A First Report on Applying Interactive Education Techniques to an Astronphysics Class for Majors

Science.gov (United States)

Perrin, Marshall D.; Ghez, A. M.

2009-05-01

Learner-centered interactive instruction methods now have a proven track record in improving learning in "Astro 101" courses for non-majors, but have rarely been applied to higher-level astronomy courses. Can we hope for similar gains in classes aimed at astrophysics majors, or is the subject matter too fundamentally different for those techniques to apply? We present here an initial report on an updated calculus-based Introduction to Astrophysics class at UCLA that suggests such techniques can indeed result in increased learning for major students. We augmented the traditional blackboard-derivation lectures and challenging weekly problem sets by adding online questions on pre-reading assignments (''just-in-time teaching'') and frequent multiple-choice questions in class ("Think-Pair-Share''). We describe our approach, and present examples of the new Think-Pair-Share questions developed for this more sophisticated material. Our informal observations after one term are that with this approach, students are more engaged and alert, and score higher on exams than typical in previous years. This is anecdotal evidence, not hard data yet, and there is clearly a vast amount of work to be done in this area. But our first impressions strongly encourage us that interactive methods should be able improve the astrophysics major just as they have improved Astro 101.

Leadership in evidence-based practice: a systematic review.

Science.gov (United States)

Reichenpfader, Ursula; Carlfjord, Siw; Nilsen, Per

2015-01-01

This study aims to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field. A systematic review with narrative synthesis was conducted. Relevant electronic bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design. A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency, and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level. The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement. Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention.

Soft X-ray Focusing Telescope Aboard AstroSat: Design, Characteristics and Performance

DEFF Research Database (Denmark)

Singh, K; Stewart, G.; Westergaard, Niels Jørgen Stenfeldt

2017-01-01

The Soft X-ray focusing Telescope (SXT), India’s first X-ray telescope based on the principle of grazing incidence, was launched aboard the AstroSat and made operational on October 26, 2015. X-rays in the energy band of 0.3–8.0 keV are focussed on to a cooled charge coupled device thus providing ...

AstroML: "better, faster, cheaper" towards state-of-the-art data mining and machine learning

Science.gov (United States)

Ivezic, Zeljko; Connolly, Andrew J.; Vanderplas, Jacob

2015-01-01

We present AstroML, a Python module for machine learning and data mining built on numpy, scipy, scikit-learn, matplotlib, and astropy, and distributed under an open license. AstroML contains a growing library of statistical and machine learning routines for analyzing astronomical data in Python, loaders for several open astronomical datasets (such as SDSS and other recent major surveys), and a large suite of examples of analyzing and visualizing astronomical datasets. AstroML is especially suitable for introducing undergraduate students to numerical research projects and for graduate students to rapidly undertake cutting-edge research. The long-term goal of astroML is to provide a community repository for fast Python implementations of common tools and routines used for statistical data analysis in astronomy and astrophysics (see http://www.astroml.org).

Phenomenological and Astro-particle analysis of light dark matter particles

International Nuclear Information System (INIS)

Albornoz Vasquez, D.

2011-09-01

The nature of Dark Matter (DM) is still unveiled. Experimental efforts aiming to detect the Dark Matter have shown a great progress in the last decade. This work is devoted to the phenomenological and astro-particle studies of Dark Matter candidates of supersymmetric nature - the neutralino - and beyond - scalar particles. The former, in the (1-100) GeV mass range, is currently being tested by the Large Hadron Collider, direct detection and indirect detection experiments; this work shows that the interplay between experimental techniques is a decisive tool to thoroughly search for theoretical predictions. The latter is a non-standard candidate as light as 1 MeV which could be copiously produced at the Large Hadron Collider and, at the same time, it could explain other phenomena such as neutrino masses and/or the 511 keV line from the galactic center of the Milky Way. We start by describing the DM problem in Part I, where we give a review for evidence of the existence of DM, we set the cosmological framework in which we work and describe the history of DM from the Early Universe (EU), to the formation of structure and up to the current distribution of the DM in haloes. Then, in Part II, we go through the important Cosmological, Astro-particle and Particle Physics constraints to particle DM candidates and subsequently introduce models providing relatively light DM candidates, models of standard supersymmetric nature such as the Minimal Supersymmetric Standard Model (MSSM) and the Next-to-MSSM (NMSSM) with neutralino DM, and beyond N=1 SUSY in a light scalar DM scenario inspired in N=2 SUSY. Finally, in Part III we present the findings of the investigations carried out: we describe a numerical tool developed to scan the multidimensional supersymmetric parameter space, then we present an application of this tool to the search of light neutralino configurations in the MSSM and NMSSM as well as an application to the search for neutralino DM in directional detectors, and

Improving the evidence base for energy policy: The role of systematic reviews

International Nuclear Information System (INIS)

Sorrell, Steve

2007-01-01

The concept of evidence-based policy and practice (EBPP) has gained increasing prominence in the UK over the last 10 years and now plays a dominant role in a number of policy areas, including healthcare, education, social work, criminal justice and urban regeneration. But despite this substantial, influential and growing activity, the concept remains largely unknown to policymakers and researchers within the energy field. This paper defines EBPP, identifies its key features and examines the potential role of systematic reviews of evidence in a particular area of policy. It summarises the methods through which systematic reviews are achieved; discusses their advantages and limitations; identifies the particular challenges they face in the energy policy area; and assesses whether and to what extent they can usefully be applied to contemporary energy policy questions. The concept is illustrated with reference to a proposed review of evidence for a 'rebound effect' from improved energy efficiency. The paper concludes that systematic reviews may only be appropriate for a subset of energy policy questions and that research-funding priorities may need to change if their use is to become more widespread

Evidence-based systematic review of saw palmetto by the Natural Standard Research Collaboration.

Science.gov (United States)

Ulbricht, Catherine; Basch, Ethan; Bent, Steve; Boon, Heather; Corrado, Michelle; Foppa, Ivo; Hashmi, Sadaf; Hammerness, Paul; Kingsbury, Eileen; Smith, Michael; Szapary, Philippe; Vora, Mamta; Weissner, Wendy

2006-01-01

Here presented is an evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth

Science.gov (United States)

Lam, Juleen; Sutton, Patrice; Johnson, Paula I.; Atchley, Dylan S.; Sen, Saunak; Robinson, Karen A.; Axelrad, Daniel A.; Woodruff, Tracey J.

2014-01-01

Background: In contrast to current methods of expert-based narrative review, the Navigation Guide is a systematic and transparent method for synthesizing environmental health research from multiple evidence streams. The Navigation Guide was developed to effectively and efficiently translate the available scientific evidence into timely prevention-oriented action. Objectives: We applied the Navigation Guide systematic review method to answer the question “Does fetal developmental exposure to perfluorooctanoic acid (PFOA) or its salts affect fetal growth in animals ?” and to rate the strength of the experimental animal evidence. Methods: We conducted a comprehensive search of the literature, applied prespecified criteria to the search results to identify relevant studies, extracted data from studies, obtained additional information from study authors, conducted meta-analyses, and rated the overall quality and strength of the evidence. Results: Twenty-one studies met the inclusion criteria. From the meta-analysis of eight mouse gavage data sets, we estimated that exposure of pregnant mice to increasing concentrations of PFOA was associated with a change in mean pup birth weight of –0.023 g (95% CI: –0.029, –0.016) per 1-unit increase in dose (milligrams per kilogram body weight per day). The evidence, consisting of 15 mammalian and 6 nonmammalian studies, was rated as “moderate” and “low” quality, respectively. Conclusion: Based on this first application of the Navigation Guide methodology, we found sufficient evidence that fetal developmental exposure to PFOA reduces fetal growth in animals. Citation: Koustas E, Lam J, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health: systematic review of nonhuman evidence for PFOA effects on fetal growth. Environ Health Perspect 122:1015–1027; http://dx.doi.org/10.1289/ehp.1307177 PMID:24968374

[Evidence-based effectiveness of road safety interventions: a literature review].

Science.gov (United States)

Novoa, Ana M; Pérez, Katherine; Borrell, Carme

2009-01-01

Only road safety interventions with scientific evidence supporting their effectiveness should be implemented. The objective of this study was to identify and summarize the available evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths. All literature reviews published in scientific journals that assessed the effectiveness of one or more road safety interventions and whose outcome measure was road traffic crashes, injuries or fatalities were included. An exhaustive search was performed in scientific literature databases. The interventions were classified according to the evidence of their effectiveness in reducing road traffic injuries (effective interventions, insufficient evidence of effectiveness, ineffective interventions) following the structure of the Haddon matrix. Fifty-four reviews were included. Effective interventions were found before, during and after the collision, and across all factors: a) the individual: the graduated licensing system (31% road traffic injury reduction); b) the vehicle: electronic stability control system (2 to 41% reduction); c) the infrastructure: area-wide traffic calming (0 to 20%), and d) the social environment: speed cameras (7 to 30%). Certain road safety interventions are ineffective, mostly road safety education, and others require further investigation. The most successful interventions are those that reduce or eliminate the hazard and do not depend on changes in road users' behavior or on their knowledge of road safety issues. Interventions based exclusively on education are ineffective in reducing road traffic injuries.

Large underground, liquid based detectors for astro-particle physics in Europe scientific case and prospects

CERN Document Server

Autiero, D; Badertscher, A; Bezrukov, L; Bouchez, J; Bueno, A; Busto, J; Campagne, J -E; Cavata, C; De Bellefon, A; Dumarchez, J; Ebert, J; Enqvist, T; Ereditato, A; Von Feilitzsch, F; Perez, P Fileviez; Goger-Neff, M; Gninenko, S; Gruber, W; Hagner, C; Hess, M; Hochmuth, K A; Kisiel, J; Knecht, L; Kreslo, I; Kudryavtsev, V A; Kuusiniemi, P; Lachenmaier, T; Laffranchi, M; Lefièvre, B; Lightfoot, P K; Lindner, M; Maalampi, J; Maltoni, M; Marchionni, A; Undagoitia, T Marrodan; Meregaglia, A; Messina, M; Mezzetto, M; Mirizzi, A; Mosca, L; Moser, U; Müller, A; Natterer, G; Oberauer, L; Otiougova, P; Patzak, T; Peltoniemi, J; Potzel, W; Pistillo, C; Raffelt, G G; Rondio, E; Roos, M; Rossi, B; Rubbia, André; Savvinov, N; Schwetz, T; Sobczyk, J; Spooner, N J C; Stefan, D; Tonazzo, A; Trzaska, W; Ulbricht, J; Volpe, C; Winter, J; Wurm, M; Zalewska-Bak, A; Zimmermann, R

2007-01-01

This document reports on a series of experimental and theoretical studies conducted to assess the astro-particle physics potential of three future large-scale particle detectors proposed in Europe as next generation underground observatories. The proposed apparatus employ three different and, to some extent, complementary detection techniques: GLACIER (liquid Argon TPC), LENA (liquid scintillator) and MEMPHYS (\\WC), based on the use of large mass of liquids as active detection media. The results of these studies are presented along with a critical discussion of the performance attainable by the three proposed approaches coupled to existing or planned underground laboratories, in relation to open and outstanding physics issues such as the search for matter instability, the detection of astrophysical- and geo-neutrinos and to the possible use of these detectors in future high-intensity neutrino beams.

The ASTRO-H (Hitomi) X-Ray Astronomy Satellite

Science.gov (United States)

Takahashi, Tadayuki; Kokubun, Motohide; Mitsuda, Kazuhisa; Kelley, Richard; Ohashi, Takaya; Aharonian, Felix; Akamatsu, Hiroki; Akimoto, Fumie; Allen, Steve; Anabuki, Naohisa;

Astro-H/Hitomi data analysis, processing, and archive

Science.gov (United States)

Angelini, Lorella; Terada, Yukikatsu; Dutka, Michael; Eggen, Joseph; Harrus, Ilana; Hill, Robert S.; Krimm, Hans; Loewenstein, Michael; Miller, Eric D.; Nobukawa, Masayoshi; Rutkowski, Kristin; Sargent, Andrew; Sawada, Makoto; Takahashi, Hiromitsu; Yamaguchi, Hiroya; Yaqoob, Tahir; Witthoeft, Michael

2018-01-01

Astro-H is the x-ray/gamma-ray mission led by Japan with international participation, launched on February 17, 2016. Soon after launch, Astro-H was renamed Hitomi. The payload consists of four different instruments (SXS, SXI, HXI, and SGD) that operate simultaneously to cover the energy range from 0.3 keV up to 600 keV. On March 27, 2016, JAXA lost contact with the satellite and, on April 28, they announced the cessation of the efforts to restore mission operations. Hitomi collected about one month's worth of data with its instruments. This paper presents the analysis software and the data processing pipeline created to calibrate and analyze the Hitomi science data, along with the plan for the archive. These activities have been a collaborative effort shared between scientists and software engineers working in several institutes in Japan and United States.

Evidence-Based Practice and School Nurse Practice: A Review of Literature

Science.gov (United States)

Yonkaitis, Catherine F.

2018-01-01

School nurses report that evidence-based practice (EBP) is not a part of their daily practice, and most have had no formal education regarding EBP or its implementation. The purpose of this review is to identify what strategies might be effective to educate school nurses about EBP as a first step toward establishing EBP in school nurse practice.…

Developing an evidence base for interdisciplinary learning: a systematic review.

Science.gov (United States)

Cooper, H; Carlisle, C; Gibbs, T; Watkins, C

2001-07-01

The overall aim of the study was to explore the feasibility of introducing interdisciplinary education within undergraduate health professional programmes. This paper reports on the first stage of the study in which a systematic review was conducted to summarize the evidence for interdisciplinary education of undergraduate health professional students. Systematic reviews integrate valid information providing a basis for rational decision making about health care which should be based on empirical and not anecdotal evidence. The accepted principles for systematic reviews were adapted in order to allow integration of the literature to produce recommendations for educational practice and guidelines for future research. The literature on interdisciplinary education was found to be diverse, including relatively small amounts of research data and much larger amounts of evaluation literature. Methodological rating schemes were used to test for confounding influences in the research studies. The number of studies found was 141 but only 30 (21%) were included in the analysis because of lack of methodological rigour in the research and poorly developed outcome measures. Student health professionals were found to benefit from interdisciplinary education with outcome effects primarily relating to changes in knowledge, skills, attitudes and beliefs. Effects upon professional practice were not discernible and educational and psychological theories were rarely used to guide the development of the educational interventions.

An Evidence-Based Framework for Evidence-Based Management in ...

African Journals Online (AJOL)

2018-05-01

May 1, 2018 ... BACKGROUND: Evidence-based management (EBMgt) is a growing literature concept in ... principles are developing across disciplines such as education, criminology ..... Australian Health Review. 2012;36(3):284-90. 17.

Fast-track Orthognathic Surgery: An Evidence-based Review

Science.gov (United States)

Otero, Joel Joshi; Detriche, Olivier; Mommaerts, Maurice Yves

2017-01-01

The aim of this study was to establish a fast-track protocol for bimaxillary orthognathic surgery (OGS). Fast-track surgery (FTS) is a multidisciplinary approach where the pre-, intra-, and postoperative management is focusing maximally on a quick patient recovery and early discharge. To enable this, the patients’ presurgical stress and postsurgical discomfort should be maximally reduced. Both referral patterns and expenses within the health-care system are positively influenced by FTS. University hospital-literature review through Medline, Embase, and the Cochrane Library (January 2000–July 2016) using the following words – “fast track, enhanced recovery, multimodal, and perioperative care” – to define a protocol evidence based for OGS, as well as evidenced-based medicine search of every term added to the protocol during the same period. The process has resulted in an OGS protocol that may improve the outcome of the patient through several nonoperative and operative measures such as preoperative patient education and intra/postoperative measures that should improve overall patient satisfaction, decrease morbidity such as postoperative nausea, headache, dizziness, pain, and intubation discomfort, and shorten hospital stay. A literature review allowed us to fine-tune a fast-track protocol for uncomplicated OGS that can be prospectively studied against currently applied ones. PMID:29264281

Exploring Wellness Interventions in Progressive Multiple Sclerosis: an Evidence-Based Review.

Science.gov (United States)

Venasse, Myriam; Edwards, Thomas; Pilutti, Lara A

2018-04-10

There has been recent interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for patients with progressive MS, considering limited therapeutic options currently available. The purpose of this review is to examine the role of wellness-based interventions including exercise training, emotional well-being therapies, and dietary modification in patients with progressive MS. We conducted a literature search on the efficacy of wellness-based interventions in patients with progressive MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention. There is level C evidence (possibly effective; one class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in patients with progressive MS. There is level B evidence (probably effective; one class I study) for the efficacy of mindfulness training on psychological distress, depression, anxiety, pain, and quality of life in patients with progressive MS. There is inadequate evidence (level U) for efficacy of dietary modification (one class III study and one class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one class IV study). High-quality research is needed to provide evidence-based recommendations for wellness behaviors and lifestyle change in patients with progressive MS.

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

Science.gov (United States)

Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

2016-02-01

Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

Selections from 2017: Image Processing with AstroImageJ

Science.gov (United States)

Kohler, Susanna

2017-12-01

Editors note:In these last two weeks of 2017, well be looking at a few selections that we havent yet discussed on AAS Nova from among the most-downloaded paperspublished in AAS journals this year. The usual posting schedule will resume in January.AstroImageJ: Image Processing and Photometric Extraction for Ultra-Precise Astronomical Light CurvesPublished January2017The AIJ image display. A wide range of astronomy specific image display options and image analysis tools are available from the menus, quick access icons, and interactive histogram. [Collins et al. 2017]Main takeaway:AstroImageJ is a new integrated software package presented in a publication led byKaren Collins(Vanderbilt University,Fisk University, andUniversity of Louisville). Itenables new users even at the level of undergraduate student, high school student, or amateur astronomer to quickly start processing, modeling, and plotting astronomical image data.Why its interesting:Science doesnt just happen the momenta telescope captures a picture of a distantobject. Instead, astronomical images must firstbe carefully processed to clean up thedata, and this data must then be systematically analyzed to learn about the objects within it. AstroImageJ as a GUI-driven, easily installed, public-domain tool is a uniquelyaccessible tool for thisprocessing and analysis, allowing even non-specialist users to explore and visualizeastronomical data.Some features ofAstroImageJ:(as reported by Astrobites)Image calibration:generate master flat, dark, and bias framesImage arithmetic:combineimages viasubtraction, addition, division, multiplication, etc.Stack editing:easily perform operations on a series of imagesImage stabilization and image alignment featuresPrecise coordinate converters:calculate Heliocentric and Barycentric Julian DatesWCS coordinates:determine precisely where atelescope was pointed for an image by PlateSolving using Astronomy.netMacro and plugin support:write your own macrosMulti-aperture photometry

Evidence-based Frameworks for Teaching and Learning in Classical Singing Training: A Systematic Review.

Science.gov (United States)

Crocco, Laura; Madill, Catherine J; McCabe, Patricia

2017-01-01

The study systematically reviews evidence-based frameworks for teaching and learning of classical singing training. This is a systematic review. A systematic literature search of 15 electronic databases following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines was conducted. Eligibility criteria included type of publication, participant characteristics, intervention, and report of outcomes. Quality rating scales were applied to support assessment of the included literature. Data analysis was conducted using meta-aggregation. Nine papers met the inclusion criteria. No complete evidence-based teaching and learning framework was found. Thematic content analysis showed that studies either (1) identified teaching practices in one-to-one lessons, (2) identified student learning strategies in one-to-one lessons or personal practice sessions, and (3) implemented a tool to enhance one specific area of teaching and learning in lessons. The included studies showed that research in music education is not always specific to musical genre or instrumental group, with four of the nine studies including participant teachers and students of classical voice training only. The overall methodological quality ratings were low. Research in classical singing training has not yet developed an evidence-based framework for classical singing training. This review has found that introductory information on teaching and learning practices has been provided, and tools have been suggested for use in the evaluation of the teaching-learning process. High-quality methodological research designs are needed. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Perancangan Corporate Identity Astro Rent Car Surabaya

OpenAIRE

Gunardi, Yohanes Calvin; Negara, I Nengah Sudika; Aryanto, Hendro

2017-01-01

Corporate Identity merupakan hal yang krusial dalam perkembangan sebuah Perusahaan dalam segi internal maupun eksternal. Dalam membuat perancangan Corporate identity yang efektif, perancangan ini menampilkan segala teori dan ilmu yang berhubungan dengan Corporate identity. Dengan adanya perancangan ini diharapkan para pembaca mengerti betapa pentingnya peran sebuah corporate identity yang tepat dan mengena.Kata kunci: corporate identity, Astro, logo.

Scrutiny of the ASTRO consensus definition of biochemical failure in irradiated prostate cancer patients demonstrates its usefulness and robustness

International Nuclear Information System (INIS)

Hanlon, Alexandra L.; Hanks, Gerald E.

2000-01-01

immediately following treatment under the ASTRO definition. Modifying the censoring pattern had little effect on failure estimates in any patient group, regardless of definition used. The exclusion of patients with slow prostate-specific antigen (PSA) doubling time did not result in biochemical estimates that differed significantly from those for all patients. The analysis of patients with agreement in failure status continued to demonstrate significant differences in estimates between the two definitions, and thus differences may be attributed to the specification of time to failure. For all patient groups, hazard rates were dependent upon failure definition: under the FCCC failure definition, patients were at constant risk of failure over the observation period; under the ASTRO failure definition, patients were at risk of failure during the first 4 years following treatment, and then at low risk of failure beyond 5 years. Conclusions: Both FCCC and ASTRO failure definitions were robust to modifications in censoring and the inclusion of patients with long doubling times. The ASTRO failure definition was robust to specifying the time to failure at first rise, as opposed to midway between nadir and first rise. Similarities in estimates for all patients versus patients with agreeing failure status suggest that differences in failure definition lie in the specification of time to failure. The ASTRO definition of failure is more appropriate because it does not impose an empirical failure marker but is based on the initiation of biochemical rise. The use of the ASTRO consensus definition demonstrated little risk of biochemical failure 4 years beyond treatment. The ASTRO failure definition should be adopted in all research involving biochemical failure analysis of men treated with radiation therapy

Soft X-ray focusing Telescope aboard AstroSat

DEFF Research Database (Denmark)

Singh, K. P.; Dewangan, G. C.; Chandra, S.

2017-01-01

The Soft X-ray focusing Telescope (SXT) is a moderateresolution X-ray imaging spectrometer supplementing the ultraviolet and hard X-ray payloads for broadband studies of cosmic sources with AstroSat. Well suited for observing bright X-ray sources, SXT observations of nearby active galactic nuclei...

AstroBlend: An astrophysical visualization package for Blender

Science.gov (United States)

Naiman, J. P.

2016-04-01

The rapid growth in scale and complexity of both computational and observational astrophysics over the past decade necessitates efficient and intuitive methods for examining and visualizing large datasets. Here, I present AstroBlend, an open-source Python library for use within the three dimensional modeling software, Blender. While Blender has been a popular open-source software among animators and visual effects artists, in recent years it has also become a tool for visualizing astrophysical datasets. AstroBlend combines the three dimensional capabilities of Blender with the analysis tools of the widely used astrophysical toolset, yt, to afford both computational and observational astrophysicists the ability to simultaneously analyze their data and create informative and appealing visualizations. The introduction of this package includes a description of features, work flow, and various example visualizations. A website - www.astroblend.com - has been developed which includes tutorials, and a gallery of example images and movies, along with links to downloadable data, three dimensional artistic models, and various other resources.

2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

Science.gov (United States)

2014-01-01

The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

Treatment for unicameral bone cysts in long bones: an evidence based review.

Science.gov (United States)

Donaldson, Sandra; Chundamala, Josie; Yandow, Suzanne; Wright, James G

2010-03-20

The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments.

Treatment for unicameral bone cysts in long bones: an evidence based review

Directory of Open Access Journals (Sweden)

Sandra E. Donaldson

2010-05-01

Full Text Available The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009 was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments.

Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008.

Science.gov (United States)

Cicerone, Keith D; Langenbahn, Donna M; Braden, Cynthia; Malec, James F; Kalmar, Kathleen; Fraas, Michael; Felicetti, Thomas; Laatsch, Linda; Harley, J Preston; Bergquist, Thomas; Azulay, Joanne; Cantor, Joshua; Ashman, Teresa

2011-04-01

To update our clinical recommendations for cognitive rehabilitation of people with traumatic brain injury (TBI) and stroke, based on a systematic review of the literature from 2003 through 2008. PubMed and Infotrieve literature searches were conducted using the terms attention, awareness, cognitive, communication, executive, language, memory, perception, problem solving, and/or reasoning combined with each of the following terms: rehabilitation, remediation, and training for articles published between 2003 and 2008. The task force initially identified citations for 198 published articles. One hundred forty-one articles were selected for inclusion after our initial screening. Twenty-nine studies were excluded after further detailed review. Excluded articles included 4 descriptive studies without data, 6 nontreatment studies, 7 experimental manipulations, 6 reviews, 1 single case study not related to TBI or stroke, 2 articles where the intervention was provided to caretakers, 1 article redacted by the journal, and 2 reanalyses of prior publications. We fully reviewed and evaluated 112 studies. Articles were assigned to 1 of 6 categories reflecting the primary area of intervention: attention; vision and visuospatial functioning; language and communication skills; memory; executive functioning, problem solving and awareness; and comprehensive-holistic cognitive rehabilitation. Articles were abstracted and levels of evidence determined using specific criteria. Of the 112 studies, 14 were rated as class I, 5 as class Ia, 11 as class II, and 82 as class III. Evidence within each area of intervention was synthesized and recommendations for Practice Standards, Practice Guidelines, and Practice Options were made. There is substantial evidence to support interventions for attention, memory, social communication skills, executive function, and for comprehensive-holistic neuropsychologic rehabilitation after TBI. Evidence supports visuospatial rehabilitation after right

The astro-geodetic use of CCD for gravity field refinement

Science.gov (United States)

Gerstbach, G.

1996-07-01

The paper starts with a review of geoid projects, where vertical deflections are more effective than gravimetry. In alpine regions the economy of astrogeoids is at least 10 times higher, but many countries do not make use of this fact - presumably because the measurements are not fully automated up to now. Based upon the experiences of astrometry of high satellites and own tests the author analyses the use of CCD for astro-geodetic measurements. Automation and speeding up will be possible in a few years, the latter depending on the observation scheme. Sensor characteristics, cooling and reading out of the devices should be harmonized. Using line sensors in small prism astrolabes, the CCD accuracy will reach the visual one (±0.2″) within 5-10 years. Astrogeoids can be combined ideally with geological data, because vertical variation of rock densities does not cause systematic effects (contrary to gravimetry). So a geoid of ±5 cm accuracy (achieved in Austria and other alpine countries by 5-10 points per 1000 km 2) can be improved to ±2 cm without additional observations and border effects.

A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease.

Science.gov (United States)

Sabater-Hernández, Daniel; Sabater-Galindo, Marta; Fernandez-Llimos, Fernando; Rotta, Inajara; Hossain, Lutfun N; Durks, Desire; Franco-Trigo, Lucia; Lopes, Livia A; Correr, Cassyano J; Benrimoj, Shalom I

2016-06-01

Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related information in order to support the previous activities. This review provides pharmacy service

Managing Workplace Violence With Evidence-Based Interventions: A Literature Review.

Science.gov (United States)

Martinez, Angel Johann Solorzano

2016-09-01

Workplace violence in health care settings is an occupational issue concerning nurses and other health care professionals. Patient aggression against nurses is often the most common form of violence in clinical settings, occurring in emergency departments, inpatient psychiatric settings, and nursing homes. Physical and verbal assaults are the major forms of workplace violence encountered by nurses. Current research has identified staff, environmental, and patient risk factors as the major precursors of workplace violence initiated by patients. Nurses often experience significant physical and psychological negative consequences after an episode of workplace violence. A review of the evidence was conducted to identify current evidence-based interventions that can help nurses minimize the incidence of workplace violence. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 31-36.]. Copyright 2016, SLACK Incorporated.

ASTRO 850: Teaching Teachers about Exoplanets

Science.gov (United States)

Barringer, Daniel; Palma, Christopher

2017-01-01

The Earth and Space Science Partnership (ESSP) is a collaboration among Penn State scientists, science educators and seven school districts across Pennsylvania. Penn State also offers through its fully online World Campus the opportunity for In-Service science teachers to earn an M.Ed. degree in Earth Science, and we currently offer a required online astronomy course for that program. We have previously presented descriptions of how have incorporated research-based pedagogical practices into ESSP-sponsored workshops for in-service teachers (Palma et al. 2013), a pilot section of introductory astronomy for non-science majors (Palma et al. 2014), and into the design of an online elective course on exoplanets for the M.Ed. in Earth Science (Barringer and Palma, 2016). Here, we present the finished version of that exoplanet course, ASTRO 850. We gratefully acknowledge support from the NSF MSP program award DUE#0962792.

The Research and Education of Evidence Based Library and Information Practice; A Narrative Review

Directory of Open Access Journals (Sweden)

Vahideh Zareh Gavgani

2018-01-01

Full Text Available Background and Objectives: Evidence based librarianship (EBL was defined as “use of best available evidence from qualitative and quantitative research results and rational experience and decisions acquired from the daily practice of library”. However there are controversies about if the nature of EBL deals with library services or professional practice and if it needs a formal education or informal continuing education is enough? To shed light on this ambiguity, the aim of this study was to find out the state-of-the-art of education of EBL in the world. Material and Methods: The study utilized library and documentation methods to investigate the academic education of EBL through review of the available literature and websites. Results: The findings of the study revealed that evidence based librarianship does have formal curriculum for academic education in post graduate levels (post master and master. It also revealed that “Evidence Based Approach” (EBA and “Evidence Based Medicine” (EBM were also similar courses that are offered in Master and PhD levels. Conclusion: Based on the history and revolution of EBA, it is time to develop formal curriculum and field of study for Evidence Based Information Practice. This study suggests establishment of the academic field of Evidence Based and Information Science to overcome the problems and limitations that library science faces in practice.

Is chronic pain associated with somatization/hypochondriasis? An evidence-based structured review.

Science.gov (United States)

Fishbain, David A; Lewis, John E; Gao, Jinrun; Cole, Brandly; Steele Rosomoff, R

2009-01-01

This is an evidence-based structured review. The objectives of this review were to answer the following questions: (1) Are somatization/hypochondriasis associated with chronic pain? (2) Is the degree of somatization/hypochondriasis related to pain levels? (3) Does pain treatment improve somatization/hypochondriasis? (4) Are some pain diagnoses differentially associated with somatization/hypochondriasis? Fifty-seven studies which fulfilled inclusion criteria and had high quality scores were sorted by the above-mentioned objectives. Agency for health care policy and research guidelines were utilized to type and characterize the strength/consistency of the study evidence within each objective. Somatization and hypochondriasis were both consistently associated with chronic pain (consistency ratings B and A, respectively). Study evidence indicated a correlation between pain intensity and presence of somatization and hypochondriasis (consistency rating A and B, respectively). Pain treatment improved somatization and hypochondriasis (consistency rating B and A, respectively). Some chronic pain diagnostic groups somatized more (consistency rating B). Somatization is commonly associated with chronic pain and may relate to pain levels.

The Effects of Oral-Motor Exercises on Swallowing in Children: An Evidence-Based Systematic Review

Science.gov (United States)

Arvedson, Joan; Clark, Heather; Lazarus, Cathy; Schooling, Tracy; Frymark, Tobi

2010-01-01

Aim: The aim of this unregistered evidence-based systematic review was to determine the state and quality of evidence on the effects of oral motor exercises (OME) on swallowing physiology, pulmonary health, functional swallowing outcomes, and drooling management in children with swallowing disorders. Method: A systematic search of 20 electronic…

The Astro-Wise system: a federated information accumulator for astronomy

NARCIS (Netherlands)

Valentijn, Edwin A.; Verdoes Kleijn, Gijs

2007-01-01

The Astro-Wise consortium has designed a new paradigm, ‘Awe‘, and implemented a fully scalable and distributed information system to overcome the huge information avalanche in wide-field astronomical imaging Surveys.

Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

Directory of Open Access Journals (Sweden)

Meredith Harrell

2014-01-01

Full Text Available Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC. Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014 using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease.

Optimising treatment resources for OCD: a review of the evidence base for technology-enhanced delivery.

Science.gov (United States)

Lovell, Karina; Bee, Penny

2011-12-01

Obsessive-compulsive disorder (OCD) is a chronic and disabling mental health problem. Only a minority of people receive evidence-based psychological treatments, and this deficit has prompted an increasing focus on delivering cognitive behaviour therapy (CBT) in new and innovative ways. To conduct a scoping review of the published evidence base for CBT-based interventions incorporating a health technology in the treatment of OCD. The questions posed by the review were (a) are technology-assisted treatments clinically effective, (b) are patient outcomes durable and (c) are more innovative services deemed acceptable by those individuals who engage in them? Scoping review of published studies using any study design examining CBT interventions incorporating a health technology for OCD. Electronic databases searched included MEDLINE (1966-2010), PsycInfo (1967-2010), EMBASE (1980-2010) and CINAHL databases (1982-2010). Thirteen studies were identified, of these, five used bibliotherapy, five examined computerised CBT (cCBT), two investigated telephone delivered CBT and one evaluated video conferencing. Overall studies were small and methodologically flawed, which precludes definitive conclusions of clinical effectiveness, durability or stakeholder satisfaction. To date the evidence base for technology-enhanced OCD treatments has undergone limited development. Future research should seek to overcome the methodological shortcomings of published work by conducting large-scale trials that incorporate clinical, cost and acceptability outcomes.

MAPPING THE GAS TURBULENCE IN THE COMA CLUSTER: PREDICTIONS FOR ASTRO-H

Energy Technology Data Exchange (ETDEWEB)

ZuHone, J. A. [Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Markevitch, M. [Astrophysics Science Division, X-ray Astrophysics Laboratory, Code 662, NASA/Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Zhuravleva, I. [Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94305-4085 (United States)

2016-02-01

Astro-H will be able for the first time to map gas velocities and detect turbulence in galaxy clusters. One of the best targets for turbulence studies is the Coma cluster, due to its proximity, absence of a cool core, and lack of a central active galactic nucleus. To determine what constraints Astro-H will be able to place on the Coma velocity field, we construct simulated maps of the projected gas velocity and compute the second-order structure function, an analog of the velocity power spectrum. We vary the injection scale, dissipation scale, slope, and normalization of the turbulent power spectrum, and apply measurement errors and finite sampling to the velocity field. We find that even with sparse coverage of the cluster, Astro-H will be able to measure the Mach number and the injection scale of the turbulent power spectrum—the quantities determining the energy flux down the turbulent cascade and the diffusion rate for everything that is advected by the gas (metals, cosmic rays, etc.). Astro-H will not be sensitive to the dissipation scale or the slope of the power spectrum in its inertial range, unless they are outside physically motivated intervals. We give the expected confidence intervals for the injection scale and the normalization of the power spectrum for a number of possible pointing configurations, combining the structure function and velocity dispersion data. Importantly, we also determine that measurement errors on the line shift will bias the velocity structure function upward, and show how to correct this bias.

Mapping the Gas Turbulence in the Coma Cluster: Predictions for Astro-H

Science.gov (United States)

ZuHone, J. A.; Markevitch, M.; Zhuravleva, I.

2016-01-01

Astro-H will be able for the first time to map gas velocities and detect turbulence in galaxy clusters. One of the best targets for turbulence studies is the Coma cluster, due to its proximity, absence of a cool core, and lack of a central active galactic nucleus. To determine what constraints Astro-H will be able to place on the Coma velocity field, we construct simulated maps of the projected gas velocity and compute the second-order structure function, an analog of the velocity power spectrum. We vary the injection scale, dissipation scale, slope, and normalization of the turbulent power spectrum, and apply measurement errors and finite sampling to the velocity field. We find that even with sparse coverage of the cluster, Astro-H will be able to measure the Mach number and the injection scale of the turbulent power spectrum-the quantities determining the energy flux down the turbulent cascade and the diffusion rate for everything that is advected by the gas (metals, cosmic rays, etc.). Astro-H will not be sensitive to the dissipation scale or the slope of the power spectrum in its inertial range, unless they are outside physically motivated intervals. We give the expected confidence intervals for the injection scale and the normalization of the power spectrum for a number of possible pointing configurations, combining the structure function and velocity dispersion data. Importantly, we also determine that measurement errors on the line shift will bias the velocity structure function upward, and show how to correct this bias.

AstroBox2 – Detector for low-energy β-delayed particle detection

Energy Technology Data Exchange (ETDEWEB)

Saastamoinen, A., E-mail: ajsaasta@comp.tamu.edu [Cyclotron Institute, Texas A& M University, College Station, TX 77843 (United States); Pollacco, E. [IRFU, CEA Saclay, Gif-sur-Yvette (France); Roeder, B.T.; Spiridon, A.; Daq, M. [Cyclotron Institute, Texas A& M University, College Station, TX 77843 (United States); Trache, L.; Pascovici, G. [National Institute of Physics and Nuclear Engineering, Bucharest-Magurele RO-077125 (Romania); De Oliveira, R. [CERN, Geneva (Switzerland); Rodrigues, M.R.D. [Instituto de Física, Universidade de São Paulo, Caixa Postal 66318, CEP 05314-970, São Paulo, SP (Brazil); Tribble, R.E. [Cyclotron Institute, Texas A& M University, College Station, TX 77843 (United States)

2016-06-01

Efficient suppression of β-background is essential for studies of low-energy β-delayed charged particle decays of astrophysical interest. A promising method for such studies has been a micro pattern gas amplifier detector where the sample is implanted into the gas volume and the decays that follow are observed with high gain and signal to noise ratio. An upgraded version of the original AstroBox detector has been built and commissioned at Texas A&M University. Here a description of the new AstroBox2 detector is given, selected results from the commissioning tests are presented, and future perspectives discussed.

Management of respiration in MND/ALS patients: an evidence based review.

Science.gov (United States)

Heffernan, Catherine; Jenkinson, Crispin; Holmes, Tricia; Macleod, Heidi; Kinnear, William; Oliver, David; Leigh, Nigel; Ampong, Mary-Ann

2006-03-01

This systematic review comprises an objective appraisal of the evidence in regard to the management of respiration in patients with motor neuron disease (MND/ALS). Studies were identified through computerised searches of 32 databases. Internet searches of websites of drug companies and MND/ALS research web sites, 'snow balling' and hand searches were also employed to locate any unpublished study or other 'grey literature' on respiration and MND/ALS. Since management of MND/ALS involves a number of health professionals and care workers, searches were made across multiple disciplines. No time frame was imposed on the search in order to increase the probability of identifying all relevant studies, although there was a final limit of March 2005. Recommendations for patient and carer-based guidelines for the clinical management of respiration for MND/ALS patients are suggested on the basis of qualitative analyses of the available evidence. However, these recommendations are based on current evidence of best practice, which largely comprises observational research and clinical opinion. There is a clear need for further evidence, in particular randomised and non-randomised controlled trials on the effects of non-invasive ventilation and additional larger scale cohort studies on the issues of initial assessment of respiratory symptoms, and management and timing of interventions.

Historical perspectives on evidence-based nursing.

Science.gov (United States)

Beyea, Suzanne C; Slattery, Mary Jo

2013-04-01

The authors of this article offer a review and historical perspective on research utilization and evidence-based practice in nursing. They present the evolution of research utilization to the more contemporary framework of evidence-based nursing practice. The authors address the role of qualitative research in the context of evidence-based practice. Finally, some approaches and resources for learning more about the fundamentals of evidence-based healthcare are provided.

A systematic review on barriers, facilities, knowledge and attitude toward evidence-based medicine in Iran

Directory of Open Access Journals (Sweden)

Morteza Ghojazadeh

2015-03-01

Full Text Available Introduction: Evidence-based medicine (EBM is the ability and skill in using and integration of the best up-to-date evidences. The aim of this study was a systematic review of barriers, facilities, knowledge and attitude of EBM in Iran. Methods: In this study, database and manual search was used with keywords such as, "evidence-based, EBM, evidence-based nursing, evidence-based practice, evidence-based care, evidence-based activities, evidence-based education" and their combination with the keywords of the barrier, facilitator, attitude, awareness, prospective, knowledge, practice and Iran. The databases of SID (Scientific information database, Magiran, MEDLIB, PubMed, Google scholar, IranMedex and CINAHL (Cumulative index to nursing and allied health literature were used for data collection. Results: Finally, 28 papers were included in this study. The lack of facilities, time and skill in research methodology were the most important barriers to EBM. The most and least important factors were orderly creating ample opportunity and detecting needs and problems. The degree of familiarity with the terminology of evidence-based performance was low (44.2%. The textbooks have been considered as the most significant source of obtaining information. The level of awareness, knowledge, and evidence-based performance was less than 50.0%. Conclusion: There are many various barriers in use of EBM and healthcare providers despite the positive attitude toward EBM had a low level knowledge in EBM setting. Consideration of the importance of EBM proper planning and effective intervention are necessary to removing the barriers and increase the knowledge of healthcare providers.

Evidence-based cancer imaging

Energy Technology Data Exchange (ETDEWEB)

Shinagare, Atul B.; Khorasani, Ramin [Dept. of Radiology, Brigham and Women' s Hospital, Boston (Korea, Republic of)

2017-01-15

With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.

A framework for production of systematic review based briefings to support evidence-informed decision-making.

Science.gov (United States)

Chambers, Duncan; Wilson, Paul

2012-07-09

We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers.Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT) tools for evidence-informed policymaking. To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.

Cosmetic gynecology in the view of evidence-based medicine and ACOG recommendations: a review.

Science.gov (United States)

Ostrzenski, Adam

2011-09-01

To conduct a methodological review of the existing scientific literature within the field of cosmetic gynecology in the view of evidence-based medicine and to establish their relevance to the ACOG Committee Opinion No. 378. The appropriate medical subject heading terms were selected and applied in the search of the Internet multiple databases since 1900 until January 2010. Articles focusing on cosmetic gynecology were reviewed. Also, anecdotal and advertising literatures were analyzed. A methodological review of the literatures was conducted. In peer review journals, 72 relevant articles related to cosmetic gynecology were identified. Anecdotal information was identified in 3 sources and over 1,100 published marketing literatures were identified on the Internet and no scientific journals. Among reviewed articles on cosmetic gynecology, only two articles met the level II-2 in evidence-based medicine. The absence of documentations on the safety and effectiveness of cosmetic vaginal procedures in the scientific literatures was ACOG's main concern. Practicing cosmetic gynecology within ACOG recommendations is desirable and possible. Currently, the standard of practice of cosmetic gynecology cannot be determined due to the absence of the documentation on safety and effectiveness. Traditional gynecologic surgical procedures cannot be called cosmetic procedures, since it is a deceptive form of practice and marketing. Creating medical terminology trademarks and establishing a business model that tries to control clinical-scientific knowledge dissemination is unethical.

Contemporary management of chronic rhinosinusitis with nasal polyposis in aspirin-exacerbated respiratory disease: an evidence-based review with recommendations.

Science.gov (United States)

Levy, Joshua M; Rudmik, Luke; Peters, Anju T; Wise, Sarah K; Rotenberg, Brian W; Smith, Timothy L

2016-12-01

Chronic rhinosinusitis (CRS) in aspirin-exacerbated respiratory disease (AERD) represents a recalcitrant form of sinonasal inflammation for which a multidisciplinary consensus on patient management has not been reached. Several medical interventions have been investigated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence-based approach for the multidisciplinary management of CRS in AERD. A systematic review of the literature was performed and the guidelines for development of an evidence-based review with recommendations were followed. Study inclusion criteria included: adult population >18 years old; CRS based on published diagnostic criteria, and a presumptive diagnosis of AERD. We focused on reporting higher-quality studies (level 2 or higher) when available, but reported lower-quality studies if the topic contained insufficient evidence. Treatment recommendations were based on American Academy of Otolaryngology (AAO) guidelines, with defined grades of evidence and evaluation of research quality and risk/benefits associated with each treatment. This review identified and evaluated the literature on 3 treatment strategies for CRS in AERD: dietary salicylate avoidance, leukotriene modification, and desensitization with daily aspirin therapy. Based on the available evidence, dietary salicylate avoidance and leukotriene-modifying drugs are options following appropriate treatment with nasal corticosteroids and saline irrigation. Desensitization with daily aspirin therapy is recommended following revision endoscopic sinus surgery (ESS). © 2016 ARS-AAOA, LLC.

Contemporary management of chronic rhinosinusitis with nasal polyposis in aspirin exacerbated respiratory disease: an evidence-based review with recommendations

Science.gov (United States)

Levy, Joshua M.; Rudmik, Luke; Peters, Anju T.; Wise, Sarah K.; Rotenberg, Brian W.; Smith, Timothy L.

2016-01-01

Background Chronic rhinosinusitis (CRS) in aspirin exacerbated respiratory disease (AERD) represents a recalcitrant form of sinonasal inflammation for which a multidisciplinary consensus on patient management has not been reached. Several medical interventions have been investigated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence-based approach for the multidisciplinary management of CRS in AERD. Methods A systematic review of the literature was performed and the guidelines for development of an evidence-based review with recommendations were followed. Study inclusion criteria included: adult population>18 years old; CRS based on published diagnostic criteria and a presumptive diagnosis of AERD. We focused on reporting higher-quality studies (level 2 or higher) when available, but reported lower-quality studies if the topic contained insufficient evidence. Treatment recommendations were based on American Academy of Otolaryngology guidelines, with defined grades of evidence and evaluation of research quality and risk/benefits associated with each treatment. Results This review identified and evaluated the literature on 3 treatment strategies for CRS in AERD: dietary salicylate avoidance, leukotriene modification and desensitization with daily aspirin therapy. Conclusion Based on the available evidence, dietary salicylate avoidance and leukotriene modifying drugs are options following appropriate treatment with nasal corticosteroids and saline irrigation. Desensitization with daily aspirin therapy is recommended following revision ESS. PMID:27480830

Creating Interactive Teaching Methods for ASTRO 101 That Really Work

Science.gov (United States)

Prather, E. E.; Adams, J. P.; Bailey, J. M.; Huggins, D.; Jones, L. V.; Slater, T. F.

2004-05-01

Acknowledging that lecture-based teaching methods are insufficient at promoting significant conceptual gains for students in the introductory astronomy course for non-science majors (ASTRO 101) is only the first step. But then, what can you do besides lecture? The Conceptual Astronomy and Physics Education Research (CAPER) Team at the University of Arizona has been developing and conducting research on the effectiveness of learner-centered instructional materials that put students in an active role in the classroom. With the support of an NSF CCLI (9952232) and NSF Geosciences Education (9907755) awards, we have designed and field-tested a set of innovative instructional materials called Lecture Tutorials. These Lecture Tutorial activities are intended for use with collaborative student learning groups and are designed specifically to be easily integrated into existing conventional lecture-based courses. As such, these instructional materials directly address the needs of heavily loaded teaching faculty in that they offer effective, learner-centered, classroom-ready activities that do not require any outside equipment/staffing or a drastic course revision for implementation. Each 15-minute Lecture-Tutorial poses a carefully crafted sequence of conceptually challenging, Socratic-dialogue driven questions, along with graphs and data tables, all designed to encourage students to reason critically about conceptually challenging and commonly taught topics in astronomy. The materials are based on research into student beliefs and reasoning difficulties and make use of a conceptual change instructional framework that promotes the intellectual engagement of students. Our research into the effectiveness of the Lecture Tutorials illustrates that traditional lectures alone make unsatisfactory gains on student understanding; however, supplementing traditional instruction with the lecture tutorials helps students make impressive conceptual gains over traditional instruction. In

Payload specialist Ronald Parise checks on ASTRO-2 payload

Science.gov (United States)

1995-01-01

Payload specialist Ronald A. Parise, a senior scientist in the Space Observatories Department of Computer Sciences Corporation (CSC), checks on the ASTRO-2 payload (out of frame in the cargo bay of the Space Shuttle Endeavour). Parise is on the aft flight deck of the Earth orbiting Endeavour during STS-67.

Evidence-Based Advances in Ferret Medicine.

Science.gov (United States)

Huynh, Minh; Chassang, Lucile; Zoller, Graham

2017-09-01

This literature review covers approximately 35 years of veterinary medicine. This article develops the current state of knowledge in pet ferret medicine regarding the most common diseases according to evidence-based data and gives insight into further axis of research. Literature review was conducted through identification of keywords (title + ferret) with Web-based database searching. To appreciate the methodological quality and the level of evidence of each article included in the review, full-text versions were reviewed and questions addressed in the articles were formulated. Analysis of the articles' content was performed by the authors, and relevant clinical information was extracted. Copyright © 2017 Elsevier Inc. All rights reserved.

Evidence-based librarianship: an overview.

Science.gov (United States)

Eldredge, J D

2000-10-01

To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors.

A framework for production of systematic review based briefings to support evidence-informed decision-making

Directory of Open Access Journals (Sweden)

Chambers Duncan

2012-07-01

Full Text Available Abstract Background We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers. Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT tools for evidence-informed policymaking. Findings To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. Conclusions The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.

Evidence-Based Toxicology.

Science.gov (United States)

Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

Choosing wisely after publication of level I evidence in breast cancer radiotherapy.

Science.gov (United States)

Niska, Joshua R; Keole, Sameer R; Pockaj, Barbara A; Halyard, Michele Y; Patel, Samir H; Northfelt, Donald W; Gray, Richard J; Wasif, Nabil; Vargas, Carlos E; Wong, William W

2018-01-01

Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT) as part of breast-conserving therapy (BCT). Evidence also suggests that radiotherapy (RT) omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT) is more expensive than 3-dimensional conformal RT (3DCRT). Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO) recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT. To assess response to level I evidence and adherence to ASTRO recommendations, we evaluated the pattern of RT use for early-stage breast cancer at our National Comprehensive Cancer Network institution from 2006 to 2008 and 2011 to 2013 and compared the results with national trends. Data from a prospective database were extracted to include patients treated with BCT, aged ≥50 years, with histologic findings of invasive ductal carcinoma, stage T1-T2N0M0, estrogen receptor-positive, and HER2 normal. We retrospectively reviewed the medical records and estimated costs based on 2016 Hospital Outpatient Prospective Payment System (technical fees) and Medicare Physician Fee Schedule (professional fees). Among 55 cases from 2006 to 2008, treatment regimens were 11% hypofractionated, 69% traditional schedule, and 20% RT omission (29% of patients were aged >70 years). Among 83 cases from 2011 to 2013, treatment regimens were 54% hypofractionated, 19% traditional schedule, and 27% RT omission (48% of patients were aged >70 years). 3DCRT was used for all WBRT treatments. Direct medical cost estimates were as follows: 15 fractions 3DCRT, $7,197.87; 15 fractions IMRT, $11,232.33; 25 fractions 3DCRT, $9,731.39; and 25 fractions IMRT, $16,877.45. Despite apparent resistance to shorter radiation schedules in the United States, we demonstrate that rapid practice change in response to level I

Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

Science.gov (United States)

Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

2017-10-01

A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

Treatment of Sjögren's syndrome-associated dry eye an evidence-based review.

Science.gov (United States)

Akpek, Esen Karamursel; Lindsley, Kristina B; Adyanthaya, Rohit S; Swamy, Ramya; Baer, Alan N; McDonnell, Peter J

2011-07-01

Outcomes-based review of reported treatment options for patients with dry eye secondary to Sjögren's syndrome (SS). Dry eye affects many individuals worldwide. Significant proportion of patients with dry eye has underlying SS, a progressive autoimmune condition. The few suggested guidelines for the treatment of dry eye are mostly based on severity of symptoms and/or clinical findings rather than on outcomes analysis, and do not differentiate SS from other causes of dry eye. METHODS AND LITERATURE REVIEW: A search strategy was developed to identify prospective, interventional studies of treatments for SS-associated dry eye from electronic databases. Eligible references were restricted to English-language articles published after 1975. These sources were augmented by hand searches of reference lists from accessed articles. Study selection, data extraction, and grading of evidence were completed independently by ≥4 review authors. The searches identified 3559 references as of August 10, 2010. After duplicate review of the titles and abstracts, 245 full-text papers were assessed, 62 of which were relevant for inclusion in the review. In the current literature on SS-associated dry eye, there is a paucity of rigorous clinical trials to support therapy recommendations. Nonetheless, the recommended treatments include topical lubricants, topical anti-inflammatory therapy, and tear-conserving strategies. The efficacy of oral secretagogues seems greater in the treatment of oral dryness than ocular dryness. Although oral hydroxychloroquine is commonly prescribed to patients with SS to alleviate fatigue and arthralgias, the literature lacks strong evidence for the efficacy of this treatment for dry eye. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

ASTRO's Advances in Radiation Oncology: Success to date and future plans

Directory of Open Access Journals (Sweden)

Robert C. Miller, MD, MBA, FASTRO

2017-07-01

Full Text Available ASTRO's Advances in Radiation Oncology was launched as a new, peer-reviewed scientific journal in December 2015. More than 200 manuscripts have been submitted and 97 accepted for publication as of May 2017. As Advances enters its second year of publication, we have chosen to highlight subjects that will transform the way we practice radiation oncology in special issues or ongoing series: immunotherapy, biomedical analytics, and social media. A teaching case report contest for North American radiation oncology residents will be launched at American Society of Radiation Oncology 2017 to encourage participation in scientific publication by trainees early in their careers. Recognizing our social mission, Advances will also begin a series of articles devoted to highlighting the growing disparities in access to radiation oncology services in vulnerable populations in North America. We wish to encourage the American Society of Radiation Oncology membership to continue its support of the journal through high-quality manuscript submission, participation in the peer review process, and highlighting important manuscripts through sharing on social media.

The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Human Evidence for PFOA Effects on Fetal Growth

Science.gov (United States)

Sutton, Patrice; Atchley, Dylan S.; Koustas, Erica; Lam, Juleen; Sen, Saunak; Robinson, Karen A.; Axelrad, Daniel A.; Woodruff, Tracey J.

2014-01-01

Background: The Navigation Guide methodology was developed to meet the need for a robust method of systematic and transparent research synthesis in environmental health science. We conducted a case study systematic review to support proof of concept of the method. Objective: We applied the Navigation Guide systematic review methodology to determine whether developmental exposure to perfluorooctanoic acid (PFOA) affects fetal growth in humans. Methods: We applied the first 3 steps of the Navigation Guide methodology to human epidemiological data: 1) specify the study question, 2) select the evidence, and 3) rate the quality and strength of the evidence. We developed a protocol, conducted a comprehensive search of the literature, and identified relevant studies using prespecified criteria. We evaluated each study for risk of bias and conducted meta-analyses on a subset of studies. We rated quality and strength of the entire body of human evidence. Results: We identified 18 human studies that met our inclusion criteria, and 9 of these were combined through meta-analysis. Through meta-analysis, we estimated that a 1-ng/mL increase in serum or plasma PFOA was associated with a –18.9 g (95% CI: –29.8, –7.9) difference in birth weight. We concluded that the risk of bias across studies was low, and we assigned a “moderate” quality rating to the overall body of human evidence. Conclusion: On the basis of this first application of the Navigation Guide systematic review methodology, we concluded that there is “sufficient” human evidence that developmental exposure to PFOA reduces fetal growth. Citation: Johnson PI, Sutton P, Atchley DS, Koustas E, Lam J, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health: systematic review of human evidence for PFOA effects on fetal growth. Environ Health Perspect 122:1028–1039; http://dx.doi.org/10.1289/ehp.1307893 PMID:24968388

Making evidence more wanted: a systematic review of facilitators to enhance the uptake of evidence from systematic reviews and meta-analyses.

Science.gov (United States)

Wallace, John; Byrne, Charles; Clarke, Mike

2012-12-01

Australia, one from Iran and one from South-east Asia (Indonesia, Malaysia, Thailand and the Philippines), with one study covering both Canada and UK. In total, the 15 studies covered eight countries from four continents. Of 2495 participants in the 15 studies, at least 1343 (53.8%) were physicians. Perceived facilitators to the use of evidence from systematic reviews varied. The 15 studies yielded 54 potential facilitators to systematic review uptake. The five most commonly reported perceived facilitators to uptake of evidence from systematic reviews were the following: the perception that systematic reviews have multiple uses for improving knowledge, research, clinical protocols and evidence-based medicine skills (6/15); a content that included benefits, harms and costs and is current, transparent and timely (6/15); a format with a 1:3:25 staged access and executive summary (5/15); training in use (4/15); and peer-group support (4/15). The results expand our understanding of how multiple factors act as facilitators to optimal clinical practice. This systematic review reveals that interventions to foster uptake of evidence from systematic reviews, meta-analyses and The Cochrane Library can build on a broad range of facilitators. © 2012 The Authors. International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute.

History of evidence-based medicine

Directory of Open Access Journals (Sweden)

Roger L Sur

2011-01-01

Full Text Available This essay reviews the historical circumstances surrounding the introduction and evolution of evidence-based medicine. Criticisms of the approach are also considered. Weaknesses of existing standards of clinical practice and efforts to bring more certainty to clinical decision making were the foundation for evidence-based medicine, which integrates epidemiology and medical research. Because of its utility in designing randomized clinical trials, assessing the quality of the literature, and applying medical research at the bedside, evidence-based medicine will continue to have a strong influence on everyday clinical practice.

Beyond Astro 101 -- Examining Lower Division Astronomy Curriculum For The 21 St Century

Science.gov (United States)

Kao, Lancelot L.; Umurhan, O. M.; Summer, T. J.

2009-01-01

So-called "ASTRO 101” survey courses in general astronomy are offered to non-science majors in colleges and universities across the United States, to fulfill general-education requirements in the physical sciences. At least two of the common Student Learning Outcomes (SLO) for these courses are critical thinking and understanding astronomy as a scientific discipline. We argue that a comprehensive lower-division astronomy program surpassing ASTRO 101 would increase science literacy for non-science majors, STEM students, and the general public. The program would include diverse astronomy course offerings, interdisciplinary science courses (e.g. astrobiology), service-learning and peer-mentoring activities, and internship opportunities.

Finding a million-star hotel an astro-tourist’s guide to dark sky places

CERN Document Server

Mizon, Bob

2016-01-01

Finding a Million-Star Hotel explores the modern phenomenon of astro-tourism, the efforts by increasing numbers of people to find nearby and distant locations where they can see the real night sky so often hidden by light pollution. Astronomer Bob Mizon directs readers to dark sky sites in the United Kingdom, the United States, and a few further afield. This is more than just a hotel guide with links for accommodation at or near the locations. There are chapters on choosing telescopes and binoculars, on celestial objects astro-tourists can look for in the night sky, and an investigation into the causes of the skyglow that veils our view of the stars. Most of those who go seeking the stars are not professional astronomers. This book is aimed at those observers with limited knowledge of the night sky who are eager to explore and enjoy it. Even those contemplating setting up astro-themed hotels, campsites, or astronomy events can benefit from reading this book and from the advice included on how to equip such pl...

The Sustainable Development of Space: Astro-environmental and dynamical considerations

Science.gov (United States)

Boley, Aaron; Byers, Michael; Russell, Sara

2018-04-01

The sustainable development of space is a global (and exo-global) challenge that is not limited by borders or research disciplines. Sustainable development is "development that meets the needs of the present without compromising the ability of future generations to meet their own needs". While the development of space brings new economic and scientific possibilities, it also carries significant political, legal, and technical uncertainties. For example, the rapidly increasing accessibility of space is motivating states to unilaterally adopt legislation for the new era of space use, which may have significant unintended consequences, such as increased risks to space assets, disputes among state as well as non-state actors, and changes to unique astro-environments. Any policy or legal position must be informed by the dynamical and astrophysical realities of space use, creating complex and interwoven challenges. Here, we explore several of these potential challenges related to astro-environmentalism, space minining operations, and the associated dynamics.

Astro-particle physics in Europe: present and future

International Nuclear Information System (INIS)

Bourquin, M.

2014-01-01

One hundred years ago physicist Victor Hess discovered cosmic rays during balloon flights. This discovery can be considered as the birth of a new field of research: astro-particle physics. This article gives an overview of the main lines of experimental and theoretical research and future plans in the domains of dark matter, dark energy, high-energy cosmic messengers, gravitational waves, proton decay and the properties of neutrinos. (author)

Are the American Society for Radiation Oncology Guidelines Accurate Predictors of Recurrence in Early Stage Breast Cancer Patients Treated with Balloon-Based Brachytherapy?

Directory of Open Access Journals (Sweden)

Moira K. Christoudias

2013-01-01

Full Text Available The American Society for Radiation Oncology (ASTRO consensus statement (CS provides guidelines for patient selection for accelerated partial breast irradiation (APBI following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the “suitable,” “cautionary,” and “unsuitable” ASTRO categories (0%, 7.2%, and 4.3%, resp., P=0.28. ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients.

The Astro-WISE approach to quality control for astronomical data

NARCIS (Netherlands)

Mc Farland, John; Helmich, Ewout M.; Valentijn, Edwin A.

We present a novel approach to quality control during the processing of astronomical data. Quality control in the Astro-WISE Information System is integral to all aspects of data handing and provides transparent access to quality estimators for all stages of data reduction from the raw image to the

Evidence-based Nursing Education - a Systematic Review of Empirical Research

Science.gov (United States)

Reiber, Karin

2011-01-01

The project „Evidence-based Nursing Education – Preparatory Stage“, funded by the Landesstiftung Baden-Württemberg within the programme Impulsfinanzierung Forschung (Funding to Stimulate Research), aims to collect information on current research concerned with nursing education and to process existing data. The results of empirical research which has already been carried out were systematically evaluated with aim of identifying further topics, fields and matters of interest for empirical research in nursing education. In the course of the project, the available empirical studies on nursing education were scientifically analysed and systematised. The over-arching aim of the evidence-based training approach – which extends beyond the aims of this project - is the conception, organisation and evaluation of vocational training and educational processes in the caring professions on the basis of empirical data. The following contribution first provides a systematic, theoretical link to the over-arching reference framework, as the evidence-based approach is adapted from thematically related specialist fields. The research design of the project is oriented towards criteria introduced from a selection of studies and carries out a two-stage systematic review of the selected studies. As a result, the current status of research in nursing education, as well as its organisation and structure, and questions relating to specialist training and comparative education are introduced and discussed. Finally, the empirical research on nursing training is critically appraised as a complementary element in educational theory/psychology of learning and in the ethical tradition of research. This contribution aims, on the one hand, to derive and describe the methods used, and to introduce the steps followed in gathering and evaluating the data. On the other hand, it is intended to give a systematic overview of empirical research work in nursing education. In order to preserve a

Post-wildfire seeding in forests of the western United States: An evidence-based review

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Donna Peppin; Peter Z. Fule; Carolyn Hull Sieg; Jan L. Beyers; Molly E. Hunter

2010-01-01

Broadcast seeding is one of the most widely used post-wildfire emergency response treatments intended to reduce soil erosion, increase vegetative ground cover, and minimize establishment and spread of non-native plant species. We conducted an evidence-based review to examine the effectiveness and effects of post-wildfire seeding treatments on soil stabilization, non-...

The Movement Disorder Society Evidence-Based Medicine Review Update: Treatments for the motor symptoms of Parkinson's disease.

Science.gov (United States)

Fox, Susan H; Katzenschlager, Regina; Lim, Shen-Yang; Ravina, Bernard; Seppi, Klaus; Coelho, Miguel; Poewe, Werner; Rascol, Olivier; Goetz, Christopher G; Sampaio, Cristina

2011-10-01

The objective was to update previous evidence-based medicine reviews of treatments for motor symptoms of Parkinson's disease published between 2002 and 2005. Level I (randomized, controlled trial) reports of pharmacological, surgical, and nonpharmacological interventions for the motor symptoms of Parkinson's disease between January 2004 (2001 for nonpharmacological) and December 2010 were reviewed. Criteria for inclusion, clinical indications, ranking, efficacy conclusions, safety, and implications for clinical practice followed the original program outline and adhered to evidence-based medicine methodology. Sixty-eight new studies qualified for review. Piribedil, pramipexole, pramipexole extended release, ropinirole, rotigotine, cabergoline, and pergolide were all efficacious as symptomatic monotherapy; ropinirole prolonged release was likely efficacious. All were efficacious as a symptomatic adjunct except pramipexole extended release, for which there is insufficient evidence. For prevention/delay of motor fluctuations, pramipexole and cabergoline were efficacious, and for prevention/delay of dyskinesia, pramipexole, ropinirole, ropinirole prolonged release, and cabergoline were all efficacious, whereas pergolide was likely efficacious. Duodenal infusion of levodopa was likely efficacious in the treatment of motor complications, but the practice implication is investigational. Entacapone was nonefficacious as a symptomatic adjunct to levodopa in nonfluctuating patients and nonefficacious in the prevention/delay of motor complications. Rasagiline conclusions were revised to efficacious as a symptomatic adjunct, and as treatment for motor fluctuations. Clozapine was efficacious in dyskinesia, but because of safety issues, the practice implication is possibly useful. Bilateral subthalamic nucleus deep brain stimulation, bilateral globus pallidus stimulation, and unilateral pallidotomy were updated to efficacious for motor complications. Physical therapy was revised

Literature Review of the Evidence Base for a Hospice at Home Service

OpenAIRE

Stosz, Laura

2008-01-01

This literature review aimed to identify the evidence base for a hospice at home service at the end of life for facilitating death at home to narrow the gap between preference and reality. This study defines ‘hospice at home’ as hospice style care provided in the home environment; this means specialist palliative care, equipment and medication is available 24/7. However, services operating under this term are not uniform across the literature. Terms encountered in the literature that are used...

Evidence-Based Psychotherapy: Advantages and Challenges.

Science.gov (United States)

Cook, Sarah C; Schwartz, Ann C; Kaslow, Nadine J

2017-07-01

Evidence-based psychotherapies have been shown to be efficacious and cost-effective for a wide range of psychiatric conditions. Psychiatric disorders are prevalent worldwide and associated with high rates of disease burden, as well as elevated rates of co-occurrence with medical disorders, which has led to an increased focus on the need for evidence-based psychotherapies. This chapter focuses on the current state of evidence-based psychotherapy. The strengths and challenges of evidence-based psychotherapy are discussed, as well as misperceptions regarding the approach that may discourage and limit its use. In addition, we review various factors associated with the optimal implementation and application of evidence-based psychotherapies. Lastly, suggestions are provided on ways to advance the evidence-based psychotherapy movement to become truly integrated into practice.

Evidence-based clinical guidelines for eating disorders : International comparison

NARCIS (Netherlands)

Hilbert, Anja; Hoek, Hans W.; Schmidt, Ricarda

2017-01-01

Purpose of review: The current systematic review sought to compare available evidence-based clinical treatment guidelines for all specific eating disorders. Recent findings: Nine evidence-based clinical treatment guidelines for eating disorders were located through a systematic search. The

Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol.

Science.gov (United States)

Peters, Jaime L; Cooper, Chris; Buchanan, James

2015-11-11

Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Astro4Girls and Their Families: Sharing Science via Public Libraries

Science.gov (United States)

Sharma, M.; Smith, D.; Eisenhamer, B.; Ryer, H.; Dussault, M.; Braswell, E.; Cominsky, L.; Apple, N.; Della, T.; Whiffen, P.; Harman, P.; Mitchell, S.; Eyermann, S.; Brandehoff, S.; Dominiak, J.

2013-04-01

The “Astro4Girls and Their Families” pilot program offered a variety of informal science events at nine public libraries nationwide in conjunction with Women's History Month (March) 2012. The goals were to engage girls and their families in science, by helping them discover the Universe for themselves and celebrating the contribution of women to astronomy and science. We offered a wide range of activities, from using robotic telescopes for “Do-It-Yourself (DIY) astrophotography” to making edible black holes, to exploring the infrared Universe. Our main target audience was middle-school aged girls, but students of all ages, their families and the public were welcome to participate in many of the activities. Five NASA Science Mission Directorate-funded Astrophysics Education and Public Outreach teams partnered with public libraries in this pilot program; each worked with 1 or 2 libraries to offer a total of about 15 events reaching over 300 people in both urban and rural areas. The American Library Association Public Programs Office identified participating libraries and facilitated their participation through its role in the SMD-funded “Visions of the Universe: Four Centuries of Discovery” traveling exhibit. The NASA Astrophysics Science Education and Public Outreach Forum coordinated the collaboration. The website is: http://www.ala.org/programming/astro4girls. This poster outlines the details of planning and implementing the 2012 pilot program, its successes, and lessons learned. The collaborators would like to engage the EPO community in a discussion of how to sustain Astro4Girls and engage additional public libraries nationwide during future Women's History Months.

Polyphenol-based nutraceuticals for the prevention and treatment of cardiovascular disease: Review of human evidence.

Science.gov (United States)

Tomé-Carneiro, Joao; Visioli, Francesco

2016-10-15

In addition to prescription drugs, nutraceuticals/functional foods/medical foods are being increasingly added as adjunct treatment of cardiovascular disease (CVD), even though most of them have been exclusively studied in vitro. We review the available evidence (focusing on when the amount of polyphenols' intake was measured) coming from randomized controlled trials (RCTs) of (poly)phenol-based supplements. We conclude that (poly)phenol-based nutraceuticals and functional foods might be indeed used as adjunct therapy of CVD, but additional long-term RCTs with adequate numerosity and with clinically relevant end points are needed to provide unequivocal evidence of their clinical usefulness. Copyright © 2015. Published by Elsevier GmbH.

astroABC : An Approximate Bayesian Computation Sequential Monte Carlo sampler for cosmological parameter estimation

Energy Technology Data Exchange (ETDEWEB)

Jennings, E.; Madigan, M.

2017-04-01

Given the complexity of modern cosmological parameter inference where we arefaced with non-Gaussian data and noise, correlated systematics and multi-probecorrelated data sets, the Approximate Bayesian Computation (ABC) method is apromising alternative to traditional Markov Chain Monte Carlo approaches in thecase where the Likelihood is intractable or unknown. The ABC method is called"Likelihood free" as it avoids explicit evaluation of the Likelihood by using aforward model simulation of the data which can include systematics. Weintroduce astroABC, an open source ABC Sequential Monte Carlo (SMC) sampler forparameter estimation. A key challenge in astrophysics is the efficient use oflarge multi-probe datasets to constrain high dimensional, possibly correlatedparameter spaces. With this in mind astroABC allows for massive parallelizationusing MPI, a framework that handles spawning of jobs across multiple nodes. Akey new feature of astroABC is the ability to create MPI groups with differentcommunicators, one for the sampler and several others for the forward modelsimulation, which speeds up sampling time considerably. For smaller jobs thePython multiprocessing option is also available. Other key features include: aSequential Monte Carlo sampler, a method for iteratively adapting tolerancelevels, local covariance estimate using scikit-learn's KDTree, modules forspecifying optimal covariance matrix for a component-wise or multivariatenormal perturbation kernel, output and restart files are backed up everyiteration, user defined metric and simulation methods, a module for specifyingheterogeneous parameter priors including non-standard prior PDFs, a module forspecifying a constant, linear, log or exponential tolerance level,well-documented examples and sample scripts. This code is hosted online athttps://github.com/EliseJ/astroABC

Non-Traditional Systemic Treatments for Diabetic Retinopathy: An
Evidence-Based Review

Science.gov (United States)

Simó, Rafael; Ballarini, Stefania; Cunha-Vaz, José; Ji, Linong; Haller, Hermann; Zimmet, Paul; Wong, Tien Y.

2015-01-01

The rapid escalation in the global prevalence diabetes, with more than 30% being afflicted with diabetic retinopathy (DR), means it is likely that associated vision-threatening conditions will also rise substantially. This means that new therapeutic approaches need to be found that go beyond the current standards of diabetic care, and which are effective in the early stages of the disease. In recent decades several new pharmacological agents have been investigated for their effectiveness in preventing the appearance and progression of DR or in reversing DR; some with limited success while others appear promising. This up-to-date critical review of non-traditional systemic treatments for DR is based on the published evidence in MEDLINE spanning 1980-December 2014. It discusses a number of therapeutic options, paying particular attention to the mechanisms of action and the clinical evidence for the use of renin-angiotensin system blockade, fenofibrate and calcium dobesilate monohydrate in DR. PMID:25989912

Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: an updated evidence-based systematic review.

Science.gov (United States)

Ravi, D K; Kumar, N; Singhi, P

2017-09-01

The use of virtual reality systems in the motor rehabilitation of children with cerebral palsy is new, and thus the scientific evidence for its effectiveness needs to be evaluated through a systematic review. To provide updated evidence-based guidance for virtual reality rehabilitation in sensory and functional motor skills of children and adolescents with cerebral palsy. PubMed, PEDro, Web of Science, OTseeker, PsycINFO and Cochrane Library were searched from their earliest records up to 1 June, 2016. Two reviewers applied the population intervention comparison outcome (PICO) question to screen the studies for this review. Information on study design, subjects, intervention, outcome measures and efficacy results were extracted into a pilot-tested form. Method quality was assessed independently by two reviewers using the Downs and Black checklist. Thirty-one studies included 369 participants in total. Best evidence synthesis was applied to summarize the outcomes, which were grouped according to International Classification of Functioning, Disability and Health. Moderate evidence was found for balance and overall motor development. The evidence is still limited for other motor skills. This review uncovered additional literature showing moderate evidence that virtual reality rehabilitation is a promising intervention to improve balance and motor skills in children and adolescents with cerebral palsy. The technique is growing, so long-term follow-up and further research are required to determine its exact place in the management of cerebral palsy. Systematic review registration number PROSPERO 2015:CRD42015026048. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Imiglucerase in the management of Gaucher disease type 1: an evidence-based review of its place in therapy

Science.gov (United States)

Serratrice, Christine; Carballo, Sebastian; Serratrice, Jacques; Stirnemann, Jérome

2016-01-01

Introduction Gaucher disease is the first lysosomal disease to benefit from enzyme replacement therapy, thus serving as model for numerous other lysosomal diseases. Alglucerase was the first glucocerebrosidase purified from placental extracts, and this was then replaced by imiglucerase – a Chinese hamster ovary cell-derived glucocerebrosidase. Aim The aim was to review the evidence underlying the use of imiglucerase in Gaucher disease type 1 Evidence review Data from clinical trials and Gaucher Registries were analyzed. Conclusion Imiglucerase has been prescribed and found to have an excellent efficacy and safety profile. We report herein the evidence-based data published for 26 years justifying the use of imiglucerase. PMID:27790078

Evidence-based clinical practice

DEFF Research Database (Denmark)

Garattini, Silvio; Jakobsen, Janus C; Wetterslev, Jørn

2016-01-01

was considered through literature searches combined with personal files. Treatments should generally not be chosen based only on evidence from observational studies or single randomised clinical trials. Systematic reviews with meta-analysis of all identifiable randomised clinical trials with Grading...

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

Science.gov (United States)

Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

2015-09-28

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

Behavioral Activation Is an Evidence-Based Treatment for Depression

Science.gov (United States)

Sturmey, Peter

2009-01-01

Recent reviews of evidence-based treatment for depression did not identify behavioral activation as an evidence-based practice. Therefore, this article conducted a systematic review of behavioral activation treatment of depression, which identified three meta-analyses, one recent randomized controlled trial and one recent follow-up of an earlier…

Complementary and alternative medicine approaches to blood pressure reduction: An evidence-based review.

Science.gov (United States)

Nahas, Richard

2008-11-01

ABSTRACTOBJECTIVETo review the evidence supporting complementary and alternative medicine approaches used in the treatment of hypertension.QUALITY OF EVIDENCEMEDLINE and EMBASE were searched from January 1966 to May 2008 combining the key words hypertension or blood pressure with acupuncture, chocolate, cocoa, coenzyme Q10, ubiquinone, melatonin, vitamin D, meditation, and stress reduction. Clinical trials, prospective studies, and relevant references were included.MAIN MESSAGEEvidence from systematic reviews supports the blood pressure-lowering effects of coenzyme Q10, polyphenol-rich dark chocolate, Qigong, slow breathing, and transcendental meditation. Vitamin D deficiency is associated with hypertension and cardiovascular risk; supplementation lowered blood pressure in 2 trials. Acupuncture reduced blood pressure in 3 trials; in 1 of these it was no better than an invasive placebo. Melatonin was effective in 2 small trials, but caution is warranted in patients taking pharmacotherapy.CONCLUSIONSeveral complementary and alternative medicine therapies can be considered as part of an evidence-based approach to the treatment of hypertension. The potential benefit of these interventions warrants further research using cardiovascular outcomes.

Morphea: Evidence-based recommendations for treatment

OpenAIRE

Nicole M Fett

2012-01-01

Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on ran...

Cognitive rehabilitation in epilepsy: An evidence-based review.

Science.gov (United States)

Farina, Elisabetta; Raglio, Alfredo; Giovagnoli, Anna Rita

2015-01-01

To review the modalities of cognitive rehabilitation (CR), outcome endpoints, and the levels of evidence of efficacy of different interventions. A systematic research in Pubmed, Psychinfo, and SCOPUS was performed assessing the articles written in the entire period covered by these databases till December 2013. Articles in English, Spanish or French were evaluated. A manual research evaluated the references of all of the articles. The experimental studies were classified according to the level of evidence of efficacy, using a standardized Italian method (SPREAD, 2007), adopting the criteria reported by Cicerone et al. (2000, 2011). Eighteen papers were classified into two reviews, four papers dealing with the principles and efficacy of CR in epilepsy, a methodological paper, a single-case report, a multiple-case report, and nine experimental papers. Most studies involved patients with temporal lobe epilepsy. Different types of CR were used to treat patients with epilepsy. A holistic rehabilitation approach was more useful than selective interventions to treat memory and attention disturbances. CR may be a useful tool to treat cognitive impairment in patients with epilepsy. However, the modalities of treatment and outcome endpoints are important concerns of clinical care and research. Controlled studies are needed to determine the efficacy of rehabilitation in well-defined groups of patients with epilepsy. Copyright © 2014 Elsevier B.V. All rights reserved.

Visualization studies on evidence-based medicine domain knowledge (series 3): visualization for dissemination of evidence based medicine information.

Science.gov (United States)

Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li

2011-05-01

To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor

Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.

Science.gov (United States)

Alnemer, Khalid A; Alhuzaim, Waleed M; Alnemer, Ahmed A; Alharbi, Bader B; Bawazir, Abdulrahman S; Barayyan, Omar R; Balaraj, Faisal K

2015-10-29

Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (PTwitter were found to be false based on expert

Integration of the MUSE Software Pipeline into the Astro-WISE System

NARCIS (Netherlands)

Pizagno, J.; Streicher, O.; Vriend, W.-J.; Ballester, P.; Egret, D.; Lorente, N.P.F.

We discuss the current state of integrating the Mutli Unit Spectroscopic Explorer (hereafter: MUSE) software pipeline (Weilbacher et al. 2006) into the Astro-WISE system (Valentijn et al. 2007a; Vriend et al. 2012). MUSE is a future integral-field spectrograph for the VLT, consisting of 24 Integral

Introduction: evidence-based action in humanitarian crises

NARCIS (Netherlands)

Dijkzeul, D.; Hilhorst, D.; Walker, P.

2013-01-01

This introductory paper sets the stage for this special issue of Disasters on evidence-based action in humanitarian crises. It reviews definition(s) of evidence and it examines the different disciplinary and methodological approaches to collecting and analysing evidence. In humanitarian action, the

"ASTRO 101" Course Materials 2.0: Next Generation Lecture Tutorials and Beyond

Science.gov (United States)

Slater, Stephanie; Grazier, Kevin

2015-01-01

Early efforts to create course materials were often local in scale and were based on "gut instinct," and classroom experience and observation. While subsequent efforts were often based on those same instincts and observations of classrooms, they also incorporated the results of many years of education research. These "second generation" course materials, such as lecture tutorials, relied heavily on research indicating that instructors need to actively engage students in the learning process. While imperfect, these curricular innovations, have provided evidence that research-based materials can be constructed, can easily be disseminated to a broad audience, and can provide measureable improvement in student learning across many settings. In order to improve upon this prior work, next generation materials must build upon the strengths of these innovations while engineering in findings from education research, cognitive science, and instructor feedback. A next wave of materials, including a set of next generation lecture tutorials, have been constructed with attention to the body of research on student motivation, and cognitive load; and they are responsive to our body of knowledge on learning difficulties related to specific content in the domain. From instructor feedback, these materials have been constructed to have broader coverage of the materials typically taught in an ASTRO 101 course, to take less class time, and to be more affordable for students. This next generation of lecture tutorials may serve as a template of the ways in which course materials can be reengineered to respond to current instructor and student needs.

Astro-H Data Analysis, Processing and Archive

Science.gov (United States)

Angelini, Lorella; Terada, Yukikatsu; Loewenstein, Michael; Miller, Eric D.; Yamaguchi, Hiroya; Yaqoob, Tahir; Krimm, Hans; Harrus, Ilana; Takahashi, Hiromitsu; Nobukawa, Masayoshi;

Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

Science.gov (United States)

Olesen, Tine Kold; Denys, Marie-Astrid; Vande Walle, Johan; Everaert, Karel

2018-02-06

Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria. Data were extracted from each paper regarding subject age, sex, ethnicity, health status, sample size, data collection methods, and diagnostic discrimination of proposed definitions including sensitivity, specificity, positive and negative predictive value. Results The sample size of study cohorts, participant age, sex, ethnicity, and health status varied considerably in 13 studies reporting on the diagnostic performance of seven different definitions of nocturnal polyuria using frequency-volume chart data from 4968 participants. Most study cohorts were small, mono-ethnic, including only Caucasian males aged 50 or higher with primary or secondary polyuria that were compared to a control group of healthy men without nocturia in prospective or retrospective settings. Proposed definitions had poor discriminatory accuracy in evaluations based on data from subjects independent from the original study cohorts with findings being similar regarding the most widely evaluated definition endorsed by ICS. Conclusions Diagnostic performance characteristics for proposed definitions of nocturnal polyuria show poor to modest discrimination and are not based on sufficient level of evidence from representative, multi-ethnic population-based data from both females and males of all adult ages.

The benefits of breakfast cereal consumption: a systematic review of the evidence base.

Science.gov (United States)

Williams, Peter G

2014-09-01

There have been no comprehensive reviews of the relation of breakfast cereal consumption to nutrition and health. This systematic review of all articles on breakfast cereals to October 2013 in the Scopus and Medline databases identified 232 articles with outcomes related to nutrient intake, weight, diabetes, cardiovascular disease, hypertension, digestive health, dental and mental health, and cognition. Sufficient evidence was available to develop 21 summary evidence statements, ranked from A (can be trusted to guide practice) to D (weak and must be applied with caution). Breakfast cereal consumption is associated with diets higher in vitamins and minerals and lower in fat (grade B) but is not associated with increased intakes of total energy or sodium (grade C) or risk of dental caries (grade B). Most studies on the nutritional impact are cross-sectional, with very few intervention studies, so breakfast cereal consumption may be a marker of an overall healthy lifestyle. Oat-, barley-, or psyllium-based cereals can help lower cholesterol concentrations (grade A), and high-fiber, wheat-based cereals can improve bowel function (grade A). Regular breakfast cereal consumption is associated with a lower body mass index and less risk of being overweight or obese (grade B). Presweetened breakfast cereals do not increase the risk of overweight and obesity in children (grade C). Whole-grain or high-fiber breakfast cereals are associated with a lower risk of diabetes (grade B) and cardiovascular disease (grade C). There is emerging evidence of associations with feelings of greater well-being and a lower risk of hypertension (grade D), but more research is required. © 2014 American Society for Nutrition.

Morphea: Evidence-based recommendations for treatment

Directory of Open Access Journals (Sweden)

Nicole M Fett

2012-01-01

Full Text Available Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on randomized controlled trials, prospective interventional trials without controls and retrospective reviews with greater than five subjects.

Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales

Science.gov (United States)

Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

2012-01-01

Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

Peer-review Platform for Astronomy Education Activities

Science.gov (United States)

Heenatigala, Thilina; Russo, Pedro; Gomez, Edward; Strubbe, Linda

2015-08-01

Astronomy educators and teachers worldwide commonly request and search for high-quality astronomy activities to do with their students. Hundreds of astronomy education activities exist, as well as many resource repositories to find them. However, the quality of such resources is highly variable as they are not updated regularly or limited with content review. Since its launch in 2013, astroEDU has been addressing these issues and more by following a peer-review process. Each activity submitted is reviewed by an educator and a professional astronomer, balancing both the scientific and educational value of the content. Moreover, the majority of the reviewers are invited from IAU commissions related to the field of the activity, as an effort to get IAU members actively involved in the project. The website code, activities and layout design are open-access in order to make them accessible and adoptable for educators around the world. Furthermore the platform harnesses the OAD volunteer database to develop existing astronomy education activities into the astroEDU activity format. Published activities are also pushed to partner repositories and each activity is registered for DOI, allowing authors to cite their work. To further test the activities and improve the platform, astroEDU editorial team organises workshops.

An evidence based protocol for peer review of radiographer musculoskeletal plain film reporting

International Nuclear Information System (INIS)

Stephenson, Paul; Hannah, April; Jones, Helen; Edwards, Rosemary; Harrington, Kate; Baker, Sally-Anne; Fitzgerald, Nicole; Belfield, Jane

2012-01-01

Aims: Medical image interpretation by non-medically trained staff continues to court controversy. This article aims to show that any potential risks associated with radiographer reporting can be monitored and mitigated if a robust peer review system is introduced. A search of the evidence base illustrates a paucity of guidance on how reporting radiographers should be audited or how a peer review process should be implemented. A practical framework for designing a reporting radiographer peer review process is provided. Methods: Following a literature review, key issues faced when designing a peer review protocol were identified. The following questions are answered: How frequent should peer review take place? How many reports should be reviewed? How are reports selected for review? Who should peer review the radiographer reports? How should radiographer's reporting performance be measured? What standard of reporting is acceptable? Results: Details are provided of the process that has been used for over three years at a busy inner-city teaching hospital for auditing musculoskeletal plain film radiographer reporting. The peer review method presented is not intended to produce robust statistical data; it is a practical method of locally assessing the reporting competency. As such, our protocol should be viewed as part of a larger programme for continuing professional development. Conclusion: It is hoped that this practical protocol will encourage radiology departments to engage in a programme of peer review for reporting radiographers.

Yoga into cancer care: A review of the evidence-based research

Directory of Open Access Journals (Sweden)

Ram P Agarwal

2018-01-01

Full Text Available To cope with cancer and its treatment-related side effects and toxicities, people are increasingly using complementary and alternative medicine (CAM. Consequently, integrative oncology, which combines conventional therapies and evidence-based CAM practices, is an emerging discipline in cancer care. The use of yoga as a CAM is proving to be beneficial and increasingly gaining popularity. An electronic database search (PubMed, through December 15, 2016, revealed 138 relevant clinical trials (single-armed, nonrandomized, and randomized controlled trials on the use of yoga in cancer patients. A total of 10,660 cancer patients from 20 countries were recruited in these studies. Regardless of some methodological deficiencies, most of the studies reported that yoga improved the physical and psychological symptoms, quality of life, and markers of immunity of the patients, providing a strong support for yoga's integration into conventional cancer care. This review article presents the published clinical research on the prevalence of yoga's use in cancer patients so that oncologists, researchers, and the patients are aware of the evidence supporting the use of this relatively safe modality in cancer care.

From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics.

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Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van der Zee, Anke-Hilse; Deneer, Vera

2013-06-01

The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its implementation in daily clinical practice. Literature review. A mechanism based approach may be helpful to personalize medicine for the individual patient to which pharmacogenetics may contribute significantly. The lack of consistency in what we accept in bioequivalence and in pharmacogenetics of drug metabolising enzymes is discussed and illustrated with the example of nortriptyline. The impact of pharmacogenetics on examples like tramadol, clopidogrel, coumarins and abacavir is described. Also the present status of the polymorphisms of 5-HT2A and C receptors in antipsychotic-induced weight gain is presented as a pharmacodynamic example with until now a greater distance to clinical implementation. The contribution of pharmacogenetics to tailor-made pharmacotherapy, which especially might be of value for patients deviating from the average, has not yet reached the position it seems to deserve.

Palliative radiotherapy in head and neck cancers: Evidence based review

Directory of Open Access Journals (Sweden)

Talapatra Kaustav

2006-01-01

Full Text Available Squamous cell carcinoma of head and neck (SCCHN is one of the commonest cancers seen in India, constituting up to 25% of their overall cancer burden. Advanced SCCHN is a bad disease with a poor prognosis and patients usually die of uncontrolled loco-regional disease. Curative intent management of loco-regionally advanced SCCHN has become more evidence-based with active clinical research in the form of large prospective randomized controlled trials and meta-analyses. However, little has been written about palliative radiotherapy (PRT in head and neck cancers. It is widely recognized that PRT provides effective palliation and improved quality-of-life in advanced incurable malignancies. It is in this context that this study proposes to review the existing literature on palliative radiotherapy in advanced incurable SCCHN to help formulate consensus guidelines and recommendations.

Evidence-based interventions in pediatric psychology: progress over the decades.

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Palermo, Tonya M

2014-09-01

This introduction to the special issue on Evidence-Based Interventions in Pediatric Psychology provides background on the process used to develop the special issue, a summary of the key findings from the series of reviews, and discussion of the implications for evidence-based practice. Authors followed a three-phase approach to develop their systematic reviews using rigorous systematic review methodology drawn heavily from the Cochrane Collaboration. The strength of the evidence for each pediatric psychology intervention was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The introduction discusses the progress that has been made in the evidence base for pediatric psychology interventions since the first special series published in 1999. Recommendations to stimulate further research and expand and strengthen the quality of the evidence base are described. The introduction concludes with implications from the special issue for pediatric psychology training in evidence-based practice. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Recognition and management of idiopathic systemic capillary leak syndrome: an evidence-based review.

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Baloch, Noor Ul-Ain; Bikak, Marvi; Rehman, Abdul; Rahman, Omar

2018-05-01

Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases. Areas covered: The purpose of the present review is to provide an up-to-date, evidence-based review of our understanding of SCLS and its management in the light of currently available evidence. Idiopathic SCLS was first described in 1960 and, since then, more than 250 cases have been reported. A large number of cases have been reported over the past one decade, most likely due to improved recognition. In the acute care setting, most patients with SCLS are managed as per the Surviving Sepsis guidelines and receive aggressive volume resuscitation - which is not the optimal management strategy for such patients. There is a need to raise awareness amongst physicians and clinicians in order to improve recognition of this disorder and ensure its appropriate management.

Evidence-Based Systematic Review: Effects of Oral Motor Interventions on Feeding and Swallowing in Preterm Infants

Science.gov (United States)

Arvedson, Joan; Clark, Heather; Lazarus, Cathy; Schooling, Tracy; Frymark, Tobi

2010-01-01

Purpose: To conduct an evidence-based systematic review and provide an estimate of the effects of oral motor interventions (OMIs) on feeding/swallowing outcomes (both physiological and functional) and pulmonary health in preterm infants. Method: A systematic search of the literature published from 1960 to 2007 was conducted. Articles meeting the…

The Heart of the Matter of Opinion and Evidence: The Value of Evidence-Based Medicine

OpenAIRE

Masvidal, Daniel; Lavie, Carl J.

2012-01-01

Evidence-based medicine is an important aspect of continuing medical education. This article reviews previous and current examples of conflicting topics that evidence-based medicine has clarified to allow us to provide the best possible patient care.

The Benefits of Breakfast Cereal Consumption: A Systematic Review of the Evidence Base1234

Science.gov (United States)

Williams, Peter G.

2014-01-01

There have been no comprehensive reviews of the relation of breakfast cereal consumption to nutrition and health. This systematic review of all articles on breakfast cereals to October 2013 in the Scopus and Medline databases identified 232 articles with outcomes related to nutrient intake, weight, diabetes, cardiovascular disease, hypertension, digestive health, dental and mental health, and cognition. Sufficient evidence was available to develop 21 summary evidence statements, ranked from A (can be trusted to guide practice) to D (weak and must be applied with caution). Breakfast cereal consumption is associated with diets higher in vitamins and minerals and lower in fat (grade B) but is not associated with increased intakes of total energy or sodium (grade C) or risk of dental caries (grade B). Most studies on the nutritional impact are cross-sectional, with very few intervention studies, so breakfast cereal consumption may be a marker of an overall healthy lifestyle. Oat-, barley-, or psyllium-based cereals can help lower cholesterol concentrations (grade A), and high-fiber, wheat-based cereals can improve bowel function (grade A). Regular breakfast cereal consumption is associated with a lower body mass index and less risk of being overweight or obese (grade B). Presweetened breakfast cereals do not increase the risk of overweight and obesity in children (grade C). Whole-grain or high-fiber breakfast cereals are associated with a lower risk of diabetes (grade B) and cardiovascular disease (grade C). There is emerging evidence of associations with feelings of greater well-being and a lower risk of hypertension (grade D), but more research is required. PMID:25225349

The religion of evidence-based practice

DEFF Research Database (Denmark)

Wigram, Tony; Gold, Christian

2012-01-01

This chapter begins by outlining the challenges of preparing a chapter on evidence-based practice (EBP) to underpin the use of music as a therapeutic tool in treatment, in the overall frame of music, health, and wellbeing. It then reviews the terminology of EBP and evidence-based medicine...... practice as health, education, and social services tighten their belts and the demand on their resources grows, there is increasing interest in the value of music for health and wellbeing, despite even less ‘hard’ evidence that it is effective against illness and disability....

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

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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.

Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review.

Science.gov (United States)

Kyriakoulis, Konstantinos; Patelarou, Athina; Laliotis, Aggelos; Wan, Andrew C; Matalliotakis, Michail; Tsiou, Chrysoula; Patelarou, Evridiki

2016-01-01

The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was

Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review

Directory of Open Access Journals (Sweden)

Konstantinos Kyriakoulis

2016-09-01

Full Text Available Purpose The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. Methods The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016. Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM. Results Twenty articles were included in the review. The majority of the studies sampled medical students (n=13 and only few conducted among nursing (n=2, pharmacy (n=2, physiotherapy/therapy (n=1, dentistry (n=1, or mixed disciplines (n=1 students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions, or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Conclusion Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions

AstroCom NYC: A City Partnership for the Next Generation of Astrophysicists

Science.gov (United States)

Paglione, Timothy; Ford, K. E. Saavik; Robbins, Dennis; Mac Low, Mordecai; Agüeros, Marcel; Anchordoqui, Luis; Acquaviva, Viviana; Bellovary, Jillian; Cruz, Kelle; Liu, Charles; Maller, Ari; McKernan, Barry; Minor, Quinn; O'Dowd, Matthew; Rice, Emily; Sheffield, Allyson

2018-01-01

AstroCom NYC is an undergraduate mentoring program designed to improve urban minority student access to opportunities in astrophysical research by greatly enhancing partnerships between research astronomers in New York City (City University of New York – an MSI, American Museum of Natural History, and Columbia). AstroCom NYC also partnered this past year with the Flatiron Institute Center for Computational Astrophysics to provide new and exciting midtown opportunities for students, and foster an expanding mentor network through the city. We provide centralized, personalized mentoring as well as financial and academic support, to CUNY undergraduates throughout their studies, plus the resources and opportunities to further CUNY faculty research with students. The goal is that students’ residency in the unique research environments at AMNH and the CCA helps them build a sense of belonging in the field, and readies and inspires them for graduate study. We welcomed our fifth and largest cohort last year, and had some of our first graduates accepted to grad school and bridge programs.

Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses.

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Modabbernia, Amirhossein; Velthorst, Eva; Reichenberg, Abraham

2017-01-01

According to recent evidence, up to 40-50% of variance in autism spectrum disorder (ASD) liability might be determined by environmental factors. In the present paper, we conducted a review of systematic reviews and meta-analyses of environmental risk factors for ASD. We assessed each review for quality of evidence and provided a brief overview of putative mechanisms of environmental risk factors for ASD. Current evidence suggests that several environmental factors including vaccination, maternal smoking, thimerosal exposure, and most likely assisted reproductive technologies are unrelated to risk of ASD. On the contrary, advanced parental age is associated with higher risk of ASD. Birth complications that are associated with trauma or ischemia and hypoxia have also shown strong links to ASD, whereas other pregnancy-related factors such as maternal obesity, maternal diabetes, and caesarian section have shown a less strong (but significant) association with risk of ASD. The reviews on nutritional elements have been inconclusive about the detrimental effects of deficiency in folic acid and omega 3, but vitamin D seems to be deficient in patients with ASD. The studies on toxic elements have been largely limited by their design, but there is enough evidence for the association between some heavy metals (most important inorganic mercury and lead) and ASD that warrants further investigation. Mechanisms of the association between environmental factors and ASD are debated but might include non-causative association (including confounding), gene-related effect, oxidative stress, inflammation, hypoxia/ischemia, endocrine disruption, neurotransmitter alterations, and interference with signaling pathways. Compared to genetic studies of ASD, studies of environmental risk factors are in their infancy and have significant methodological limitations. Future studies of ASD risk factors would benefit from a developmental psychopathology approach, prospective design, precise exposure

The Heart of the Matter of Opinion and Evidence: The Value of Evidence-Based Medicine

Science.gov (United States)

Masvidal, Daniel; Lavie, Carl J.

2012-01-01

Evidence-based medicine is an important aspect of continuing medical education. This article reviews previous and current examples of conflicting topics that evidence-based medicine has clarified to allow us to provide the best possible patient care. PMID:22438783

Reflectivity around the gold L-edges of X-ray reector of the soft X-ray telescope onboard ASTRO-H

DEFF Research Database (Denmark)

Maeda, Yoshitomo; Kikuchi, Naomichi; Kurashima, Sho

2017-01-01

We report the atomic scattering factor in the 11.2-15.4 keV for the ASTRO-H Soft X-ray Telescope (SXT)9 obtained in the ground based measurements. The large effective area of the SXT covers above 10 keV. In fact, the flight data show the spectra of the celestical objects in the hard X-ray band. I...

State-of-the-evidence reviews: advantages and challenges of including grey literature.

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Benzies, Karen M; Premji, Shahirose; Hayden, K Alix; Serrett, Karen

2006-01-01

Increasingly, health policy decision-makers and professionals are turning to research-based evidence to support decisions about policy and practice. Systematic reviews are useful for gathering, summarizing, and synthesizing published and unpublished research about clearly defined interventions. State-of-the-evidence reviews are broader than traditional systematic reviews and may include not only published and unpublished research, but also published and unpublished non-research literature. Decisions about whether to include this "grey literature" in a review are challenging and lead to many questions about whether the advantages outweigh the challenges. The primary purpose of this article is to describe what constitutes grey literature, and methods to locate it and assess its quality. The secondary purpose is to discuss the core issues to consider when making decisions to include grey literature in a state-of-the-evidence review. A recent state-of-the-evidence review is used as an exemplar to present advantages and challenges related to including grey literature in a review. Despite the challenges, in the exemplar, inclusion of grey literature was useful to validate the results of a research-based literature search. Decisions about whether to include grey literature in a state-of-the-evidence review are complex. A checklist to assist in decision-making was created as a tool to assist the researcher in determining whether it is advantageous to include grey literature in a review.

Practice Parameter: Evaluation of the child with microcephaly (an evidence-based review)

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Ashwal, Stephen; Michelson, David; Plawner, Lauren; Dobyns, William B.

2009-01-01

Objective: To make evidence-based recommendations concerning the evaluation of the child with microcephaly. Methods: Relevant literature was reviewed, abstracted, and classified. Recommendations were based on a 4-tiered scheme of evidence classification. Results: Microcephaly is an important neurologic sign but there is nonuniformity in its definition and evaluation. Microcephaly may result from any insult that disturbs early brain growth and can be seen in association with hundreds of genetic syndromes. Annually, approximately 25,000 infants in the United States will be diagnosed with microcephaly (head circumference microcephaly (head circumference microcephaly (−2 to −3 SD; ∼40%). Coexistent conditions include epilepsy (∼40%), cerebral palsy (∼20%), mental retardation (∼50%), and ophthalmologic disorders (∼20% to ∼50%). Recommendations: Neuroimaging may be considered useful in identifying structural causes in the evaluation of the child with microcephaly (Level C). Targeted and specific genetic testing may be considered in the evaluation of the child with microcephaly who has clinical or imaging abnormalities that suggest a specific diagnosis or who shows no evidence of an acquired or environmental etiology (Level C). Screening for coexistent conditions such as cerebral palsy, epilepsy, and sensory deficits may also be considered (Level C). Further study is needed regarding the yield of diagnostic testing in children with microcephaly. GLOSSARY CP = cerebral palsy; GDD = global developmental delay; HC = head circumference; MRE = medically refractory epilepsy; OMIM = Online Mendelian Inheritance in Man. PMID:19752457

Evidence Based Management as a Tool for Special Libraries

Directory of Open Access Journals (Sweden)

Bill Fisher

2007-12-01

Full Text Available Objective ‐ To examine the evidence based management literature, as an example of evidence based practice, and determine how applicable evidence based management might be in the special library environment. Methods ‐ Recent general management literature and the subject‐focused literature of evidence based management were reviewed; likewise recent library/information science management literature and the subject‐focused literature of evidence based librarianshipwere reviewed to identify relevant examples of the introduction and use of evidence based practice in organizations. Searches were conducted in major business/management databases, major library/information science databases, and relevant Web sites, blogs and wikis. Citation searches on key articles and follow‐up searches on cited references were also conducted. Analysis of the retrieved literature was conducted to find similarities and/or differences between the management literature and the library/information scienceliterature, especially as it related to special libraries.Results ‐ The barriers to introducing evidence based management into most organizations were found to apply to many special libraries and are similar to issues involved with evidence based practice in librarianship in general. Despite these barriers, a set of resources to assist special librarians in accessing research‐based information to help them use principles of evidence based management is identified.Conclusion ‐ While most special librarians are faced with a number of barriers to using evidence based management, resources do exist to help overcome these obstacles.

Evidence for Busines Intelligence in Health Care: A Literature Review.

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Loewen, Liz; Roudsari, Abdul

2017-01-01

This paper outlines a systematic literature review undertaken to establish current evidence regarding the impact of Business Intelligence (BI) on health system decision making and organizational performance. The review also examined BI implementation factors contributing to these constructs. Following the systematic review, inductive content analysis was used to categorize themes within the eight articles identified. This study demonstrated there is little evidence based literature focused on BI impact on organizational decision making and performance within health care. There was evidence found that BI does improve decision making. Implementation success was found to be dependent on several factors, many of which relate to broader organizational culture and readiness.

Systematic, Evidence-Based Review of Exercise, Physical Activity, and Physical Fitness Effects on Cognition in Persons with Multiple Sclerosis.

Science.gov (United States)

Sandroff, Brian M; Motl, Robert W; Scudder, Mark R; DeLuca, John

2016-09-01

Cognitive dysfunction is highly prevalent, disabling, and poorly-managed in persons with multiple sclerosis (MS). Recent evidence suggests that exercise might have beneficial effects on cognition in this population. The current systematic, evidence-based review examined the existing literature on exercise, physical activity, and physical fitness effects on cognition in MS to accurately describe the current status of the field, offer recommendations for clinicians, and identify study-specific and participant-specific characteristics for providing future direction for ongoing MS research. We performed an open-dated search of Medline, PsychInfo, and CINAHL in December 2015. The search strategy involved using the terms 'exercise' OR 'physical activity' OR 'physical fitness' OR 'aerobic' OR 'resistance' OR 'balance' OR 'walking' OR 'yoga' OR 'training' OR 'rehabilitation' AND 'multiple sclerosis'. Articles were eliminated from the systematic review if it was a review article, theoretical paper, or textbook chapter; did not involve persons with MS; involved only persons with pediatric-onset MS; did not involve neuropsychological outcomes; did not include empirical data to evaluate outcomes; involved pharmacological interventions; or was not available in English. The selected articles were first classified as examining exercise, physical activity, or physical fitness, and were then randomly assigned to 2 independent reviewers who rated each article for level of evidence based on American Academy of Neurology criteria. Reviewers further completed a table to characterize important elements of each study (i.e., intervention characteristics), the cognitive domain(s) that were targeted, participant-specific characteristics, outcome measures, and study results. The present review resulted in 26 studies on the effects of exercise, physical activity, and physical fitness on cognition in persons with MS. This included 1 Class I study, 3 Class II studies, 8 Class III studies, and

AstroDAbis: Annotations and Cross-Matches for Remote Catalogues

Science.gov (United States)

Gray, N.; Mann, R. G.; Morris, D.; Holliman, M.; Noddle, K.

2012-09-01

Astronomers are good at sharing data, but poorer at sharing knowledge. Almost all astronomical data ends up in open archives, and access to these is being simplified by the development of the global Virtual Observatory (VO). This is a great advance, but the fundamental problem remains that these archives contain only basic observational data, whereas all the astrophysical interpretation of that data — which source is a quasar, which a low-mass star, and which an image artefact — is contained in journal papers, with very little linkage back from the literature to the original data archives. It is therefore currently impossible for an astronomer to pose a query like “give me all sources in this data archive that have been identified as quasars” and this limits the effective exploitation of these archives, as the user of an archive has no direct means of taking advantage of the knowledge derived by its previous users. The AstroDAbis service aims to address this, in a prototype service enabling astronomers to record annotations and cross-identifications in the AstroDAbis service, annotating objects in other catalogues. We have deployed two interfaces to the annotations, namely one astronomy-specific one using the TAP protocol (Dowler et al. 2011), and a second exploiting generic Linked Open Data (LOD) and RDF techniques.

Using pedagogical discipline representations (PDRs) to enable Astro 101 students to reason about modern astrophysics

Science.gov (United States)

Wallace, Colin Scott; Prather, Edward E.; Chambers, Timothy G.; Kamenetzky, Julia R.; Hornstein, Seth D.

2017-01-01

Instructors of introductory, college-level, general education astronomy (Astro 101) often want to include topics from the cutting-edge of modern astrophysics in their course. Unfortunately, the teaching of these cutting-edge topics is typically confined to advanced undergraduate or graduate classes, using representations (graphical, mathematical, etc.) that are inaccessible to the vast majority of Astro 101 students. Consequently, many Astro 101 instructors feel that they have no choice but to cover these modern topics at a superficial level. Pedagogical discipline representations (PDRs) are one solution to this problem. Pedagogical discipline representations are representations that are explicitly designed to enhance the teaching and learning of a topic, even though these representations may not typically be found in traditional textbooks or used by experts in the discipline who are engaged in topic-specific discourse. In some cases, PDRs are significantly simplified or altered versions of typical discipline representations (graphs, data tables, etc.); in others they may be novel and highly contextualized representations with unique features that purposefully engage novice learners’ pre-existing mental models and reasoning difficulties, facilitating critical discourse. In this talk, I will discuss important lessons that my colleagues and I have learned while developing PDRs and describe how PDRs can enable students to reason about complex modern astrophysical topics.

Plasmapheresis in immune hematology: review of clinical outcome data with respect to evidence-based medicine and clinical experience.

Science.gov (United States)

von Baeyer, Hans

2003-02-01

The objective of this paper is to assess the role of plasmapheresis in immune hematology by reviewing published clinical outcome data and narrative review articles. This information will be used to define evidence levels for appraisal of the efficacy and rank of plasmapheresis among other management options. This evidence-based strategy conforms to the concepts of the American Society of Hematology (ASH). as put forward in 1996 in the context of immune thrombocytopenia (ITP) treatment. The term 'experimental' is used to describe indications where the only scientific evidence of the efficacy of plasmapheresis consists of pathophysiological reasoning and empiric clinical findings. We reviewed the available literature on the use of plasmapheresis in autoimmune hemolytic anemia (AIHA), hemolytic disease of the newborn (HDN), autoimmune thrombocytopenic purpura (AITP), heparin-induced thrombocytopenia type II (HIT II), post-transfusion purpura (PTP), refractoriness to platelet transfusion (RPT), coagulation factor inhibitor (CFI) and catastrophic antiphospholipid syndrome (CAS). Plasmapheresis completes the spectrum of management options as it eliminates physically circulating free antibodies involved in the pathogenesis of these immune hematological syndromes. Because of the paucity of data, evidence levels had to be defined based on the findings of uncontrolled case series and the opinions of independent experts. In many cases, randomized clinical trials were not feasible because the syndromes are so rare. When defined as an 'experimental indication', plasmapheresis has a firm scientific basis, but larger scale clinical experience with the method is still lacking. In these cases, the detection and monitoring of symptomatic disease-related circulating free antibodies or immune complexes is a mandatory prerequisite for the use of plasmapheresis. The therapeutic benefit of plasmapheresis is substantiated by the level V of evidence of its efficacy in treatment of HDN, HIV

Overview of reviews in child health: evidence synthesis and the knowledge base for a specific population.

Science.gov (United States)

Thomson, Denise; Foisy, Michelle; Oleszczuk, Marta; Wingert, Aireen; Chisholm, Annabritt; Hartling, Lisa

2013-01-01

Overviews of reviews are an evolving form of evidence synthesis. The Cochrane Child Health Field has been producing overviews since 2006, during which time the methods that have been used have changed, both due to the development of guidance within The Cochrane Collaboration and to the decisions made by individual author teams. This paper studies the first 29 overviews published in EBCH. To describe some aspects of the approaches taken in EBCH overviews to producing evidence syntheses relevant to the healthcare needs of children; to highlight the contribution that overviews can make to the knowledge base for treatment for a particular population. Data was extracted on: whether the overview included systematic review (SR) data only, or also data from individual trials not present in the included SRs; name(s) of the Cochrane Review Group (CRG) that prepared the included SRs; topics of the overviews as compared to the topics of the included reviews; age-subgroup analyses presented in the overviews. In 23 overviews, all published in 2012, the authors included trial data as well as SR data; two overviews addressed conditions not explicitly addressed by the included reviews; three overviews included pre-specified age-subgroup analyses. The aim of clinical relevance has been achieved by means such as: drawing from reviews produced by multiple CRGs; using SR evidence to explore clinically relevant topics that may not match exactly with the topics covered by the SRs; ensuring that the evidence in overviews is as up to date as possible by redoing searches and including trials not incorporated in the included SRs; and, where permitted by the data, using age-subgroup analyses to present the data in a way which matches the stages of childhood development. Overview authors are dependent on the nature of the data and methods reported in the included SRs. This suggests a need for further study about how SRs could be conducted in order to facilitate the conduct of overviews

Team based learning in nursing and midwifery higher education; a systematic review of the evidence for change.

Science.gov (United States)

Dearnley, Chris; Rhodes, Christine; Roberts, Peter; Williams, Pam; Prenton, Sarah

2018-01-01

The aim of this study is to review the evidence in relation to the experiences and outcomes of students on nursing and/or midwifery higher education programmes, who experience team based learning. To examine the relationship between team based learning and attainment for nursing and midwifery students in professional higher education. To examine the relationship between team based learning and student satisfaction for nurses and midwifery students in higher education. To identify and report examples of good practice in the implementation of team based learning in Nursing and Midwifery higher education. A systematic Review of the literature was undertaken. The population were nurses and midwives studying on higher education pre and post registration professional programmes. The intervention was learning and teaching activities based on a team-based learning approach. Data sources included CINAHL and MEDLINE. ERIC and Index to Theses were also searched. International research papers published in English between 2011 and 2017 that met the inclusion criteria were included in the study. Papers that met the criteria were subjected to quality appraisal and agreement amongst authors for inclusion in the review. A total of sixteen papers were reviewed and four themes emerged for discussion. These were Student Engagement, Student Satisfaction, Attainment and Practice Development and Transformational Teaching and Learning. There is a tentative, though growing body of evidence to support TBL as a strategy that can impact on student engagement, student satisfaction, attainment, practice development and transformative teaching and learning. The literature indicates that implementing TBL within the curriculum is not without challenge and requires a sustained and structured approach. Staff and students need to understand the processes involved, and why they should be adhered to, in the pursuit of enhanced student experiences and outcomes for nurses and midwives in Higher Education

Neutrino nuclear responses for double beta decays and astro neutrinos by charge exchange reactions

Science.gov (United States)

Ejiri, Hiroyasu

2014-09-01

Neutrino nuclear responses are crucial for neutrino studies in nuclei. Charge exchange reactions (CER) are shown to be used to study charged current neutrino nuclear responses associated with double beta decays(DBD)and astro neutrino interactions. CERs to be used are high energy-resolution (He3 ,t) reactions at RCNP, photonuclear reactions via IAR at NewSUBARU and muon capture reactions at MUSIC RCNP and MLF J-PARC. The Gamow Teller (GT) strengths studied by CERs reproduce the observed 2 neutrino DBD matrix elements. The GT and spin dipole (SD) matrix elements are found to be reduced much due to the nucleon spin isospin correlations and the non-nucleonic (delta isobar) nuclear medium effects. Impacts of the reductions on the DBD matrix elements and astro neutrino interactions are discussed.

Antidotes and treatments for chemical warfare/terrorism agents: an evidence-based review.

Science.gov (United States)

Rodgers, G C; Condurache, C T

2010-09-01

This article reviews the evidence supporting the efficacy of antidotes used or recommended for the potential chemical warfare agents of most concern. Chemical warfare agents considered include cyanide, vesicants, pulmonary irritants such as chlorine and phosgene, and nerve agents. The strength of evidence for most antidotes is weak, highlighting the need for additional research in this area.

The Australian government's review of positron emission tomography: evidence-based policy-making in action.

Science.gov (United States)

Ware, Robert E; Francis, Hilton W; Read, Kenneth E

2004-06-21

The Commonwealth Government constituted the Medicare Services Advisory Committee (MSAC) to implement its commitment to entrench the principles of evidence-based medicine in Australian clinical practice. With its recent review of positron emission tomography (PETReview), the Commonwealth intervened in an established MSAC process, and sanctioned the stated objective to restrict expenditure on the technology. In our opinion: The evaluation of evidence by PETReview was fundamentally compromised by a failure to meet the terms of reference, poor science, poor process and unique decision-making benchmarks. By accepting the recommendations of PETReview, the Commonwealth is propagating information which is not of the highest quality. The use of inferior-quality information for decision-making by doctors, patients and policy-makers is likely to harm rather than enhance healthcare outcomes.

Holiday review. Snappy answers to stupid questions: an evidence-based framework for responding to peer-review feedback.

Science.gov (United States)

Rosenfield, Daniel; Hoffman, Steven J

2009-12-08

Authors are inundated with feedback from peer reviewers. Although this feedback is usually helpful, it can also be incomprehensible, rude or plain silly. Inspired by Al Jaffe's classic comic from Mad Magazine, we sought to develop an evidenced-based framework for providing "snappy answers to stupid questions," in the hope of aiding emerging academics in responding appropriately to feedback from peer review. We solicited, categorized and analyzed examples of silly feedback from peer reviewers using the grounded theory qualitative research paradigm from 50 key informants. The informants represented 15 different professions, 33 institutions and 11 countries (i.e., Australia, Barbados, Canada, Germany, Japan, New Zealand, South Africa, Sweden, Switzerland, UK and USA). We developed a Scale of Silliness (SOS) and a Scale of Belligerence (SOB) to facilitate the assessment of inadequate peer-review feedback and guide users in preparing suitable responses to it. The SOB score is tempered by users' current mood, as captured by the Mood Reflective Index (MRI), and dictates the Appropriate Degree of Response (ADR) for the particular situation. Designed using the highest quality of (most easily accessible anecdotal) evidence available, this framework may fill a significant gap in the research literature by helping emerging academics respond to silly feedback from peer reviewers. Although use of the framework to its full extent may have negative consequences (e.g., loss of promotion), its therapeutic value cannot be understated.

International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

International Nuclear Information System (INIS)

Mayr, Nina A.; Hu, Kenneth S.; Liao, Zhongxing; Viswanathan, Akila N.; Wall, Terry J.; Amendola, Beatriz E.; Calaguas, Miriam J.; Palta, Jatinder R.; Yue, Ning J.; Rengan, Ramesh; Williams, Timothy R.

2014-01-01

In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups

International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

Energy Technology Data Exchange (ETDEWEB)

Mayr, Nina A., E-mail: ninamayr@uw.edu [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Hu, Kenneth S. [Department of Radiation Oncology, Beth Israel Medical Center, New York, New York (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Wall, Terry J. [St. Luke' s Cancer Institute, Kansas City, Missouri (United States); Amendola, Beatriz E. [Innovative Cancer Institute, Miami, Florida (United States); Calaguas, Miriam J. [Department of Radiation Oncology, St. Luke' s Medical Center, Quezon City (Philippines); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Yue, Ning J. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Rengan, Ramesh [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Williams, Timothy R. [Lynn Cancer Institute, Boca Raton Regional Hospital, Boca Raton, Florida (United States)

2014-07-01

In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups.

Persuasive Evidence: Improving Customer Service through Evidence Based Librarianship

Directory of Open Access Journals (Sweden)

Wendy A. Abbott

2006-03-01

Full Text Available Objective - To demonstrate how evidence based practice has contributed to informaing decisions and resolving issues if concern in service delivery at Bond University Librray. Methods - This paper critically analyses three evidence based research projects conducted at Bond University Library. Each project combined a range of research methods including surveys, literature reviews and the analysis of internal performance data to find solutions to problems in library service delivery. The first research project investigated library opening hours and the feasability of twenty-four hour opening. Another project reseached questions about the management of a collection of feature films on DVD and video. The thrd project investigated issues surrounding the teaching of EndNote to undergarduate students. Results - Despite some deficiencies in the methodologies used, each evidence based research project had positive outcomes. One of the highlights asn an essential feature of the process at Bond University Library was the involvement of stakeholders. The ability to build consensus and agree action plans with stakeholders was an important outcome of that process. Conclusion - Drawing on the experience of these research projects, the paper illustrates the benefits of evidence based information practice to stimulate innovation and improve library services. Librarians, like most professionals, need to continue to develop the skills and a culture to effectively carry out evidence based practice.

Introduction to evidence-based medicine(EBM)

International Nuclear Information System (INIS)

Choe, Jae Gol

2001-01-01

EBM is 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.' EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures

Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review.

Science.gov (United States)

Li, Shelly-Anne; Jeffs, Lianne; Barwick, Melanie; Stevens, Bonnie

2018-05-05

Organizational contextual features have been recognized as important determinants for implementing evidence-based practices across healthcare settings for over a decade. However, implementation scientists have not reached consensus on which features are most important for implementing evidence-based practices. The aims of this review were to identify the most commonly reported organizational contextual features that influence the implementation of evidence-based practices across healthcare settings, and to describe how these features affect implementation. An integrative review was undertaken following literature searches in CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Cochrane databases from January 2005 to June 2017. English language, peer-reviewed empirical studies exploring organizational context in at least one implementation initiative within a healthcare setting were included. Quality appraisal of the included studies was performed using the Mixed Methods Appraisal Tool. Inductive content analysis informed data extraction and reduction. The search generated 5152 citations. After removing duplicates and applying eligibility criteria, 36 journal articles were included. The majority (n = 20) of the study designs were qualitative, 11 were quantitative, and 5 used a mixed methods approach. Six main organizational contextual features (organizational culture; leadership; networks and communication; resources; evaluation, monitoring and feedback; and champions) were most commonly reported to influence implementation outcomes in the selected studies across a wide range of healthcare settings. We identified six organizational contextual features that appear to be interrelated and work synergistically to influence the implementation of evidence-based practices within an organization. Organizational contextual features did not influence implementation efforts independently from other features. Rather, features were interrelated and often influenced each

Oral Antibacterial Therapy for Acne Vulgaris: An Evidence-Based Review.

Science.gov (United States)

Bienenfeld, Amanda; Nagler, Arielle R; Orlow, Seth J

2017-08-01

To some degree, acne vulgaris affects nearly every individual worldwide. Oral antibiotic therapy is routinely prescribed for the treatment of moderate to severe inflammatory acne; however, long-term use of oral antibiotics for acne may have unintended consequences. The aim of this study was to provide a systematic evaluation of the scientific evidence on the efficacy and appropriate use of oral antibiotics in the treatment of acne. A systematic search of MEDLINE was conducted to identify randomized controlled clinical trials, systematic reviews, and meta-analyses evaluating the efficacy of oral antibiotics for acne. Overall, 41 articles that examined oral antibiotics compared with placebo, another oral therapy, topical therapy, alternate dose, or duration were included in this study. Tetracyclines, macrolides, and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate to severe inflammatory acne. Superior efficacy of one type or class of antibiotic could not be determined, therefore the choice of antibiotic is generally based on the side-effect profile. Although different dosing regimens have been studied, there is a lack of standardized comparator trials to determine optimal dosing and duration of each oral antibiotic used in acne. The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone. This article provides a systematic evaluation of the scientific evidence of the efficacy of oral antibiotics for acne. Due to heterogeneity in the design of the trials, there is insufficient evidence to support one type, dose, or duration of oral antibiotic over another in terms of efficacy; however, due to increasing resistance to antibiotics, dermatologists should heed consensus guidelines for their appropriate use.

Contemplative Education: A Systematic, Evidence-Based Review of the Effect of Meditation Interventions in Schools

Science.gov (United States)

Waters, Lea; Barsky, Adam; Ridd, Amanda; Allen, Kelly

2015-01-01

Schools need reliable evidence about the outcomes of meditation programs before they consider if and how such programmes can influence learning agendas, curriculum and timetables. This paper reviewed evidence from 15 peer-reviewed studies of school meditation programmes with respect to three student outcomes: well-being, social competence and…

Depression in the workplace: a systematic review of evidence-based prevention strategies.

Science.gov (United States)

Dietrich, Sandra; Deckert, Stefanie; Ceynowa, Martin; Hegerl, Ulrich; Stengler, Katarina

2012-01-01

Depression is one of the most common mental disorders, causing enormous personal and economic burden. In its early stages, however, it is the most manageable of mental disorders. The workplace, where a large proportion of the adult population can be reached, might be a good setting for prevention interventions that target depression directly. Identify evidence-based indicated/secondary prevention strategies for depression in the workplace. Systematic review of articles published until February 2010 using PubMed, EbscoHost and the Cochrane Library. Studies were selected based on different inclusion criteria, such as diagnosis of depression with validated screening instruments and presence of a control group. A total of 9,173 articles were found. One evaluated intervention study in the workplace met all inclusion criteria (French APRAND programme). The intervention, which combined the provision of diagnosis and psychoeducation, had a positive effect on people with depression, with a significant trend towards chances of recovery or remission after 1 year. The remaining studies did not meet the predefined inclusion criteria of this systematic review. The findings are quite sobering given the high prevalence of depression and the individual and societal burden caused by it. More tailor-made interventions in the workplace targeting depression directly are needed.

Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition

Directory of Open Access Journals (Sweden)

Mickenautsch Steffen

2012-01-01

Full Text Available Abstract Background This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare. Results The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials. Conclusions A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.

Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review

NARCIS (Netherlands)

Leenarts, L.E.W.; Diehle, J.; Doreleijers, T.A.H.; Jansma, E.P.; Lindauer, R.J.L.

2013-01-01

This is a systematic review of evidence-based treatments for children exposed to childhood maltreatment. Because exposure to childhood maltreatment has been associated with a broad range of trauma-related psychopathology (e.g., PTSD, anxiety, suicidal ideation, substance abuse) and with aggressive

Rapid Evidence Assessment of the Literature (REAL(©)): streamlining the systematic review process and creating utility for evidence-based health care.

Science.gov (United States)

Crawford, Cindy; Boyd, Courtney; Jain, Shamini; Khorsan, Raheleh; Jonas, Wayne

2015-11-02

Systematic reviews (SRs) are widely recognized as the best means of synthesizing clinical research. However, traditional approaches can be costly and time-consuming and can be subject to selection and judgment bias. It can also be difficult to interpret the results of a SR in a meaningful way in order to make research recommendations, clinical or policy decisions, or practice guidelines. Samueli Institute has developed the Rapid Evidence Assessment of the Literature (REAL) SR process to address these issues. REAL provides up-to-date, rigorous, high quality SR information on health care practices, products, or programs in a streamlined, efficient and reliable manner. This process is a component of the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™) program developed by Samueli Institute, which aims at answering the question of "What works?" in health care. The REAL process (1) tailors a standardized search strategy to a specific and relevant research question developed with various stakeholders to survey the available literature; (2) evaluates the quantity and quality of the literature using structured tools and rulebooks to ensure objectivity, reliability and reproducibility of reviewer ratings in an independent fashion and; (3) obtains formalized, balanced input from trained subject matter experts on the implications of the evidence for future research and current practice. Online tools and quality assurance processes are utilized for each step of the review to ensure a rapid, rigorous, reliable, transparent and reproducible SR process. The REAL is a rapid SR process developed to streamline and aid in the rigorous and reliable evaluation and review of claims in health care in order to make evidence-based, informed decisions, and has been used by a variety of organizations aiming to gain insight into "what works" in health care. Using the REAL system allows for the facilitation of recommendations on appropriate next steps in policy, funding

Efficacy of individual computer-based auditory training for people with hearing loss: a systematic review of the evidence.

Directory of Open Access Journals (Sweden)

Helen Henshaw

Full Text Available BACKGROUND: Auditory training involves active listening to auditory stimuli and aims to improve performance in auditory tasks. As such, auditory training is a potential intervention for the management of people with hearing loss. OBJECTIVE: This systematic review (PROSPERO 2011: CRD42011001406 evaluated the published evidence-base for the efficacy of individual computer-based auditory training to improve speech intelligibility, cognition and communication abilities in adults with hearing loss, with or without hearing aids or cochlear implants. METHODS: A systematic search of eight databases and key journals identified 229 articles published since 1996, 13 of which met the inclusion criteria. Data were independently extracted and reviewed by the two authors. Study quality was assessed using ten pre-defined scientific and intervention-specific measures. RESULTS: Auditory training resulted in improved performance for trained tasks in 9/10 articles that reported on-task outcomes. Although significant generalisation of learning was shown to untrained measures of speech intelligibility (11/13 articles, cognition (1/1 articles and self-reported hearing abilities (1/2 articles, improvements were small and not robust. Where reported, compliance with computer-based auditory training was high, and retention of learning was shown at post-training follow-ups. Published evidence was of very-low to moderate study quality. CONCLUSIONS: Our findings demonstrate that published evidence for the efficacy of individual computer-based auditory training for adults with hearing loss is not robust and therefore cannot be reliably used to guide intervention at this time. We identify a need for high-quality evidence to further examine the efficacy of computer-based auditory training for people with hearing loss.

Strategies for rehabilitation professionals to move evidence-based knowledge into practice: a systematic review.

Science.gov (United States)

Menon, Anita; Korner-Bitensky, Nicol; Kastner, Monika; McKibbon, K Ann; Straus, Sharon

2009-11-01

Rehabilitation clinicians need to stay current regarding best practices, especially since adherence to clinical guidelines can significantly improve patient outcomes. However, little is known about the benefits of knowledge translation interventions for these professionals. To examine the effectiveness of single or multi-component knowledge translation interventions for improving knowledge, attitudes, and practice behaviors of rehabilitation clinicians. Systematic review of 7 databases conducted to identify studies evaluating knowledge translation interventions specific to occupational therapists and physical therapists. 12 studies met the eligibility criteria. For physical therapists, participation in an active multi-component knowledge translation intervention resulted in improved evidence-based knowledge and practice behaviors compared with passive dissemination strategies. These gains did not translate into change in clinicians' attitudes towards best practices. For occupational therapists, no studies have examined the use of multi-component interventions; studies of single interventions suggest limited evidence of effectiveness for all outcomes measured. While this review suggests the use of active, multi-component knowledge translation interventions to enhance knowledge and practice behaviors of physical therapists, additional research is needed to understand the impact of these strategies on occupational therapists. Serious research gaps remain regarding which knowledge translation strategies impact positively on patient outcomes.

Evidence-based practice within nutrition

DEFF Research Database (Denmark)

Laville, Martine; Segrestin, Berenice; Alligier, Maud

2017-01-01

BACKGROUND: Evidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities for im...

Bridging Ayurveda with evidence-based scientific approaches in medicine.

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Patwardhan, Bhushan

2014-01-01

This article reviews contemporary approaches for bridging Ayurveda with evidence-based medicine. In doing so, the author presents a pragmatic assessment of quality, methodology and extent of scientific research in Ayurvedic medicine. The article discusses the meaning of evidence and indicates the need to adopt epistemologically sensitive methods and rigorous experimentation using modern science. The author critically analyzes the status of Ayurvedic medicine based on personal observations, peer interactions and published research. This review article concludes that traditional knowledge systems like Ayurveda and modern scientific evidence-based medicine should be integrated. The author advocates that Ayurvedic researchers should develop strategic collaborations with innovative initiatives like 'Horizon 2020' involving predictive, preventive and personalized medicine (PPPM).

Strengths and Limitations of Evidence-Based Dermatology

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Williams, Hywel C

2014-01-01

The need for understanding and reflecting on evidence-based dermatology (EBD) has never been greater given the exponential growth of new external evidence to inform clinical practice. Like any other branch of medicine, dermatologists need to acquire new skills in constructing answerable questions, efficiently searching electronic bibliographic databases, and critically appraising different types of studies. Secondary summaries of evidence in the form of systematic reviews (SR), that is, reviews that are conducted in a systematic, unbiased and explicit manner, reside at the top of the evidence hierarchy, because they are less prone to bias than traditional expert reviews. In addition to providing summaries of the best external evidence, systematic reviews and randomized controlled trials (RCTs) are also powerful ways of identifying research gaps and ultimately setting the agenda of future clinical research in dermatology. But like any paradigm, EBD can have its limitations. Wrong application, misuse and overuse of EBD can have serious consequences. For example, mindless pooling together of data from dissimilar studies in a meta-analysis may render it a form of reductionism that does not make any sense. Similarly, even highly protocolised study designs such as SRs and RCTs are still susceptible to some degree of dishonesty and bias. Over-reliance on randomized controlled trials (RCT) may be inappropriate, as RCTs are not a good source for picking up rare but important adverse effects such as lupus syndrome with minocycline. A common criticism leveled against SRs is that these frequently conclude that there is lack of sufficient evidence to inform current clinical practice, but arguably, such a perception is grounded more on the interpretation of the SRs than anything else. The apparent absence of evidence should not paralyze the dermatologist to adopt a state of therapeutic nihilism. Poor primary data and an SR based on evidence that is not up-to-date are also

Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia - An updated clinical guideline

DEFF Research Database (Denmark)

Beck, Anne Marie; Kjærsgaard, Annette; Hansen, Tina

2017-01-01

/chin down (RR 1.18; 95% CI 1.01-1.37). No evidence was identified for review question 2. CONCLUSIONS: Based on the quality of the evidence, assessment of the risk benefit ratio, and perceived patient preferences a weak recommendation against the use of texture modified liquids and good clinical practice......BACKGROUND & AIMS: Oropharyngeal dysphagia (OD) has significant consequences for both the person with dysphagia and the society. An often-used treatment for OD is the recommendation of the texture of food and liquids. This recommendation seems to be based more on best practice than on evidence from...... a systematic review of existing scientific evidence. The aim of this paper was to report the result of an up-date of an original national guideline focussing on whether thickened liquids (review question 1) and modified foods (review question 2) are beneficial for adults above 17 years with OD in relation...

Rail-suicide prevention: Systematic literature review of evidence-based activities.

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Barker, Emma; Kolves, Kairi; De Leo, Diego

2017-09-01

Rail-related suicide is a relatively rare but extremely lethal method of suicide that can have far-reaching consequences. The aim of the systematic literature review was to analyze the existing literature on the effectiveness of rail-suicide prevention activities. Databases used were Scopus, Medline, and ProQuest. The search terms used were "suicid*," "prevent*," "rail*," or "train." English-language studies published in peer-reviewed journals between 1 January 1990 and 30 April 2015 that presented an overview of rail-related suicide prevention activities and included an analysis of effectiveness were used. We retrieved 1,229 results in the original search with nine papers presenting empirical evidence. Three studies in the review analyzed the effectiveness of platform screen doors and another three analyzed the installation of blue lights, two papers analyzed the effectiveness of suicide pits, and one included the influence of media reporting guidelines. Platform screen doors, suicide pits, blue lights, and improved media guidelines all have the potential to reduce rail-related suicide events and deaths. The review was restricted to English-language peer-reviewed papers published within the chosen time period. © 2016 John Wiley & Sons Australia, Ltd.

Interventions for acute stroke management in Africa: a systematic review of the evidence

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Leonard Baatiema

2017-10-01

Full Text Available Abstract Background The past decades have witnessed a rapid evolution of research on evidence-based acute stroke care interventions worldwide. Nonetheless, the evidence-to-practice gap in acute stroke care remains variable with slow and inconsistent uptake in low-middle income countries (LMICs. This review aims to identify and compare evidence-based acute stroke management interventions with alternative care on overall patient mortality and morbidity outcomes, functional independence, and length of hospital stay across Africa. Methods This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guideline. An electronic search was conducted in six databases comprising MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL, Web of Science, Academic Search Complete and Cochrane Library for experimental and non-experimental studies. Eligible studies were abstracted into evidence tables and their methodological quality appraised using the Joanna Briggs Institute checklist. Data were analysed and presented narratively with reference to observed differences in patient outcomes, reporting p values and confidence intervals for any possible relationship. Results Initially, 1896 articles were identified and 37 fully screened. Four non-experimental studies (three cohort and one case series studies were included in the final review. One study focused on the clinical efficacy of a stroke unit whilst the remaining three reported on thrombolytic therapy. The results demonstrated a reduction in patient deaths attributed to stroke unit care and thrombolytic therapy. Thrombolytic therapy was also associated with reductions in symptomatic intracerebral haemorrhage (SICH. However, the limited eligible studies and methodological limitations compromised definitive conclusions on the extent of and level of efficacy of evidence-based acute stroke care interventions across Africa

Results from the Ultraviolet Imaging Telescope on the Astro-2 Mission

Science.gov (United States)

Stecher, T. P.; Bohlin, R. C.; Neff, S. G.; O'Connell, R. W.; Roberts, M. R.; Smith, A. M.

1995-03-01

The solar-blind UIT camera with a CsI cathode obtained 722 frames with a cumulative exposure time of 260705 seconds during the March 1995 Astro-2 mission of Space Shuttle Endeavour. Filters were used to isolate selected bandpasses in the range 1200-1800 Angstroms, over the 40 arcmin field of view. Spatial resolution on most of the images is about 3 arcsec. Calibrated data, converted to machine-readable form, are under analysis and several posters on these investigations are presented in the Astro-2 poster session at this meeting (a first look at the UIT observations of Omega Cen, M31, and the Cygnus Loop is further elaborated here). UIT imagery of 20 spiral galaxies was obtained as part of a Guest Investigator program (Wendy Freedman et al.). UV imaging suppresses the red stellar population as expected and enhances the appearance of tracers of recent star formation. Known \\hii regions in these galaxies are made apparent through the scattering of stellar ultraviolet light by interstellar dust; typically their shapes differ from those seen in \\ha. A radial color gradient investigation will be delayed until ground observations can be made as the long-wavelength camera failed on launch and only the 1520 Angstroms and 1620 Angstroms images were made. The far-UV (1520 Angstroms) features are detected well beyond the Holmberg radius. UV/visible color-magnitude diagrams will be made as they were for the data from Astro-1. Our deepest images of the Magellanic Clouds reveal a rich field of luminous clusters and stars that are being searched for UV counterparts of the known x-ray sources in the photographed areas. The observed stars in the Clouds will be used to determine the current mass function. The respective contributions of nebular and stellar UV light in reflection nebulae are will be studied as several nebulae were observed with differing geometries and will provide interesting results on the far-UV albedo and phase function of nebular dust. A dozen globular and

Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

Science.gov (United States)

Gambrill, E

1999-03-01

Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.

Systematic Review of Cyberbullying Interventions for Youth and Parents With Implications for Evidence-Based Practice.

Science.gov (United States)

Hutson, Elizabeth; Kelly, Stephanie; Militello, Lisa K

2018-02-01

Cyberbullying is a new risk factor for the well-being of pediatric populations. Consequences of cyberbullying include both physical and mental health concerns such as depression, anxiety, and somatic concerns. Adolescents who have been victims of cyberbullying and developed secondary symptoms are often recommended to visit a healthcare provider to obtain effective, evidence-based treatment. To date, no interventions exist in the healthcare setting for adolescents who are victims of cyberbullying. The purpose of this project is to review interventional studies on cyberbullying that have components for adolescents who have been involved with cyberbullying and their parents and to provide recommendations on effective intervention components with the goal of guiding clinical practice. A systematic review was conducted using the Institute of Medicine guidelines. A comprehensive electronic literature search was completed targeting interventions of cyberbullying in any setting. No date limits were used. Literature was searched in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Communication and Mass Media Complete, Education Information Resource Center (ERIC), and PsycINFO databases. The following search terms were applied "cyberbullying" + "intervention" or "treatment" or "therapy" or "program." Only articles with a pediatric population were selected for review. Seventeen cyberbullying intervention programs in 23 articles were found to meet the search criteria. The most frequently used intervention components included education on cyberbullying for the adolescent, coping skills, empathy training, communication and social skills, and digital citizenship. Parent education on cyberbullying was also found to be important and was included in programs with significant outcomes. As youth present to healthcare providers with symptoms related to cyberbullying, effective interventions are needed to guide evidence-based practice. This review

Choosing wisely after publication of level I evidence in breast cancer radiotherapy

Directory of Open Access Journals (Sweden)

Niska JR

2018-02-01

Full Text Available Joshua R Niska,1 Sameer R Keole,1 Barbara A Pockaj,2 Michele Y Halyard,1 Samir H Patel,1 Donald W Northfelt,3 Richard J Gray,2 Nabil Wasif,2 Carlos E Vargas,1 William W Wong1 1Department of Radiation Oncology, 2Division of General Surgery, 3Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA Background: Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT as part of breast-conserving therapy (BCT. Evidence also suggests that radiotherapy (RT omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT is more expensive than 3-dimensional conformal RT (3DCRT. Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT. To assess response to level I evidence and adherence to ASTRO recommendations, we evaluated the pattern of RT use for early-stage breast cancer at our National Comprehensive Cancer Network institution from 2006 to 2008 and 2011 to 2013 and compared the results with national trends. Methods: Data from a prospective database were extracted to include patients treated with BCT, aged ≥50 years, with histologic findings of invasive ductal carcinoma, stage T1-T2N0M0, estrogen receptor-positive, and HER2 normal. We retrospectively reviewed the medical records and estimated costs based on 2016 Hospital Outpatient Prospective Payment System (technical fees and Medicare Physician Fee Schedule (professional fees. Results: Among 55 cases from 2006 to 2008, treatment regimens were 11% hypofractionated, 69% traditional schedule, and 20% RT omission (29% of patients were aged >70 years. Among 83 cases from 2011 to 2013, treatment regimens were 54% hypofractionated, 19% traditional schedule, and 27% RT omission (48% of patients were aged >70

Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review.

Science.gov (United States)

Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki

2016-07-13

Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for

Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: Recommendations of the RTOG-ASTRO Phoenix Consensus Conference

International Nuclear Information System (INIS)

Roach, Mack; Hanks, Gerald; Thames, Howard; Schellhammer, Paul; Shipley, William U.; Sokol, Gerald H.; Sandler, Howard

2006-01-01

In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined 'at call' (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to 'adequate follow-up.' To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature

Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective

OpenAIRE

Beidas, Rinad S.; Kendall, Philip C.

2010-01-01

Evidence-based practice (EBP), a preferred psychological treatment approach, requires training of community providers. The systems-contextual (SC) perspective, a model for dissemination and implementation efforts, underscores the importance of the therapist, client, and organizational variables that influence training and consequent therapist uptake and adoption of EBP. This review critiques the extant research on training in EBP from an SC perspective. Findings suggest that therapist knowled...

Salvage radiotherapy for patients with P.S.A. relapse after radical prostatectomy: comparisons among Astro and Phoenix biochemical failure definitions

International Nuclear Information System (INIS)

Quero, L.; Hennequin, V.; Maylin, C.; Hennequin, C.; Ravery, V.; Mongiat-Artus, P.; Desgrandchamps, F.

2009-01-01

Purpose Study about the efficacy of salvage radiotherapy (R.T.), in terms of biochemical disease free survival (b.D.F.S.), according to Astro and Phoenix (nadir + 2) definitions, for persistent or rising P.S.A. after radical prostatectomy. Patients and methods Retrospective analysis of 59 patients who underwent R.T. between 1990 and 2003 for P.S.A. recurrence after radical prostatectomy. Patients received a median of 66 Gy to the prostate bed with 3D or 2D R.T.. The main end point was b.D.F.S. according to Astro and Phoenix (nadir + 2) definitions. Different criterion sets were analysed to calculate b.D.F.S. and pretreatment factors that might predict biochemical relapse were sought for each. Results After a 38-month median follow-up, the 3-year b.D.F.S. rates were: 60 and 72% for Astro and Phoenix (nadir + 2 ng/ml) definitions respectively. According to univariate analysis, pre-R.T. P.S.A. = 1 ng/ml and seminal vesicle involvement were associated with biochemical relapse. Multivariate analysis retained only pre-R.T. P.S.A. = 1 ng/ml as an independent predictor of biochemical relapse for the two definitions. Conclusion Salvage R.T. is an effective treatment after radical prostatectomy according to Astro or Phoenix definitions. Only pre-R.T. P.S.A. = 1 ng/ml predicted relapse. (authors)

Systematic review of available evidence on 11 high-priced inpatient orphan drugs

NARCIS (Netherlands)

T.A. Kanters (Tim A.); C. de Sonneville (Caroline); W.K. Redekop (Ken); L. van Hakkaart-van Roijen (Leona)

2013-01-01

markdownabstract__Abstract__ __Background__: Attention for Evidence Based Medicine (EBM) is growing, but evidence for orphan drugs is argued to be limited and inferior. This study systematically reviews the available evidence on clinical effectiveness, costeffectiveness and budget impact for

Evidence mapping based on systematic reviews of therapeutic interventions for gastrointestinal stromal tumors (GIST

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Mónica Ballesteros

2017-09-01

Full Text Available Abstract Background Gastrointestinal Stromal Tumours (GISTs are the most common mesenchymal tumours. Currently, different pharmacological and surgical options are used to treat localised and metastatic GISTs, although this research field is broad and the body of evidence is scattered and expanding. Our objectives are to identify, describe and organise the current available evidence for GIST through an evidence mapping approach. Methods We followed the methodology of Global Evidence Mapping (GEM. We searched Pubmed, EMBASE, The Cochrane Library and Epistemonikos in order to identify systematic reviews (SRs with or without meta-analyses published between 1990 and March 2016. Two authors assessed eligibility and extracted data. Methodological quality of the included systematic reviews was assessed using AMSTAR. We organised the results according to identified PICO questions and presented the evidence map in tables and a bubble plot. Results A total of 17 SRs met eligibility criteria. These reviews included 66 individual studies, of which three quarters were either observational or uncontrolled clinical trials. Overall, the quality of the included SRs was moderate or high. In total, we extracted 14 PICO questions from them and the corresponding results mostly favoured the intervention arm. Conclusions The most common type of study used to evaluate therapeutic interventions in GIST sarcomas has been non-experimental studies. However, the majority of the interventions are reported as beneficial or probably beneficial by the respective authors of SRs. The evidence mapping is a useful and reliable methodology to identify and present the existing evidence about therapeutic interventions.

ASTRO 101 Labs and the Invasion of the Cognitive Scientists

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Slater, Stephanie J.

2015-04-01

Since the mid 1800's there has been widespread agreement that we should be about the business of engaging students in the practices of scientific research in order to best teach the methods and practices of science. There has been significantly less agreement on precisely how to teach science by mimicking scientific inquiry in a way that can be empirically supported, even with our ``top students.'' Engaging ``ASTRO 101 students'' in scientific inquiry is a task that has left our astronomy education research community more than a little stymied, to the extent that it is difficult to find non-major science students practicing anything other than confirmation exercises in college labs. Researchers at the CAPER Center for Astronomy & Physics Education Research have struggled with this problem as well, until in our frustration we had to ask: ``Can research tell us anything about how to get students to do research?'' This talk presents an overview of the cognitive science that we've brought to bear in the ASTRO 101 laboratory setting for non-science majoring undergraduates and future teachers, along with the results of early studies that suggest that a ``backwards faded scaffolding'' approach to instruction in Intro Labs can successfully support large numbers of students in enhancing their understanding of the nature of scientific inquiry. Supported by NSF DUE 1312562.

"Insufficient evidence of effectiveness" is not "evidence of no effectiveness:" evaluating computer-based education for patients with severe mental illness.

Science.gov (United States)

Stoltz, Peter; Skärsäter, Ingela; Willman, Ania

2009-01-01

This article reports on commissioned research funded by the Swedish Council of Technology Assessment in Health Care (SBU) and the Swedish Nursing Society (SSF). The objective was to review computer-based education programs. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to a previous incident where such evidence was misunderstood by Swedish policy and health care decision makers. This article highlights the concept of evidence with regard to the consequences of insufficient evidence of effectiveness being mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computer-based education program for patients suffering from severe mental illness. Systematic database searches in Medline, CINAHL, PsycINFO and the Cochrane Library identified a total of 131 potentially relevant references. Thereafter, 27 references were retrieved as full-text documents, of which 5 were finally included and co-reviewed by two independent researchers. The review found no decisive evidence of effectiveness regarding computer-based education programs designed to assist persons suffering from severe mental illness. Failing to see the difference between insufficient evidence and evidence of no effectiveness may have unexpected consequences. As a result, practice may be misguided and treatments withheld, which at worse may have harmful consequences for patients. In the end, it is of utmost importance that researchers do good quality research by ensuring statistical power and quality of outcome measurement. For example, this review of computer-based education programs could have revealed effective ways of dealing with severe mental illness if the studies included had been conducted using more sophisticated designs.

Development of porous plug phase separator and superfluid film flow suppression system for the Soft X-ray Spectrometer onboard ASTRO-H

Science.gov (United States)

Ezoe, Yuichiro; Ishikawa, Kumi; Ohashi, Takaya; Yamaguchi, Hiroya; Mitsuda, Kazuhisa; Fujimoto, Ryuichi; Murakami, Masahide; Kanao, Kenichi; Yoshida, Seiji; Tsunematsu, Shoji; DiPirro, Michael; Shirron, Peter; the SXS Team

2012-04-01

ASTRO-H is the sixth Japanese astronomy satellite scheduled for launch in 2014. The Soft X-ray Spectrometer instrument is onboard ASTRO-H. This is a 6 × 6 array of X-ray microcalorimeters with an energy resolution of gravity, a porous plug phase separator made of sintered stainless is used. Since the vapor mass flow rate is only 29 μg/s, any additional superfluid film loss influences the lifetime of the liquid helium. Therefore, a film flow suppression system consisting of an orifice, a heat exchanger, and knife edge devices is adopted based on the design used for the X-ray Spectrometer onboard Suzaku. The film flow will be suppressed to <2 μg/s, sufficiently smaller than the vapor flow rate. In the present investigation, the design and ground experiments of a helium vent system composed of the porous plug and film flow suppression system are presented. The results show that the phase separation and the film flow suppression are satisfactorily achieved.

What constitutes evidence-based patient information? Overview of discussed criteria.

Science.gov (United States)

Bunge, Martina; Mühlhauser, Ingrid; Steckelberg, Anke

2010-03-01

To survey quality criteria for evidence-based patient information (EBPI) and to compile the evidence for the identified criteria. Databases PubMed, Cochrane Library, PsycINFO, PSYNDEX and Education Research Information Center (ERIC) were searched to update the pool of criteria for EBPI. A subsequent search aimed to identify evidence for each criterion. Only studies on health issues with cognitive outcome measures were included. Evidence for each criterion is presented using descriptive methods. 3 systematic reviews, 24 randomized-controlled studies and 1 non-systematic review were included. Presentation of numerical data, verbal presentation of risks and diagrams, graphics and charts are based on good evidence. Content of information and meta-information, loss- and gain-framing and patient-oriented outcome measures are based on ethical guidelines. There is a lack of studies on quality of evidence, pictures and drawings, patient narratives, cultural aspects, layout, language and development process. The results of this review allow specification of EBPI and may help to advance the discourse among related disciplines. Research gaps are highlighted. Findings outline the type and extent of content of EBPI, guide the presentation of information and describe the development process. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Evidence-based anatomical review areas derived from systematic analysis of cases from a radiological departmental discrepancy meeting.

Science.gov (United States)

Chin, S C; Weir-McCall, J R; Yeap, P M; White, R D; Budak, M J; Duncan, G; Oliver, T B; Zealley, I A

2017-10-01

To produce short checklists of specific anatomical review sites for different regions of the body based on the frequency of radiological errors reviewed at radiology discrepancy meetings, thereby creating "evidence-based" review areas for radiology reporting. A single centre discrepancy database was retrospectively reviewed from a 5-year period. All errors were classified by type, modality, body system, and specific anatomical location. Errors were assigned to one of four body regions: chest, abdominopelvic, central nervous system (CNS), and musculoskeletal (MSK). Frequencies of errors in anatomical locations were then analysed. There were 561 errors in 477 examinations; 290 (46%) errors occurred in the abdomen/pelvis, 99 (15.7%) in the chest, 117 (18.5%) in the CNS, and 125 (19.9%) in the MSK system. In each body system, the five most common location were chest: lung bases on computed tomography (CT), apices on radiography, pulmonary vasculature, bones, and mediastinum; abdominopelvic: vasculature, colon, kidneys, liver, and pancreas; CNS: intracranial vasculature, peripheral cerebral grey matter, bone, parafalcine, and the frontotemporal lobes surrounding the Sylvian fissure; and MSK: calvarium, sacrum, pelvis, chest, and spine. The five listed locations accounted for >50% of all perceptual errors suggesting an avenue for focused review at the end of reporting. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Smoking cessation: How compelling is the evidence? A review

DEFF Research Database (Denmark)

Tønnesen, Philip

2009-01-01

OBJECTIVES: To provide a short review of the evidence base supporting smoking cessation interventions, including behavioral therapy and pharmacological treatment options. METHODS: Published meta-analysis was mainly used supplemented with a limited literature search. RESULTS: Effective smoking ces...... in smoking cessation. On-going research is examining the potential effects of nicotine vaccination as relapse prevention.......OBJECTIVES: To provide a short review of the evidence base supporting smoking cessation interventions, including behavioral therapy and pharmacological treatment options. METHODS: Published meta-analysis was mainly used supplemented with a limited literature search. RESULTS: Effective smoking...... cessation consists of pharmacotherapy and behavioral support. Counseling increases abstinence rates parallel to the intensity of support. First-line pharmacological drugs for smoking cessation are nicotine replacement products (patch, gum, inhaler, nasal spray, lozenge/tablets), varenicline and bupropion SR...

5th International Heidelberg Conference on Dark Matter in Astro- and Particle Physics

CERN Document Server

Arnowitt, Richard; DARK 2004; Dark Matter in Astro- and Particle Physics

2006-01-01

The search for dark matter in the universe has established itself as one of the most exciting and central fields of astrophysics, particle physics and cosmology. The lectures and talks in this book emphasize the experimental and theoretical status and future perspectives, stressing in particular the interplay between astro- and particle physics.

Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews.

Science.gov (United States)

Parker, Jacqui A; Barroso, Filipa; Stanworth, Simon J; Spiby, Helen; Hopewell, Sally; Doree, Carolyn J; Renfrew, Mary J; Allard, Shubha

2012-06-24

Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24) and postnatal periods (n = 3). Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19). Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

[Observational studies in the era of evidence based medicine: short review on their relevance, taxonomy and designs].

Science.gov (United States)

Fronteira, Ines

2013-01-01

In this review of the literature, we distinguish between experimental and observational studies, highlighting the importance that the later have gained in the era of evidence-based medicine. We further analyze the value of observational studies in light of experimental studies. We present a taxonomy for observational studies based on units of observation and measurement (cross-sectional or longitudinal). We distinguish between descriptive studies and analytical studies. Then, and given its specificity, we define and present a classification for ecological studies. We define and consider the advantages and disadvantages of cross-sectional, case control and cohort studies. We analyze the strength of the evidence given by each study design. We finished by examining what should guide the choice of a study design.

Applicability and feasibility of systematic review for performing evidence-based risk assessment in food and feed safety

DEFF Research Database (Denmark)

Aiassa, E.; Higgins, J.P.T.; Frampton, G. K.

2015-01-01

for answering questions in health care, and can be implemented to minimise biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all......Food and feed safety risk assessment uses multi-parameter models to evaluate the likelihood of adverse events associated with exposure to hazards in human health, plant health, animal health, animal welfare and the environment. Systematic review and meta-analysis are established methods...... parameters in the risk model. This approach to planning and prioritising systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment....

Selective neck dissection: a review of the evidence.

Science.gov (United States)

Pagedar, Nitin A; Gilbert, Ralph W

2009-01-01

The management of regional metastatic disease in patients with oral cancer is a topic of controversy. Comprehensive neck dissection has been the mainstay of treatment historically, but clinicians have sought alternatives to limit the morbidity of the classic radical neck dissection. This article will review evidence on the applicability of selective neck dissection in two settings: as primary treatment of the clinically positive neck and as salvage treatment of recurrent neck disease after radiotherapy. In the text, for each article cited we supply the level of evidence thereof according to the Oxford Centre for Evidence-based medicine.

Clinical use of Skype: a review of the evidence base.

Science.gov (United States)

Armfield, Nigel R; Gray, Leonard C; Smith, Anthony C

2012-04-01

Skype is a popular and free software application that allows PCs and mobile devices to be used for video communication over the Internet. We reviewed the literature to determine whether the clinical use of Skype is supported by evidence. One small (n = 7) controlled clinical trial had assessed the effect of nursing communication using Skype on elderly patients with dementia and their carers. However, we were unable to identify any large, well-designed studies which had formally evaluated the safety, clinical effectiveness, security and privacy of Skype for the routine delivery of patient care. While there were many case reports and small studies, no firm evidence either in favour of, or against the use of Skype for clinical telehealth was found. The risks and benefits of using Skype for clinical purposes are not known.

Hospital nurses' information retrieval behaviours in relation to evidence based nursing: a literature review.

Science.gov (United States)

Alving, Berit Elisabeth; Christensen, Janne Buck; Thrysøe, Lars

2018-03-01

The purpose of this literature review is to provide an overview of the information retrieval behaviour of clinical nurses, in terms of the use of databases and other information resources and their frequency of use. Systematic searches carried out in five databases and handsearching were used to identify the studies from 2010 to 2016, with a populations, exposures and outcomes (PEO) search strategy, focusing on the question: In which databases or other information resources do hospital nurses search for evidence based information, and how often? Of 5272 titles retrieved based on the search strategy, only nine studies fulfilled the criteria for inclusion. The studies are from the United States, Canada, Taiwan and Nigeria. The results show that hospital nurses' primary choice of source for evidence based information is Google and peers, while bibliographic databases such as PubMed are secondary choices. Data on frequency are only included in four of the studies, and data are heterogenous. The reasons for choosing Google and peers are primarily lack of time; lack of information; lack of retrieval skills; or lack of training in database searching. Only a few studies are published on clinical nurses' retrieval behaviours, and more studies are needed from Europe and Australia. © 2018 Health Libraries Group.

Re-excision rates after breast conserving surgery following the 2014 SSO-ASTRO guidelines.

Science.gov (United States)

Heelan Gladden, Alicia A; Sams, Sharon; Gleisner, Ana; Finlayson, Christina; Kounalakis, Nicole; Hosokawa, Patrick; Brown, Regina; Chong, Tae; Mathes, David; Murphy, Colleen

2017-12-01

In 2014, SSO-ASTRO published guidelines which recommended "no ink on tumor" as adequate margins for patients undergoing breast conservation for invasive breast cancer. In 2016, new SSO-ASTRO-ASCO guidelines recommended 2 mm margins for DCIS. We evaluated whether these guidelines affected re-excision rates at our institution. Patients treated with breast conservation surgery from January 1, 2010-March 1, 2016 were identified. Re-excision rates, tumor characteristics, and presence of residual disease were recorded. The 2016 guidelines were retrospectively applied to the same cohort and expected re-excision rates calculated. Re-excision rates did not significantly decline before and after 2014 guideline adoption (11.9% before, 10.9% after; p = 0.65) or when the 2016 guidelines were retrospectively applied (8.4%; p = 0.10). The 2014 and 2016 guidelines had minimal impact on our re-excision rates, as most re-excisions were done for DCIS and 2016 guidelines supported our prior institutional practices of 2 mm margins for these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Psiquiatria baseada em evidências Evidence-based psychiatry

Directory of Open Access Journals (Sweden)

Maurício S de Lima

2000-09-01

Full Text Available Em psiquiatria, observa-se grande variabilidade de práticas clínicas, muitas vezes desnecessária. Essas variações podem estar relacionadas à ausência de evidência científica confiável ou ao desconhecimento das evidências de boa qualidade disponíveis. A medicina baseada em evidências (MBE é uma combinação de estratégias que busca assegurar que o cuidado individual do paciente seja baseado na melhor informação disponível, a qual deve ser incorporada à prática clínica. Neste artigo, conceitos de MBE são discutidos com relação a aspectos e desafios no tratamento de pacientes com distimia, bulimia nervosa e esquizofrenia. A partir de resultados de três revisões sistemáticas recentemente publicadas, conclui-se que a prática de psiquiatria baseada em evidências acrescenta qualidade à prática psiquiátrica tradicional.The unnecessary variability often seen in the clinical practice can be related to both the absence of reliable evidence and unawareness of the existence of good quality evidence. Evidence-Based Medicine (EBM is a set of linked strategies designed to assist clinicians in keeping themselves up-to-date with the best available evidence. Such evidence must be incorporated into the clinical practice. EBM concepts are discussed here through common aspects and challenges doctors face when treating patients with dysthymia, bulimia nervosa, and schizophrenia. In the light of some results from three systematic reviews it is concluded that Evidence-Based Psychiatry strategies, rather than replacing the traditional ones, may be a valuable tool to improving quality in a good clinical practice.

Implementing Evidence-Based Practices for People With Schizophrenia

Science.gov (United States)

Drake, Robert E.; Bond, Gary R.; Essock, Susan M.

2009-01-01

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions. PMID:19491315

Evidence-based medical review update: pharmacological and surgical treatments of Parkinson's disease: 2001 to 2004.

Science.gov (United States)

Goetz, Christopher G; Poewe, Werner; Rascol, Olivier; Sampaio, Cristina

2005-05-01

The objective of this study is to update a previous evidence-based medicine (EBM) review on Parkinson's disease (PD) treatments, adding January 2001 to January 2004 information. The Movement Disorder Society (MDS) Task Force prepared an EBM review of PD treatments covering data up to January 2001. The authors reviewed Level I (randomized clinical trials) reports of pharmacological and surgical interventions for PD, published as full articles in English (January 2001-January 2004). Inclusion criteria and ranking followed the original program and adhered to EBM methodology. For Efficacy Conclusions, treatments were designated Efficacious, Likely Efficacious, Non-Efficacious, or Insufficient Data. Four clinical indications were considered for each intervention: prevention of disease progression; treatment of Parkinsonism, as monotherapy and as adjuncts to levodopa where indicated; prevention of motor complications; treatment of motor complications. Twenty-seven new studies qualified for efficacy review, and others covered new safety issues. Apomorphine, piribedil, unilateral pallidotomy, and subthalamic nucleus stimulation moved upward in efficacy ratings. Rasagiline, was newly rated as Efficacious monotherapy for control of Parkinsonism. New Level I data moved human fetal nigral transplants, as performed to date, from Insufficient Data to Non- efficacious for the treatment of Parkinsonism, motor fluctuations, and dyskinesias. Selegiline was reassigned as Non-efficacious for the prevention of dyskinesias. Other designations did not change. In a field as active in clinical trials as PD, frequent updating of therapy-based reviews is essential. We consider a 3-year period a reasonable time frame for published updates and are working to establish a Web-based mechanism to update the report in an ongoing manner. Copyright 2005 Movement Disorder Society.

Astro 101 Students' Perceptions of Science: Results from the "Thinking about Science Survey Instrument"

Science.gov (United States)

Wallace, Colin S.; Prather, Edward E.; Mendelsohn, Benjamin M.

2013-01-01

What are the underlying worldviews and beliefs about the role of science in society held by students enrolled in a college-level, general education, introductory astronomy course (Astro 101)--and are those beliefs affected by active engagement instruction shown to significantly increase students' conceptual knowledge and reasoning abilities…

Evidence based mental healthcare and service innovation: review of concepts and challenges.

Science.gov (United States)

Kouimtsidis, Ch; John-Smith, St; Kemp, P; Ikkos, G

2013-01-01

Health provision systems in the developed western nations are currently facing major financial challenges. In order to meet these challenges, a number of new approaches used to assist the provision of health have been introduced, including the practice of health professionals. These approaches utilize specific methods of data capture and summarization such as: evidence based medicine (EBM) and practice guidelines. Evidence is generated from systematic clinical research as well as reported clinical experience and individually case based empirical evidence. All types of research though (quantitative or qualitative) have limitations. Similarly all types of evidence have advantages and disadvantages and can be complimentary to each other. Evidencebased individual decision (EBID) making is the commonest evidence-based medicine as practiced by the individual clinician in making decisions about the care of the individual patient. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. However this sort of evidence-based medicine, focuses excessively on the individual (potentially at the expense of others) in a system with limited budgets. Evidence-based guidelines (EBG) also support the practice of evidence-based medicine but at the organizational or institutional level. The main aim is to identify which interventions, over a range of patients, work best and which is cost-effective in order to guide service development and provision at a strategic level. Doing this effectively is a scientific and statistical skill in itself and the quality of guidelines is based primarily on the quality research evidence. It is important to note that lack of systematic evidence to support an intervention does not automatically mean that an intervention must instantly be abandoned. It is also important that guidelines are understood for what they are, i.e. not rules, or complete statements of knowledge. EBM will

The Healthcare Improvement Scotland evidence note rapid review process: providing timely, reliable evidence to inform imperative decisions on healthcare.

Science.gov (United States)

McIntosh, Heather M; Calvert, Julie; Macpherson, Karen J; Thompson, Lorna

2016-06-01

Rapid review has become widely adopted by health technology assessment agencies in response to demand for evidence-based information to support imperative decisions. Concern about the credibility of rapid reviews and the reliability of their findings has prompted a call for wider publication of their methods. In publishing this overview of the accredited rapid review process developed by Healthcare Improvement Scotland, we aim to raise awareness of our methods and advance the discourse on best practice. Healthcare Improvement Scotland produces rapid reviews called evidence notes using a process that has achieved external accreditation through the National Institute for Health and Care Excellence. Key components include a structured approach to topic selection, initial scoping, considered stakeholder involvement, streamlined systematic review, internal quality assurance, external peer review and updating. The process was introduced in 2010 and continues to be refined over time in response to user feedback and operational experience. Decision-makers value the responsiveness of the process and perceive it as being a credible source of unbiased evidence-based information supporting advice for NHSScotland. Many agencies undertaking rapid reviews are striving to balance efficiency with methodological rigour. We agree that there is a need for methodological guidance and that it should be informed by better understanding of current approaches and the consequences of different approaches to streamlining systematic review methods. Greater transparency in the reporting of rapid review methods is essential to enable that to happen.

Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews

Directory of Open Access Journals (Sweden)

Parker Jacqui A

2012-06-01

Full Text Available Abstract Background Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Methods Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. Results 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24 and postnatal periods (n = 3. Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19. Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. Conclusions The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

Evidence-based policy? The use of mobile phones in hospital

NARCIS (Netherlands)

Ettelt, Stefanie; Nolte, Ellen; McKee, Martin; Haugen, Odd Arild; Karlberg, Ingvar; Klazinga, Niek; Ricciardi, Walter; Teperi, Juha

2006-01-01

BACKGROUND: Evidence-based policies have become increasingly accepted in clinical practice. However, policies on many of the non-clinical activities that take place in health care facilities may be less frequently evidence based. METHODS: We carried out a review of literature on safety of mobile

Astro Data Science: The Next Generation

Science.gov (United States)

Mentzel, Chris

2018-01-01

Astronomers have been at the forefront of data-driven discovery since before the days of Kepler. Using data in the scientific inquiry into the workings of the the universe is the lifeblood of the field. This said, data science is considered a new thing, and researchers from every discipline are rushing to learn data science techniques, train themselves on data science tools, and even leaving academia to become data scientists. It is undeniable that our ability to harness new computational and statistical methods to make sense of today’s unprecedented size, complexity, and fast streaming data is helping scientists make new discoveries. The question now is how to ensure that researchers can employ these tools and use them appropriately. This talk will cover the state of data science as it relates to scientific research and the role astronomers play in its development, use, and training the next generation of astro-data scientists.

Household waste prevention--a review of evidence.

Science.gov (United States)

Cox, Jayne; Giorgi, Sara; Sharp, Veronica; Strange, Kit; Wilson, David C; Blakey, Nick

2010-03-01

This paper reports a synthesis of policy-relevant evidence on household waste prevention, based on a UK portfolio of primary research and a broad international review. Waste prevention was defined as strict avoidance, reduction at source (e.g. home composting) and reuse (for the product's original purpose) - recycling was excluded. A major focus was on consumers. Waste prevention is not one but many behaviours; the review revealed a general hierarchy in their popularity, from donating goods to charity at the top; through small reuse behaviours around the home; to activities involving changes in consumption habits at the bottom; one estimate is that 60% of the public does at least one of these activities, some of the time. Barriers to engaging householders include both modern consumer culture and a genuine confusion that waste prevention is equivalent to recycling. The public can be engaged through local or national campaigns, with a wide range of interventions and communications approaches available. On the products and services side, the primary opportunity within the scope of the review was identified as increasing reuse. The barriers included operational difficulties (funding, capacity, logistics) and consumer attitudes towards second-hand goods. The main opportunities are to ensure more strategic planning for reuse by local authorities and better co-ordination and joint working with the third sector. The review examined the impact or potential of various policy measures designed to influence household behaviour directly or the products and services provided to them. Overall, the international evidence suggests that waste prevention benefits will be derived from a 'package' of measures, including, for example, prevention targets, producer responsibility, householder charging, funding for pilot projects, collaboration between the public, private and third sectors, and public intervention campaigns. UK evidence suggests that the greatest tonnage diversions can be

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

Science.gov (United States)

Davidoff, F

1999-03-01

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

Evidence-based treatment strategies for treatment-resistant bipolar depression: a systematic review

NARCIS (Netherlands)

Sienaert, P.; Lambrichts, L.; Dols, A.; De Fruyt, J.

2013-01-01

Objectives: Treatment resistance in bipolar depression is a common clinical problem that constitutes a major challenge for the treating clinician as there is a paucity of treatment options. The objective of this paper was to review the evidence for treatment options in treatment-resistant bipolar

Validity evidence based on test content.

Science.gov (United States)

Sireci, Stephen; Faulkner-Bond, Molly

2014-01-01

Validity evidence based on test content is one of the five forms of validity evidence stipulated in the Standards for Educational and Psychological Testing developed by the American Educational Research Association, American Psychological Association, and National Council on Measurement in Education. In this paper, we describe the logic and theory underlying such evidence and describe traditional and modern methods for gathering and analyzing content validity data. A comprehensive review of the literature and of the aforementioned Standards is presented. For educational tests and other assessments targeting knowledge and skill possessed by examinees, validity evidence based on test content is necessary for building a validity argument to support the use of a test for a particular purpose. By following the methods described in this article, practitioners have a wide arsenal of tools available for determining how well the content of an assessment is congruent with and appropriate for the specific testing purposes.

Pathogenesis of chronic pancreatitis: an evidence-based review of past theories and recent developments.

Science.gov (United States)

Stevens, Tyler; Conwell, Darwin L; Zuccaro, Gregory

2004-11-01

In the past several decades, four prominent theories of chronic pancreatitis pathogenesis have emerged: the toxic-metabolic theory, the oxidative stress hypothesis, the stone and duct obstruction theory, and the necrosis-fibrosis hypothesis. Although these traditional theories are formulated based on compelling scientific observations, substantial contradictory data also exist for each. Furthermore, the basic premises of some of these theories are directly contradictory. Because of the recent scientific progress in the underlying genetic, cellular, and molecular pathophysiology, there have been substantial advances in the understanding of chronic pancreatitis pathogenesis. This paper will provide an evidence-based review and critique of the traditional pathogenic theories, followed by a discussion of the new advances in pancreatic fibrogenesis. Moreover, we will discuss plausible pathogenic sequences applied to each of the known etiologies.

Systematic review of evidence underpinning non-pharmacological therapies in dementia.

Science.gov (United States)

Olley, Richard; Morales, Andrea

2017-05-15

Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35million people around the globe. It is expected that this number will increase to 65.7million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected. The main goal of the present systematic literature review was to examine contemporary evidence relating to non-pharmacological therapy in the treatment of dementia. Methods To achieve the study goal, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used. Results This study identified the five most common behaviours in patients with dementia as aggression, wandering, agitation, apathy and sleep disturbances. Two non-pharmacological therapies were the most studied treatment: music therapy and aromatherapy. Ten other non-pharmacological therapies were also identified, but these lack a sufficient evidence-base. Conclusion Although all the therapies identified could be used as part of the treatment of behavioural symptoms, there is insufficient evidence relating to the indications, appropriate use and effectiveness of these therapies to apply in each behavioural treatment. Thus, the present study has demonstrated a significant research gap. What is known about the topic? Despite the widespread use of many different types of therapies, there is limited evidence regarding the efficacy of non-pharmaceutical therapies deployed in the management of behaviours of concern manifested by some people who suffer with dementia in all its forms. What does this paper add? This systematic review examines contemporary evidence from the literature to determine whether there is an evidence base available that would

Evidence-Based Family-School Interventions with Preschool Children

Science.gov (United States)

Bates, Stacey L.

2005-01-01

Fifteen studies of family-school interventions with preschool children conducted between 1980 and 2002, and published in peer-reviewed journals, were reviewed and evaluated according to the criteria developed by the Task Force on Evidence-Based Intervention in School Psychology (Division 16 and Society for the Study of School Psychology Task…

Contemporary surgical management of advanced end stage emphysema: an evidence based review.

Science.gov (United States)

Sachithanandan, Anand; Badmanaban, Balaji

2012-06-01

Emphysema is a progressive unrelenting component of chronic obstructive pulmonary disease and a major source of mortality and morbidity globally. The prevalence of moderate to severe emphysema is approximately 5% in Malaysia and likely to increase in the future. Hence advanced emphysema will emerge as a leading cause of hospital admission and a major consumer of healthcare resources in this country in the future. Patients with advanced disease have a poor quality of life and reduced survival. Medical therapy has been largely ineffective for many patients however certain subgroups have disease amenable to surgical palliation. Effective surgical therapies include lung volume reduction surgery, lung transplantation and bullectomy. This article is a comprehensive evidence based review of the literature evaluating the rationale, efficacy, safety and limitations of surgery for advanced emphysema highlighting the importance of meticulous patient selection and local factors relevant to Malaysia.

The Navigation Guide - evidence-based medicine meets environmental health: systematic review of human evidence for PFOA effects on fetal growth.

Science.gov (United States)

Johnson, Paula I; Sutton, Patrice; Atchley, Dylan S; Koustas, Erica; Lam, Juleen; Sen, Saunak; Robinson, Karen A; Axelrad, Daniel A; Woodruff, Tracey J

2014-10-01

The Navigation Guide methodology was developed to meet the need for a robust method of systematic and transparent research synthesis in environmental health science. We conducted a case study systematic review to support proof of concept of the method. We applied the Navigation Guide systematic review methodology to determine whether developmental exposure to perfluorooctanoic acid (PFOA) affects fetal growth in humans. We applied the first 3 steps of the Navigation Guide methodology to human epidemiological data: 1) specify the study question, 2) select the evidence, and 3) rate the quality and strength of the evidence. We developed a protocol, conducted a comprehensive search of the literature, and identified relevant studies using prespecified criteria. We evaluated each study for risk of bias and conducted meta-analyses on a subset of studies. We rated quality and strength of the entire body of human evidence. We identified 18 human studies that met our inclusion criteria, and 9 of these were combined through meta-analysis. Through meta-analysis, we estimated that a 1-ng/mL increase in serum or plasma PFOA was associated with a -18.9 g (95% CI: -29.8, -7.9) difference in birth weight. We concluded that the risk of bias across studies was low, and we assigned a "moderate" quality rating to the overall body of human evidence. On the basis of this first application of the Navigation Guide systematic review methodology, we concluded that there is "sufficient" human evidence that developmental exposure to PFOA reduces fetal growth.

SiPM and ADD as advanced detectors for astro-particle physics

International Nuclear Information System (INIS)

Mirzoyan, Razmick; Dolgoshein, Boris; Holl, Peter; Klemin, Sergei; Merck, Christine; Moser, Hans-Guenther; Otte, Adam Nepomuk; Ninkovic, Jelena; Popova, Elena; Richter, Rainer; Teshima, Masahiro

2007-01-01

In recent years, a few scientific groups are developing a novel type light sensor. These so-called silicon photo multipliers (SiPM) operate at relatively low bias voltage of 20-60 V, show unprecedented amplitude resolution and already now can provide photon detection efficiencies (PDE) comparable to or better than that of classical photo multipliers (PMT). We are developing the novel sensors for the astro-particle physics experiments MAGIC [J. Albert, et al., Astrophys. Lett. 642 (2006) L119. ] and also for EUSO [M. Teshima, et al., EUSO (The Extreme Universe Space Observatory), in: Scientific Objectives Proceedings ICRC, 2003, p. 10690. ]. The front-illuminated SiPM are developing with the group from MEPhI in Moscow and the back-illuminated Avalanche Drift Diodes (ADD) with the semiconductor laboratory (HLL) attached to the MPI for Physics. Our goal is to produce 5-10 mm size ultra-fast, low-noise and very high PDE (60-80%) sensors operating in the wavelength range 300-600 nm. Together with MEPhI, we have already produced and successfully tested 1.3x1.3, 3x3 and 5x5 mm 2 size SiPMs. Very recently, the first ADD test structures were produced and are under evaluation at the HLL. In this report, we want to outline the main parameters of the new sensors for the needs of astro-particle physics experiments

Decision making in advanced otosclerosis: an evidence-based strategy

NARCIS (Netherlands)

Merkus, P.; van Loon, M.C.; Smit, C.F.G.M.; Smits, J.C.M.; de Cock, A.F.C.; Hensen, E.F.

2011-01-01

Objectives/Hypothesis: To propose an evidence-based strategy for the management of patients with advanced otosclerosis accompanied by severe to profound hearing loss. Study Design: Systematic review of the literature and development of treatment guidelines. Methods: A systematic review was conducted

Evidence-Based Advances in Reptile Medicine.

Science.gov (United States)

Mitchell, Mark A; Perry, Sean M

2017-09-01

Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty. Copyright © 2017 Elsevier Inc. All rights reserved.

City-based action to reduce harmful alcohol use: review of reviews.

Science.gov (United States)

Anderson, Peter; Jané-Llopis, Eva; Hasan, Omer Syed Muhammad; Rehm, Jürgen

2018-01-01

Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register, and Epub Ahead of Print databases. All reviews that address adults, without language or date restrictions resulting from combining the terms ("review" or "literature review" or "review literature" or "data pooling" or "comparative study" or "systematic review" or "meta-analysis" or "pooled analysis"), and "alcohol", and "intervention" and ("municipal" or "city" or "community"). Results: Five relevant reviews were identified. Studies in the reviews were all from high income countries and focussed on the acute consequences of drinking, usually with one target intervention, commonly bars, media, or drink-driving. No studies in the reviews reported the impact of comprehensive city-based action. One community cluster randomized controlled trial in Australia, published after the reviews, failed to find convincing evidence of an impact of community-based interventions in reducing adult harmful use of alcohol.     Conclusions: To date, with one exception, the impact of adult-oriented comprehensive community and municipal action to reduce the harmful use of alcohol has not been studied. The one exception failed to find a convincing effect. We conclude with recommendations for closing this evidence gap.

Sensor-based evaluation and treatment of nocturnal hypokinesia in Parkinson's disease: An evidence-based review.

Science.gov (United States)

Bhidayasiri, Roongroj; Sringean, Jirada; Thanawattano, Chusak

2016-01-01

The manifestations of nocturnal movements in Parkinson's disease (PD) are protean, with major disabilities related to nocturnal hypokinesia. While it can be assessed by clinical interviews and screening instruments, these are often inaccurate and prone to recall bias. In light of advances in sensor technology, we explored the use of sensors in the study of nocturnal hypokinesia, by performing a systematic review of the professional literature on this topic. Evidence suggests that nocturnal hypokinesia exists even in patients in the early stages, and PD patients turned significantly less and with much slower speed and acceleration than controls, partly related to low nocturnal dopamine level. We conducted another systematic review to evaluate the evidence of the efficacy of dopaminergic agents in the treatment of nocturnal hypokinesia. Several lines of evidence support the use of long-acting drugs or by continuous administration of short-acting agents to control symptoms. Sensor parameters could be considered as one of the important objective outcomes in future clinical trials investigating potential drugs to treat nocturnal hypokinesia. Physicians should be aware of this technology as it can aid the clinical assessment of nocturnal hypokinesia and enhance the quality of patient care. In addition, the use of sensors currently is being considered for various aspects of research on early diagnosis, treatment, and rehabilitation of PD patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards

Directory of Open Access Journals (Sweden)

Valkenhoef Gert

2012-09-01

Full Text Available Abstract Background Decisions concerning drug safety and efficacy are generally based on pivotal evidence provided by clinical trials. Unfortunately, finding the relevant clinical trials is difficult and their results are only available in text-based reports. Systematic reviews aim to provide a comprehensive overview of the evidence in a specific area, but may not provide the data required for decision making. Methods We review and analyze the existing information systems and standards for aggregate level clinical trials information from the perspective of systematic review and evidence-based decision making. Results The technology currently used has major shortcomings, which cause deficiencies in the transfer, traceability and availability of clinical trials information. Specifically, data available to decision makers is insufficiently structured, and consequently the decisions cannot be properly traced back to the underlying evidence. Regulatory submission, trial publication, trial registration, and systematic review produce unstructured datasets that are insufficient for supporting evidence-based decision making. Conclusions The current situation is a hindrance to policy decision makers as it prevents fully transparent decision making and the development of more advanced decision support systems. Addressing the identified deficiencies would enable more efficient, informed, and transparent evidence-based medical decision making.

Astrobites: The Astro-ph Reader's Digest For Undergraduates

Science.gov (United States)

Kohler, Susanna; Astrobites Team

2013-04-01

Astrobites (http://astrobites.com) is a daily blog aimed primarily at undergraduates interested in astrophysical research and written by a team of graduate students located at diverse institutions around the world. Nearly every day we present a journal article recently posted to astro-ph in a brief format that is accessible to anyone with a general background in the physical sciences. In addition to summarizing new work, Astrobites provides valuable context for readers not yet familiar with the astrophysical literature. Special posts offer career guidance for undergraduates (e.g. applying for an NSF graduate fellowship) and describe personal experiences (e.g. attending an astronomy summer school). We will discuss the Astrobites format and recent readership statistics, as well as potential methods for incorporating Astrobites into the classroom.

Extensive Broadband X-Ray Monitoring During the Formation of a Giant Radio Jet Base in Cyg X-3 with AstroSat

Science.gov (United States)

Pahari, Mayukh; Yadav, J. S.; Verdhan Chauhan, Jai; Rawat, Divya; Misra, Ranjeev; Agrawal, P. C.; Chandra, Sunil; Bagri, Kalyani; Jain, Pankaj; Manchanda, R. K.; Chitnis, Varsha; Bhattacharyya, Sudip

2018-01-01

We present X-ray spectral and timing behavior of Cyg X-3 as observed by AstroSat during the onset of a giant radio flare on 2017 April 1–2. Within a timescale of a few hours, the source shows a transition from the hypersoft state (HPS) to a more luminous state (we termed as the very high state), which coincides with the time of the steep rise in radio flux density by an order of magnitude. Modeling the Soft X-ray Telescope (SXT) and Large Area X-ray Proportional Counter (LAXPC) spectra jointly in 0.5–70.0 keV, we found that the first few hours of the observation is dominated by the HPS with no significant counts above 17 keV. Later, an additional flat power-law component suddenly appeared in the spectra that extends to very high energies with the power-law photon index of {1.49}-0.03+0.04. Such a flat power-law component has never been reported from Cyg X-3. Interestingly the fitted power-law model in 25–70 keV, when extrapolated to the radio frequency, predicts the radio flux density to be consistent with the trend measured from the RATAN-600 telescope at 11.2 GHz. This provides direct evidence of the synchrotron origin of flat X-ray power-law component and the most extensive monitoring of the broadband X-ray behavior at the moment of decoupling the giant radio jet base from the compact object in Cyg X-3. Using SXT and LAXPC observations, we determine the giant flare ejection time as MJD 57845.34 ± 0.08 when 11.2 GHz radio flux density increases from ∼100 to ∼478 mJy.

Building an evidence base for community health: a review of the quality of program evaluations.

Science.gov (United States)

Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise

2007-11-01

An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

A systematic literature review on reviews and meta-analyses of biologically based CAM-practices for cancer patients

DEFF Research Database (Denmark)

Paludan-Müller, Christine; Lunde, Anita; Johannessen, Helle

2010-01-01

levels of evidence and were excluded from further evaluation. Among the 32 high-quality reviews the most reviewed practices were soy/plant hormones (7), Chinese herbal medicine (7), antioxidants (5) and mistletoe (4). Fifteen of the 32 reviews included data on the efficacy of biologically-based CAM......-practices against cancer, but none of the reviews concluded a positive effect on the cancer. Reviews including data on quality of life (10) and/or reduction of side effects (12) showed promising, but yet insufficient evidence for Chinese herbal medicine against pain  and side effects of chemotherapy, and mistletoe......Purpose To provide an overview and evaluate the evidence of biologically based CAM-practices for cancer patients. Methods Pubmed, Social Science Citation Index, AMED and the Cochrane library were systematically searched for reviews on effects of biologically based CAM-practices, including herbal...

Expert consensus v. evidence-based approaches in the revision of the DSM.

Science.gov (United States)

Kendler, K S; Solomon, M

2016-08-01

The development of DSM-III through DSM-5 has relied heavily on expert consensus. In this essay, we provide an historical and critical perspective on this process. Over the last 40 years, medicine has struggled to find appropriate methods for summarizing research results and making clinical recommendations. When such recommendations are issued by authorized organizations, they can have widespread influence (i.e. DSM-III and its successors). In the 1970s, expert consensus conferences, led by the NIH, reviewed research about controversial medical issues and successfully disseminated results. However, these consensus conferences struggled with aggregating the complex available evidence. In the 1990s, the rise of evidence-based medicine cast doubt on the reliability of expert consensus. Since then, medicine has increasingly relied on systematic reviews, as developed by the evidence-based medicine movement, and advocated for their early incorporation in expert consensus efforts. With the partial exception of DSM-IV, such systematic evidence-based reviews have not been consistently integrated into the development of the DSMs, leaving their development out of step with the larger medical field. Like the recommendations made for the NIH consensus conferences, we argue that the DSM process should be modified to require systematic evidence-based reviews before Work Groups make their assessments. Our suggestions - which would require leadership and additional resources to set standards for appropriate evidence hierarchies, carry out systematic reviews, and upgrade the group process - should improve the objectivity of the DSM, increase the validity of its results, and improve the reception of any changes in nosology.

Evidence-based pathology: umbilical cord coiling.

Science.gov (United States)

Khong, T Y

2010-12-01

The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

The Pushchino Radio Astronomy Observatory of the P N Lebedev Physical Institute Astro Space Center: yesterday, today, and tomorrow

International Nuclear Information System (INIS)

Dagkesamanskii, Rustam D

2009-01-01

The development of Russian (formerly Soviet) radio astronomy is indissolubly linked with the P N Lebedev Physical Institute (LPI), Russian Academy of Sciences. From the late 1940s, the institute conducted most of its radio astronomy research in the Crimea, at stations or on field trips; in the late 1950s, the center of gravity of research moved to the southern Moscow region, where one of the largest radio astronomy observatories in the country and in the world was developed within less than twenty years. The observatory unique instrumentation system is briefly reviewed in a historical perspective. Key research areas and some major achievements are outlined, and the prospects of the observatory as (currently) part of the LPI Astro Space Center are examined. (conferences and symposia)

The Pushchino Radio Astronomy Observatory of the P N Lebedev Physical Institute Astro Space Center: yesterday, today, and tomorrow

Energy Technology Data Exchange (ETDEWEB)

Dagkesamanskii, Rustam D [Pushchino Radio Astronomy Observatory, Astro Space Center, Lebedev Physical Institute, Russian Academy of Sciences, Pushchino, Moscow region (Russian Federation)

2009-11-30

The development of Russian (formerly Soviet) radio astronomy is indissolubly linked with the P N Lebedev Physical Institute (LPI), Russian Academy of Sciences. From the late 1940s, the institute conducted most of its radio astronomy research in the Crimea, at stations or on field trips; in the late 1950s, the center of gravity of research moved to the southern Moscow region, where one of the largest radio astronomy observatories in the country and in the world was developed within less than twenty years. The observatory unique instrumentation system is briefly reviewed in a historical perspective. Key research areas and some major achievements are outlined, and the prospects of the observatory as (currently) part of the LPI Astro Space Center are examined. (conferences and symposia)

WE-E-204-01: ASTRO Based Journals

Energy Technology Data Exchange (ETDEWEB)

Klein, E. [Long Island Jewish Medical Center (United States)

2016-06-15

Research papers authored by Medical Physicists address a large spectrum of oncologic, imaging, or basic research problems; exploit a wide range of physical and engineering methodologies; and often describe the efforts of a multidisciplinary research team. Given dozens of competing journals accepting medical physics articles, it may not be clear to an individual author which journal is the best venue for disseminating their work to the scientific community. Relevant factors usually include the Journal’s audience and scientific impact, but also such factors as perceived acceptance rate, interest in their topic, and quality of service. The purpose of this symposium is to provide the medical physics community with an overview of scope, review processes, and article guidelines for the following journals: Radiology, Medical Physics, International Journal of Radiation Biology and Physics, Journal of Applied Clinical Medical Physics, and Practical Radiation Oncology. Senior members of the editorial board for each journal will provide details as to the journals review process, for example: single blind versus double blind reviews; open access policies, the hierarchy of the review process in terms of editorial board structure; the reality of acceptance, in terms of acceptance rate; and the types of research the journal prefers to publish. Other journals will be discussed as well. The goal is to provide for authors guidance before they begin to write their papers, not only for proper formatting, but also that the readership is appropriate for the particular paper, hopefully increasing the quality and impact of the paper and the likelihood of publication. Learning Objectives: To review each Journal’s submission and review process Guidance as to how to increase quality, impact and chances of acceptance To help decipher which journal is appropriate for a given work A. Karellas, Research collaboration with Koning, Corporation.

WE-E-204-01: ASTRO Based Journals

International Nuclear Information System (INIS)

Klein, E.

2016-01-01

Research papers authored by Medical Physicists address a large spectrum of oncologic, imaging, or basic research problems; exploit a wide range of physical and engineering methodologies; and often describe the efforts of a multidisciplinary research team. Given dozens of competing journals accepting medical physics articles, it may not be clear to an individual author which journal is the best venue for disseminating their work to the scientific community. Relevant factors usually include the Journal’s audience and scientific impact, but also such factors as perceived acceptance rate, interest in their topic, and quality of service. The purpose of this symposium is to provide the medical physics community with an overview of scope, review processes, and article guidelines for the following journals: Radiology, Medical Physics, International Journal of Radiation Biology and Physics, Journal of Applied Clinical Medical Physics, and Practical Radiation Oncology. Senior members of the editorial board for each journal will provide details as to the journals review process, for example: single blind versus double blind reviews; open access policies, the hierarchy of the review process in terms of editorial board structure; the reality of acceptance, in terms of acceptance rate; and the types of research the journal prefers to publish. Other journals will be discussed as well. The goal is to provide for authors guidance before they begin to write their papers, not only for proper formatting, but also that the readership is appropriate for the particular paper, hopefully increasing the quality and impact of the paper and the likelihood of publication. Learning Objectives: To review each Journal’s submission and review process Guidance as to how to increase quality, impact and chances of acceptance To help decipher which journal is appropriate for a given work A. Karellas, Research collaboration with Koning, Corporation.

ASTRO-H CdTe detectors proton irradiation at PIF

International Nuclear Information System (INIS)

Limousin, O.; Renaud, D.; Horeau, B.; Dubos, S.; Laurent, P.; Lebrun, F.; Chipaux, R.; Boatella Polo, C.; Marcinkowski, R.; Kawaharada, M.; Watanabe, S.; Ohta, M.; Sato, G.; Takahashi, T.

2015-01-01

Asbstract: The French Atomic Energy Commission (CEA), with the support of the European Space Agency (ESA), is partner of the Soft Gamma-Ray Detector (SGD) and the Hard X-ray Imager (HXI) onboard the 6th Japanese X-ray scientific satellite ASTRO-H (JAXA) initiated by the Institute of Space and Astronautical Science (ISAS). Both scientific instruments, one hosting a series of Compton Gamma Cameras and the other being a focal plane of a grazing incidence mirror telescope in the hard X-ray domain, are equipped with Cadmium Telluride based detectors. ASTRO-H will be operated in a Low Earth Orbit with a 31° inclination at ~550 km altitude, thus passing daily through the South Atlantic Anomaly radiation belt, a specially harsh environment where the detectors are suffering the effect of the interaction with trapped high energy protons. As CdTe detector performance might be affected by the irradiation, we investigate the effect of the accumulated proton fluence on their spectral response. To do so, we have characterized and irradiated representative samples of SGD and HXI detector under different conditions. The detectors in question, from ACRORAD, are single-pixels having a size of 2 mm by 2 mm and 750 µm thick. The Schottky contact is either made of an Indium or Aluminum for SGD and HXI respectively. We ran the irradiation test campaign at the Proton Irradiation Facility (PIF) at PSI, and ESA approved equipment to evaluate the radiation hardness of flight hardware. We simulated the proton flux expected on the sensors over the entire mission, and secondary neutrons flux due to primary proton interactions into the surrounding BGO active shielding. We eventually characterized the detector response evolution, emphasizing each detector spectral response as well as its stability by studying the so-called Polarization effect. The latter is provoking a spectral response degradation against time as a charge accumulation process occurs in Schottky type CdTe sensors. In this paper

An evidence-based public health approach to climate change adaptation.

Science.gov (United States)

Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

2014-11-01

Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the R.T.O.G.-Astro phoenix consensus conference

International Nuclear Information System (INIS)

Roach, M.; Hanks, G.; Thames, H.; Schellhammer, P.; Shipley, W.U.; Sokol, G.H.; Sandler, H.

2008-01-01

In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and back-dating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined 'at call' (not back-dated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to 'adequate follow-up.' To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature. (authors)

Do You Need a Textbook to Teach Astro 101?

Science.gov (United States)

Rudolph, Alexander L.; Collaboration of Astronomy Teaching Scholars CATS

2011-01-01

During educational sessions at astronomy meetings, especially during Center for Astronomy Education (CAE) Teaching Excellence workshops, which I have attended and now help present, one of the questions everyone wants to discuss is which textbook to use to teach Astro 101 classes (general education astronomy courses for non-science majors). Some instructors have a favorite. Others will claim that they are all the same and that it doesn't matter. Increasingly, however, the discussions turn to the question of whether any textbook is needed at all. Some of this discussion has been driven by the increase in the use of interactive learning strategies such as Think-Pair-Share questions, Lecture-Tutorials, and Ranking Tasks. These activities provide students a learning modality very different from the traditional lecture supplemented by homework, and raises the question of whether the learning that takes place during such interactive activities is enough to teach students what we wish them to know about astronomy. I had been teaching an Astro 101 class for almost three years using a full suite of interactive learning strategies, when I decided to teach it without requiring the students to purchase a textbook. Comparison of test scores before and after this change shows that there is no statistical difference in student achievement whether a textbook is required or not. Details on the course and methodology used to reach this conclusion will be presented. This work is supported by the National Science Foundation under Grant No. 0847170, a PAARE Grant for the Calfornia-Arizona Minority Partnership for Astronomy Research and Education (CAMPARE), and Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation.

Evidence-based competencies for improving communication skills in graduate medical education: a review with suggestions for implementation.

Science.gov (United States)

Henry, Stephen G; Holmboe, Eric S; Frankel, Richard M

2013-05-01

Communicating with patients is arguably the most common and important activity in medical practice, but this activity receives relatively little emphasis in graduate medical education. We propose 12 evidence-based communication competencies that program directors can adopt as a framework for teaching and evaluating residents' communication skills. We review supporting evidence for these competencies and argue that communication should be treated like a procedural skill that must be taught and evaluated by observing real resident-patient interactions. We make practical suggestions for implementing these competencies by addressing three critical components of a competency-based approach to communication skills: patient safety, faculty development, and direct observation of residents. This approach to teaching and assessing communication skills provides a rationale for incorporating routine direct observation into graduate medical education programs and also for designing communication skills training that ensures graduating residents develop the skills needed to provide safe, effective patient care.

Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

Science.gov (United States)

Cairney, Paul; Oliver, Kathryn

2017-04-26

There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda - should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise 'evidence-based' policymaking above other factors? The latter includes governance principles such the 'co-production' of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.We conclude that successful engagement in 'evidence-based policymaking' requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions

Outcomes After Accelerated Partial Breast Irradiation in Patients With ASTRO Consensus Statement Cautionary Features

International Nuclear Information System (INIS)

McHaffie, Derek R.; Patel, Rakesh R.; Adkison, Jarrod B.; Das, Rupak K.; Geye, Heather M.; Cannon, George M.

2011-01-01

Purpose: To evaluate outcomes among women with American Society for Radiation Oncology (ASTRO) consensus statement cautionary features treated with brachytherapy-based accelerated partial breast irradiation (APBI). Methods and Materials: Between March 2001 and June 2006, 322 consecutive patients were treated with high-dose-rate (HDR) APBI at the University of Wisconsin. A total of 136 patients were identified who met the ASTRO cautionary criteria. Thirty-eight (27.9%) patients possessed multiple cautionary factors. All patients received 32 to 34 Gy in 8 to 10 twice-daily fractions using multicatheter (93.4%) or Mammosite balloon (6.6%) brachytherapy. Results: With a median follow-up of 60 months, there were 5 ipsilateral breast tumor recurrences (IBTR), three local, and two loco-regional. The 5-year actuarial rate of IBTR was 4.8% ± 4.1%. The 5-year disease-free survival was 89.6%, with a cause-specific survival and overall survival of 97.6% and 95.3%, respectively. There were no IBTRs among 32 patients with ductal carcinoma in situ (DCIS) vs. 6.1% for patients with invasive carcinoma (p = 0.24). Among 104 patients with Stage I or II invasive carcinoma, the IBTR rate for patients considered cautionary because of age alone was 0% vs. 12.7% in those deemed cautionary due to histopathologic factors (p = 0.018). Conclusions: Overall, we observed few local recurrences among patients with cautionary features. Women with DCIS and patients 50 to 59 years of age with Stage I/II disease who otherwise meet the criteria for suitability appear to be at a low risk of IBTR. Patients with tumor-related cautionary features will benefit from careful patient selection.

Convergent and sequential synthesis designs: implications for conducting and reporting systematic reviews of qualitative and quantitative evidence.

Science.gov (United States)

Hong, Quan Nha; Pluye, Pierre; Bujold, Mathieu; Wassef, Maggy

2017-03-23

Systematic reviews of qualitative and quantitative evidence can provide a rich understanding of complex phenomena. This type of review is increasingly popular, has been used to provide a landscape of existing knowledge, and addresses the types of questions not usually covered in reviews relying solely on either quantitative or qualitative evidence. Although several typologies of synthesis designs have been developed, none have been tested on a large sample of reviews. The aim of this review of reviews was to identify and develop a typology of synthesis designs and methods that have been used and to propose strategies for synthesizing qualitative and quantitative evidence. A review of systematic reviews combining qualitative and quantitative evidence was performed. Six databases were searched from inception to December 2014. Reviews were included if they were systematic reviews combining qualitative and quantitative evidence. The included reviews were analyzed according to three concepts of synthesis processes: (a) synthesis methods, (b) sequence of data synthesis, and (c) integration of data and synthesis results. A total of 459 reviews were included. The analysis of this literature highlighted a lack of transparency in reporting how evidence was synthesized and a lack of consistency in the terminology used. Two main types of synthesis designs were identified: convergent and sequential synthesis designs. Within the convergent synthesis design, three subtypes were found: (a) data-based convergent synthesis design, where qualitative and quantitative evidence is analyzed together using the same synthesis method, (b) results-based convergent synthesis design, where qualitative and quantitative evidence is analyzed separately using different synthesis methods and results of both syntheses are integrated during a final synthesis, and (c) parallel-results convergent synthesis design consisting of independent syntheses of qualitative and quantitative evidence and an

Procedures for identifying evidence-based psychological treatments for older adults.

Science.gov (United States)

Yon, Adriana; Scogin, Forrest

2007-03-01

The authors describe the methods used to identify evidence-based psychological treatments for older adults in this contribution to the special section. Coding teams were assembled to review the literature on several problems relevant to mental health and aging. These teams used the manual developed by the Committee on Science and Practice of the Society for Clinical Psychology (Division 12) of the American Psychological Association that provided definitions of key constructs used in coding. The authors provide an overview of the process followed by the review teams and of some of the issues that emerged to illustrate the steps involved in the coding procedure. Identifying evidence-based treatments is a fundamental aspect of promoting evidence-based practice with older adults; such practice is advocated by most health care disciplines, including psychology. ((c) 2007 APA, all rights reserved).

Evidence and recommendations for imaging liver fat in children, based on systematic review.

Science.gov (United States)

Awai, Hannah I; Newton, Kimberly P; Sirlin, Claude B; Behling, Cynthia; Schwimmer, Jeffrey B

2014-05-01

Fatty liver is a common problem in children and increases their risk for cirrhosis, diabetes, and cardiovascular disease. Liver biopsy is the clinical standard for diagnosing and grading fatty liver. However, noninvasive imaging modalities are needed to assess liver fat in children. We performed a systematic review of studies that evaluated imaging liver fat in children. We searched PubMed for original research articles in peer-reviewed journals from January 1, 1982, through December 31, 2012, using the key words "imaging liver fat." Studies included those in English, and those performed in children from birth to 18 years of age. To be eligible for inclusion, studies were required to measure hepatic steatosis via an imaging modality and a quantitative comparator as the reference standard. We analyzed 9 studies comprising 610 children; 4 studies assessed ultrasonography and 5 studies assessed magnetic resonance imaging (MRI). Ultrasonography was used in the diagnosis of fatty liver with positive predictive values of 47% to 62%. There was not a consistent relationship between ultrasound steatosis score and the reference measurement of hepatic steatosis. Liver fat as measurements by MRI or by spectroscopy varied with the methodologies used. Liver fat measurements by MRI correlated with results from histologic analyses, but sample size did not allow for an assessment of diagnostic accuracy. Available evidence does not support the use of ultrasonography for the diagnosis or grading of fatty liver in children. Although MRI is a promising approach, the data are insufficient to make evidence-based recommendations regarding its use in children for the assessment of hepatic steatosis. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

Clustering analysis of line indices for LAMOST spectra with AstroStat

Science.gov (United States)

Chen, Shu-Xin; Sun, Wei-Min; Yan, Qi

2018-06-01

The application of data mining in astronomical surveys, such as the Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) survey, provides an effective approach to automatically analyze a large amount of complex survey data. Unsupervised clustering could help astronomers find the associations and outliers in a big data set. In this paper, we employ the k-means method to perform clustering for the line index of LAMOST spectra with the powerful software AstroStat. Implementing the line index approach for analyzing astronomical spectra is an effective way to extract spectral features for low resolution spectra, which can represent the main spectral characteristics of stars. A total of 144 340 line indices for A type stars is analyzed through calculating their intra and inter distances between pairs of stars. For intra distance, we use the definition of Mahalanobis distance to explore the degree of clustering for each class, while for outlier detection, we define a local outlier factor for each spectrum. AstroStat furnishes a set of visualization tools for illustrating the analysis results. Checking the spectra detected as outliers, we find that most of them are problematic data and only a few correspond to rare astronomical objects. We show two examples of these outliers, a spectrum with abnormal continuumand a spectrum with emission lines. Our work demonstrates that line index clustering is a good method for examining data quality and identifying rare objects.

The Care and Feeding of Evidence Based Medicine

OpenAIRE

Tabrah, Frank L

2012-01-01

Wide interest in evidence based medicine (EBM) and its value in patient care, insurance payment decisions, and public health planning has triggered intense medical journal and media coverage that merits review, explanation, and comment.

Technical Packages in Injury and Violence Prevention to Move Evidence into Practice: Systematic Reviews and Beyond

Science.gov (United States)

Haegerich, Tamara M.; David-Ferdon, Corinne; Noonan, Rita K.; Manns, Brian J.; Billie, Holly C.

2016-01-01

Injury and violence prevention strategies have greater potential for impact when they are based on scientific evidence. Systematic reviews of the scientific evidence can contribute key information about which policies and programs might have the greatest impact when implemented. However, systematic reviews have limitations, such as lack of implementation guidance and contextual information, that can limit the application of knowledge. “Technical packages,” developed by knowledge brokers such as the federal government, nonprofit agencies, and academic institutions, have the potential to be an efficient mechanism for making information from systematic reviews actionable. Technical packages provide information about specific evidence-based prevention strategies, along with the estimated costs and impacts, and include accompanying implementation and evaluation guidance to facilitate adoption, implementation, and performance measurement. We describe how systematic reviews can inform the development of technical packages for practitioners, provide examples of technical packages in injury and violence prevention, and explain how enhancing review methods and reporting could facilitate the use and applicability of scientific evidence. PMID:27604301

Review of Evidence for Adult Diabetic Ketoacidosis Management Protocols

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Tara T. T. Tran

2017-06-01

Full Text Available BackgroundDiabetic ketoacidosis (DKA is an endocrine emergency with associated risk of morbidity and mortality. Despite this, DKA management lacks strong evidence due to the absence of large randomised controlled trials (RCTs.ObjectiveTo review existing studies investigating inpatient DKA management in adults, focusing on intravenous (IV fluids; insulin administration; potassium, bicarbonate, and phosphate replacement; and DKA management protocols and impact of DKA resolution rates on outcomes.MethodsOvid Medline searches were conducted with limits “all adult” and published between “1973 to current” applied. National consensus statements were also reviewed. Eligibility was determined by two reviewers’ assessment of title, abstract, and availability.ResultsA total of 85 eligible articles published between 1973 and 2016 were reviewed. The salient findings were (i Crystalloids are favoured over colloids though evidence is lacking. The preferred crystalloid and hydration rates remain contentious. (ii IV infusion of regular human insulin is preferred over the subcutaneous route or rapid acting insulin analogues. Administering an initial IV insulin bolus before low-dose insulin infusions obviates the need for supplemental insulin. Consensus-statements recommend fixed weight-based over “sliding scale” insulin infusions although evidence is weak. (iii Potassium replacement is imperative although no trials compare replacement rates. (iv Bicarbonate replacement offers no benefit in DKA with pH > 6.9. In severe metabolic acidosis with pH < 6.9, there is lack of both data and consensus regarding bicarbonate administration. (v There is no evidence that phosphate replacement offers outcome benefits. Guidelines consider replacement appropriate in patients with cardiac dysfunction, anaemia, respiratory depression, or phosphate levels <0.32 mmol/L. (vi Upon resolution of DKA, subcutaneous insulin is recommended with IV insulin infusions

The development of evidence-based guidelines in dentistry.

Science.gov (United States)

Faggion, C M

2013-02-01

Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

Exploring the Evidence Base for Acupuncture in the Treatment of Ménière's Syndrome—A Systematic Review

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Andrew F. Long

2011-01-01

Full Text Available Ménière's syndrome is a long-term, progressive disease that damages the balance and hearing parts of the inner ear. To address the paucity of information on which evidence-based treatment decisions should be made, a systematic review of acupuncture for Ménière's syndrome was undertaken. The method used was a systematic review of English and Chinese literature, from six databases for randomized, non-randomized and observational studies. All studies were critically appraised and a narrative approach to data synthesis was adopted. Twenty-seven studies were included in this review (9 in English and 18 in Chinese languages: three randomized controlled trials, three non-randomized controlled studies and four pre-test, post-test designs. All but one of the studies was conducted in China. The studies covered body acupuncture, ear acupuncture, scalp acupuncture, fluid acupuncture point injection and moxibustion. The studies were of varying quality. The weight of evidence, across all study types, is of beneficial effect from acupuncture, for those in an acute phase or those who have had Ménière's syndrome for a number of years. The review reinforces the importance of searching for studies from English and Chinese literature. The transferability of the findings from China to a Western context needs confirmation. Further research is also needed to clarify questions around the appropriate frequency and number of treatment/courses of acupuncture. The weight of evidence suggests a potential benefit of acupuncture for persons with Ménière's disease, including those in an acute phase and reinforces the importance of searching for published studies in the Chinese language.

Do systematic reviews address community healthcare professionals' wound care uncertainties? Results from evidence mapping in wound care.

Science.gov (United States)

Christie, Janice; Gray, Trish A; Dumville, Jo C; Cullum, Nicky A

2018-01-01

Complex wounds such as leg and foot ulcers are common, resource intensive and have negative impacts on patients' wellbeing. Evidence-based decision-making, substantiated by high quality evidence such as from systematic reviews, is widely advocated for improving patient care and healthcare efficiency. Consequently, we set out to classify and map the extent to which up-to-date systematic reviews containing robust evidence exist for wound care uncertainties prioritised by community-based healthcare professionals. We asked healthcare professionals to prioritise uncertainties based on complex wound care decisions, and then classified 28 uncertainties according to the type and level of decision. For each uncertainty, we searched for relevant systematic reviews. Two independent reviewers screened abstracts and full texts of reviews against the following criteria: meeting an a priori definition of a systematic review, sufficiently addressing the uncertainty, published during or after 2012, and identifying high quality research evidence. The most common uncertainty type was 'interventions' 24/28 (85%); the majority concerned wound level decisions 15/28 (53%) however, service delivery level decisions (10/28) were given highest priority. Overall, we found 162 potentially relevant reviews of which 57 (35%) were not systematic reviews. Of 106 systematic reviews, only 28 were relevant to an uncertainty and 18 of these were published within the preceding five years; none identified high quality research evidence. Despite the growing volume of published primary research, healthcare professionals delivering wound care have important clinical uncertainties which are not addressed by up-to-date systematic reviews containing high certainty evidence. These are high priority topics requiring new research and systematic reviews which are regularly updated. To reduce clinical and research waste, we recommend systematic reviewers and researchers make greater efforts to ensure that research

Evidence-based healthcare and the Cochrane Collaboration: an unfinished journey as yet!

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Meyer, Sascha

2013-11-01

Although evidence-based medicine and the Cochrane Collaboration have become key players in modern medicine, it is important to note that evidencebased medicine and the Cochrane Collaboration are confronted with a number of substantial challenges that need to be addressed. The aim of this work is to highlight some of these problems. This comment is based on a semi-structured literature review and my personal experience in the field of evidence-based medicine. In this comment, 3 important areas of controversy and conflict ("Improving the quality of Cochrane Review"; "Increasing the relevance to middle- and low-income countries"; and "Keeping reviews up to date") will be highlighted, and possible solutions will be presented. With the Cochrane Collaboration now having been at the forefront of promoting and implementing core principles of evidence-based medicine, further organizational, political and administrative efforts will have to be put in place to further improve the impact of evidence-based medicine in the field of health care. This process can best be realized through networking and cooperation of the medical community worldwide, irrespective of geographic origin. When successfully tackling the above mentioned issues and obstacles, the already amazing success story of evidence-based medicine and the Cochrane Collaboration will grow even more substantial. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Integrating evidence-based principles into the undergraduate ...

African Journals Online (AJOL)

Background. The research methodology module was reviewed as part of the overall revision of the undergraduate physiotherapy curriculum of Stellenbosch University. This created an ideal platform from which to assess how to align the principles of evidence-based practice (EBP) with research methodology. Fostering the ...

Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

Science.gov (United States)

Engel, Lisa; Chui, Adora; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

2018-03-07

To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. Seven databases were searched in May 2015. Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Current status of evidence-based sports medicine.

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Harris, Joshua D; Cvetanovich, Gregory; Erickson, Brandon J; Abrams, Geoffrey D; Chahal, Jaskarndip; Gupta, Anil K; McCormick, Frank M; Bach, Bernard R

2014-03-01

The purpose of this investigation is to determine the proportion of sports medicine studies that are labeled as Level I Evidence in 5 journals and compare the quality of surgical and nonsurgical studies using simple quality assessment tools (Consolidated Standards of Reporting Trials [CONSORT] and Jadad). By use of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines over the prior 2 years in the top 5 (citation and impact factor based) sports medicine journals, only Level I Evidence studies were eligible for inclusion and were analyzed. All study types (therapeutic, prognostic, diagnostic, and economic) were analyzed. Study quality was assessed with the level of evidence, Jadad score, and CONSORT 2010 guidelines. Study demographic data were compared among journals and between surgical and nonsurgical studies by use of χ(2), 1-way analysis of variance, and 2-sample Z tests. We analyzed 190 Level I Evidence studies (10% of eligible studies) (119 randomized controlled trials [RCTs]). Therapeutic, nonsurgical, single-center studies from the United States were the most common studies published. Sixty-two percent of studies reported a financial conflict of interest. The knee was the most common body part studied, and track-and-field/endurance sports were the most common sports analyzed. Significant differences (P journals reviewed. Overall, the Jadad and CONSORT scores were 2.71 and 77%, respectively. No differences (P > .05) were shown among journals based on the proportion of Level I studies or appropriate randomization. Significant strengths and limitations of RCTs were identified. This study showed that Level I Evidence and RCTs comprise 10% and 6% of contemporary sports medicine literature, respectively. Therapeutic, nonsurgical, single-center studies are the most common publications with Level I Evidence. Significant differences across sports medicine journals were found in study quality. Surgical studies appropriately described

Using evidence-based medicine to protect healthcare workers from pandemic influenza: Is it possible?

Science.gov (United States)

Gralton, Jan; McLaws, Mary-Louise

2011-01-01

To use evidence-based principles to develop infection control algorithms to ensure the protection of healthcare workers and the continuity of health service provision during a pandemic. : Evidence-based algorithms were developed from published research as well as "needs and values" assessments. Research evidence was obtained from 97 studies reporting the protectiveness of antiviral prophylaxis, seasonal vaccination, and mask use. Needs and values assessments were undertaken by international experts in pandemic infection control and local healthcare workers. Opportunity and resources costs were not determined. The Australian government commissioned the development of an evidence-based algorithm for inclusion in the 2008 revision of the Australian Health and Management Plan for Pandemic Influenza. Two international infection control teams responsible for healthcare worker safety during the Severe Acute Respiratory Syndrome outbreak reviewed the evidence-based algorithms. The algorithms were then reviewed for needs and values by eight local clinicians who were considered key frontline clinicians during the contain and sustain phases. The international teams reviewed for practicability of implementation, whereas local clinicians reviewed for clinician compliance. Despite strong evidence for vaccination and antiviral prophylaxis providing significant protection, clinicians believed they required the additional combinations of both masks and face shields. Despite the equivocal evidence for the efficacy of surgical and N95 masks and the provision of algorithms appropriate for the level of risk according to clinical care during a pandemic, clinicians still demanded N95 masks plus face shields in combination with prophylaxis and novel vaccination. Conventional evidence-based principles could not be applied to formulate recommendations due to the lack of pandemic-specific efficacy data of protection tools and the inherent unpredictability of pandemics. As an alternative

The scale of the evidence base on the health effects of conventional yogurt consumption: findings of a scoping review

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Julie M Glanville

2015-10-01

Full Text Available Background: The health effects of conventional yogurt have been investigated for over a century; however, few systematic reviews have been conducted to assess the extent of the health benefits of yogurt.Objective: The aim of this scoping review was to assess the volume of available evidence on the health effects of conventional yogurt. Methods: The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013. Randomized controlled trials were selected and categorized according to the eligibility criteria established in the protocol. Results: 213 studies were identified as relevant to the scoping question. The number of eligible studies identified for each outcome were: bone health (14 studies, weight management and nutrition related health outcomes (81 studies, metabolic health (6 studies; cardiovascular health (57 studies; gastrointestinal health (24 studies; cancer (39 studies; diabetes (13 studies, Parkinson’s disease risk (3 studies, all-cause mortality (3 studies, skin complaints (3 studies, respiratory complaints (3 studies, joint pain/function (2 studies; the remaining 8 studies reported a variety of other outcomes. For studies of a similar design and which assessed the same outcomes in similar population groups, we report the potential for the combining of data across studies in systematic reviews. Conclusions: This scoping review has revealed the extensive evidence base for many outcomes which could be the focus of systematic reviews exploring the health effects of yogurt consumption.

The scale of the evidence base on the health effects of conventional yogurt consumption: findings of a scoping review

Science.gov (United States)

Glanville, Julie M.; Brown, Sam; Shamir, Raanan; Szajewska, Hania; Eales, Jacqualyn F.

2015-01-01

Background: The health effects of conventional yogurt have been investigated for over a century; however, few systematic reviews have been conducted to assess the extent of the health benefits of yogurt. Objective: The aim of this scoping review was to assess the volume of available evidence on the health effects of conventional yogurt. Methods: The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013. Randomized controlled trials were selected and categorized according to the eligibility criteria established in the protocol. Results: 213 studies were identified as relevant to the scoping question. The number of eligible studies identified for each outcome were: bone health (14 studies), weight management and nutrition related health outcomes (81 studies), metabolic health (6 studies); cardiovascular health (57 studies); gastrointestinal health (24 studies); cancer (39 studies); diabetes (13 studies), Parkinson's disease risk (3 studies), all-cause mortality (3 studies), skin complaints (3 studies), respiratory complaints (3 studies), joint pain/function (2 studies); the remaining 8 studies reported a variety of other outcomes. For studies of a similar design and which assessed the same outcomes in similar population groups, we report the potential for the combining of data across studies in systematic reviews. Conclusions: This scoping review has revealed the extensive evidence base for many outcomes which could be the focus of systematic reviews exploring the health effects of conventional yogurt consumption. PMID:26578956

Updates from Astrobites: The Astro-ph Reader's Digest

Science.gov (United States)

Montet, Benjamin; Chisari, N.; Donaldson, J.; Dressing, C. D.; Drout, M.; Faesi, C.; Fuchs, J. T.; Kohler, S.; Lovegrove, E.; Mills, E. A.; Nesvold, E.; Newton, E. R.; Olmstead, A.; Vasel, J. A.; Weiss, L. M.; Astrobites Team

2014-01-01

Astrobites (http://astrobites.com) is a daily blog aimed at undergraduates interested in astrophysical research and written by a team of graduate students located at diverse institutions across the United States. Primarily, we present journal articles recently posted to astro-ph in a brief format that is accessible to anyone with a general background in the physical sciences, including readers who are not yet familiar with the astrophysical literature. Special posts offer career guidance for undergraduates (e.g. applying for an NSF graduate fellowship) and describe personal experiences (e.g. attending an astronomy summer school). We present recent readership statistics and potential methods for incorporating Astrobites into the classroom. We also discuss the Astrobites format across multiple social media platforms, including the newly launched Astroplots, and highlight our recent work organizing the annual "Communicating Science" workshop for graduate students.

Book Review: Market Liquidity: Theory, Evidence, and Policy

DEFF Research Database (Denmark)

Boscan, Luis

2014-01-01

Review of: Market Liquidity: Theory, Evidence, and Policy / by Thierry Foucault, Marco Pagano and Ailsa Röell. Oxford University Press. April 2013.......Review of: Market Liquidity: Theory, Evidence, and Policy / by Thierry Foucault, Marco Pagano and Ailsa Röell. Oxford University Press. April 2013....

Why is the center of evidence - based dermatology relevant to Indian dermatology ?

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Williams Hywel

2009-01-01

Full Text Available Evidence-based dermatology is the application of high-quality evidence to the care of individual patients with skin diseases. The Centre of Evidence-Based Dermatology in the UK promotes activities in this field through its three interlinking cogs, composed of the international Cochrane Skin Group, the UK Dermatology Clinical Trials Network (UKDCTN, and the UK national electronic library for skin disorders. The Cochrane Skin Group summarises what is already known about health care interventions by supporting systematic reviews of relevant randomized controlled trials (RCTs. The UKDCTN then addresses the key research gaps identified in systematic reviews by coordinating and carrying out well-designed RCTs. The Skin Disorders specialist library then plays a key role in disseminating new knowledge from systematic reviews and RCTs to a community of clinical users. The electronic resources at the Centre of Evidence-Based Dermatology are all freely available to Indian Dermatologists who can use the resources in a way that could benefit their patients. Such new knoweldge only has value if it is shared and used.

Evidence-Based Assessment of Obsessive–Compulsive Disorder

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Amy M. Rapp

2016-01-01

Full Text Available Obsessive–compulsive disorder (OCD is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress.

The Benefits of Breakfast Cereal Consumption: A Systematic Review of the Evidence Base 1 2 3 4

OpenAIRE

Williams, Peter G.

2014-01-01

There have been no comprehensive reviews of the relation of breakfast cereal consumption to nutrition and health. This systematic review of all articles on breakfast cereals to October 2013 in the Scopus and Medline databases identified 232 articles with outcomes related to nutrient intake, weight, diabetes, cardiovascular disease, hypertension, digestive health, dental and mental health, and cognition. Sufficient evidence was available to develop 21 summary evidence statements, ranked from A...

Factor analysis methods and validity evidence: A systematic review of instrument development across the continuum of medical education

Science.gov (United States)

Wetzel, Angela Payne

Previous systematic reviews indicate a lack of reporting of reliability and validity evidence in subsets of the medical education literature. Psychology and general education reviews of factor analysis also indicate gaps between current and best practices; yet, a comprehensive review of exploratory factor analysis in instrument development across the continuum of medical education had not been previously identified. Therefore, the purpose for this study was critical review of instrument development articles employing exploratory factor or principal component analysis published in medical education (2006--2010) to describe and assess the reporting of methods and validity evidence based on the Standards for Educational and Psychological Testing and factor analysis best practices. Data extraction of 64 articles measuring a variety of constructs that have been published throughout the peer-reviewed medical education literature indicate significant errors in the translation of exploratory factor analysis best practices to current practice. Further, techniques for establishing validity evidence tend to derive from a limited scope of methods including reliability statistics to support internal structure and support for test content. Instruments reviewed for this study lacked supporting evidence based on relationships with other variables and response process, and evidence based on consequences of testing was not evident. Findings suggest a need for further professional development within the medical education researcher community related to (1) appropriate factor analysis methodology and reporting and (2) the importance of pursuing multiple sources of reliability and validity evidence to construct a well-supported argument for the inferences made from the instrument. Medical education researchers and educators should be cautious in adopting instruments from the literature and carefully review available evidence. Finally, editors and reviewers are encouraged to recognize

Evidence Based Medicine Teaching in Undergraduate Medical Education: A Literature Review

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Misa Mi

2012-09-01

Full Text Available Objectives – To determine the year when evidence based medicine (EBM wasintroduced and the extent to which medical students were exposed to EBM inundergraduate medical education and to investigate how EBM interventions weredesigned, developed, implemented, and evaluated in the medical curriculum.Methods – A qualitative review of the literature on EBM interventions was conductedto synthesize results of studies published from January 1997 to December 2011. Acomprehensive search was performed on PubMed, CINAHL, Web of Science,Cochrane Library, ProQuest Dissertations & Theses, PsycINFO, and ERIC. Articleswere selected if the studies involved some form of quantitative and qualitativeresearch design. Articles were excluded if they studied EBM interventions in medicalschools outside the United States or if they examined EBM interventions for alliedhealth profession education or at the levels of graduate medical education andcontinuing medical education. Thirteen studies which met the selection criteria wereidentified and reviewed. Information was abstracted including study design, year andsetting of EBM intervention, instructional method, instruction delivery format,outcome measured, and evaluation method.Results – EBM was introduced to preclinical years in three studies, integrated intoclinical clerkship rotations in primary care settings in eight studies, and spannedpreclinical and clinical curricula in two studies. The duration of EBM interventionsdiffered, ranging from a workshop of three student contact hours to a curriculum of 30 student contact hours. Five studies incorporated interactive and clinically integrated teaching and learning activities to support student learning. Diverse research designs, EBM interventions, and evaluation methods resulted in heterogeneity in results across the 13 studies.Conclusions – The review reveals wide variations in duration of EBM interventions, instructional methods, delivery formats for EBM

Snappy answers to stupid questions: an evidence-based framework for responding to peer-review feedback

Science.gov (United States)

Rosenfield, Daniel; Hoffman, Steven J.

2009-01-01

Background Authors are inundated with feedback from peer reviewers. Although this feedback is usually helpful, it can also be incomprehensible, rude or plain silly. Inspired by Al Jaffe’s classic comic from Mad Magazine, we sought to develop an evidenced-based framework for providing “snappy answers to stupid questions,” in the hope of aiding emerging academics in responding appropriately to feedback from peer review. Methods We solicited, categorized and analyzed examples of silly feedback from peer reviewers using the grounded theory qualitative research paradigm from 50 key informants. The informants represented 15 different professions, 33 institutions and 11 countries (i.e., Australia, Barbados, Canada, Germany, Japan, New Zealand, South Africa, Sweden, Switzerland, UK and USA). Results We developed a Scale of Silliness (SOS) and a Scale of Belligerence (SOB) to facilitate the assessment of inadequate peer-review feedback and guide users in preparing suitable responses to it. The SOB score is tempered by users’ current mood, as captured by the Mood Reflective Index (MRI), and dictates the Appropriate Degree of Response (ADR) for the particular situation. Conclusion Designed using the highest quality of (most easily accessible anecdotal) evidence available, this framework may fill a significant gap in the research literature by helping emerging academics respond to silly feedback from peer reviewers. Although use of the framework to its full extent may have negative consequences (e.g., loss of promotion), its therapeutic value cannot be understated. PMID:19969574

Integration of an Evidence Base into a Probabilistic Risk Assessment Model. The Integrated Medical Model Database: An Organized Evidence Base for Assessing In-Flight Crew Health Risk and System Design

Science.gov (United States)

Saile, Lynn; Lopez, Vilma; Bickham, Grandin; FreiredeCarvalho, Mary; Kerstman, Eric; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

2011-01-01

This slide presentation reviews the Integrated Medical Model (IMM) database, which is an organized evidence base for assessing in-flight crew health risk. The database is a relational database accessible to many people. The database quantifies the model inputs by a ranking based on the highest value of the data as Level of Evidence (LOE) and the quality of evidence (QOE) score that provides an assessment of the evidence base for each medical condition. The IMM evidence base has already been able to provide invaluable information for designers, and for other uses.

Scientific evidence-based effects of hydrotherapy on various systems of the body.

Science.gov (United States)

Mooventhan, A; Nivethitha, L

2014-05-01

The use of water for various treatments (hydrotherapy) is probably as old as mankind. Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. Use of water in various forms and in various temperatures can produce different effects on different system of the body. Many studies/reviews reported the effects of hydrotherapy only on very few systems and there is lack of studies/reviews in reporting the evidence-based effects of hydrotherapy on various systems. We performed PubMed and PubMed central search to review relevant articles in English literature based on "effects of hydrotherapy/balneotherapy" on various systems of the body. Based on the available literature this review suggests that the hydrotherapy has a scientific evidence-based effect on various systems of the body.

Evidence on multimorbidity from definition to intervention: An overview of systematic reviews.

Science.gov (United States)

Xu, Xiaolin; Mishra, Gita D; Jones, Mark

2017-08-01

The increasing challenge of multiple chronic diseases (multimorbidity) requires more evidence-based knowledge and effective practice. In order to better understand the existing evidence on multimorbidity, we performed a systematic review of systematic reviews on multimorbidity with pre-established search strategies and exclusion criteria by searching multiple databases and grey literature. Of 8006 articles found, 53 systematic reviews (including meta-analysis and qualitative research synthesis performed in some reviews) that stated multimorbidity as the main focus were included, with 79% published during 2013-2016. Existing evidence on definition, measurement, prevalence, risk factors, health outcomes, clinical practice and medication (polypharmacy), and intervention and management were identified and synthesised. There were three major definitions from three perspectives. Seven studies on prevalence reported a range from 3.5% to 100%. As six studies showed, depression, hypertension, diabetes, arthritis, asthma, and osteoarthritis were prone to be comorbid with other conditions. Four groups of risk factors and eight multimorbidity associated outcomes were explored by five and six studies, respectively. Nine studies evaluated interventions, which could be categorized into either organizational or patient-oriented, the effects of these interventions were varied. Self-management process, priority setting and decision making in multimorbidity were synthesised by evidence from 4 qualitative systematic reviews. We were unable to draw solid conclusions from this overview due to the heterogeneity in methodology and inconsistent findings among included reviews. As suggested by all included studies, there is a need for prospective research, especially longitudinal cohort studies and randomized control trials, to provide more definitive evidence on multimorbidity. Copyright © 2017 Elsevier B.V. All rights reserved.

How evidence-based are the recommendations in evidence-based guidelines?

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Finlay A McAlister

2007-08-01

Full Text Available BACKGROUND: Treatment recommendations for the same condition from different guideline bodies often disagree, even when the same randomized controlled trial (RCT evidence is cited. Guideline appraisal tools focus on methodology and quality of reporting, but not on the nature of the supporting evidence. This study was done to evaluate the quality of the evidence (based on consideration of its internal validity, clinical relevance, and applicability underlying therapy recommendations in evidence-based clinical practice guidelines. METHODS AND FINDINGS: A cross-sectional analysis of cardiovascular risk management recommendations was performed for three different conditions (diabetes mellitus, dyslipidemia, and hypertension from three pan-national guideline panels (from the United States, Canada, and Europe. Of the 338 treatment recommendations in these nine guidelines, 231 (68% cited RCT evidence but only 105 (45% of these RCT-based recommendations were based on high-quality evidence. RCT-based evidence was downgraded most often because of reservations about the applicability of the RCT to the populations specified in the guideline recommendation (64/126 cases, 51% or because the RCT reported surrogate outcomes (59/126 cases, 47%. CONCLUSIONS: The results of internally valid RCTs may not be applicable to the populations, interventions, or outcomes specified in a guideline recommendation and therefore should not always be assumed to provide high-quality evidence for therapy recommendations.

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

Science.gov (United States)

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

2016-04-01

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

Establishing CASA as an evidence-based practice.

Science.gov (United States)

Lawson, Jennifer; Berrick, Jill Duerr

2013-01-01

In this article the authors examine the evidentiary status of the Court Appointed Special Advocates (CASA) program through a review of current research findings and a critical analysis of the study methodologies used to produce those findings. Due to the equivocal research findings and widespread methodological weaknesses (most notably selection bias) in the literature base, it is determined that there is not currently enough evidence to establish CASA as an evidence-based practice. In spite of the challenges to the feasibility of such research, a future research agenda is suggested that calls for the execution of large randomized controlled trials in order to produce findings that will inform a deeper understanding of CASA effectiveness in improving child outcomes.

Evidence-based radiography

International Nuclear Information System (INIS)

Hafslund, Bjorg; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica

2008-01-01

Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain

Astro. A multimedia System for training of personnel

International Nuclear Information System (INIS)

Garate Abenza, M.; Mercade Seijas, O.; Munoz, J.F.; Ruiz-Andino, J.L.

1994-01-01

ASTRO is an integrated software package used to train system operators and is directly applicable to all types of power-generation plant operator training. The following are its salient characteristics: - Installed in work stations with multimedia capabilities a user-friendly interface - Covers various types of instruction on theory, procedure and maintenance allowing the execution of trainee-customized courses. - Includes all the phases of the teaching-learning task: compilation or creation and adaptation of course design information, execution and evaluation. - Combines the capabilities of traditional teaching tools, focusing basically on theoretical training, with the power of necessary real-time simulators for the assimilation of operation and maintenance procedures. Moreover, it provides the capacity to extract information instantly from the simulated system, without existing the simulation process. - It is run on inexpensive platforms (work stations) as compared to the traditional system of simulator training or training at site. (Author)

The ICARUS project. An underground observatory for astro-particle physics

International Nuclear Information System (INIS)

Ereditato, A.

2004-01-01

The ICARUS project aims at the realization of a large-mass, high-sensitivity observatory at the Gran Sasso underground Laboratory for the observation of rare astro-particle reactions, such as the interaction of astrophysical and accelerator neutrinos, and the nucleon decay. The detection technique exploits large-volume Time Projection Chambers filled with liquid Argon (LAr TPC). The general principles of this technique are briefly recalled, together with the milestones in the establishment of the present status. The main focus is given to the realization and tests of the first large-mass (600 ton) detector module, built with fully industrial methods, suitable to be cloned in order to reach the final detector mass of about 3000 ton by 2006. (author)

Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review.

Science.gov (United States)

Kushnerev, E; Yates, J M

2015-10-01

The inferior alveolar nerve (IAN) and lingual (LN) are susceptible to iatrogenic surgical damage. Systematically review recent clinical evidence regarding IAN/LN repair methods and to develop updated guidelines for managing injury. Recent publications on IAN/LN microsurgical repair from Medline, Embase and Cochrane Library databases were screened by title/abstract. Main texts were appraised for exclusion criteria: no treatment performed or results provided, poor/lacking procedural description, cohort nerve recovery occurred after direct apposition and suturing if nerve ending gaps were nerve grafting (sural/greater auricular nerve). Timing of microneurosurgical repair after injury remains debated. Most authors recommend surgery when neurosensory deficit shows no improvement 90 days post-diagnosis. Nerve transection diagnosed intra-operatively should be repaired in situ; minor nerve injury repair can be delayed. No consensus exists regarding optimal methods and timing for IAN/LN repair. We suggest a schematic guideline for treating IAN/LN injury, based on the most current evidence. We acknowledge that additional RCTs are required to provide definitive confirmation of optimal treatment approaches. © 2015 John Wiley & Sons Ltd.

Estudio de caso: estrategias internacionales aplicadas a la empresa Astro Maquinaria Ltda.

OpenAIRE

Araujo Peñate, Ana Maria; Piza Mora, Juan David; Velasco Zamora, Maria Ximena

2013-01-01

En el estudio de caso se podrá encontrar información relacionada a la empresa ASTRO MAQUINARIA Ltda. la cual lleva más de 20 años en el mercado, generando soluciones a las necesidades de maquinaria y equipos, especialmente en el área de bombeo. Desde el principio la empresa ha estado importando desde Estados Unidos el portafolio de productos que ofrecen, actualmente tienen la representación comercial de la empresa Pentair Pump Group. Este estudio de caso pretende identificar cual es la estrat...

2014 Cardiovascular Risks SRP Evidence Review Final Report. [Evidence Review For: The Risk of Orthostatic Intolerance During Re-Exposure to Gravity

Science.gov (United States)

Steinberg, Susan; Ziegler, Michael; Carter, Jason; Claydon, Victoria; Krummen, David; Thomas, Gail

2015-01-01

The 2014 Cardiovascular Risks Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on December 17-18, 2014. The SRP reviewed the updated evidence report for The Risk of Orthostatic Intolerance During re-Exposure to Gravity (OI Risk). The SRP found the 2014 OI Evidence Report to be a well written, comprehensive overview of the OI risk; that clearly documents the key scientific evidence relevant for both mechanistic understanding and countermeasure development. The 2014 OI Evidence Report could be further strengthened by addressing the points discussed below.

Evidence-based decision making in health care settings: from theory to practice.

Science.gov (United States)

Kohn, Melanie Kazman; Berta, Whitney; Langley, Ann; Davis, David

2011-01-01

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.

NASA's Astro-Venture Engages Exceptional Students in Earth System Science Using Inquiry

Science.gov (United States)

Oguinn, C.

2003-12-01

Astro-Venture is an educational, interactive, multimedia Web environment highlighting NASA careers and astrobiology research in the areas of Astronomy, Geology, Biology and Atmospheric Sciences. Students in grades 5-8 role-play NASA careers, as they search for and design a planet with the necessary characteristics for human habitation. Astro-Venture uses online multimedia activities and off-line inquiry explorations to engage students in guided inquiry aligned with the 5 E inquiry model. This model has proven to be effective with exceptional students. Students are presented with the intellectual confrontation of how to design a planet and star system that would be able to meet their biological survival needs. This provides a purpose for the online and off-line explorations used throughout the site. Students first explore "what" conditions are necessary to support human habitability by engaging in multimedia training modules, which allow them to change astronomical, atmospheric, geological and biological aspects of the Earth and our star system and to view the effects of these changes on Earth. By focusing on Earth, students draw on their prior knowledge, which helps them to connect their new knowledge to their existing schema. Cause and effect relationships of Earth provide a concrete model from which students can observe patterns and generalize abstract results to an imagined planet. From these observations, students draw conclusions about what aspects allowed Earth to remain habitable. Once students have generalized needed conditions of "what" we need for a habitable planet, they conduct further research in off-line, standards-based classroom activities that also follow the inquiry model and help students to understand "why" we need these conditions. These lessons focus on standards-based concepts such as states of matter and the structure and movement of the Earth's interior. These lessons follow the inquiry structure commonly referred to as the five E's as

[Conservative treatment of nonspecific, chronic low back pain : Evidence of the efficacy - a systematic literature review].

Science.gov (United States)

Bredow, J; Bloess, K; Oppermann, J; Boese, C K; Löhrer, L; Eysel, P

2016-07-01

Non-specific chronic low back pain (NSCLBP): Which conservative therapy shows an evident effectiveness - A review of the current literature. Our results are based on literature reviews of current randomised control studies, reviews and meta-analysis drawn from the Cochrane Library and Medline-Database between the years 2004 until 2015. German and English Studies were included. We focused on different conservative Treatments of NSCLBP, which are listed at, the NVL-Guidelines. Based on the given evidence we evaluated their effectiveness. As part of the review we identified 4657 Publications, 85 were included in this study. Therapeutic options such as bed rest, TENS, Massage, Spine Supports, Back Schools and Antidepressants showed no evident effectiveness. Injections, NSAR analgesic therapy, Thermotherapy and Opioid analgesic therapy indicated a short-time effectiveness. A long term success (> 6 weeks) however, can not be shown. Only the Movement therapy can, in the summation of the included studies, postulate an evident (Evidence Level I) long-term effect treating NSCLBP. Only a few therapy options indicate a significant evident effectiveness for treating NSCLBP conservatively. At short notice methods such as injection therapy, thermo-therapy and analgesic therapies with NSAR and/or opioids help coping the acute phase. In the long term only movement therapy seems to provide an evident effectiveness. In the case of therapy-refractory NSCLBP a multimodal therapy should be considered.

Interventions for replacing missing teeth: Antibiotics in dental implant placement to prevent complications: Evidence summary of Cochrane review.

Science.gov (United States)

Jayaraman, Srinivasan

2015-01-01

The failure of dental implant can occurs at the preoperative planning stage, at the surgical stage, and at the postoperative stage. The success of this treatment can be increased if the clinical implant practice guidelines are prepared based on the recommendations from the highest level of research evidence (i.e.,) from systematic review of randomized controlled trials (RCTs) with meta-analysis. The Cochrane reviews of interventions are basically systematic reviews of RCTs with meta-analysis but follow a systematic methodological approach following the guidelines from Cochrane handbook for Systematic Reviews of Intervention. They give the current best evidence as they are updated every 2 years which is being the minimum period for an update. This evidence summary recommends the use of antibiotics, single dose of 2 g of amoxicillin 1 h prior to implant surgery to prevent implant failure, based on the body of evidence from the Cochrane review that was first published in 2003, 2008, and then updated twice in 2010 and 2013. The included studies are not from our population for the research question asked in this updated Cochrane review; hence, the need to do primary research in our population to support the available evidence is mandatory.

Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.

Science.gov (United States)

Robertson, Clare; Archibald, Daryll; Avenell, Alison; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne; Stewart, Fiona; Boachie, Charles; Fioratou, Evie; Wilkins, David; Street, Tim; Carroll, Paula; Fowler, Colin

2014-05-01

Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services. The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by integrating the quantitative, qualitative and health economic evidence base. Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database were searched from inception to January 2012, with a limited update search in July 2012. Subject-specific websites, reference lists and professional health-care and commercial organisations were also consulted. Six systematic reviews were conducted to consider the clinical effectiveness, cost-effectiveness and qualitative evidence on interventions for treating obesity in men, and men in contrast to women, and the effectiveness of interventions to engage men in their weight reduction. Randomised controlled trials (RCTs) with follow-up data of at least 1 year, or any study design and length of follow-up for UK studies, were included. Qualitative and mixed-method studies linked to RCTs and non-randomised intervention studies, and UK-based, men-only qualitative studies not linked to interventions were included. One reviewer extracted data from the included studies and a second reviewer checked data for omissions or inaccuracies. Two reviewers carried out quality assessment. We undertook meta-analysis of quantitative data and a realist approach to integrating the qualitative and quantitative evidence synthesis. From a total of 12,764 titles reviewed, 33 RCTs with 12 linked reports, 24 non-randomised reports, five economic evaluations with two

Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016.

Science.gov (United States)

Bikson, Marom; Grossman, Pnina; Thomas, Chris; Zannou, Adantchede Louis; Jiang, Jimmy; Adnan, Tatheer; Mourdoukoutas, Antonios P; Kronberg, Greg; Truong, Dennis; Boggio, Paulo; Brunoni, André R; Charvet, Leigh; Fregni, Felipe; Fritsch, Brita; Gillick, Bernadette; Hamilton, Roy H; Hampstead, Benjamin M; Jankord, Ryan; Kirton, Adam; Knotkova, Helena; Liebetanz, David; Liu, Anli; Loo, Colleen; Nitsche, Michael A; Reis, Janine; Richardson, Jessica D; Rotenberg, Alexander; Turkeltaub, Peter E; Woods, Adam J

2016-01-01

This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, and limited to, the absence of evidence for a Serious Adverse Effect, the criteria for which are rigorously defined. This review adopts an evidence-based approach, based on an aggregation of experience from human trials, taking care not to confuse speculation on potential hazards or lack of data to refute such speculation with evidence for risk. Safety data from animal tests for tissue damage are reviewed with systematic consideration of translation to humans. Arbitrary safety considerations are avoided. Computational models are used to relate dose to brain exposure in humans and animals. We review relevant dose-response curves and dose metrics (e.g. current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to theoretically vulnerable populations including children and the elderly, subjects with mood disorders, epilepsy, stroke, implants, and home users. Evidence from relevant animal models indicates that brain injury by Direct Current Stimulation (DCS) occurs at predicted brain current densities (6.3-13 A/m(2)) that are over an order of magnitude above those produced by conventional tDCS. To date, the use of conventional tDCS protocols in human trials (≤40 min, ≤4 milliamperes, ≤7.2 Coulombs) has not produced any reports of a Serious Adverse Effect or irreversible injury across over 33,200 sessions and 1000 subjects with repeated sessions. This includes a wide variety of subjects, including persons from potentially vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence-based Practice in libraries - Principles and discussions

DEFF Research Database (Denmark)

Johannsen, Carl Gustav

2012-01-01

The article examines problems concerning the introduction and future implementation of evidence-based practice (EBP) in libraries. It includes important conceptual distinctions and definitions, and it reviews the more controversial aspects of EBP, primarely based on experiences from Denmark. The ....... The purpose of the article is both to qualify existing scepticism and reservations and - maybe - to clarify misunderstandings and objections through the presentation of arguments and data....

Evidence-based review and appraisal of the use of droperidol in the emergency department

Directory of Open Access Journals (Sweden)

Pei-Chun Lai

2018-01-01

Full Text Available Droperidol is a short-acting, potent dopamine D2 antagonist that can pass through the blood–brain barrier. A black box warning was issued for droperidol by the United States Food and Drug Administration in 2001 because of a risk of development of torsades de pointes induced by QT prolongation. Many experts feel that the incidence of arrhythmia is overestimated, and low-dose droperidol is almost always used by anesthesiologists for postoperative nausea and vomiting. In this review, we used evidence-based analysis to appraise high-quality studies with a low risk of bias published after 2001 on the use of droperidol in the emergency department (ED. Droperidol appears not only efficacious but also safe to treat patients with nausea/vomiting, acute psychosis, and migraine in the ED. For these conditions, droperidol may be an option for shared decision-making.

Evidence-based medicine: Mandible fractures.

Science.gov (United States)

Morrow, Brad T; Samson, Thomas D; Schubert, Warren; Mackay, Donald R

2014-12-01

After studying this article, the participant should be able to: 1. Describe the anatomy and subunits of the mandible. 2. Review the cause and epidemiology of mandible fractures. 3. Discuss the preoperative evaluation and diagnostic imaging. 4. Understand the principles and techniques of mandible fracture reduction and fixation. The management of mandibular fractures has undergone significant improvement because of advancements in plating technology, imaging, and instrumentation. As the techniques in management continue to evolve, it is imperative for the practicing physician to remain up-to-date with the growing body of scientific literature. The objective of this Maintenance of Certification article is to present a review of the literature so that the physician may make treatment recommendation based on the best evidence available. Pediatric fractures have been excluded from this article.

Evidence-Based Practice in Liposuction.

Science.gov (United States)

Collins, Patrick S; Moyer, Kurtis E

2018-01-24

The goal of this study is to examine the existing peer reviewed literature comparing modern adjunctive techniques in liposuction including laser-assisted liposuction (LAL) and ultrasound-assisted liposuction (UAL) to standard suction-assisted liposuction (SAL). We intend to interpret these findings into a literature-based clinical application to influence practice patterns. A literature review was conducted using a keyword search in PubMed. Keyword search items included liposuction, lipoplasty, suction assisted liposuction, ultrasound assisted liposuction, laser assisted liposuction, tumescent, liposuction comparison, liposuction review, and combinations therein. Exclusion criteria included articles with a primary focus on histologic effects of energy devices, primary animal models, primary opinion papers with no reference to available data, and industry-sponsored publications. Inclusion criteria included articles with direct comparison of liposuction modalities, randomized or blinded studies, and studies with objective outcomes. Twenty-five articles that met the inclusion criteria comparing SAL to UAL or LAL out of 9972 articles identified were obtained. The selected literature was assigned into 3 categories: evidence demonstrating an advantage of 1 modality (SAL, UAL, or LAL) over another, evidence that showed no benefit of 1 modality over another, and evidence that demonstrated risks of complications of 1 modality over another. The benefits of UAL and LAL over SAL include the following: (1) UAL over SAL in the treatment of gynecomastia, (2) LAL and UAL over SAL with decreased hemoglobin/hematocrit in high-volume lipoaspirates, and (3) LAL over SAL with skin tightening in select areas specifically the submental area. Otherwise, the literature demonstrates equivocal results among the described techniques with no clear benefit to set one apart from the other. There appears to be no demonstrable added benefit to the addition of either UAL or LAL that would urge a

Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review

DEFF Research Database (Denmark)

Loving, Sys; Nordling, Jørgen; Jaszczak, Poul

2012-01-01

dysfunction is frequently cited as a possible aetiology. Physiotherapy is therefore recommended as one treatment modality. The aim of this systematic review was to source and critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment...... (RevMan) version 5.0 was used for data analysis. Effect estimates (relative risk, mean difference and mean change) with 95% confidence intervals were calculated for the above outcomes. For significant outcomes the numbers needed to treat were calculated. Results The search strategy identified 3469...... is a new approach that appears to be promising and randomised clinical trials are underway in order to establish its evidence base. Implications Based on the findings of this review, recommendations for physiotherapy in chronic pelvic pain clinical guidelines, textbooks and narrative reviews should...

EULAR evidence-based recommendations for the management of fibromyalgia syndrome

DEFF Research Database (Denmark)

Carville, S.F.; Arendt-Nielsen, S.; Bliddal, H.

2008-01-01

Objective: To develop evidence-based recommendations for the management of fibromyalgia syndrome. Methods: A multidisciplinary task force was formed representing 11 European countries. The design of the study, including search strategy, participants, interventions, outcome measures, data collection...... quality studies were used to base recommendations on. When there was insufficient evidence from the literature, a Delphi process was used to provide basis for recommendation. Results: 146 studies were eligible for the review. 39 pharmacological intervention studies and 59 non-pharmacological were included......-pharmacological''. In many studies sample size was small and the quality of the study was insufficient for strong recommendations to be made. Conclusions: Nine recommendations for the management of fibromyalgia syndrome were developed using a systematic review and expert consensus Udgivelsesdato: 2008/4...

The History of Evidence-Based Practice in Nursing Education and Practice.

Science.gov (United States)

Mackey, April; Bassendowski, Sandra

Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

Is the evidence supporting dental procedures strong? A survey of Cochrane systematic reviews in oral health.

Science.gov (United States)

Faggion, Clovis Mariano

2012-09-01

Every day a large number and variety of dental procedures are performed in clinical dental practice. There is, however, no information on the overall quality of evidence supporting these procedures. The objective of this study was to assess whether several common dental procedures are based on sound evidence. All Cochrane systematic reviews (CSR) published in dentistry were surveyed. The authors' conclusions about the quality of evidence supporting a specific clinical treatment were used as the measure of outcome. The evidence was considered adequate if the authors did not clearly state the evidence was weak in the conclusions while also suggesting some evidence of the effectiveness of the therapy. Of 120 CSRs assessed, in only 26 (22.0% of the reviews) was the quality of evidence regarded as adequate for supporting clinical decisions, although some methodological limitations were identified in the full text of these reviews. Moreover, the authors of most reviews reported weak or unavailable evidence. On the basis of CSRs, the overall quality of evidence can be regarded as low or nonexistent for most of the dental procedures assessed. The information reported may guide future research. Copyright © 2012 Elsevier Inc. All rights reserved.

Rotavirus vaccination and herd immunity: an evidence-based review

Directory of Open Access Journals (Sweden)

Seybolt LM

2012-06-01

Full Text Available Lorna M Seybolt, Rodolfo E BéguéDepartment of Pediatrics, Division of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, LA, USAAbstract: Until recently, rotavirus was the most common cause of diarrhea in infants and young children with over 100 million cases and 400,000 deaths every year worldwide. Yet, its epidemiology is changing rapidly with the introduction of two rotavirus vaccines in the mid 2000s. Both vaccines were shown to be highly efficacious in prelicensure studies to reduce severe rotavirus disease; the efficacy being more pronounced in high- and middle-income countries than in low-income countries. Herd immunity – the indirect protection of unimmunized individuals as a result of others being immunized – was not expected to be a benefit of rotavirus vaccination programs since the vaccines were thought to reduce severe disease but not to decrease virus transmission significantly. Postlicensure studies, however, have suggested that this assumption may need reassessment. Studies in a variety of settings have shown evidence of greater than expected declines in rotavirus disease. While these studies were not designed specifically to detect herd immunity – and few failed to detect this phenomenon – the consistency of the evidence is compelling. These studies are reviewed and described here. While further work is needed, clarifying the presence of herd immunity is not just an academic exercise but an important issue for rotavirus control, especially in lower income countries where the incidence of the disease is highest and the direct protection of the vaccines is lower.Keywords: rotavirus, vaccine, herd immunity, efficacy

The value of gynecologic cancer follow-up: evidence-based ignorance?

Science.gov (United States)

Lajer, Henrik; Jensen, Mette B; Kilsmark, Jannie; Albæk, Jens; Svane, Danny; Mirza, Mansoor R; Geertsen, Poul F; Reerman, Diana; Hansen, Kåre; Milter, Maya C; Mogensen, Ole

2010-11-01

To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. Systematic literature searches according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were conducted separately for each of the 4 perspectives. In addition, the organizational analysis included a nationwide questionnaire survey among all relevant hospital departments, and the operating costs were calculated. None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had poor sensitivity and specificity in detecting recurrence. Small changes in applied technologies and organization lead to substantial changes in costs. Substantial differences especially in frequency and applied methods were found between departments. The literature review did not find evidence that follow-up affects the women's quality of life. The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer. The conception of follow-up among physicians, patients, and their relatives therefore needs revision. Follow-up after treatment should have a clearly defined and evidence-based purpose. Based on the existing literature, this purpose should presently focus on other end points rather than early detection of relapse and improved survival. These end points could be quality of life, treatment toxicity, and economy.

Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions.

Science.gov (United States)

Davis, S Fowler; Enderby, P; Harrop, D; Hindle, L

2017-03-01

The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development and verification of signal processing system of avalanche photo diode for the active shields onboard ASTRO-H

Energy Technology Data Exchange (ETDEWEB)

Ohno, M., E-mail: ohno@hep01.hepl.hiroshima-u.ac.jp [Department of Physical Sciences, Hiroshima University, Hiroshima 739-8526 (Japan); Kawano, T.; Edahiro, I.; Shirakawa, H.; Ohashi, N.; Okada, C.; Habata, S.; Katsuta, J.; Tanaka, Y.; Takahashi, H.; Mizuno, T.; Fukazawa, Y. [Department of Physical Sciences, Hiroshima University, Hiroshima 739-8526 (Japan); Murakami, H.; Kobayashi, S.; Miyake, K.; Ono, K.; Kato, Y.; Furuta, Y.; Murota, Y.; Okuda, K. [Department of Physics, University of Tokyo, Tokyo 113-0033 (Japan); and others

2016-09-21

The hard X-ray Imager and Soft Gamma-ray Detector onboard ASTRO-H demonstrate high sensitivity to hard X-ray (5–80 keV) and soft gamma-rays (60–600 keV), respectively. To reduce the background, both instruments are actively shielded by large, thick Bismuth Germanate scintillators. We have developed the signal processing system of the avalanche photodiode in the BGO active shields and have demonstrated its effectiveness after assembly in the flight model of the HXI/SGD sensor and after integration into the satellite. The energy threshold achieved is about 150 keV and anti-coincidence efficiency for cosmic-ray events is almost 100%. Installed in the BGO active shield, the developed signal processing system successfully reduces the room background level of the main detector. - Highlights: • A detail of development of signal processing system for ASTRO-H is presented. • Digital filer with FPGA instead of discrete analog circuit is applied. • Expected performance is verified after integration of the satellite.

Target and (Astro-)WISE technologies Data federations and its applications

Science.gov (United States)

Valentijn, E. A.; Begeman, K.; Belikov, A.; Boxhoorn, D. R.; Brinchmann, J.; McFarland, J.; Holties, H.; Kuijken, K. H.; Kleijn, G. Verdoes; Vriend, W.-J.; Williams, O. R.; Roerdink, J. B. T. M.; Schomaker, L. R. B.; Swertz, M. A.; Tsyganov, A.; van Dijk, G. J. W.

2017-06-01

After its first implementation in 2003 the Astro-WISE technology has been rolled out in several European countries and is used for the production of the KiDS survey data. In the multi-disciplinary Target initiative this technology, nicknamed WISE technology, has been further applied to a large number of projects. Here, we highlight the data handling of other astronomical applications, such as VLT-MUSE and LOFAR, together with some non-astronomical applications such as the medical projects Lifelines and GLIMPS; the MONK handwritten text recognition system; and business applications, by amongst others, the Target Holding. We describe some of the most important lessons learned and describe the application of the data-centric WISE type of approach to the Science Ground Segment of the Euclid satellite.

Healthy food subsidies and unhealthy food taxation: A systematic review of the evidence.

Science.gov (United States)

Niebylski, Mark L; Redburn, Kimbree A; Duhaney, Tara; Campbell, Norm R

2015-06-01

The Global Burden of Disease Study and related studies report unhealthy diet is the leading risk for death and disability globally. Given the evidence associating diet and non-communicable diseases (NCDs), international and national health bodies including the World Health Organization and United Nations have called for population health interventions to improve diet as a means to target NCDs. One of the proposed interventions is to ensure healthy foods/beverages are more accessible to purchasers and unhealthy ones less accessible via fiscal policy, namely taxation and subsidies. The objective of this systematic review was to evaluate the evidence base to assess the effect of healthy food/beverage subsidies and unhealthy food/beverage taxation. A comprehensive review was conducted by searching PubMed, Medline, and Google Scholar for peer-reviewed publications and seventy-eight studies were identified for inclusion in this review. This review was performed in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Although moderate in quality, there was consistent evidence that taxation and subsidy intervention influenced dietary behaviors. The quality, level and strength of evidence along with identified gaps in research support the need for further policies and ongoing evaluation of population-wide food/beverage subsidies and taxation. To maximize success and effect, this review suggests that food taxes and subsidies should be a minimum of 10 to 15% and preferably used in tandem. Implementation of population-wide polices for taxation and subsides with ongoing evaluation of intended and unintended effects are supported by this review. Copyright © 2015 Elsevier Inc. All rights reserved.

The judgement process in evidence-based medicine and health technology assessment

OpenAIRE

Kelly, Michael P; Moore, Tessa A

2011-01-01

This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA). It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources. At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver...

Evidence based policy-making: A review

CSIR Research Space (South Africa)

Strydom, FW

2010-04-01

Full Text Available The process of facilitating the uptake of evidence, for example, scientific research findings, into the policymaking process is multifaceted and thus complex. It is therefore important for scientists to understand this process in order to influence...

Developing the skills required for evidence-based practice.

Science.gov (United States)

French, B

1998-01-01

The current health care environment requires practitioners with the skills to find and apply the best currently available evidence for effective health care, to contribute to the development of evidence-based practice protocols, and to evaluate the impact of utilizing validated research findings in practice. Current approaches to teaching research are based mainly on gaining skills by participation in the research process. Emphasis on the requirement for rigour in the process of creating new knowledge is assumed to lead to skill in the process of using research information created by others. This article reflects upon the requirements for evidence-based practice, and the degree to which current approaches to teaching research prepare practitioners who are able to find, evaluate and best use currently available research information. The potential for using the principles of systematic review as a teaching and learning strategy for research is explored, and some of the possible strengths and weakness of this approach are highlighted.

Evidence-based medicine: the value of vision screening.

Science.gov (United States)

Beauchamp, George R; Ellepola, Chalani; Beauchamp, Cynthia L

2010-01-01

To review the literature for evidence-based medicine (EBM), to assess the evidence for effectiveness of vision screening, and to propose moving toward value-based medicine (VBM) as a preferred basis for comparative effectiveness research. Literature based evidence is applied to five core questions concerning vision screening: (1) Is vision valuable (an inherent good)?; (2) Is screening effective (finding amblyopia)?; (3) What are the costs of screening?; (4) Is treatment effective?; and (5) Is amblyopia detection beneficial? Based on EBM literature and clinical experience, the answers to the five questions are: (1) yes; (2) based on literature, not definitively so; (3) relatively inexpensive, although some claim benefits for more expensive options such as mandatory exams; (4) yes, for compliant care, although treatment processes may have negative aspects such as "bullying"; and (5) economic productive values are likely very high, with returns of investment on the order of 10:1, while human value returns need further elucidation. Additional evidence is required to ascertain the degree to which vision screening is effective. The processes of screening are multiple, sequential, and complicated. The disease is complex, and good visual outcomes require compliance. The value of outcomes is appropriately analyzed in clinical, human, and economic terms.

Fibercore AstroGain fiber: multichannel erbium doped fibers for optical space communications

Science.gov (United States)

Hill, Mark; Gray, Rebecca; Hankey, Judith; Gillooly, Andy

2014-03-01

Fibercore have developed AstroGainTM fiber optimized for multichannel amplifiers used in optical satellite communications and control. The fiber has been designed to take full advantage of the photo-annealing effect that results from pumping in the 980nm region. The proprietary trivalent structure of the core matrix allows optimum recovery following radiation damage to the fiber, whilst also providing a market leading Erbium Doped Fiber Amplifier (EDFA) efficiency. Direct measurements have been taken of amplifier efficiency in a multichannel assembly, which show an effective photo-annealing recovery of up to 100% of the radiation induced attenuation through excitation of point defects.

Strength-based leadership coaching in organizations an evidence-based guide to positive leadership development

CERN Document Server

MacKie, Doug

2016-01-01

Positive organizational psychology, with its focus on the identification and development of strengths, is a natural ally to executive development and leadership coaching. However, this approach is only just beginning to come to the attention of organizations and consequently, the research base for strength-based coaching is in its early stages of development. Strength-based Leadership Coaching in Organizations reviews strength-based approaches to positive leadership development and evaluates the evidence for their effectiveness, critically assesses their apparent distinctiveness and considers how strengths can be reliably assessed and developed in their organizational context. This book reviews key areas of leader and team development are reviewed and outlines and describes a model of strengths development in organizations. The application of strength-based leadership coaching will be discussed from the managerial and external perspective within the context of career stage, seniority, role challenges and orga...

Food and Beverage Marketing in Schools: A Review of the Evidence

OpenAIRE

Velazquez, Cayley E.; Black, Jennifer L.; Potvin Kent, Monique

2017-01-01

Despite growing interest from government agencies, non-governmental organizations and school boards in restricting or regulating unhealthy food and beverage marketing to children, limited research has examined the emerging knowledge base regarding school-based food and beverage marketing in high-income countries. This review examined current approaches for measuring school food and beverage marketing practices, and evidence regarding the extent of exposure and hypothesized associations with c...

An evidence-based view on hyperbilirubinaemia

NARCIS (Netherlands)

Dijk, Peter H.; Hulzebos, Christian V.

Introduction: We conducted a review of the evidence which contributes to the current care of jaundiced newborn infants. Methods: Literature was searched for reviews and randomized controlled trials (RCTs). Results: Six Cochrane reviews and eight other reviews and eighteen recent RCTs are discussed.

International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease.

Science.gov (United States)

Fox, Susan H; Katzenschlager, Regina; Lim, Shen-Yang; Barton, Brandon; de Bie, Rob M A; Seppi, Klaus; Coelho, Miguel; Sampaio, Cristina

2018-03-23

The objective of this review was to update evidence-based medicine recommendations for treating motor symptoms of Parkinson's disease (PD). The Movement Disorder Society Evidence-Based Medicine Committee recommendations for treatments of PD were first published in 2002 and updated in 2011, and we continued the review to December 31, 2016. Level I studies of interventions for motor symptoms were reviewed. Criteria for inclusion and quality scoring were as previously reported. Five clinical indications were considered, and conclusions regarding the implications for clinical practice are reported. A total of 143 new studies qualified. There are no clinically useful interventions to prevent/delay disease progression. For monotherapy of early PD, nonergot dopamine agonists, oral levodopa preparations, selegiline, and rasagiline are clinically useful. For adjunct therapy in early/stable PD, nonergot dopamine agonists, rasagiline, and zonisamide are clinically useful. For adjunct therapy in optimized PD for general or specific motor symptoms including gait, rivastigmine is possibly useful and physiotherapy is clinically useful; exercise-based movement strategy training and formalized patterned exercises are possibly useful. There are no new studies and no changes in the conclusions for the prevention/delay of motor complications. For treating motor fluctuations, most nonergot dopamine agonists, pergolide, levodopa ER, levodopa intestinal infusion, entacapone, opicapone, rasagiline, zonisamide, safinamide, and bilateral STN and GPi DBS are clinically useful. For dyskinesia, amantadine, clozapine, and bilateral STN DBS and GPi DBS are clinically useful. The options for treating PD symptoms continues to expand. These recommendations allow the treating physician to determine which intervention to recommend to an individual patient. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

Twelve evidence-based principles for implementing self-management support in primary care.

Science.gov (United States)

Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

2010-12-01

Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

Hydration in advanced cancer: can bioelectrical impedance analysis improve the evidence base? A systematic review of the literature.

Science.gov (United States)

Nwosu, Amara Callistus; Mayland, Catriona R; Mason, Stephen R; Khodabukus, Andrew F; Varro, Andrea; Ellershaw, John E

2013-09-01

Decisions surrounding the administration of clinically assisted hydration to patients dying of cancer can be challenging because of the limited understanding of hydration in advanced cancer and a lack of evidence to guide health care professionals. Bioelectrical impedance analysis (BIA) has been used to assess hydration in various patient groupings, but evidence for its use in advanced cancer is limited. To critically appraise existing methods of hydration status assessment in advanced cancer and review the potential for BIA to assess hydration in advanced cancer. Searches were carried out in four electronic databases. A hand search of selected peer-reviewed journals and conference abstracts also was conducted. Studies reporting (de)hydration assessment (physical examination, biochemical measures, symptom assessment, and BIA) in patients with advanced cancer were included. The results highlight how clinical examination and biochemical tests are standard methods of assessing hydration, but limitations exist with these methods in advanced cancer. Furthermore, there is disagreement over the evidence for some commonly associated symptoms with dehydration in cancer. Although there are limitations with using BIA alone to assess hydration in advanced cancer, analysis of BIA raw measurements through the method of bioelectrical impedance vector analysis may have a role in this population. The benefits and burdens of providing clinically assisted hydration to patients dying of cancer are unclear. Bioelectrical impedance vector analysis shows promise as a hydration assessment tool but requires further study in advanced cancer. Innovative methodologies for research are required to add to the evidence base and ultimately improve the care for the dying. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Recruiting for Values in Healthcare: A Preliminary Review of the Evidence

Science.gov (United States)

Patterson, Fiona; Prescott-Clements, Linda; Zibarras, Lara; Edwards, Helena; Kerrin, Maire; Cousans, Fran

2016-01-01

Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several…

Management of skin toxicity during radiation therapy: a review of the evidence

International Nuclear Information System (INIS)

Kumar, S.; Juresic, E.; Barton, M.; Shafiq, J.

2010-01-01

Acute skin toxicity occurs in the majority of the patients undergoing radical radiotherapy. While a variety of topical agents and dressing are used to ameliorate side effects, there is minimal evidence to support their use. The aims of this study were to systematically review evidence on acute skin toxicity management and to assess the current practices in ANZ. A systematic review of the literature was conducted on studies published between 1980 and 2008. A meta-analysis was performed on articles on clinical trials reporting grade II or greater toxicity. Analyses were divided into breast (the most common site) and other sites. A survey of Radiation Oncology departments across ANZ was conducted to identify patterns of practices and compare these with the published evidence. Twenty-nine articles were reviewed. Only seven articles demonstrated statistically significant results for management of side-effects. These were for topical corticosteroids, hyaluronic acid, sucralfate, calendula, Cavilon cream (3M, St Paul, Minnesota, USA) and silver leaf dressing. Meta-analysis demonstrated statistical significance for the prophylactic use of topical agents in the management acute toxicity. The survey of departments had a low response rate but demonstrated variation in skin care practices across ANZ. A considerable number of these practices were based only on anecdotal evidence. Lack of evidence in the literature for the care of radiation skin reactions was associated with variation in practice. Only a limited number of studies have demonstrated a significant benefit of specific topical agents. There is a need for objective and prospective recording of skin toxicity to collect meaningful comparative data on which to base recommendations for practice.

Evidence-Based Scholarly Communication: Information Professionals Unlocking Translational Research

Directory of Open Access Journals (Sweden)

Philip J. Kroth

2010-12-01

Full Text Available The Evidence-Based Scholarly Communication Conference (EBSCC was held March 11-12, 2010 in Albuquerque, NM. The conference addressed the perceived gap in knowledge and training for scholarly communication principles in the National Institutes of Health (NIH Clinical and Translational Science Award (CTSA Program. The EBSCC brought together librarians and information specialists to share evidence based strategies for developing effective local scholarly communication support and training and, it is hoped, to form new coalitions to address this topic at the local and national levels. This brief communication summarizes the need for theconference, highlights the general sessions in order of presentation, and introduces the EBSCC research papers appearing in this issue of Evidence Based Library and Information Practice (EBLIP. It also includes a description of a unique peer-review process methodology pioneered at EBSCC.

An Evidence-Based Review Literature About Risk Indicators and Management of Unknown-Origin Xerostomia

Directory of Open Access Journals (Sweden)

Farzaneh Agha-hosseini

2013-01-01

Full Text Available Objective: This evidence-based article reviews risk indicators and management of unknown-origin xerostomia. Xerostomia and hyposalivation refer to different aspects of dry mouth. Xerostomia is a subjective sensation of dry mouth, whilst hyposalivation is defined as an objective assessment of reduced salivary flow rate. About 30% of the elderly (65 years and older experience xerostomia and hyposalivation. Structural and functional factors, or both may lead to salivary gland dysfunction.Study Selection: The EBM literature search was conducted by using the medical literature database MEDLINE via PubMed and OvidMedline search engines. Results were limited to English language articles (1965 to present including clinical trials (CT, randomized controlled trials (RCT, systematic reviews and review articles. Case control or cohort studies were included for the etiology.Results: Neuropathic etiology such as localized oral alteration of thermal sensations, saliva composition change (for example higher levels of K, Cl, Ca, IgA, amylase, calcium, PTH and cortisol, lower levels of estrogen and progesterone, smaller salivary gland size, and illnesses such as lichen planus, are risk indicators for unknown-origin xerostomia. The management is palliative and preventative. Management of symptoms includes drug administration (systemic secretogogues, saliva substitutes and bile secretion-stimulator, night guard, diet and habit modifications. Other managements may be indicated to treat adverse effects.Conclusion: Neuropathic etiology, saliva composition change, smaller salivary gland size, and illnesses such as oral lichen planus can be suggestive causes for unknown-origin xerostomia. However, longitudinal studies will be important to elucidate the causes of unknown-origin xerostomia.

Evidence-Base Update of Psychosocial Treatments for Child and Adolescent Depression

Science.gov (United States)

Weersing, V. Robin; Jeffreys, Megan; Do, Minh-Chau T.; Schwartz, Karen T. G.; Bolano, Carl

2017-01-01

Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30 year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and re-evaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in sub-clinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and Interpersonal Psychotherapy (IPT) are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the IPT literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. In conclusion, data on predictors, moderators, and mediators are examined and priorities for future research discussed. PMID:27870579

Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression.

Science.gov (United States)

Weersing, V Robin; Jeffreys, Megan; Do, Minh-Chau T; Schwartz, Karen T G; Bolano, Carl

2017-01-01

Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30-year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and reevaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in subclinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and interpersonal psychotherapy are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the interpersonal psychotherapy literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. Data on predictors, moderators, and mediators are examined and priorities for future research discussed.

Central presbycusis: a review and evaluation of the evidence.

Science.gov (United States)

Humes, Larry E; Dubno, Judy R; Gordon-Salant, Sandra; Lister, Jennifer J; Cacace, Anthony T; Cruickshanks, Karen J; Gates, George A; Wilson, Richard H; Wingfield, Arthur

2012-09-01

The authors reviewed the evidence regarding the existence of age-related declines in central auditory processes and the consequences of any such declines for everyday communication. This report summarizes the review process and presents its findings. The authors reviewed 165 articles germane to central presbycusis. Of the 165 articles, 132 articles with a focus on human behavioral measures for either speech or nonspeech stimuli were selected for further analysis. For 76 smaller-scale studies of speech understanding in older adults reviewed, the following findings emerged: (1) the three most commonly studied behavioral measures were speech in competition, temporally distorted speech, and binaural speech perception (especially dichotic listening); (2) for speech in competition and temporally degraded speech, hearing loss proved to have a significant negative effect on performance in most of the laboratory studies; (3) significant negative effects of age, unconfounded by hearing loss, were observed in most of the studies of speech in competing speech, time-compressed speech, and binaural speech perception; and (4) the influence of cognitive processing on speech understanding has been examined much less frequently, but when included, significant positive associations with speech understanding were observed. For 36 smaller-scale studies of the perception of nonspeech stimuli by older adults reviewed, the following findings emerged: (1) the three most frequently studied behavioral measures were gap detection, temporal discrimination, and temporal-order discrimination or identification; (2) hearing loss was seldom a significant factor; and (3) negative effects of age were almost always observed. For 18 studies reviewed that made use of test batteries and medium-to-large sample sizes, the following findings emerged: (1) all studies included speech-based measures of auditory processing; (2) 4 of the 18 studies included nonspeech stimuli; (3) for the speech-based measures

Central Presbycusis: A Review and Evaluation of the Evidence

Science.gov (United States)

Humes, Larry E.; Dubno, Judy R.; Gordon-Salant, Sandra; Lister, Jennifer J.; Cacace, Anthony T.; Cruickshanks, Karen J.; Gates, George A.; Wilson, Richard H.; Wingfield, Arthur

2018-01-01

Background The authors reviewed the evidence regarding the existence of age-related declines in central auditory processes and the consequences of any such declines for everyday communication. Purpose This report summarizes the review process and presents its findings. Data Collection and Analysis The authors reviewed 165 articles germane to central presbycusis. Of the 165 articles, 132 articles with a focus on human behavioral measures for either speech or nonspeech stimuli were selected for further analysis. Results For 76 smaller-scale studies of speech understanding in older adults reviewed, the following findings emerged: (1) the three most commonly studied behavioral measures were speech in competition, temporally distorted speech, and binaural speech perception (especially dichotic listening); (2) for speech in competition and temporally degraded speech, hearing loss proved to have a significant negative effect on performance in most of the laboratory studies; (3) significant negative effects of age, unconfounded by hearing loss, were observed in most of the studies of speech in competing speech, time-compressed speech, and binaural speech perception; and (4) the influence of cognitive processing on speech understanding has been examined much less frequently, but when included, significant positive associations with speech understanding were observed. For 36 smaller-scale studies of the perception of nonspeech stimuli by older adults reviewed, the following findings emerged: (1) the three most frequently studied behavioral measures were gap detection, temporal discrimination, and temporal-order discrimination or identification; (2) hearing loss was seldom a significant factor; and (3) negative effects of age were almost always observed. For 18 studies reviewed that made use of test batteries and medium-to-large sample sizes, the following findings emerged: (1) all studies included speech-based measures of auditory processing; (2) 4 of the 18 studies included

Nutraceuticals in the prophylaxis of pediatric migraine: Evidence-based review and recommendations.

Science.gov (United States)

Orr, Serena L; Venkateswaran, Sunita

2014-07-01

The literature on complementary and alternative medicine (CAM) is expanding. One of the most common conditions for which CAM is studied in the pediatric population is migraine. Nutraceuticals are a form of CAM that is being used for pediatric migraine prophylaxis. A literature search was carried out in order to identify both observational studies and randomized controlled trials on the use of nutraceuticals for the prophylaxis of pediatric migraine. Adult studies on included nutraceuticals were also reviewed. Thirty studies were reviewed on six different nutraceuticals: butterbur, riboflavin, ginkgolide B, magnesium, coenzyme Q10 and polyunsaturated fatty acids. Overall, the quality of the evidence for the use of nutraceuticals in pediatric migraine prophylaxis is poor. Further research needs to be done in order to study the efficacy of nutraceuticals for the prophylaxis of pediatric migraine. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

Science.gov (United States)

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.

A rapid evidence review on the effectiveness of institutional health partnerships.

Science.gov (United States)

Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

2015-12-14

Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically

Limitations in conduct and reporting of cochrane reviews rarely inhibit the determination of the validity of evidence for clinical decision-making.

Science.gov (United States)

Alper, Brian S; Fedorowicz, Zbys; van Zuuren, Esther J

2015-08-01

To determine how often clinical conclusions derived from Cochrane Reviews have uncertain validity due to review conduct and reporting deficiencies. We evaluated 5142 clinical conclusions in DynaMed (an evidence-based point-of-care clinical reference) based on 4743 Cochrane Reviews. Clinical conclusions with level 2 evidence due to shortcomings in the review's conduct or reporting (rather than deficiencies in the underlying evidence) were confirmed by a DynaMed editor and two Cochrane Review authors. Thirty-one Cochrane Reviews (0.65%) had confirmed deficiencies in conduct and reporting as the reason for classifying 37 assessed clinical conclusions (0.72%) as level 2 evidence. In all cases, it was not feasible for the assessors to specify a clear criticism of the studies included in the reviews. The deficiencies were specific to not accounting for dropouts (2) or inadequate assessment and reporting of allocation concealment (11), other specific trial quality criteria (14), or all trial quality criteria (4). Cochrane Reviews provide high-quality assessment and synthesis of evidence, with fewer than 1% of Cochrane Reviews having limitations which hinder the summary of best current evidence for clinical decision-making. We expect this will further decrease following recent Cochrane quality initiatives. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Recruiting for values in healthcare: a preliminary review of the evidence

OpenAIRE

Patterson, F.; Prescott-Clements, L.; Zibarras, L. D.; Edwards, H.; Kerrin, M.; Cousans, F.

2016-01-01

Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several different databases, journals and government reports were searched to retrieve studies relating to values-based recruitment published between 1998 a...

A systematic review of the individual determinants of research evidence use in allied health

Directory of Open Access Journals (Sweden)

Lizarondo L

2011-07-01

Full Text Available L Lizarondo, K Grimmer-Somers, S KumarInternational Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaBackground: The use of evidence-based practice (EBP is often not reflected in allied health (AH practitioners’ day-to-day practice (the research-practice gap. Research suggests that considerable differences between and within AH disciplines exist, which require different approaches in order to influence practice behavior. It is therefore important to develop a better understanding of what influences individual AH practitioners’ adoption of evidence into daily practice.Objective: This systematic review aims to examine the individual characteristics of AH practitioners which determine their uptake of evidence into practice.Methods: Studies which examined individual factors or variables that influence research evidence use by any AH practitioner were included in the review. The methodological quality of the included papers was assessed using the Quality Assessment and Validity Tool for Cross-sectional Studies. A narrative summary of the findings was presented.Results: Six studies were included and the methodological quality scores indicated that two were weak and the remainder had moderate–weak quality. The review demonstrated that factors such as educational degree or academic qualification, involvement in research or EBP-related activities, and practitioners’ perceptions, attitudes and beliefs about research and EBP are significant predictors of self-reported research evidence use in AH. The effect of other factors such as professional characteristics, clinical setting/work environment, information-seeking behavior and sociodemographic variables are less clear. Whether there is an interaction effect between evidence-uptake factors has not been tested.Conclusion: Improving the research knowledge of clinicians and overcoming negative attitudes toward EBP have the potential to move AH

Lofar information system design

NARCIS (Netherlands)

Valentijn, E.; Belikov, A. N.

2009-01-01

The Lofar Information System is a solution for Lofar Long Term Archive that is capable to store and handle PBs of raw and processed data. The newly created information system is based on Astro-WISE - the information system for wide field astronomy. We review an adaptation of Astro-WISE for the new

Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol

Directory of Open Access Journals (Sweden)

Hill Sophie

2012-03-01

Full Text Available Abstract Background Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. Methods This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1, we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2, before being uploaded to the Internet and evaluated (Stages 3 and 4. Discussion This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader

Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol.

Science.gov (United States)

Hill, Sophie; Filippini, Graziella; Synnot, Anneliese; Summers, Michael; Beecher, Deirdre; Colombo, Cinzia; Mosconi, Paola; Battaglia, Mario A; Shapland, Sue; Osborne, Richard H; Hawkins, Melanie

2012-03-16

Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4). This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for

Evidence-based gender findings for children affected by HIV and AIDS ? a systematic overview

OpenAIRE

Sherr, Lorraine; Mueller, Joanne; Varrall, Rebecca

2009-01-01

This review (under the International Joint Learning Initiative on Children and AIDS)provides a detailed evidence analysis of gender, children and AIDS. Six systematic reviews provide the most up to date evidence base on research surrounding children and HIV on key topics of treatment resistance and adherence, schooling, nutrition, cognitive development and orphaning and bereavement. Traditional systematic review techniques were used to identify all published studies on four key topics, then s...

The evidence base for psychological interventions for rheumatoid arthritis: A systematic review of reviews.

Science.gov (United States)

Prothero, Louise; Barley, Elizabeth; Galloway, James; Georgopoulou, Sofia; Sturt, Jackie

2018-06-01

Psychological interventions are an important but often overlooked adjunctive treatment option for patients with rheumatoid arthritis. Findings from systematic reviews of psychological interventions for this patient group are conflicting. A systematic review of reviews can explain inconsistencies between studies and provide a clearer understanding of the effects of interventions. To: 1) determine the effectiveness of psychological interventions in improving biopsychosocial outcomes for adults with rheumatoid arthritis, 2) determine the relationship between the intensity of the psychological interventions (number of sessions, duration of sessions, duration of intervention) on outcomes, and 3) assess the impact of comparator group (usual care, education only) on outcomes. We conducted a systematic review of reviews using the following inclusion criteria: 1) randomised controlled trials of psychological interventions (including cognitive behavioural therapy, supportive counselling, psychotherapy, self-regulatory techniques, mindfulness-based cognitive therapy and disclosure therapy) provided as an adjunct to medication, 2) included rheumatoid arthritis patients aged ≥ 18 years, 3) reported findings for at least 1 of the primary outcomes: pain, fatigue, psychological status, functional disability and disease activity and 4) were published in English between January 2000 and March 2015 (updated January 2018). We searched in MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. Reference lists were searched for additional reviews. Study selection and 50% of the quality assessments were performed by two independent reviewers. Methodological quality was measured using the Assessment of Multiple Systematic Reviews checklist. Data extraction was conducted by one reviewer using a predesigned data extraction form. Eight systematic reviews met inclusion criteria (one review was excluded due to

Simulation-Based Abdominal Ultrasound Training – A Systematic Review

DEFF Research Database (Denmark)

Østergaard, Mia L.; Ewertsen, Caroline; Konge, Lars

2016-01-01

of Science, and the Cochrane Library was searched. Articles were divided into three categories based on study design (randomized controlled trials, before-and-after studies and descriptive studies) and assessed for level of evidence using the Oxford Centre for Evidence Based Medicine (OCEBM) system......PURPOSE: The aim is to provide a complete overview of the different simulation-based training options for abdominal ultrasound and to explore the evidence of their effect. MATERIALS AND METHODS: This systematic review was performed according to the PRISMA guidelines and Medline, Embase, Web...

Evidence synthesis for decision making 7: a reviewer's checklist.

Science.gov (United States)

Ades, A E; Caldwell, Deborah M; Reken, Stefanie; Welton, Nicky J; Sutton, Alex J; Dias, Sofia

2013-07-01

This checklist is for the review of evidence syntheses for treatment efficacy used in decision making based on either efficacy or cost-effectiveness. It is intended to be used for pairwise meta-analysis, indirect comparisons, and network meta-analysis, without distinction. It does not generate a quality rating and is not prescriptive. Instead, it focuses on a series of questions aimed at revealing the assumptions that the authors of the synthesis are expecting readers to accept, the adequacy of the arguments authors advance in support of their position, and the need for further analyses or sensitivity analyses. The checklist is intended primarily for those who review evidence syntheses, including indirect comparisons and network meta-analyses, in the context of decision making but will also be of value to those submitting syntheses for review, whether to decision-making bodies or journals. The checklist has 4 main headings: A) definition of the decision problem, B) methods of analysis and presentation of results, C) issues specific to network synthesis, and D) embedding the synthesis in a probabilistic cost-effectiveness model. The headings and implicit advice follow directly from the other tutorials in this series. A simple table is provided that could serve as a pro forma checklist.

Evidence-Based Secondary Transition Practices for Enhancing School Completion

Science.gov (United States)

Test, David W.; Fowler, Catherine H.; White, James; Richter, Sharon; Walker, Allison

2009-01-01

Approximately 28% of students with disabilities do not complete high school (National Longitudinal Transition Study-2, 2005). This increases the likelihood that these students will experience low wages, high rates of incarceration, and limited access to postsecondary education. This article reviews evidence-based secondary transition practices…

Prevention of oral mucositis in children receiving cancer therapy: a systematic review and evidence-based analysis.

Science.gov (United States)

Qutob, Akram F; Gue, Sumant; Revesz, Tamas; Logan, Richard M; Keefe, Dorothy

2013-02-01

This systematic review investigated, critically appraised, and rated the evidence on agents used to prevent oral mucositis in children. A comprehensive search of the relevant literature was performed up to December 2011. Articles were included according to the inclusion/exclusion criteria and were critically appraised for validation and quality assessment using a checklist consisting of 18 categories. Each article was then rated for its strength of evidence. 16,471 articles were retrieved from 19 different databases and then reduced to 27 articles that fit the inclusion criteria. Five articles on oral care protocols supported their use to prevent oral mucositis in children. Seven articles on chlorhexidine mouthwash and three on laser therapy had conflicting evidence of its use. The preventative agents that were supported by one or two articles included: benzydamine mouthwash, iseganan mouthwash, granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash, oral/enteral glutamine, oral propantheline and cryotherapy, oral cryotherapy, oral sucralfate suspension, prostaglandin E2 tablets, and chewing gum. The reduction in the rates of occurrence of oral mucositis when using agents of fair (B) to good (A) evidence ranged from 22% to 52%. In conclusion, this review suggests the use of oral care protocols to prevent oral mucositis in children because of their strength of evidence (fair to good). The authors suggest avoiding agents with fair to good evidence against their use (oral sucralfate suspension, prostaglandin E2 tablets, and GM-CSF mouthwash). Agents with conflicting evidence (chlorhexidine mouthwash (used solely), laser therapy, and glutamine) should also be avoided until further research confirms their efficacy. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Preparing Dental Students and Residents to Overcome Internal and External Barriers to Evidence-Based Practice.

Science.gov (United States)

Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D

2016-10-01

In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.

Prosthetic joint infection development of an evidence-based diagnostic algorithm.

Science.gov (United States)

Mühlhofer, Heinrich M L; Pohlig, Florian; Kanz, Karl-Georg; Lenze, Ulrich; Lenze, Florian; Toepfer, Andreas; Kelch, Sarah; Harrasser, Norbert; von Eisenhart-Rothe, Rüdiger; Schauwecker, Johannes

2017-03-09

Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps. We reviewed relevant publications between 1990 and 2015 using a systematic literature search in MEDLINE and PUBMED. The selected search results were then classified into levels of evidence. The keywords were prosthetic joint infection, biofilm, diagnosis, sonication, antibiotic treatment, implant-associated infection, Staph. aureus, rifampicin, implant retention, pcr, maldi-tof, serology, synovial fluid, c-reactive protein level, total hip arthroplasty (THA), total knee arthroplasty (TKA) and combinations of these terms. From an initial 768 publications, 156 publications were stringently reviewed. Publications with class I-III recommendations (EAST) were considered. We developed an algorithm for the diagnostic approach to display the complex diagnosis of PJI in a clear and logically structured process according to ISO 5807. The evidence-based standardized algorithm combines modern clinical requirements and evidence-based treatment principles. The algorithm provides a detailed transparent standard operating procedure (SOP) for diagnosing PJI. Thus, consistently high, examiner-independent process quality is assured to meet the demands of modern quality management in PJI diagnosis.

Economic evidence for the prevention and treatment of atopic eczema: a protocol for a systematic review.

Science.gov (United States)

Sach, Tracey Helen; McManus, Emma; Mcmonagle, Christopher; Levell, Nick

2016-05-27

Eczema, synonymous with atopic eczema or atopic dermatitis, is a chronic skin disease that has a similar impact on health-related quality of life as other chronic diseases. The proposed research aims to provide a comprehensive systematic assessment of the economic evidence base available to inform economic modelling and decision making on interventions to prevent and treat eczema at any stage of the life course. Whilst the Global Resource of Eczema Trials (GREAT) database collects together the effectiveness evidence for eczema, there is currently no such systematic resource on the economics of eczema. It is important to gain an overview of the current state of the art of economic methods in the field of eczema in order to strengthen the economic evidence base further. The proposed study is a systematic review of the economic evidence surrounding interventions for the prevention and treatment of eczema. Relevant search terms will be used to search MEDLINE, EMBASE, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, National Health Service (NHS) Economic Evaluation Database, Health Technology Assessment, Cumulative Index to Nursing and Allied Health Literature, EconLit, Scopus, Cost-Effectiveness Analysis Registry and Web of Science in order to identify relevant evidence. To be eligible for inclusion studies will be primary empirical studies evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema. Two reviewers will independently assess studies for eligibility and perform data abstraction. Evidence tables will be produced presenting details of study characteristics, costing methods, outcome methods and quality assessment. The methodological quality of studies will be assessed using accepted checklists. The systematic review is being undertaken to identify the type of economic evidence available, summarise the results of the available

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

Directory of Open Access Journals (Sweden)

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.

An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions

Science.gov (United States)

Persaud, Ricardo; Garas, George; Silva, Sanjeev; Stamatoglou, Constantine; Chatrath, Paul; Patel, Kalpesh

2013-01-01

Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, ‘first bite syndrome’, facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as ‘the poison that heals’. PMID:23476731

Teaching Your First Astro 101 Course: What They Don't Tell You

Science.gov (United States)

Bruning, D.

2014-07-01

Designing your Astro 101 course should not be about what topics you can omit but should be a thoughtful process that regards your fundamental teaching goals and which topics and skills promote those goals. Establishing goals and assessments that lead to measurable student outcomes enable one to more constructively design a learning experience for students. Just as any good novel has multiple story lines that weave throughout the book, your course has several narratives that wind through different topics and help to tie goals together. Sharing this underlying organizational structure of your course with students helps them to connect ideas and be more successful.

Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review

Science.gov (United States)

2013-01-01

Background Levomepromazine is an antipsychotic drug that is used clinically for a variety of distressing symptoms in palliative and end-of-life care. We undertook a systematic review based on the question “What is the published evidence for the use of levomepromazine in palliative symptom control?”. Methods To determine the level of evidence for the use of levomepromazine in palliative symptom control, and to discover gaps in evidence, relevant studies were identified using a detailed, multi-step search strategy. Emerging data was then scrutinized using appropriate assessment tools, and the strength of evidence systematically graded in accordance with the Oxford Centre for Evidence-Based Medicine’s ‘levels of evidence’ tool. The electronic databases Medline, Embase, Cochrane, PsychInfo and Ovid Nursing, together with hand-searching and cross-referencing provided the full research platform on which the review is based. Results 33 articles including 9 systematic reviews met the inclusion criteria: 15 on palliative sedation, 8 regarding nausea and three on delirium and restlessness, one on pain and six with other foci. The studies varied greatly in both design and sample size. Levels of evidence ranged from level 2b to level 5, with the majority being level 3 (non-randomized, non-consecutive or cohort studies n = 22), with the quality of reporting for the included studies being only low to medium. Conclusion Levomepromazine is widely used in palliative care as antipsychotic, anxiolytic, antiemetic and sedative drug. However, the supporting evidence is limited to open series and case reports. Thus prospective randomized trials are needed to support evidence-based guidelines. PMID:23331515

Evidence-based medicine - an appropriate tool for evidence-based health policy? A case study from Norway.

Science.gov (United States)

Malterud, Kirsti; Bjelland, Anne Karen; Elvbakken, Kari Tove

2016-03-05

Evidence-based policy (EBP), a concept modelled on the principles of evidence-based medicine (EBM), is widely used in different areas of policymaking. Systematic reviews (SRs) with meta-analyses gradually became the methods of choice for synthesizing research evidence about interventions and judgements about quality of evidence and strength of recommendations. Critics have argued that the relation between research evidence and service policies is weak, and that the notion of EBP rests on a misunderstanding of policy processes. Having explored EBM standards and knowledge requirements for health policy decision-making, we present an empirical point of departure for discussing the relationship between EBM and EBP. In a case study exploring the Norwegian Knowledge Centre for the Health Services (NOKC), an independent government unit, we first searched for information about the background and development of the NOKC to establish a research context. We then identified, selected and organized official NOKC publications as an empirical sample of typical top-of-the-line knowledge delivery adhering to EBM standards. Finally, we explored conclusions in this type of publication, specifically addressing their potential as policy decision tools. From a total sample of 151 SRs published by the NOKC in the period 2004-2013, a purposive subsample from 2012 (14 publications) advised major caution about their conclusions because of the quality or relevance of the underlying documentation. Although the case study did not include a systematic investigation of uptake and policy consequences, SRs were found to be inappropriate as universal tools for health policy decision-making. The case study demonstrates that EBM is not necessarily suited to knowledge provision for every kind of policy decision-making. Our analysis raises the question of whether the evidence-based movement, represented here by an independent government organization, undertakes too broad a range of commissions using

Evidence-Based Mental Health Practices with Children Self-Efficacy Scale: Development and Preliminary Findings

Science.gov (United States)

McMeel, Lorri S.; Leathers, Sonya J.; Strand, Tonya C.

2017-01-01

This article reviews existing measures related to evidence-based practices with children and self-efficacy and describes the development and psychometric properties of the Evidence-Based Mental Health Practices With Children Efficacy Scale. This scale was developed to assess students' and clinicians' self-efficacy in their abilities to use…

Approaches to the Surveillance of Foodborne Disease: A Review of the Evidence.

Science.gov (United States)

Ford, Laura; Miller, Megge; Cawthorne, Amy; Fearnley, Emily; Kirk, Martyn

2015-12-01

Foodborne disease surveillance aims to reduce the burden of illness due to contaminated food. There are several different types of surveillance systems, including event-based surveillance, indicator-based surveillance, and integrated food chain surveillance. These approaches are not mutually exclusive, have overlapping data sources, require distinct capacities and resources, and can be considered a hierarchy, with each level being more complex and resulting in a greater ability to detect and control foodborne disease. Event-based surveillance is generally the least resource-intensive system and makes use of informal data sources. Indicator-based surveillance is seen as traditional notifiable disease surveillance and consists of routinely collected data. Integrated food chain surveillance is viewed as the optimal practice for conducting continuous risk analysis for foodborne diseases, but also requires significant ongoing resources and greater multisectoral collaboration compared to the other systems. Each country must determine the most appropriate structure for their surveillance system for foodborne diseases based on their available resources. This review explores the evidence on the principles, minimum capabilities, and minimum requirements of each type of surveillance and discusses examples from a range of countries. This review forms the evidence base for the Strengthening the Surveillance and Response for Foodborne Diseases: A Practical Manual.

Evaluation of nurse engagement in evidence-based practice.

Science.gov (United States)

Davidson, Judy E; Brown, Caroline

2014-01-01

The purpose of this project was to explore nurses' willingness to question and change practice. Nurses were invited to report practice improvement opportunities, and participants were supported through the process of a practice change. The project leader engaged to the extent desired by the participant. Meetings proceeded until the participant no longer wished to continue, progress was blocked, or practice was changed. Evaluation of the evidence-based practice change process occurred. Fifteen nurses reported 23 practice improvement opportunities. The majority (12 of 15) preferred to have the project leader review the evidence. Fourteen projects changed practice; 4 were presented at conferences. Multiple barriers were identified throughout the process and included loss of momentum, the proposed change involved other disciplines, and low level or controversial evidence. Practice issues were linked to quality metrics, cost of care, patient satisfaction, regulatory compliance, and patient safety. Active engagement by nurse leaders was needed for a practice change to occur. Participants identified important problems previously unknown to hospital administrators. The majority of nurses preferred involvement in practice change based on clinical problem solving when supported by others to provide literature review and manage the process through committees. Recommendations include supporting a culture that encourages employees to report practice improvement opportunities and provide resources to assist in navigating the identified practice change.

The State-of-the-art HST Astro-photometric Analysis of the Core of ω Centauri. I. The Catalog

Energy Technology Data Exchange (ETDEWEB)

Bellini, A.; Anderson, J.; Van der Marel, R. P. [Space Telescope Science Institute, 3700 San Martin Dr., Baltimore, MD 21218 (United States); Bedin, L. R.; Piotto, G. [Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Padova, v.co dell’Osservatorio 5, Padova I-35122 (Italy); King, I. R. [Department of Astronomy, University of Washington, Box 351580, Seattle, WA 98195, USA (United States); Cool, A., E-mail: bellini@stsci.edu [Department of Physics and Astronomy, San Francisco State University, 1600 Holloway Ave., San Francisco, CA 94132 (United States)

2017-06-10

We have constructed the most comprehensive catalog of photometry and proper motions ever assembled for a globular cluster (GC). The core of ω Cen has been imaged over 650 times through WFC3's UVIS and IR channels for the purpose of detector calibration. There exist from 4 to over 60 exposures through each of 26 filters stretching continuously from F225W in the UV to F160W in the infrared. Furthermore, the 11 yr baseline between these data and a 2002 ACS survey has allowed us to more than double the proper-motion accuracy and triple the number of well-measured stars compared to our previous groundbreaking effort. This totally unprecedented complete spectral coverage of over 470,000 stars within the cluster’s core, from the tip of the red giant branch down to the white dwarfs, provides the best astro-photometric observational database yet to understand the multiple-population phenomenon in any GC. In this first paper of the series, we describe in detail the data-reduction processes and deliver the astro-photometric catalog to the astronomical community.

Persistent misunderstandings about evidence-based (sorry: informed!) policy-making.

Science.gov (United States)

Bédard, Pierre-Olivier; Ouimet, Mathieu

2016-01-01

The field of research on knowledge mobilization and evidence-informed policy-making has seen enduring debates related to various fundamental assumptions such as the definition of 'evidence', the relative validity of various research methods, the actual role of evidence to inform policy-making, etc. In many cases, these discussions serve a useful purpose, but they also stem from serious disagreement on methodological and epistemological issues. This essay reviews the rationale for evidence-informed policy-making by examining some of the common claims made about the aims and practices of this perspective on public policy. Supplementing the existing justifications for evidence-based policy making, we argue in favor of a greater inclusion of research evidence in the policy process but in a structured fashion, based on methodological considerations. In this respect, we present an overview of the intricate relation between policy questions and appropriate research designs. By closely examining the relation between research questions and research designs, we claim that the usual points of disagreement are mitigated. For instance, when focusing on the variety of research designs that can answer a range of policy questions, the common critical claim about 'RCT-based policy-making' seems to lose some, if not all of its grip.

Evidence-based management of otitis media: a 5S model approach.

Science.gov (United States)

Wasson, J D; Yung, M W

2015-02-01

The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children. Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review. System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma. Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

Evidence Based Conservative Management of Patello-femoral Syndrome

Directory of Open Access Journals (Sweden)

E. Carlos Rodriguez-Merchan

2014-03-01

Full Text Available Background:   Patellofemoral pain syndrome (PFPS is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or   athletic activities. Patella dislocation is not included in PFPS.     Purpose:   This review analyzes the evidence based conservative management of PFPS.   Methods:   A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused   on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative   management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because   they were focused on the topic of the article. Overall ten articles were analyzed.     Results:   Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces.     Conclusions:   Non-steroidal anti-inflammatory drugs (NSAIDs may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for   patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited   with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has   been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed.    

Evidence-based information needs of public health workers: a systematized review

Directory of Open Access Journals (Sweden)

Jill Barr-Walker, MPH, MS

2017-01-01

Conclusions: Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers’ information needs.

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

NARCIS (Netherlands)

Melick, N. van; Cingel, R.E. van; Brooijmans, F.; Neeter, C.; Tienen, T. van; Hullegie, W.; Sanden, M.W. van der

2016-01-01

AIM: The Royal Dutch Society for Physical Therapy (KNGF) instructed a multidisciplinary group of Dutch anterior cruciate ligament (ACL) experts to develop an evidence statement for rehabilitation after ACL reconstruction. DESIGN: Clinical practice guideline underpinned by systematic review and

Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions.

Science.gov (United States)

Scurlock-Evans, Laura; Upton, Penney; Upton, Dominic

2014-09-01

Despite clear benefits of the Evidence-Based Practice (EBP) approach to ensuring quality and consistency of care, its uptake within physiotherapy has been inconsistent. Synthesise the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation. Literature concerning physiotherapists' practice between 2000 and 2012 was systematically searched using: Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature Plus, American Psychological Association databases, Medline, Journal Storage, and Science Direct. Reference lists were searched to identify additional studies. Thirty-two studies, focusing either on physiotherapists' EBP knowledge, attitudes or implementation, or EBP interventions in physiotherapy were included. One author undertook all data extraction and a second author reviewed to ensure consistency and rigour. Synthesis was organised around the themes of EBP barriers/enablers, attitudes, knowledge/skills, use and interventions. Many physiotherapists hold positive attitudes towards EBP. However, this does not necessarily translate into consistent, high-quality EBP. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP. Only studies published in the English language, in peer-reviewed journals were included, thereby introducing possible publication bias. Furthermore, narrative synthesis may be subject to greater confirmation bias. There is no "one-size fits all" approach to enhancing EBP implementation; assessing organisational culture prior to designing interventions is crucial. Although some interventions appear promising, further research is required to explore the most effective methods of supporting physiotherapists' adoption of EBP. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Blood donor deferral: time for change? An evidence-based analysis

Directory of Open Access Journals (Sweden)

Borra V

2016-05-01

Full Text Available Vere Borra,1 Giovani Vandewalle,1 Hans Van Remoortel,1 Veerle Compernolle,1,2 Emmy De Buck,1 Philippe Vandekerckhove1–31Belgian Red Cross-Flanders, Mechelen, 2Faculty of Medicine, University of Ghent, Ghent, 3Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, BelgiumAbstract: Donor selection remains an important part in the safety of the blood supply all over the world. Yet, donor deferral criteria seem to be strongly based on the precautionary principle protecting safety and quality, and on supply and expense considerations. This review therefore provides an overview of the available evidence on donor exclusion criteria, as well as on their cost-effectiveness, for the most frequent reasons of donor deferral in our region. PubMed was queried to retrieve primary research studies, systematic reviews, and health technology assessments (HTAs concerning donor exclusion criteria. With a similar approach, HTAs about the different blood-banking safety interventions were included. Reasons for donor deferral were recorded via the blood bank information system of the Belgian Red Cross-Flanders. Seven systematic reviews were identified: four on donor safety (hypotension, hypertension/type 2 diabetes, epilepsy, and higher age and three on recipient safety (hemochromatosis, men who have sex with men, and endoscopy. Forty-three low-quality observational studies were included, as well as 16 HTAs: three about donor exclusion criteria and 13 cost-utility analyses about blood-banking safety interventions. In general, the available evidence for deferral reasons was of low quality, and for 60% of the top 30 reasons for excluding donors, no evidence was found. Blood banking shows its unique position as many safety measures far exceed the normally accepted cost of €50,000/quality-adjusted life-years. The historical model based on the precautionary principle and on supply and expense considerations provides adequate supplies of

An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature

Directory of Open Access Journals (Sweden)

Hussain Nasir

2017-01-01

Full Text Available Within orthopedics, the use of platelet-rich plasma (PRP has been rapidly increasing in popularity, however, its true effectiveness has yet to be fully established. Several studies find that injecting PRP to the site of injury does not provide any significant benefit with respect to clinical outcomes; however, many others report the contrary. Due to the conflicting evidence and multiple meta-analyses conducted on the topic, a literature review of high-quality evidence on the use of PRP for common orthopaedic conditions was performed. Thus far, the evidence appears to suggest that PRP may provide some benefit in patients who present with knee osteoarthritis or lateral epicondylitis. On the other hand, evidence appears to be inconsistent or shows a minimal benefit for PRP usage in rotator cuff repair, patellar and Achilles tendinopathies, hamstring injuries, anterior cruciate ligament (ACL repair, and medial epicondylitis. There is limited confidence in the conclusions from the published meta-analyses due to issues with statistical pooling, and limited subgroup analyses exploring the substantial heterogeneity across studies. Evidence-based clinicians considering the use of PRP in their patients with musculoskeletal injuries should be weary that the literature appears to be inconsistent and thus far, inconclusive.

Evaluation of Evidence-based Nursing Pain Management Practice.

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Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

2015-08-01

It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality.

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Bardus, Marco; Smith, Jane R; Samaha, Laya; Abraham, Charles

2016-08-01

The use of Internet and related technologies for promoting weight management (WM), physical activity (PA), or dietary-related behaviours has been examined in many articles and systematic reviews. This overview aims to summarize and assess the quality of the review evidence specifically focusing on mobile and Web 2.0 technologies, which are the most utilized, currently available technologies. Following a registered protocol (CRD42014010323), we searched 16 databases for articles published in English until 31 December 2014 discussing the use of either mobile or Web 2.0 technologies to promote WM or related behaviors, i.e. diet and physical activity (PA). Two reviewers independently selected reviews and assessed their methodological quality using the AMSTAR checklist. Citation matrices were used to determine the overlap among reviews. Forty-four eligible reviews were identified, 39 of which evaluated the effects of interventions using mobile or Web 2.0 technologies. Methodological quality was generally low with only 7 reviews (16%) meeting the highest standards. Suggestive evidence exists for positive effects of mobile technologies on weight-related outcomes and, to a lesser extent, PA. Evidence is inconclusive regarding Web 2.0 technologies. Reviews on mobile and Web 2.0 interventions for WM and related behaviors suggest that these technologies can, under certain circumstances, be effective, but conclusions are limited by poor review quality based on a heterogeneous evidence base. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Measuring the Heat Load on the Flight ASTRO-H Soft Xray Spectrometer Dewar

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DiPirro, M.; Shirron, P.; Yoshida, S.; Kanao, K.; Tsunematsu, S.; Fujimoto, R.; Sneiderman, G.; Kimball, M.; Ezoe, Y.; Ishikawa, K.;

From Traditional Usage to Pharmacological Evidence: A Systematic Mini-Review of Spina Gleditsiae

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Jiayu Gao

2016-01-01

Full Text Available Spina Gleditsiae is an important herb with various medicinal properties in traditional and folk medicinal systems of East Asian countries. In China through the centuries, it has been traditionally used as a source of drugs for anticancer, detoxication, detumescence, apocenosis, and antiparasites effects. Recently, an increasing number of studies have been reported regarding its chemical constituents and pharmacological activities. To further evidence the traditional use, phytochemicals, and pharmacological mechanisms of this herb, a systematic literature review was performed herein for Spina Gleditsiae. The review approach consisted of searching several web-based scientific databases including PubMed, Web of Science, and Elsevier using the keywords “Spina Gleditsiae”, “Zao Jiao Ci”, and “Gleditsia sinensis”. Based on the proposed criteria, 17 articles were evaluated in detail. According to the reviewed data, it is quite evident that Spina Gleditsiae contains a number of bioactive phytochemical components, which account for variety medicinal values including anticancer, anti-inflammatory, antiatherogenic, antimicrobial, antiallergic, and antivirus activities. The phytochemical and pharmacological studies reviewed herein strongly underpin a fundamental understanding of herbal Spina Gleditsiae and support its ongoing clinical uses in China. The further phytochemical evaluation, safety verification, and clinical trials are expected to progress Spina Gleditsiae-based development to finally transform the traditional TCM herb Spina Gleditsiae to the valuable authorized drug.

Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction.

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Olivier, Jill; Tsimpo, Clarence; Gemignani, Regina; Shojo, Mari; Coulombe, Harold; Dimmock, Frank; Nguyen, Minh Cong; Hines, Harrison; Mills, Edward J; Dieleman, Joseph L; Haakenstad, Annie; Wodon, Quentin

2015-10-31

At a time when many countries might not achieve the health targets of the Millennium Development Goals and the post-2015 agenda for sustainable development is being negotiated, the contribution of faith-based health-care providers is potentially crucial. For better partnership to be achieved and for health systems to be strengthened by the alignment of faith-based health-providers with national systems and priorities, improved information is needed at all levels. Comparisons of basic factors (such as magnitude, reach to poor people, cost to patients, modes of financing, and satisfaction of patients with the services received) within faith-based health-providers and national systems show some differences. As the first report in the Series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health-care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered). The restricted and diverse evidence reported supports the idea that faith-based health providers continue to play a part in health provision, especially in fragile health systems, and the subsequent reports in this Series review controversies in faith-based health care and recommendations for how public and faith sectors might collaborate more effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

Review of the evidence on the use of arbitration or consensus within breast screening: A systematic scoping review

International Nuclear Information System (INIS)

Hackney, L.; Szczepura, A.; Moody, L.; Whiteman, B.

2017-01-01

Objectives: A systematic scoping review was undertaken to establish the evidence base on arbitration and consensus in mammography reporting. Database searches were supplemented with hand searching of peer-reviewed journals, citation tracking, key author searching, grey literature and personal contact with experts. A 3-stage process was utilised to screen a large volume of literature (601) against the inclusion and exclusion criteria. 26 papers were retained. Key findings: A lack of guidance and underpinning evidence to inform how best to use arbitration or consensus to resolve discordant reads. In particular, a lack of prospective studies to determine effectiveness in real-life clinical settings. Conclusion: The insufficiency of follow-up or reporting of true interval cancers compromised the ability to conclude the effectiveness of the processes. - Highlights: • Lack of guidance to inform how best to use arbitration or consensus. • Insufficient evidence to assess the effectiveness of one strategy versus the other. • International variance in strategies to resolve discordant cases.

[Evidence-based therapy of polycystic ovarian syndrome].

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Gődény, Sándor; Csenteri, Orsolya Karola

2015-11-08

Polycystic ovary syndrome is recognized as the most common hormonal and metabolic disorder likely to affect women. The heterogeneous endocrinopathy is characterized by clinical and/or biochemical hyperandrogenism, oligo- or amenorrhoea, anovulatory infertility, and polycystic ovarian morphology. The syndrome is often associated with obesity, hyperinsulinemia and adversely affects endocrine, metabolic, and cardiovascular health. The symptoms and complaint of the patients vary with age. To maximise health gain of the syndrome, adequate, evidence based effective, efficient and safe treatment is necessary. This article summarises the highest available evidence provided by studies, meta-analysis and systematic reviews about the therapeutical possibilities for treating obesity, hyperandrogenism, menstrual abnormalities, infertility and psychological problems related to polycystic ovary syndrome.

Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

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Elliott, Julian H; Turner, Tari; Clavisi, Ornella; Thomas, James; Higgins, Julian P T; Mavergames, Chris; Gruen, Russell L

2014-02-01

The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

The Stocker AstroScience Center at Florida International University

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Webb, James R.

2014-01-01

The new Stocker AstroScience Center located on the MMC campus at Florida International University in Miami Florida represents a unique facility for STEM education that arose from a combination of private, State and university funding. The building, completed in the fall of 2013, contains some unique spaces designed not only to educate, but also to inspire students interested in science and space exploration. The observatory consists of a 4-story building (3 floors) with a 24” ACE automated telescope in an Ash dome, and an observing platform above surrounding buildings. Some of the unique features of the observatory include an entrance/exhibition hall with a 6-ft glass tile floor mural linking the Florida climate to space travel, a state-of-the art telescope control that looks like a starship bridge, and displays such as “Music from the universe”. The observatory will also be the focus of our extensive public outreach program that is entering its 20 year.

Evidence-based review: Quality of life following head and neck intensity-modulated radiotherapy

International Nuclear Information System (INIS)

Scott-Brown, Martin; Miah, Aisha; Harrington, Kevin; Nutting, Chris

2010-01-01

Inverse planned Intensity modulated radiotherapy (IMRT) can minimize the dose to normal structures and therefore can reduce long-term radiotherapy-related morbidity and may improve patients' long-term quality of life. Despite overwhelming evidence that IMRT can reduce late functional deficits in patients with head and neck cancer, treated with radiotherapy, a review of the published literature produced conflicting results with regard to quality of life outcomes. Following a critical appraisal of the literature, reasons for the discrepant outcomes are proposed.

Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary

OpenAIRE

Cairns, G.; Angus, K.; Hastings, G.; Caraher, M.

2013-01-01

A 2009 systematic review of the international evidence on food and beverage marketing to children is the most recent internationally comprehensive review of the evidence base. Its findings are consistent with other independent, rigorous reviews conducted during the period 2003-2012. Food promotions have a direct effect on children's nutrition knowledge, preferences, purchase behaviour, consumption patterns and diet-related health. Current marketing practice predominantly promotes low nutritio...

Reduction of inequalities in health: assessing evidence-based tools

Directory of Open Access Journals (Sweden)

Shea Beverley

2006-09-01

Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

Evidence-based policy versus morality policy: the case of syringe access programs.

Science.gov (United States)

de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

2015-01-01

Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence.

Science.gov (United States)

Gillespie, David C; Bowen, Audrey; Chung, Charlie S; Cockburn, Janet; Knapp, Peter; Pollock, Alex

2015-02-01

Although cognitive impairments are common following stroke, there is considerable uncertainty about the types of interventions that can reduce activity restrictions and improve quality of life. Indeed, a recent project to identify priorities for research into life after stroke determined that the top priority for patients, carers and health professionals was how to improve cognitive impairments. To provide an overview of the evidence for the effectiveness of cognitive rehabilitation for patients with stroke and to determine the main gaps in the current evidence base. Evidence was synthesised for the six Cochrane reviews relating to rehabilitation for post-stroke cognitive impairment and any subsequently published randomized controlled trials to February 2012. Data arising from 44 trials involving over 1500 patients was identified. Though there was support for the effectiveness of cognitive rehabilitation for some cognitive impairments, significant gaps were found in the current evidence base. All of the Cochrane reviews identified major limitations within the evidence they identified. There is currently insufficient research evidence, or evidence of insufficient quality, to support clear recommendations for clinical practice. Recommendations are made as to the research required to strengthen the evidence base, and so facilitate the delivery of effective interventions to individuals with cognitive impairment after stroke. © The Author(s) 2014.

Business waste prevention: a review of the evidence.

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Wilson, David C; Parker, David; Cox, Jayne; Strange, Kit; Willis, Peter; Blakey, Nick; Raw, Lynn

2012-09-01

Waste prevention is a policy priority in many countries. For example, European Union member states are currently required to prepare a national Waste Prevention Programme. This article reports on a major international review of the evidence base for business waste prevention to underpin such policy-making. A strict definition of waste prevention is used, including waste avoidance, waste reduction at source or in process, and product reuse-recycling is outside the scope of this article. The review was organised with two key dimensions. Eight types of policy intervention were identified: standards, labelling, procurement, commitments and voluntary agreements, communication, incentives, waste minimisation clubs and other business support. Six illustrative sectors were selected: construction and demolition, food and drink, hospitality, retail, automotive and office-based services. Four broad approaches to business waste prevention have been distinguished and used as part of the analytical framework, classified into a two by two matrix, using supply- and demand-side drivers as one axis, and incremental versus radical change as the other. A fundamental focus was on attitudes and behaviours. A conceptual framework is presented to navigate the various behavioural influences on businesses, and to discuss those motivations and barriers for which the evidence is relatively robust. The results suggest that the (financial) benefits to business of waste prevention are potentially huge, and that some progress is being made, but measurement is a challenge. A taster of some of the learnings on the effectiveness of the different policy interventions to promote waste prevention is also presented.

[Evidence-based aspects of clinical mastitis treatment].

Science.gov (United States)

Mansion-de Vries, E M; Hoedemaker, M; Krömker, V

2015-01-01

Mastitis is one of the most common and expensive diseases in dairy cattle. The decision to treat clinical mastitis is usually made without any knowledge of the etiology, and can therefore only be evidence-based to a limited extent. Evidence-based medicine relies essentially on a combination of one's own clinical competence and scientific findings. In mastitis therapy, those insights depend mostly on pathogen-specific factors. Therefore, in evidence-based therapeutic decision making the pathogen identification should serve as a basis for the consideration of scientifically validated therapeutic concepts. The present paper considers evidence-based treatment of clinical mastitis based on a literature review. The authors conclude that an anti-inflammatory treatment using an NSAID should be conducted regardless of the pathogen. However, the choice of an antibiotic therapy depends on the mastitis causative pathogen, clinical symptoms and the animal itself. In principle, a local antibiotic treatment should be chosen for mild and moderate mastitis. It should be noted, that the benefit of an antibiotic therapy for coliform infections is questionable. With knowledge concerning the pathogen, it appears entirely reasonable to refrain from an antibiotic therapy. For severe (i.   e. feverish) mastitis, a parenteral antibiotic therapy should be selected. An extension of the antibiotic therapy beyond the manufacturer's information is only reasonable for streptococcal infections. It is important to make the decision on a prolonged antibiotic therapy only with the knowledge of the mastitis-causative pathogen. In terms of the therapy of a staphylococcus or streptococcus infection, a narrow-spectrum antibiotic from the penicillin family should be adopted when selecting the active agents.

How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P

Directory of Open Access Journals (Sweden)

Wilson Philip

2012-11-01

Full Text Available Abstract Background Interventions to promote positive parenting are often reported to offer good outcomes for children but they can consume substantial resources and they require rigorous appraisal. Methods Evaluations of the Triple P parenting program were subjected to systematic review and meta-analysis with analysis of biases. PsychInfo, Embase and Ovid Medline were used as data sources. We selected published articles reporting any child-based outcome in which any variant of Triple P was evaluated in relation to a comparison condition. Unpublished data, papers in languages other than English and some book chapters were not examined. Studies reporting Eyberg Child Behavior Inventory or Child Behavior Checklist scores as outcomes were used in the meta-analysis. Results A total of 33 eligible studies was identified, most involving media-recruited families. Thirty-one of these 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. Most papers only reported maternal assessments of child behavior. Twenty-three papers were incorporated in the meta-analysis. No studies involved children younger than two-years old and comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. For maternally-reported outcomes the summary effect size was 0.61 (95%CI 0.42, 0.79. Paternally-reported outcomes following Triple P intervention were smaller and did not differ significantly from the control condition (effect size 0.42 (95%CI -0.02, 0.87. The two studies involving an active control group showed no between-group differences. There was limited evidence of publication bias, but there was substantial selective reporting bias, and preferential reporting of positive results in article abstracts. Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel. No trials were registered and only two papers contained conflict of interest

No evidence-based restoration without a sound evidence base: a reply to Guldemond et al.

CSIR Research Space (South Africa)

Ntshotsho, P

2012-03-01

Full Text Available Evidence-based practice is not possible without an evidence base. Guldemond et al. confuse our attempt at assessing the status of the evidence base of restoration programs in South Africa with attempting to assess whether restoration is evidence...

An Evidence-Based Systematic Review on Communication Treatments for Individuals with Right Hemisphere Brain Damage

Science.gov (United States)

Blake, Margaret Lehman; Frymark, Tobi; Venedictov, Rebecca

2013-01-01

Purpose: The purpose of this review is to evaluate and summarize the research evidence related to the treatment of individuals with right hemisphere communication disorders. Method: A comprehensive search of the literature using key words related to right hemisphere brain damage and communication treatment was conducted in 27 databases (e.g.,…

AstroSat /LAXPC Detection of Millisecond Phenomena in 4U 1728-34

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Chauhan, Jai Verdhan; Yadav, J S; Antia, H M; Dedhia, Dhiraj; Katoch, Tilak; Madhwani, P.; Shah, Parag [Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai (India); Misra, Ranjeev; Pahari, Mayukh [Inter-University Centre for Astronomy and Astrophysics, Pune 411007 (India); Agrawal, P C [UM-DAE Center of Excellence for Basic Sciences, University of Mumbai, Kalina, Mumbai-400098 (India); Sridhar, Navin [Indian Institute of Science Education and Research, Bhauri, Bhopal 462066 (India); Manchanda, R K [University of Mumbai, Kalina, Mumbai-400098 (India); Paul, B, E-mail: jai.chauhan@tifr.res.in [Dept. of Astronomy and Astrophysics, Raman Research Institute, Bengaluru-560080 (India)

2017-05-20

The low-mass X-ray binary 4U 1728-24 was observed with AstroSat /LAXPC on 2016 March 8th. Data from a randomly chosen orbit of over 3 ks was analyzed for detection of rapid intensity variations. We found that the source intensity was nearly steady but, toward the end of the observation, a typical Type-1 burst was detected. Dynamical power spectrum of the data in the 3–20 keV band, reveals the presence of a kHz Quasi-Periodic Oscillation (QPO) for which the frequency drifted from ∼815 Hz at the beginning of the observation to about 850 Hz just before the burst. The QPO is also detected in the 10–20 keV band, which was not obtainable by earlier RXTE observations of this source. Even for such a short observation with a drifting QPO frequency, the time lag between the 5–10 and 10–20 keV bands can be constrained to be less than 100 microseconds. The Type-1 burst that lasted for about 20 s had a typical profile. During the first four seconds, dynamic power spectra reveal a burst oscillation for which the frequency increased from ∼361.5 to ∼363.5 Hz. This is consistent with the earlier results obtained with RXTE /PCA, showing the same spin frequency of the neutron star. The present results demonstrate the capability of the LAXPC instrument for detecting millisecond variability even from short observations. After RXTE ceased operation, LAXPC on AstroSat is the only instrument at present with the capability of detecting kHz QPOs and other kinds of rapid variations from 3 keV to 20 keV and possibly at higher energies as well.