WorldWideScience

Sample records for astro evidence-based review

  1. Evidence-based policymaking: A review

    Directory of Open Access Journals (Sweden)

    Karen Nortje

    2010-05-01

    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 it more effectively. Similarly, policymakers need to understand the complexities of the scientific process to improve their interaction with the scientific sphere. This literature review addresses those factors that influence the uptake of scientific evidence into policymaking, the barriers to using science in policymaking, as well as recommendations for improved science–policymaking interaction. A visual diagram of the gears of a car is used to convey the message of the complexities around the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised.

  2. Empirical methods for systematic reviews and evidence-based medicine

    NARCIS (Netherlands)

    van Enst, W.A.

    2014-01-01

    Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. Systematic reviews have become the cornerstone of evidence-based medicine, which is reflected in the position systematic reviews have in the pyramid of evidence-based medicine. Systematic

  3. Historical Review of Astro-Geodetic Observations in Serbia

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    Ogrizovic, V.; Delcev, S.; Vasilic, V.; Gucevic, J.

    2008-10-01

    Astro-geodetic determinations of vertical deflections in Serbia began during the first years of 20th century. The first field works were led by S. Bo\\vsković. After the 2nd World War, Military Geographic Institute, Department of Geodesy from the Faculty of Civil Engineering, and Federal Geodetic Directorate continued the determinations, needed for reductions of terrestrial geodetic measurements and the astro-geodetic geoid determination. Last years improvements of the astro-geodetic methods are carried out in the area of implementing modern measurement equipment and technologies.

  4. A systematic review of the evidence base for Schema Therapy.

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    Masley, Samantha A; Gillanders, David T; Simpson, Susan G; Taylor, Morag A

    2012-01-01

    Schema Therapy is becoming an increasingly popular psychological model for working with individuals who have a variety of mental health and personality difficulties. The aim of this review is to look at the current evidence base for Schema Therapy and highlight directions for further research. A systematic search of the literature was conducted up until January 2011. All studies that had clinically tested the efficacy of Schema Therapy as described by Jeffrey Young (1994 and 2003) were considered. These studies underwent detailed quality assessments based on Scottish Intercollegiate Guidelines Network (SIGN-50) culminating in 12 studies being included in the review. The culminative message (both from the popularity of this model and the medium-to-large effect sizes) is of a theory that has already demonstrated clinically effective outcomes in a small number of studies and that would benefit from ongoing research and development with complex client groups. It is imperative that psychological practice be guided by high-quality research that demonstrates efficacious, evidence-based interventions. It is therefore recommended that researchers and clinicians working with Schema Therapy seek to build on these positive outcomes and further demonstrate the clinical effectiveness of this model through ongoing research.

  5. Palliative radiotherapy in head and neck cancers: Evidence based review

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    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.

  6. Health care-associated pneumonia: an evidence-based review.

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    Attridge, Russell T; Frei, Christopher R

    2011-08-01

    Health care-associated pneumonia is a relatively new classification of pneumonia that includes community-dwelling pneumonia patients having contact with the health care system. Current data indicate that health care-associated pneumonia patients present with more severe disease, are more likely to be infected with drug-resistant pathogens, and suffer increased mortality compared with community-acquired pneumonia patients. Guidelines recommend that these patients receive empiric antibiotics similar to those recommended for nosocomial pneumonia; however, it is not currently known if outcomes are improved when health care-associated pneumonia patients are treated with these therapies. In addition, the individual health care-associated pneumonia risk factors are based on limited data and are a poor predictor of patients likely to be infected with drug-resistant pathogens. Many questions remain on how to most appropriately care for this growing group of pneumonia patients. This review is an evidence-based discussion of current health care-associated pneumonia data, the individual health care-associated pneumonia risk factors, and limitations and additional considerations for the health care-associated pneumonia classification system.

  7. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

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    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.

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

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    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.…

  9. Promotion of evidence-based practice by professional nursing associations: literature review.

    NARCIS (Netherlands)

    Holleman, G.; Eliens, A.; Vliet, M. van; Achterberg, T. van

    2006-01-01

    AIM: This paper reports a literature review examining the activities of professional nursing associations in the promotion of evidence-based practice. BACKGROUND: Professional nursing associations can play a role in the implementation and achievement of evidence-based practice as such associations a

  10. Coblation for tonsillectomy: an evidence-based review.

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    Shah, Udayan K; Dunham, Brian

    2007-01-01

    Coblation technology (Arthrocare Corp., Sunnyvale, Calif., USA) allows for tonsillectomy using plasma-mediated ablation. This review presents the evidence to date with respect to surgical and recovery measures, in order to promote an objective discussion of this surgical technology.

  11. 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

    2011-01-01

    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

  12. An evidence-based systematic review of umckaloabo (Pelargonium sidoides) by the Natural Standard Research Collaboration.

    Science.gov (United States)

    Ulbricht, Catherine; Abrams, Tracee Rae; Conquer, Julie; Costa, Dawn; Serrano, Jill M Grimes; Iovin, Ramon; Isaac, Richard; Nguyen, Yen; Rusie, Erica; Tran, Diem; Weissner, Wendy; Windsor, Regina C

    2010-09-01

    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.

  13. An evidence-based systematic review of bilberry (Vaccinium myrtillus) by the Natural Standard Research Collaboration.

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    Ulbricht, Catherine; Basch, Ethan; Basch, Samuel; Bent, Steve; Boon, Heather; Burke, Dilys; Costa, Dawn; Falkson, Carla; Giese, Nicole; Goble, Michael; Hashmi, Sadaf; Mukarjee, Siddhartta; Papaliodis, George; Seamon, Erica; Tanguay-Colucci, Shaina; Weissner, Wendy; Woods, Jen

    2009-01-01

    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.

  14. An evidence-based systematic review of senna (Cassia senna) by the Natural Standard Research Collaboration.

    Science.gov (United States)

    Ulbricht, Catherine; Conquer, Julie; Costa, Dawn; Hamilton, William; Higdon, Elizabeth R B; Isaac, Richard; Rusie, Erica; Rychlik, Idalia; Serrano, Jill M Grimes; Tanguay-Colucci, Shaina; Theeman, Mark; Varghese, Minney

    2011-06-01

    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.

  15. 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

    2013-01-01

    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

  16. Agave (Agave americana): an evidence-based systematic review by the natural standard research collaboration.

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    Hackman, Dana A; Giese, Nicole; Markowitz, John S; McLean, Adam; Ottariano, Steven G; Tonelli, Chris; Weissner, Wendy; Welch, Shannon; Ulbricht, Catherine

    2006-01-01

    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.

  17. Robotics in general surgery: an evidence-based review.

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    Baek, Se-Jin; Kim, Seon-Hahn

    2014-05-01

    Since its introduction, robotic surgery has been rapidly adopted to the extent that it has already assumed an important position in the field of general surgery. This rapid progress is quantitative as well as qualitative. In this review, we focus on the relatively common procedures to which robotic surgery has been applied in several fields of general surgery, including gastric, colorectal, hepato-biliary-pancreatic, and endocrine surgery, and we discuss the results to date and future possibilities. In addition, the advantages and limitations of the current robotic system are reviewed, and the advanced technologies and instruments to be applied in the near future are introduced. Such progress is expected to facilitate the widespread introduction of robotic surgery in additional fields and to solve existing problems.

  18. Remifentanil for labor analgesia: an evidence-based narrative review.

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    Van de Velde, M; Carvalho, B

    2016-02-01

    This manuscript reviews the available literature on remifentanil patient-controlled intravenous analgesia in labor focusing on efficacy and safety. Remifentanil compares favorably to other potent systemic opioids but with fewer opioid-related neonatal effects. However, remifentanil provides modest and short-lasting labor analgesia that is consistently inferior when compared to neuraxial analgesia. The initial analgesic effect provided with remifentanil also diminishes as labor progresses. In several studies, remifentanil induced significant respiratory depressant effects in laboring women with episodes of desaturation, hypoventilation and even apnea. Given the safety concerns, we recommend that remifentanil patient-controlled intravenous analgesia should not be a routine analgesia technique during labor. In cases where neuraxial analgesia is refused or contraindicated and the use of remifentanil justified, continuous and careful monitoring is required to detect respiratory depression to provide safe care of both the pregnant woman and unborn child.

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

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    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.

  20. A systematic review of evidence-based interventions for students with challenging behaviors in school settings.

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    Thompson, Aaron M

    2011-05-01

    The author's systematic review of 2,294 articles from 10 journals in the fields of education, special education, school social work, school psychology, and school counseling identified 42 articles meeting search criteria of addressing evidence-based interventions for students with challenging behaviors in school settings. Interventions were considered evidence-based if they were (a) manualized or structured to facilitate replication; (b) evaluated with an experimental design; and (c) demonstrated to be effective. Current practices available to address students who require evidence-based interventions for challenging behaviors are summarized. Suggestions for intervention development to address the needs of students with difficult behaviors are offered.

  1. Postprostatectomy radiation therapy: an evidence-based review.

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    Mishra, Mark V; Champ, Colin E; Den, Robert B; Scher, Eli D; Shen, Xinglei; Trabulsi, Edouard J; Lallas, Costas D; Knudsen, Karen E; Dicker, Adam P; Showalter, Timothy N

    2011-12-01

    While the majority of men with localized prostate cancer who undergo a radical prostatectomy will remain disease free, men with certain clinical and pathological features are known to be at an increased risk for developing a biochemical recurrence and, ultimately, distant metastatic disease. The optimal management of these patients continues to be a source of controversy. To date, three randomized Phase III trials have demonstrated that adjuvant radiation therapy (ART) for patients with certain adverse pathological features results in an improvement in several clinically-relevant end points, including biochemical recurrence-free survival and overall survival. Despite the evidence from these trials showing a benefit for ART, many believe that ART results in overtreatment and unwarranted treatment morbidity for a significant number of patients. Many physicians, therefore, instead advocate for close observation followed by early salvage radiation therapy (SRT) at the time of a biochemical recurrence. The purpose of this review is to evaluate the evidence for and to distinguish between ART and early SRT. We will also highlight current and future areas of research for this patient population, including radiation treatment dose escalation, hypofractionation and androgen deprivation therapy. We will also discuss the cost-effectiveness of ART and early SRT.

  2. Cardiovascular Effects of Saffron: An Evidence-Based Review

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    Shahin Akhondzadeh

    2011-05-01

    Full Text Available Herbal medicine can be a valuable source of assistance for traditional medicine. There are a number of herbs that can beused in conjunction with modern medicine. Herbs can also be taken to aid recovery from serious diseases. Although one should never aim to treat diseases such as cardiovascular disease solely with herbal medicine, the value of herbs used in tandem with modern medicine cannot be ignored. Saffron has been reported to help lower cholesterol and keep cholesterol levels healthy.Animal studies have shown saffron to lower cholesterol by as much as 50%. Saffron has antioxidant properties; it is, therefore,helpful in maintaining healthy arteries and blood vessels. Saffron is also known to have anti-inflammatory properties, which are beneficial to cardiovascular health. The people of Mediterranean countries, where saffron use is common, have lower than normal incidence of heart diseases. From saffron's cholesterol lowering benefits to its anti inflammatory properties,saffron may be one of the best supplements for cardiac health. This paper reviews the studies regarding the beneficial effects of saffron in cardiovascular health.

  3. Behavioural Treatments for Tourette Syndrome: An Evidence-Based Review

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    Madeleine Frank

    2013-01-01

    Full Text Available Tourette syndrome (TS is a disorder characterised by multiple motor and vocal tics and is frequently associated with behavioural problems. Tics are known to be affected by internal factors such as inner tension and external factors such as the surrounding environment. A number of behavioural treatments have been suggested to treat the symptoms of TS, in addition to pharmacotherapy and surgery for the most severe cases. This review compiled all the studies investigating behavioural therapies for TS, briefly describing each technique and assessing the evidence in order to determine which of these appear to be effective. Different behavioural therapies that were used included habit reversal training (HRT, massed negative practice, supportive psychotherapy, exposure with response prevention, self-monitoring, cognitive-behavioural therapy, relaxation therapy, assertiveness training, contingency management, a tension-reduction technique and biofeedback training. Overall, HRT is the best-studied and most widely-used technique and there is sufficient experimental evidence to suggest that it is an effective treatment. Most of the other treatments, however, require further investigation to evaluate their efficacy. Specifically, evidence suggests that exposure with response prevention and self-monitoring are effective, and more research is needed to determine the therapeutic value of the other treatments. As most of the studies investigating behavioural treatments for TS are small-sample or single-case studies, larger randomised controlled trials are advocated.

  4. Antioxidant supplements and semen parameters: An evidence based review

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    Ahmadi, Sedigheh; Bashiri, Reihane; Ghadiri-Anari, Akram; Nadjarzadeh, Azadeh

    2016-01-01

    Many studies have focused on male infertility. There is limited evidence about the influence of nutrition on quality of semen. Approximately, 30-80% of infertility cases are caused by oxidative stress and decreased level of seminal total antioxidant capacity. This study was aimed to review the effects of oral antioxidant supplements on improving major semen parameters such as sperm concentration, motility, morphology, DNA damage, and fertility rate. Data were extracted from PubMed and Google scholar database by using the terms “antioxidant”, “multivitamin”, “carnitine”, “CoQ10”, “vitamin C”, “vitamin E”, “zinc”, “folic acid”, “N-acetyl cysteine” and “selenium” combined with “male infertility”, “semen”, and “sperm” to generate a set of relevant citations. Supplements such as CoQ10 and alpha-tocopherol significantly improve sperm count. Also, carnitine has positive effects on sperm motility and morphology. Simultaneous administration of vitamin E and vitamin C reduces the sperm DNA damage. However, in some studies, one or more factors have not changed substantially. In most of the studies, antioxidant supplementation improved the number, motility, morphology and sometimes DNA integrity of sperm. The present study showed that antioxidant supplements, especially a combination of antioxidants such as vitamin C, vitamin E, and CoQ10 intake can effectively improve semen parameters in infertile men. PMID:28066832

  5. Rotavirus vaccination and herd immunity: an evidence-based review

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    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

  6. Botanicals in dermatology: an evidence-based review.

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    Reuter, Juliane; Merfort, Irmgard; Schempp, Christoph M

    2010-01-01

    Botanical extracts and single compounds are increasingly used in cosmetics but also in over-the-counter drugs and food supplements. The focus of the present review is on controlled clinical trials with botanicals in the treatment of acne, inflammatory skin diseases, skin infections, UV-induced skin damage, skin cancer, alopecia, vitiligo, and wounds. Studies with botanical cosmetics and drugs are discussed, as well as studies with botanical food supplements. Experimental research on botanicals was considered to a limited extent when it seemed promising for clinical use in the near future. In acne therapy, Mahonia, tea tree oil, and Saccharomyces may have the potential to become standard treatments. Mahonia, Hypericum, Glycyrrhiza and some traditional Chinese medicines appear promising for atopic dermatitis. Some plant-derived substances like dithranol and methoxsalen (8-methoxypsoralen) [in combination with UVA] are already accepted as standard treatments in psoriasis; Mahonia and Capsicum (capsaicin) are the next candidates suggested by present evidence. Oral administration and topical application of antioxidant plant extracts (green and black tea, carotenoids, coffee, and many flavonoids from fruits and vegetables) can protect skin from UV-induced erythema, early aging, and irradiation-induced cancer. Hair loss and vitiligo are also traditional fields of application for botanicals. According to the number and quality of clinical trials with botanicals, the best evidence exists for the treatment of inflammatory skin diseases, i.e. atopic dermatitis and psoriasis. However, many more controlled clinical studies are needed to determine the efficacy and risks of plant-derived products in dermatology. Safety aspects, especially related to sensitization and photodermatitis, have to be taken into account. Therefore, clinicians should not only be informed of the beneficial effects but also the specific adverse effects of botanicals used for dermatologic disorders and

  7. Evidence based approach to unani contraceptives: a review

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    Saba Mohd Athar Khan

    2016-02-01

    Full Text Available Contraception is a process or technique for preventing pregnancy by means of medication, device or method that blocks or alters one or more of the processes of reproduction in such a way that sexual union can occur without impregnation. Promotion of family planning is central to the World Health Organization work on improving maternal health and is core to achieve the Millennium Development Goal. It is estimated that 90% of abortion related and 20% of pregnancy related morbidity and mortality, could be prevented by the use of effective contraception. Population explosion is the leading cause of poverty and pollution in developing countries which has detrimental effect on the life supporting system. Hence it is necessary to control the population by the use of contraceptives. Available contraceptives in conventional medicines have many adverse effects. Therefore, there is a need for research of newer, less expensive, less toxic, self-administered, completely reversible contraceptives. Much of these properties are observed in contraceptives as mentioned in classical Unani text. Unani physician has mentioned the various medicines and techniques of contraceptives. Scientific research has confirmed the efficacy of most of the herbal drugs like Ruta graveolans (Suddab, Juniperus communis (Abhal, Piper longum (Filfil daraz, Mentha arvensis (Pudina, Azadirachta indica (Neem, Punica granatum (Anar, Alium cepa (Piyaz and Daucus carota (wild carrot etc. Therefore, the aim of this article is to review the ancient concept of contraception in Unani System of Medicine in the light of available scientific research. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 268-275

  8. Method for the evidence-based reviews on occupational therapy and stroke.

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    Arbesman, Marian; Lieberman, Deborah; Berlanstein, Debra R

    2015-01-01

    Evidence-based reviews of the literature relevant to adults with stroke are important to the practice of occupational therapy. We describe the four questions that served as the focus for the evidence-based reviews of the effectiveness of occupational therapy interventions for adults with stroke. The questions include occupation- and activity-based interventions to improve occupational performance and social participation after stroke, as well as interventions for motor, cognitive, and psychological and emotional impairments after stroke. We include the background for the reviews; the process followed for addressing each question, including search terms and search strategy; the databases searched; and the methods used to summarize and critically appraise the literature. The final number of articles included in each evidence-based review; a summary of the themes of the results; the strengths and limitations of the findings; and implications for practice, education, and research are presented.

  9. Evidence-Based Systematic Review: Effects of Nonspeech Oral Motor Exercises on Speech

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    McCauley, Rebecca J.; Strand, Edythe; Lof, Gregory L.; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: The purpose of this systematic review was to examine the current evidence for the use of oral motor exercises (OMEs) on speech (i.e., speech physiology, speech production, and functional speech outcomes) as a means of supporting further research and clinicians' use of evidence-based practice. Method: The peer-reviewed literature from 1960…

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

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    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…

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

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    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.

  12. How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

    NARCIS (Netherlands)

    Walczak, J.; Kaleta, A.; Gabrys, E.; Kloc, K.; Thangaratinam, S.; Barnfield, G.; Weinbrenner, S.; Meyerrose, B.; Arvanitis, T.N.; Horvath, A.R.; Zanrei, G.; Kunz, R.; Suter, K.; Burnand, B.; Arditi, C.; Oude Rengerink, K.; Harry, G.; Mol, B.W.J.; Khan, K.S.

    2010-01-01

    ABSTRACT: BACKGROUND: Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TT

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

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    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…

  14. An evidence-based systematic review of kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration.

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    Ulbricht, Catherine; Costa, Dawn; Dao, Julie; Isaac, Richard; LeBlanc, Yvonne C; Rhoades, Jenna; Windsor, Regina C

    2013-06-01

    An evidence-based systematic review of kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

  15. Evidence-based practice: a deconstruction and postmodern critique: book review article.

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    Griffiths, Peter

    2005-03-01

    This paper discusses the significance of postmodernism for healthcare practice, specifically the discourse known as 'evidence-based practice'. It considers two texts, both of which present postmodern analyses of contemporary issues. One text presents a deconstruction of evidence-based practice in an attempt to reveal its 'true' nature, which is portrayed as one that does not respect research paradigms other than the randomised controlled trial, merely pays lip service to expertise and fails to connect with the real nature of clinical practice. The second text considers the accusation that absolute relativism implied by postmodern approaches may permit an 'anything goes' mentality and provide succour to those advocating unacceptable practices. A 'defence' of postmodernism in relation to the accusation that it encourages holocaust denial is used to consider further the nature and limitations of postmodern critiques of evidence-based practice. This review concludes that postmodernism fundamentally challenges the apparent 'objectivity' of evidence-based practice but it does not challenge the fundamental rules for acquiring and testing evidence. Rather it is the selection of questions to be asked and answered by evidence-based practice/practitioners that is the true limitation. This is the ground upon which fruitful argument can be had about the significance of evidence without undermining the requirement that there be evidence and standards to judge such evidence.

  16. Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 1: Introduction and methodology.

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    Flannery, Ann Marie; Mitchell, Laura

    2014-11-01

    This clinical systematic review of and evidence-based guidelines for the treatment of pediatric hydrocephalus were developed by a physician volunteer task force. They are provided as an educational tool based on an assessment of current scientific and clinical information as well as accepted approaches to treatment. They are not intended to be a fixed protocol, because some patients may require more or less treatment. In Part 1, the authors introduce the reader to the complex topic of hydrocephalus and the lack of consensus on its appropriate treatment. The authors describe the development of the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force charged with reviewing the literature and recommending treatments for hydrocephalus, and they set out the basic methodology used throughout the specific topics covered in later chapters.

  17. A Review of the Evidence Base of Functional Assessment-Based Interventions for Young Students Using One Systematic Approach

    Science.gov (United States)

    Wood, Brenna K.; Oakes, Wendy Peia; Fettig, Angel; Lane, Kathleen Lynne

    2015-01-01

    This review of the literature was conducted to explore the evidence base for functional assessment-based interventions (FABIs) for one systematic approach developed by Umbreit, Ferro, Liaupsin, and Lane (2007). Specifically, this review examined the evidence base for this systematic approach to FABI for young students by applying quality…

  18. Evidence-based surgery for cesarean delivery: an updated systematic review.

    Science.gov (United States)

    Dahlke, Joshua D; Mendez-Figueroa, Hector; Rouse, Dwight J; Berghella, Vincenzo; Baxter, Jason K; Chauhan, Suneet P

    2013-10-01

    The objective of our systematic review was to provide updated evidence-based guidance for surgical decisions during cesarean delivery (CD). We performed an English-language MEDLINE, PubMed, and COCHRANE search with the terms, cesarean section, cesarean delivery, cesarean, pregnancy, and randomized trials, plus each technical aspect of CD. Randomized control trials (RCTs) involving any aspect of CD technique from Jan. 1, 2005, to Sept. 1, 2012, were evaluated to update a previous systematic review. We also summarized Cochrane reviews, systematic reviews, and metaanalyses if they included additional RCTs since this review. We identified 73 RCTs, 10 metaanalyses and/or systematic reviews, and 12 Cochrane reviews during this time frame. Recommendations with high levels of certainty as defined by the US Preventive Services Task Force favor pre-skin incision prophylactic antibiotics, cephalad-caudad blunt uterine extension, spontaneous placental removal, surgeon preference on uterine exteriorization, single-layer uterine closure when future fertility is undesired, and suture closure of the subcutaneous tissue when thickness is 2 cm or greater and do not favor manual cervical dilation, subcutaneous drains, or supplemental oxygen for the reduction of morbidity from infection. The technical aspect of CD with high-quality, evidence-based recommendations should be adopted. Although 73 RCTs over the past 8 years is encouraging, additional well-designed, adequately powered trials on the specific technical aspects of CD are warranted.

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

    Science.gov (United States)

    Barr-Walker, Jill

    2017-01-01

    Objective 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. Methods 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. Results 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. 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. PMID:28096749

  20. 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

  1. Vertebral Osteomyelitis and Spinal Epidural Abscess: An Evidence-based Review.

    Science.gov (United States)

    Boody, Barrett S; Jenkins, Tyler J; Maslak, Joseph; Hsu, Wellington K; Patel, Alpesh A

    2015-07-01

    Spinal infections have historically been associated with significant morbidity and mortality. Current treatment protocols have improved patient outcomes through prompt and accurate infection identification, medical treatment, and surgical interventions. Medical and surgical management, however, remains controversial because of a paucity of high-level evidence to guide decision making. Despite this, an awareness of presenting symptoms, pertinent risk factors, and common imaging findings are critical for treating spine infections. The purpose of this article is to review the recent literature and present the latest evidence-based recommendations for the most commonly encountered primary spinal infections: vertebral osteomyelitis and epidural abscess.

  2. Central retinal vein occlusion: A review of current Evidence-based treatment options

    Directory of Open Access Journals (Sweden)

    Amy Patel

    2016-01-01

    Full Text Available A central retinal vein occlusion (CRVO can induce an ischemic and hypoxic state with resulting sequelae of macular edema and neovascularization. Many treatment options have been studied. Our review aims to investigate the safety and efficacy of the multiple treatment options of CRVO. A PubMed and Cochrane literature search was performed. Well-controlled randomized clinical trials that demonstrated strong level 1 evidence-based on the rating scale developed by the British Centre for Evidence-Based Medicine were included. Seven clinical trials met inclusion criteria to be included in this review. These included studies that investigated the safety and efficacy of retinal photocoagulation (1 study, intravitreal steroid treatment (2 studies, and antivascular endothelial growth factor treatment (4 studies for the treatment of CRVO. In addition, studies evaluating surgical treatment options for CRVO were also included. Many treatment modalities have been demonstrated to be safe and efficacious in the treatment of CRVO. These treatment options offer therapeutic benefits for patients and clinically superior visual acuity and perhaps the quality of life after suffering from a CRVO.

  3. An evidence-based systematic review of gymnema (Gymnema sylvestre R. Br.) by the Natural Standard Research Collaboration.

    Science.gov (United States)

    Ulbricht, Catherine; Abrams, Tracee Rae; Basch, Ethan; Davies-Heerema, Theresa; Foppa, Ivo; Hammerness, Paul; Rusie, Erica; Tanguay-Colucci, Shaina; Taylor, Sarah; Ulbricht, Catherine; Varghese, Minney; Weissner, Wendy; Woods, Jen

    2011-09-01

    An evidence-based systematic review of gymnema (Gymnema sylvestre R. Br.), including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

  4. Real-time peer review: an innovative feature to an evidence-based practice conference.

    Science.gov (United States)

    Eldredge, Jonathan D; Phillips, Holly E; Kroth, Philip J

    2013-01-01

    Many health sciences librarians as well as other professionals attend conferences on a regular basis. This study sought to link an innovative peer review process of presented research papers to long-term conference outcomes in the peer-reviewed professional journal literature. An evidence-based conference included a proof-of-concept study to gauge the long-term outcomes from research papers presented during the program. Real-time peer review recommendations from the conference were linked to final versions of articles published in the peer-reviewed literature. The real-time peer review feedback served as the basis for further mentoring to guide prospective authors toward publishing their research results. These efforts resulted in the publication of two of the four research papers in the peer-viewed literature. A third presented paper appeared in a blog because the authors wanted to disseminate their findings more quickly than through the journal literature. The presenters of the fourth paper never published their study. Real-time peer review from this study can be adapted to other professional conferences that include presented research papers.

  5. 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 holistic

  6. Research review: DSM-V conduct disorder: research needs for an evidence base.

    Science.gov (United States)

    Moffitt, Terrie E; Arseneault, Louise; Jaffee, Sara R; Kim-Cohen, Julia; Koenen, Karestan C; Odgers, Candice L; Slutske, Wendy S; Viding, Essi

    2008-01-01

    This article charts a strategic research course toward an empirical foundation for the diagnosis of conduct disorder in the forthcoming DSM-V. Since the DSM-IV appeared in 1994, an impressive amount of new information about conduct disorder has emerged. As a result of this new knowledge, reasonable rationales have been put forward for adding to the conduct disorder diagnostic protocol: a childhood-limited subtype, family psychiatric history, callous-unemotional traits, female-specific criteria, preschool-specific criteria, early substance use, and biomarkers from genetics, neuroimaging, and physiology research. This article reviews the evidence for these and other potential changes to the conduct disorder diagnosis. We report that although there is a great deal of exciting research into each of the topics, very little of it provides the precise sort of evidence base required to justify any alteration to the DSM-V. We outline specific research questions and study designs needed to build the lacking evidence base for or against proposed changes to DSM-V conduct disorder.

  7. 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

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

    Science.gov (United States)

    2016-01-01

    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 varying

  9. Patient participation in medication reviews is desirable but not evidence-based: a systematic literature review.

    NARCIS (Netherlands)

    Willeboordse, F.; Hugtenburg, J.G.; Schellevis, F.G.; Elders, P.J.M.

    2014-01-01

    Aim: The aim of this systematic literature review is to investigate which types of patient participation in medication reviews have been practiced and what is known about the effects of patient participation within the medication review process. Methods: A systematic literature review was performed

  10. Nasal irrigation: From empiricism to evidence-based medicine. A review.

    Science.gov (United States)

    Bastier, P-L; Lechot, A; Bordenave, L; Durand, M; de Gabory, L

    2015-11-01

    Nasal irrigation plays a non-negligible role in the treatment of numerous sinonasal pathologies and postoperative care. There is, however, a wide variety of protocols. The present review of the evidence-based literature sought objective arguments for optimization and efficacy. It emerged that large-volume low-pressure nasal douche optimizes the distribution and cleansing power of the irrigation solution in the nasal cavity. Ionic composition and pH also influence mucociliary clearance and epithelium trophicity. Seawater is less rich in sodium ions and richer in bicarbonates, potassium, calcium and magnesium than is isotonic normal saline, while alkaline pH and elevated calcium concentration optimized ciliary motility in vitro. Bicarbonates reduce secretion viscosity. Potassium and magnesium promote healing and limit local inflammation. These results show that the efficacy of nasal irrigation is multifactorial. Large-volume low-pressure nasal irrigation using undiluted seawater seems, in the present state of knowledge, to be the most effective protocol.

  11. Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review

    Directory of Open Access Journals (Sweden)

    Daniele Cristina Perin

    Full Text Available ABSTRACT Objective: to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. Method: systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. Results: the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. Conclusions: care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units.

  12. Cesarean delivery technique: evidence or tradition? A review of the evidence-based cesarean delivery.

    Science.gov (United States)

    Encarnacion, Betsy; Zlatnik, Marya G

    2012-08-01

    Cesarean delivery is the most common surgical procedure performed in the United States, yet the techniques used during this procedure often vary significantly among providers. The purpose of this review was to evaluate and outline current evidence behind the cesarean delivery technique. A search of the PubMed database was conducted using the terms cesarean section and cesarean delivery and the technique of interest, for example, cesarean section prophylactic antibiotics. Few aspects of the cesarean delivery were found to have high-quality consistent evidence to support use of a particular technique. Because many aspects of the procedure are based on limited or no data, more studies on specific cesarean delivery techniques are clearly needed. Providers should be aware of which components of the cesarean delivery are evidence-based versus not when performing this procedure.

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Sorrell, Steve [Sussex Energy Group, SPRU - Science and Technology Policy Research, Freeman Centre, University of Sussex, Falmer, Brighton BN1 9QE (United Kingdom)]. E-mail: s.r.sorrell@sussex.ac.uk

    2007-03-15

    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.

  15. [Evidence-based evaluation of present guidelines for the treatment of tennis elbow -- a review].

    Science.gov (United States)

    Theis, C; Herber, S; Meurer, A; Lehr, H-A; Rompe, J-D

    2004-08-01

    The guidelines of the German Orthopaedic Societies regarding the treatment of lateral elbow epicondylitis were analysed on the ground of recently published reviews or randomised placebo-controlled trials (RCT). For the acute phase, reviews or RCTs failed to show a clinical effect beyond placebo if follow-up was extended over 6 weeks. For the chronic phase a current Cochrane review failed to identify any controlled trial regarding surgical procedures during the last decades. Without an adequate control group, it is not possible to draw any meaningful conclusions about the value of this modality of treatment. Therefore surgery is not indicated before repetitive low-energy extracorporeal shock wave therapy (ESWT) has been applied. This novel treatment, under strictly standardized conditions, showed effects beyond placebo in independent randomised placebo-controlled trials for follow-up periods of 3 and 6 months. To date there exists no evidence-based therapeutic algorithm for the treatment of acute and chronic tennis elbow. Even medium-term effects should be regarded as either a placebo effect or natural regression to the mean.

  16. How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

    Directory of Open Access Journals (Sweden)

    Burnand Bernard

    2010-09-01

    Full Text Available Abstract Background Teaching of evidence-based medicine (EBM has become widespread in medical education. Teaching the teachers (TTT courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses. To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. Methods We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. Results Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. Conclusion There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect.

  17. Atypical odontalgia: a systematic review following the evidence-based principles of dentistry.

    Science.gov (United States)

    Bosch-Aranda, María Louisa; Vázquez-Delgado, Eduardo; Gay-Escoda, Cosme

    2011-07-01

    Atypical odontalgia (AO) is a severe and persistent pain involving controversial pathophysiological mechanisms and clinical management. Presented here is a systematic review of the literature on AO, using the SORT criteria (Strength of Recommendation Taxonomy) to assess the level of evidence and the quality of randomized clinical trials (RCT). A total of 54 articles were obtained of which 34 belonged to level 3 evidence, 17 to level 2, and 3 to level 1. Of these, only 8 RCT had an average quality of four points. The main finding of this systematic review is that only a few studies have systematically evaluated AO. It also determines a strength recommendation of level B to the theory of neuropathic origin of pain in AO and strength of recommendation level C for the pharmacological management of this condition. The aim of this study was to carry out a systematic review of the published literature on AO in order to determine the physiopathology and treatment based on the level of scientific evidence and following the evidence-based principles of dentistry.

  18. 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

  19. Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School-Age Children

    Science.gov (United States)

    Cirrin, Frank M.; Schooling, Tracy L.; Nelson, Nickola W.; Diehl, Sylvia F.; Flynn, Perry F.; Staskowski, Maureen; Torrey, T. Zoann; Adamczyk, Deborah F.

    2010-01-01

    Purpose: The purpose of this investigation was to conduct an evidence-based systematic review (EBSR) of peer-reviewed articles from the last 30 years about the effect of different service delivery models on speech-language intervention outcomes for elementary school-age students. Method: A computer search of electronic databases was conducted to…

  20. Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews

    Science.gov (United States)

    Zegers, Marieke; Hesselink, Gijs; Geense, Wytske; Vincent, Charles; Wollersheim, Hub

    2016-01-01

    Objective To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. Design Systematic review of systematic reviews. Data sources PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. Study selection English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included. Two reviewers independently assessed each study's quality and extracted data on the study population, study design, intervention characteristics and adverse patient outcomes. Results Sixty systematic reviews with moderate to high quality were included. Statistically significant pooled effect sizes were found for 14 types of interventions, including: (1) multicomponent interventions to prevent delirium; (2) rapid response teams to reduce cardiopulmonary arrest and mortality rates; (3) pharmacist interventions to reduce adverse drug events; (4) exercises and multicomponent interventions to prevent falls; and (5) care bundle interventions, checklists and reminders to reduce infections. Most (82%) of the significant effect sizes were based on 5 or fewer primary studies with an experimental study design. Conclusions The evidence for patient-safety interventions implemented in hospitals worldwide is weak. The findings address the need to invest in high-quality research standards in order to identify interventions that have a real impact on patient safety. Interventions to prevent delirium, cardiopulmonary arrest and mortality, adverse drug events, infections and falls are most effective and should therefore be prioritised by clinicians. PMID:27687901

  1. 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.

  2. External Collection Devices as an Alternative to the Indwelling Urinary Catheter: Evidence-Based Review and Expert Clinical Panel Deliberations.

    Science.gov (United States)

    Gray, Mikel; Skinner, Claudia; Kaler, Wendy

    2016-01-01

    Multiple evidence-based guidelines have suggested clinicians consider external collection devices (ECD) as alternatives to indwelling catheters. Nevertheless, there is a dearth of evidence-based resources concerning their use. An expert consensus panel was convened to review the current state of the evidence, indications for ECDs as an alternative to an indwelling urinary catheter, identify knowledge gaps, and areas for future research. This article presents the results of the expert consensus panel meeting and a systematic literature review regarding ECD use in the clinical setting.

  3. Evidence-based treatments for pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid: A systematic review

    Directory of Open Access Journals (Sweden)

    Sanjay Singh

    2011-01-01

    Full Text Available Background: Pemphigus, bullous pemphigoid, and epidermolysis bullosa acquisita are autoimmune diseases of skin associated with considerable morbidity and sometimes mortality. There is no cure for these diseases. Aims: To summarize evidence-based treatments for these diseases by performing a systematic review. Methods: The research protocol included the following steps: identification of databases to be searched, defining search strategy, searching the databases for references, first-stage screening of the abstracts, second-stage screening of full texts of articles identified after the first-stage screening, data extraction from the identified articles after second-stage screening, quality appraisal of the studies using the Delphi list, and summarizing the findings. Results: No randomized controlled trials of interventions in pemphigus vegetans, pemphigus erythematosus, and epidermolysis bullosa acquisita could be found. After the second-stage screening, 12 randomized controlled trials were analyzed, which included patients with pemphigus vulgaris or pemphigus vulgaris and pemphigus foliaceus, and 7 which included patients with bullous pemphigoid. Conclusions: Number of high-quality randomized controlled trials conducted on pemphigus and bullous pemphigoid is small. Oral corticosteroid along with a steroid-sparing agent appears to be the most effective treatment for pemphigus. Azathioprine may be most effective as a steroid-sparing agent. Topical corticosteroid therapy (as studied is effective for bullous pemphigoid and appears to be superior to oral corticosteroid for extensive disease. Some suggestions about future research are made.

  4. Perils of paediatric anaesthesia and novel molecular approaches: An evidence-based review

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Anand, Smriti; Gupta, Hemant

    2015-01-01

    Evolution of anaesthesia has been largely helped by progress of evidence-based medicine. In spite of many advancements in anaesthesia techniques and availability of newer and safer drugs, much more needs to be explored scientifically for the development of anaesthesia. Over the last few years, the notion that the actions of the anaesthesiologist have only immediate or short-term consequences has largely been challenged. Evidences accumulated in the recent years have shown that anaesthesia exposure may have long-term consequences particularly in the extremes of ages. However, most of the studies conducted so far are in vitro or animal studies, the results of which have been extrapolated to humans. There have been confounding evidences linking anaesthesia exposure in the developing brain with poor neurocognitive outcome. The results of animal studies and human retrospective studies have raised concern over the potential detrimental effects of general anaesthetics on the developing brain. The purpose of this review is to highlight the long-term perils of anaesthesia in the very young and the potential of improving anaesthesia delivery with the novel molecular approaches. PMID:26019351

  5. How best can we plan & implement HIV prevention? A review of successful evidence based practices & research

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Chattu

    2014-07-01

    Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.

  6. Clinical utility of tadalafil in the treatment of pulmonary arterial hypertension: an evidence-based review

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    Henrie AM

    2015-11-01

    Full Text Available Adam M Henrie, James J Nawarskas, Joe R Anderson College of Pharmacy, University of New Mexico, Albuquerque, NM, USA Abstract: Pulmonary arterial hypertension (PAH is a chronic and disabling condition characterized by an elevated pulmonary vascular resistance and an elevated mean pulmonary arterial pressure. Despite recent improvements in treatment availability, PAH remains challenging to treat, burdensome for patients, and ultimately incurable. Tadalafil is a phosphodiesterase-5 inhibitor that is administered once daily by mouth for the treatment of PAH. Current treatment guidelines recommend tadalafil as an option for patients with World Health Organization functional class II or III PAH. In a placebo-controlled clinical trial, patients taking tadalafil demonstrated significantly improved exercise capacity as measured by the 6-minute walk distance. Patients also experienced decreased incidence of clinical worsening, increased quality of life, and improved cardiopulmonary hemodynamics. Uncontrolled studies and smaller trials have indicated a possible role for tadalafil as a suitable alternative to sildenafil and as a beneficial add-on option when used in combination with other treatments for PAH. Tadalafil is generally safe and well tolerated. Adverse events are typically mild-to-moderate in intensity, and discontinuation rates are usually low. The purpose of this review is to provide an evidence-based evaluation of the clinical utility of tadalafil in the treatment of PAH. Keywords: tadalafil, phosphodiesterase-5 inhibitor, pulmonary arterial hypertension

  7. The science and practice of micronutrient supplementations in nutritional anemia: an evidence-based review.

    Science.gov (United States)

    Chan, Lingtak-Neander; Mike, Leigh Ann

    2014-08-01

    Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate-specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence-based approach.

  8. Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review

    Science.gov (United States)

    Compton, Scott N.; March, John S.; Brent, David; Albano, Anne Marie; Weersing, V. Robin; Curry, John

    2004-01-01

    Objective: To review the literature on the cognitive-behavioral treatment of children and adolescents with anxiety and depressive disorders within the conceptual framework of evidence-based medicine. Method: The psychiatric and psychological literature was systematically searched for controlled trials applying cognitive-behavioral treatment to…

  9. The fatal case of a cocaine body-stuffer and a literature review - towards evidence based management.

    Science.gov (United States)

    Norfolk, G A

    2007-01-01

    The case of a 50-year old female body-stuffer who collapsed and died more than 10h after swallowing a plastic wrap of cocaine is reported. The case is discussed together with a review of the literature in order that guidelines on managing body-stuffers in police custody can be evidence based.

  10. Complementary & alternative management of Parkinson's disease: an evidence-based review of eastern influenced practices.

    Science.gov (United States)

    Bega, Danny; Zadikoff, Cindy

    2014-10-01

    The prevalence of Parkinson's disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative medicine (CAM) modalities in countries like Korea may be as high as 76%. Among patients with PD, herbal medicines, health supplement foods, and acupuncture are interventions which are increasingly used throughout the world. Countries like Korea, China, India, and Japan have long embraced and incorporated traditional medicine into modern management of conditions such as PD, but research into various CAM modalities remains in its infancy limiting evidence-based recommendations for many treatments. We reviewed the literature on CAM treatments for PD, focusing on mind-body interventions and natural products. Based on evidence limited to randomized-controlled trials we found that mind-body interventions are generally effective forms of physical activity that are likely to foster good adherence and may reduce disability associated with PD. Based on the current data, modalities like Tai Chi and dance are safe and beneficial in PD, but better studies are needed to assess the effects of other frequently used modalities such as yoga and acupuncture. Furthermore, despite centuries of experience using medicinal herbs and plants in Eastern countries, and despite substantial preclinical data on the beneficial effects of nutritional antioxidants as neuroprotective agents in PD, there is insufficient clinical evidence that any vitamin, food additive, or supplement, can improve motor function or delay disease progression in PD.

  11. The Effects of Preexercise Caffeinated Coffee Ingestion on Endurance Performance: An Evidence-Based Review.

    Science.gov (United States)

    Higgins, Simon; Straight, Chad R; Lewis, Richard D

    2016-06-01

    Endurance athletes commonly ingest caffeine as a means to enhance training intensity and competitive performance. A widely-used source of caffeine is coffee, however conflicting evidence exists regarding the efficacy of coffee in improving endurance performance. In this context, the aims of this evidence-based review were threefold: 1) to evaluate the effects of preexercise coffee on endurance performance, 2) to evaluate the effects of coffee on perceived exertion during endurance performance, and 3) to translate the research into usable information for athletes to make an informed decision regarding the intake of caffeine via coffee as a potential ergogenic aid. Searches of three major databases were performed using terms caffeine and coffee, or coffee-caffeine, and endurance, or aerobic. Included studies (n = 9) evaluated the effects of caffeinated coffee on human subjects, provided the caffeine dose administered, administered caffeine ≥ 45 min before testing, and included a measure of endurance performance (e.g., time trial). Significant improvements in endurance performance were observed in five of nine studies, which were on average 24.2% over controls for time to exhaustion trials, and 3.1% for time to completion trials. Three of six studies found that coffee reduced perceived exertion during performance measures significantly more than control conditions (p studies there is moderate evidence supporting the use of coffee as an ergogenic aid to improve performance in endurance cycling and running. Coffee providing 3-8.1 mg/kg (1.36-3.68 mg/lb) of caffeine may be used as a safe alternative to anhydrous caffeine to improve endurance performance.

  12. Review of the evidence base of strategies to prevent ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Mathur, Raj; Kailasam, Chandra; Jenkins, Julian

    2007-06-01

    The English-language literature was reviewed to examine the evidence base for strategies that have been used to prevent ovarian hyperstimulation syndrome (OHSS). Prediction of OHSS by pretreatment patient characteristics and ovarian response parameters is unreliable, with a significant number of OHSS cases occurring in patients not thought to be high risk, while the majority of 'high-risk' cycles do not result in OHSS. Alternatives to ovarian stimulation should always be considered, depending on the clinical situation. Monofollicular ovulation induction with a cautious step-up regime carries a lower risk of overstimulation than step-down regimes. In in vitro fertilization (IVF) cycles, a low starting dose of follicle-stimulating hormone (FSH) and the use of 5000 iu human chorionic gonadotrophin (hCG) for final follicular maturation may benefit patients at high risk of OHSS. The role of GnRH antagonists is unclear. In women with polycystic ovaries, who are undergoing ovarian stimulation for IVF, metformin co-treatment may reduce the risk of OHSS. Coasting of cycles with over-response is associated with a reduced risk of OHSS, although precise criteria for initiating and ending coasting are not definable at present. Elective cryopreservation of all embryos prevents late OHSS, but its value has been poorly researched. The literature does not support a role for intravenous albumin, administered around the time of oocyte retrieval, in preventing OHSS. Evidence is insufficient regarding a possible role for hexa-ethyl starch. hCG should not be used for luteal support, as it is associated with a higher risk of OHSS, and equivalent pregnancy rates are obtained with the use of progesterone.

  13. The evidence base for interventions delivered to children in primary care: an overview of cochrane systematic reviews.

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    Peter J Gill

    Full Text Available BACKGROUND: As a first step in developing a framework to evaluate and improve the quality of care of children in primary care there is a need to identify the evidence base underpinning interventions relevant to child health. Our objective was to identify all Cochrane systematic reviews relevant to the management of childhood conditions in primary care and to assess the extent to which Cochrane reviews reflect the burden of childhood illness presenting in primary care. METHODOLOGY/PRINCIPAL FINDINGS: We used the Cochrane Child Health Field register of child-relevant systematic reviews to complete an overview of Cochrane reviews related to the management of children in primary care. We compared the proportion of systematic reviews with the proportion of consultations in Australia, US, Dutch and UK general practice in children. We identified 396 relevant systematic reviews; 358 included primary studies on children while 251 undertook a meta-analysis. Most reviews (n = 218, 55% focused on chronic conditions and over half (n = 216, 57% evaluated drug interventions. Since 2000, the percentage of pediatric primary care relevant reviews only increased by 2% (7% to 9% compared to 18% (10% to 28% in all child relevant reviews. Almost a quarter of reviews (n = 78, 23% were published on asthma treatments which only account for 3-5% of consultations. Conversely, 15-23% of consultations are due to skin conditions yet they represent only 7% (n = 23 of reviews. CONCLUSIONS/SIGNIFICANCE: Although Cochrane systematic reviews focus on clinical trials and do not provide a comprehensive picture of the evidence base underpinning the management of children in primary care, the mismatch between the focus of the published research and the focus of clinical activity is striking. Clinical trials are an important component of the evidence base and the lack of trial evidence to demonstrate intervention effectiveness in substantial areas of primary care for children should

  14. EVIDENCE-BASED REVIEW OF TREATMENT OPTIONS FOR PATIENTS WITH GLOTTIC CANCER

    NARCIS (Netherlands)

    Hartl, Dana M.; Ferlito, Alfio; Brasnu, Daniel F.; Langendijk, Johannes A.; Rinaldo, Alessandra; Silver, Carl E.; Wolf, Gregory T.

    2011-01-01

    Evidence-based medicine integrates the best available data in decision making, with the goal of minimizing physicians' and patients' subjectivity. In 2006, the American Society of Clinical Oncology edited clinical practice guidelines for the use of larynx preservation strategies. The objective of th

  15. Diagnosing Appendicitis: Evidence-Based Review of the Diagnostic Approach in 2014

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    Daniel J. Shogilev

    2014-11-01

    Full Text Available Introduction: Acute appendicitis is the most common abdominal emergency requiring emergency surgery. However, the diagnosis is often challenging and the decision to operate, observe or further work-up a patient is often unclear. The utility of clinical scoring systems (namely the Alvarado score, laboratory markers, and the development of novel markers in the diagnosis of appendicitis remains controversial. This article presents an update on the diagnostic approach to appendicitis through an evidence-based review. Methods: We performed a broad Medline search of radiological imaging, the Alvarado score, common laboratory markers, and novel markers in patients with suspected appendicitis. Results: Computed tomography (CT is the most accurate mode of imaging for suspected cases of appendicitis, but the associated increase in radiation exposure is problematic. The Alvarado score is a clinical scoring system that is used to predict the likelihood of appendicitis based on signs, symptoms and laboratory data. It can help risk stratify patients with suspected appendicitis and potentially decrease the use of CT imaging in patients with certain Alvarado scores. White blood cell (WBC, C-reactive protein (CRP, granulocyte count and proportion of polymorphonuclear (PMN cells are frequently elevated in patients with appendicitis, but are insufficient on their own as a diagnostic modality. When multiple markers are used in combination their diagnostic utility is greatly increased. Several novel markers have been proposed to aid in the diagnosis of appendicitis; however, while promising, most are only in the preliminary stages of being studied. Conclusion: While CT is the most accurate mode of imaging in suspected appendicitis, the accompanying radiation is a concern. Ultrasound may help in the diagnosis while decreasing the need for CT in certain circumstances. The Alvarado Score has good diagnostic utility at specific cutoff points. Laboratory markers have

  16. Evidenzbasierte Pflegeausbildung - ein systematisches Review zur empirischen Forschungslage [Evidence-based Nursing Education - a Systematic Review of Empirical Research

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    Reiber, Karin

    2011-05-01

    Full Text Available [english] The project „Evidence-based Nursing Education – Preparatory Stage“, funded by the Baden-Württemberg within the programme (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 holistic view of

  17. Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention.

    Science.gov (United States)

    Pfefferbaum, Betty; North, Carol S

    2016-01-01

    Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.

  18. 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

  19. 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…

  20. Ocriplasmin for symptomatic vitreomacular adhesion: an evidence-based review of its potential

    Directory of Open Access Journals (Sweden)

    Song SJ

    2014-03-01

    Full Text Available Su Jeong Song,1,2 William E Smiddy1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea Abstract: Vitreomacular traction is a multicategory entity that may cause substantial visual loss due to the formation of a macular hole or traction-induced tissue distortion. The advent of optical coherent tomography (OCT has demonstrated the anatomic features of persistent vitreomacular attachment (VMA more definitively, including in many asymptomatic or minimally symptomatic patients. The indications for intervention are unclear, since it is not possible to predict which eyes might be likely to develop progressive visual loss. This has been especially important since for many years, the only treatment option involved surgical intervention (vitrectomy to release the persistent VMA. Recently, a pharmacolytic agent, ocriplasmin, has become available after many years of development and investigation, and may offer a feasible alternative to surgery, or even a risk/benefit ratio sufficiently favorable to offer intervention at an earlier stage of VMA. Several studies, including a large, prospective clinical trial, have established the foundation of its rationale and efficacy, providing the basis of its approval. The role for ocriplasmin in clinical practice is in the process of being determined. This paper summarizes current knowledge and status of investigations regarding ocriplasmin-induced pharmacologic vitreolysis, and offers some evidence-based considerations for its use. Keywords: macular edema, microplasmin, pharmacologic vitreolysis, posterior vitreous detachment

  1. 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.

  2. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

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    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

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

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    Serratrice C

    2016-10-01

    Full Text Available Christine Serratrice,1 Sebastian Carballo,2 Jacques Serratrice,2 Jérome Stirnemann2 1Department of Internal Medicine and Rehabilitation, Geneva University Hospital, Thonex, Switzerland; 2Department of General Internal Medicine, Geneva University Hospital, Geneva, Switzerland 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 1Evidence 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. Keywords: Gaucher disease, lysosomal disease, imiglucerase, treatment, therapeutic goals, safety

  4. Effectiveness of interventions to improve occupational performance of people with cognitive impairments after stroke: an evidence-based review.

    Science.gov (United States)

    Gillen, Glen; Nilsen, Dawn M; Attridge, Jessica; Banakos, Erasmia; Morgan, Marie; Winterbottom, Lauren; York, Wesley

    2015-01-01

    This evidence-based review was conducted to determine which interventions are effective in improving occupational performance after stroke. Forty-six articles met the inclusion criteria and were examined. Interventions for the following impairments were reviewed: general cognitive deficits, executive dysfunction, apraxia, memory loss, attention deficits, visual field deficits (included because of their close relationship with neglect), and unilateral neglect. Evidence is available from a variety of clinical trials to guide interventions regarding general cognition, apraxia, and neglect. The evidence regarding interventions for executive dysfunction and memory loss is limited. There is insufficient evidence regarding impairments of attention and mixed evidence regarding interventions for visual field deficits. The effective interventions have some commonalities, including being performance focused, involving strategy training, and using a compensatory as opposed to a remediation approach. The implications of the findings for practice, research, and education are discussed.

  5. 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.

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

    Science.gov (United States)

    Aiassa, E; Higgins, J P T; Frampton, G K; Greiner, M; Afonso, A; Amzal, B; Deeks, J; Dorne, J-L; Glanville, J; Lövei, G L; Nienstedt, K; O'connor, A M; Pullin, A S; Rajić, A; Verloo, D

    2015-01-01

    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 for answering questions in health care, and can be implemented to minimize 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 parameters required by a risk model may not be always feasible. This paper describes novel approaches for determining question suitability and for prioritizing questions for systematic review in this area. Risk assessment questions that aim to estimate a parameter are likely to be suitable for systematic review. Such questions can be structured by their "key elements" [e.g., for intervention questions, the population(s), intervention(s), comparator(s), and outcome(s)]. Prioritization of questions to be addressed by systematic review relies on the likely impact and related uncertainty of individual parameters in the risk model. This approach to planning and prioritizing systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment.

  7. 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.

  8. Driving and Low Vision: An Evidence-Based Review of Rehabilitation

    Science.gov (United States)

    Strong, J. Graham; Jutai, Jeffrey W.; Russell-Minda, Elizabeth; Evans, Mal

    2008-01-01

    This systematic review of the effectiveness of driver rehabilitation interventions found that driver training programs enhance driving skills and awareness, but further research is needed to determine their effectiveness in improving driving performance of drivers with low vision. More research is also needed to determine the effectiveness of low…

  9. Management of acute asthma in the pediatric patient: an evidence-based review.

    Science.gov (United States)

    Jones, Brittany Pardue; Paul, Audrey

    2013-05-01

    Asthma is the most common chronic disease of childhood, with asthma exacerbations and wheezing resulting in more than 2 million emergency department visits per year. Symptoms can vary from mild shortness of breath to fatal status asthmaticus. Given the high prevalence of asthma and its potential to progress from mild to moderate to life-threatening, it is vital for emergency clinicians to have a thorough understanding of acute asthma management. Current evidence clearly supports the use of inhaled bronchodilators and systemic steroids as first-line agents. However, in those who fail to respond to nitial therapies, a variety of adjunct therapies and interventions are available with varying degrees of evidence to support their use. This review focuses specifically on evaluation and treatment of pediatric asthma in the emergency department and reviews the current evidence for various modes of treatment.

  10. Large-diameter femoral heads in total hip arthroplasty: an evidence-based review.

    Science.gov (United States)

    Banerjee, Samik; Pivec, Robert; Issa, Kimona; Kapadia, Bhaveen H; Khanuja, Harpal S; Mont, Michael A

    2014-11-01

    Recent advances in the wear characteristics and material properties of highly cross-linked polyethyl-ene and fourth-generation ceramic bearings have led to increasing use of large-diameter (≥ 36 mm) femoral heads in total hip arthroplasty (THA). In this article, we review the current concepts and principles behind use of large-diameter ceramic or cobalt-chromium femoral heads on polyethylene bearings in THA. We specifically review the biomechanics, some of the early concerns about polyethylene wear and rim fractures, recent improvements in material properties of polyethylene and ceramic bearings, dislocation rates, and clinical and functional outcomes of large-diameter heads in THA. Recent literature suggests that the incidence of dislocation has been substantially reduced because of improvements in jump distance and impingement-free range of motion with use of large-diameter heads. Limited evidence suggests excellent short-term and midterm clinical and functional outcomes with these heads.

  11. Quality of life assessment in domestic dogs: An evidence-based rapid review.

    Science.gov (United States)

    Belshaw, Z; Asher, L; Harvey, N D; Dean, R S

    2015-11-01

    Assessment of quality of life (QoL) is an important, increasingly popular outcome measure in veterinary research and practice, particularly in dogs. In humans, QoL is commonly assessed by self-reporting and since this is not possible for animals, it is crucial that instruments designed to measure QoL are tested for reliability and validity. Using a systematic, replicable literature search strategy, the aim of this study was to find published, peer-reviewed instruments for QoL assessment in dogs and to assess the quality of these. CAB Abstracts and PubMed were searched in July 2013 using terms relevant to dogs, wellbeing and QoL. Inclusion and exclusion criteria were applied. When instruments were not published in full, authors were contacted to obtain them. Criteria were applied to assess the quality, validity and reliability of the 52 instruments obtained. Twenty-seven additional instruments used in peer-reviewed publications were not included because they had not been fully described in the publication or were not provided by authors upon request. Most of the instruments reviewed (48/52) were disease-specific rather than generic. Only four publications provided a definition of QoL or wellbeing. Only 11/52 instruments demonstrated evidence of assessing reliability or validity, and the quality of these instruments was variable. Many novel, unvalidated instruments have been generated and applied as clinical outcomes before it was known whether they measured QoL. This rapid review can be used to identify currently available and validated canine QoL instruments, and to assess the validity and quality of new or existing instruments.

  12. Bolstering the Evidence Base for Integrating Abortion and HIV Care: A Literature Review

    Directory of Open Access Journals (Sweden)

    Ruth Manski

    2012-01-01

    Full Text Available HIV-positive women have abortions at similar rates to their HIV-negative counterparts, yet little is known about clinical outcomes of abortion for HIV-positive women or the best practices for abortion provision. To fill that gap, we conducted a literature review of clinical outcomes of surgical and medication abortion among HIV-positive women. We identified three studies on clinical outcomes of surgical abortion among HIV-positive women; none showed significant differences in infectious complications by HIV status. A review of seven articles on similar gynecological procedures found no differences in complications by HIV status. No studies evaluated medication abortion among HIV-positive women. However, we did find that previously expressed concerns regarding blood loss and vomiting related to medication abortion for HIV-positive women are unwarranted based on our review of data showing that significant blood loss and vomiting are rare and short lived among women. We conclude that although there is limited research that addresses clinical outcomes of abortion for HIV-positive women, existing data suggest that medication and surgical abortion are safe and appropriate. Sexual and reproductive health and HIV integration efforts must include both options to prevent maternal mortality and morbidity and to ensure that HIV-positive women and women at risk of HIV can make informed reproductive decisions.

  13. Enzalutamide: an evidence-based review of its use in the treatment of prostate cancer

    Directory of Open Access Journals (Sweden)

    Golshayan AR

    2013-04-01

    Full Text Available Ali R Golshayan,1 Emmanuel S Antonarakis21Division of Hematology/Oncology, Medical University of South Carolina, Charleston, SC, USA; 2Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USAIntroduction: Enzalutamide is an oral androgen receptor (AR signaling inhibitor that was specifically engineered to overcome castration-resistant prostate cancer (CRPC harboring AR amplification or overexpression. Enzalutamide has demonstrated significant activity in men with metastatic CRPC.Aims: To update the evidence and provide an overview of the available data on enzalutamide.Evidence review: Peer reviewed articles published and listed in Medline Search were reviewed. In addition, relevant ASCO and ESMO abstracts were searched. The activity of enzalutamide is mediated by potently antagonizing the full-length AR, impairing translocation of the AR from the cytoplasm into the nucleus, and inhibiting the transcriptional activity of the AR by modulating the interaction of the AR with androgen-response elements in gene promoter regions. Enzalutamide has a favorable safety profile and the most common adverse events include fatigue, hot flashes and headache; 1% of patients experienced seizure. Place in Therapy: The AFFIRM phase III study evaluated the clinical utility of treatment with enzalutamide in men with docetaxel-refractory metastatic CRPC. Enzalutamide improved overall survival compared to placebo, with a median overall survival of 18.4 months versus 13.6 months respectively.Conclusion: Enzalutamide has demonstrated impressive efficacy in men with metastatic CRPC, moving swiftly from a phase I/II study to two pivotal phase III trials testing this agent in both chemotherapy-pretreated as well as chemotherapy-naïve CRPC patients. Ongoing studies are aiming to explore the utility of enzalutamide in earlier stages of the disease, and to investigate the optimal sequencing and combination of enzalutamide with other standard and novel

  14. Subcutaneous dextrose for rehydration of elderly patients – an evidence-based review

    Science.gov (United States)

    Turner, Tari; Cassano, Anne-Marie

    2004-01-01

    Background In the Rehabilitation and Aged Care Services Program at Southern Health in Victoria, saline hypodermoclysis is a relatively common method of rehydration. However, there were questions about the safety and effectiveness of subcutaneous infusion of other fluids and, in particular, dextrose solutions. This review aimed to assess the safety and effectiveness of rehydration of elderly patients with subcutaneous 5% dextrose solutions compared with intravenous 5% dextrose solutions. Methods We searched the Cochrane Library, Medline, IDIS, CINAHL, Current Contents, Premedline, Australasian Medical Index, the Joanna Briggs Institute, the US National Guideline Clearinghouse and bibliographies of retrieved articles. Searching was undertaken in July 2003. Studies selected were primary studies (or systematic reviews of primary studies) providing evidence as to the effectiveness and safety of subcutaneous infusion of dextrose solutions for rehydration of elderly patients. We included articles published in English in the last 10 years. Data were extracted by a single researcher. Results From our search we identified 15 potentially relevant articles. We obtained the full text of these articles to determine their relevance. After application of the inclusion criteria, four articles remained for appraisal including one systematic review, two randomised controlled trials and one cohort study. Conclusion The four studies appraised all provide evidence that appropriate volumes of subcutaneous dextrose infusions (in the form of half-normal saline-glucose 5%, 40 g/L dextrose and 30 mmol/L NaCl, or 5% dextrose solution and 4 g/L NaCl, or two-thirds 5% glucose and one-third normal saline) can be used effectively for the treatment of dehydration, with similar rates of adverse effects to intravenous infusion. The evidence in this area is limited, and larger randomised controlled trials using validated outcome measures would be useful to confirm these results. PMID:15086959

  15. Evidence-based review of probiotics for antibiotic-associated diarrhea and Clostridium difficile infections.

    Science.gov (United States)

    McFarland, Lynne V

    2009-12-01

    Probiotics are living microbes taken to confer a health benefit on the host. Although probiotics have a long history of use in Europe and Asia and have been on the U.S. market for over 14 years, there is still confusion about how to effectively use them. The use of probiotics for the prevention of antibiotic-associated diarrhea (AAD) and the treatment of Clostridium difficile infections (CDI) has been tested in randomized controlled clinical trials. This paper will review the evidence supporting probiotic therapy for these two diseases and also review the advantages and disadvantages of probiotics. The advantages of probiotic therapy include multiple mechanisms of action against pathogens, the ability to interact with the host's natural defense systems, survival to the target organ and a good risk to benefit ratio. Disadvantages of probiotics include lack of standardization for clinical trial designs, variations in regulatory standards, poor quality control for some products and infrequent serious adverse reactions. Overall, probiotics offer a promising strategy for the prevention and treatment for AAD and CDI.

  16. Tissue Engineering for Rotator Cuff Repair: An Evidence-Based Systematic Review

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2012-01-01

    Full Text Available The purpose of this systematic review was to address the treatment of rotator cuff tears by applying tissue engineering approaches to improve tendon healing, specifically platelet rich plasma (PRP augmentation, stem cells, and scaffolds. Our systematic search was performed using the combination of the following terms: “rotator cuff”, “shoulder”, “PRP”, “platelet rich plasma”, “stemcells”, “scaffold”, “growth factors”, and “tissue engineering”. No level I or II studies were found on the use of scaffolds and stem cells for rotator cuff repair. Three studies compared rotator cuff repair with or without PRP augmentation. All authors performed arthroscopic rotator cuff repair with different techniques of suture anchor fixation and different PRP augmentation. The three studies found no difference in clinical rating scales and functional outcomes between PRP and control groups. Only one study showed clinical statistically significant difference between the two groups at the 3-month followup. Any statistically significant difference in the rates of tendon rerupture between the control group and the PRP group was found using the magnetic resonance imaging. The current literature on tissue engineering application for rotator cuff repair is scanty. Comparative studies included in this review suggest that PRP augmented repair of a rotator cuff does not yield improved functional and clinical outcome compared with non-augmented repair at a medium and long-term followup.

  17. Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Pinky Budhrani-Shani

    2016-01-01

    Full Text Available Background. Chronic low back pain (CLBP among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.

  18. Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review

    Science.gov (United States)

    Arcari, Patricia; Langevin, Helene; Wayne, Peter M.

    2016-01-01

    Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation. PMID:27446610

  19. Evidence-based hydro- and balneotherapy in Hungary—a systematic review and meta-analysis

    Science.gov (United States)

    Bender, T.; Bálint, G.; Prohászka, Z.; Géher, P.; Tefner, I. K.

    2014-04-01

    Balneotherapy is appreciated as a traditional treatment modality in medicine. Hungary is rich in thermal mineral waters. Balneotherapy has been in extensive use for centuries and its effects have been studied in detail. Here, we present a systematic review and meta-analysis of clinical trials conducted with Hungarian thermal mineral waters, the findings of which have been published by Hungarian authors in English. The 122 studies identified in different databases include 18 clinical trials. Five of these evaluated the effect of hydro- and balneotherapy on chronic low back pain, four on osteoarthritis of the knee, and two on osteoarthritis of the hand. One of the remaining seven trials evaluated balneotherapy in chronic inflammatory pelvic diseases, while six studies explored its effect on various laboratory parameters. Out of the 18 studies, 9 met the predefined criteria for meta-analysis. The results confirmed the beneficial effect of balneotherapy on pain with weight bearing and at rest in patients with degenerative joint and spinal diseases. A similar effect has been found in chronic pelvic inflammatory disease. The review also revealed that balneotherapy has some beneficial effects on antioxidant status, and on metabolic and inflammatory parameters. Based on the results, we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for lower back pain, as well as for knee and hand osteoarthritis.

  20. Lixivaptan – an evidence-based review of its clinical potential in the treatment of hyponatremia

    Directory of Open Access Journals (Sweden)

    Bowman BT

    2013-07-01

    Full Text Available Brendan T Bowman, Mitchell H Rosner Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA Abstract: Hyponatremia is the most common electrolyte abnormality seen in clinical practice. Most cases of euvolemic or hypervolemic hyponatremia involve arginine vasopressin (AVP. AVP leads to a concentrated urine and negative free water clearance. Given this primary role of AVP, antagonizing its effect through blockade of its receptor in the distal tubule is an attractive therapeutic target. Lixivaptan is a newer, non-peptide, vasopressin type 2 receptor antagonist. Recent studies have demonstrated efficacy. This review summarizes the clinical pharmacology and data for this new agent. Keywords: vasopressin, hyponatremia, heart failure, lixivaptan, therapy, outcomes

  1. Vital pulp therapy using calcium-enriched mixture: An evidence-based review

    Directory of Open Access Journals (Sweden)

    Saeed Asgary

    2013-01-01

    Full Text Available Worldwide, casecontrol studies have revealed that the treatment outcomes of root canal therapy (RCT are generally favorable; however, the overall epidemiological success rate of RCT in the general population is relatively low. On the other hand, vitality of dental pulp is a key factor in the long-term prognosis of permanent teeth; in recent years, vital pulp therapy (VPT has received significant consideration as it has been revealed that the inflamed pulp has the potential to heal. In this review article, the current best evidence with regard to VPT using calcium-enriched mixture (CEM cement in human permanent/primary teeth is discussed. A strategy based on a search using keywords for CEM cement as well as VPT was applied.

  2. 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 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.

  3. Evidence based review of the impact of image enhanced endoscopy in the diagnosis of gastric disorders

    Science.gov (United States)

    Hussain, Ikram; Ang, Tiing Leong

    2016-01-01

    Gastric cancer is the third most common cause of cancer-related death. Advanced stages of gastric cancers generally have grim prognosis. But, good prognosis can be achieved if such cancers are detected, diagnosed and resected at early stages. However, early gastric cancers and its precursors often produce only subtle mucosal changes and therefore quite commonly remain elusive at the conventional examination with white light endoscopy. Image-enhanced endoscopy makes mucosal lesions more conspicuous and can therefore potentially yield earlier and more accurate diagnoses. Recent years have seen growing work of research in support of various types of image enhanced endoscopy (IEE) techniques (e.g., dye-chromoendoscopy; magnification endoscopy; narrow-band imaging; flexible spectral imaging color enhancement; and I-SCAN) for a variety of gastric pathologies. In this review, we will examine the evidence for the utilization of various IEE techniques in the diagnosis of gastric disorders. PMID:28042388

  4. An Evidence-Based Review of Fat Modifying Supplemental Weight Loss Products

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    Amy M. Egras

    2011-01-01

    Full Text Available Objective. To review the literature on fat modifying dietary supplements commonly used for weight loss. Methods. Recently published randomized, placebo-controlled trials were identified in PubMed, MEDLINE, International Pharmaceutical Abstracts, Cochrane Database, and Google Scholar using the search terms dietary supplement, herbal, weight loss, obesity, and individual supplement names. Discussion. Data for conjugated linoleic acid (CLA, Garcinia cambogia, chitosan, pyruvate, Irvingia gabonensis, and chia seed for weight loss were identified. CLA, chitosan, pyruvate, and Irvingia gabonensis appeared to be effective in weight loss via fat modifying mechanisms. However, the data on the use of these products is limited. Conclusion. Many obese people use dietary supplements for weight loss. To date, there is little clinical evidence to support their use. More data is necessary to determine the efficacy and safety of these supplements. Healthcare providers should assist patients in weighing the risks and benefits of dietary supplement use for weight loss.

  5. [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.

  6. Effectiveness of interventions to improve occupational performance of people with motor impairments after stroke: an evidence-based review.

    Science.gov (United States)

    Nilsen, Dawn M; Gillen, Glen; Geller, Daniel; Hreha, Kimberly; Osei, Ellen; Saleem, Ghazala T

    2015-01-01

    We conducted a review to determine the effectiveness of interventions to improve occupational performance in people with motor impairments after stroke as part of the American Occupational Therapy Association's Evidence-Based Practice Project. One hundred forty-nine studies met inclusion criteria. Findings related to key outcomes from select interventions are presented. Results suggest that a variety of effective interventions are available to improve occupational performance after stroke. Evidence suggests that repetitive task practice, constraint-induced or modified constraint-induced movement therapy, strengthening and exercise, mental practice, virtual reality, mirror therapy, and action observation can improve upper-extremity function, balance and mobility, and/or activity and participation. Commonalities among several of the effective interventions include the use of goal-directed, individualized tasks that promote frequent repetitions of task-related or task-specific movements.

  7. Evidence-based review of lasers, light sources and photodynamic therapy in the treatment of acne vulgaris

    DEFF Research Database (Denmark)

    Hædersdal, Merete; Togsverd-Bo, Katrine; Wulf, Hans Chr.

    2008-01-01

    Background There is a considerable need for effective and safe treatment for acne vulgaris. Objective In a systematic review with an evidence-based approach to assess the effects of optical treatments for acne vulgaris. Methods Original publications of controlled clinical trials were identified...... treatments included pain, erythema, oedema, crusting, hyperpigmentation, pustular eruptions and were more intense for treatments combined with ALA or MAL. Conclusion Evidence from controlled clinical trials indicates a short-term efficacy from optical treatments for acne vulgaris with the most consistent...... of 19), which applied blinded response evaluations (12 of 19) and assessed a short-term efficacy up to 12 weeks after treatment (17 of 19). Based on the present best available evidence, we conclude that optical treatments possess the potential to improve inflammatory acne on a short-term basis...

  8. Desvenlafaxine in major depressive disorder: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Daniel Z Lieberman

    2009-06-01

    Full Text Available Daniel Z Lieberman, Suena H MasseyDepartment of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USAIntroduction: Desvenlafaxine, the active metabolite of venlafaxine, is a serotonin norepinephrine reuptake inhibitor (SNRI recently approved for the treatment of major depressive disorder. It is one of only three medications in this class available in the United States.Aims: The objective of this article is to review the published evidence for the safety and efficacy of desvenlafaxine, and to compare it to other antidepressants to delineate its role in the treatment of depression.Evidence review: At the recommended dose of 50 mg per day the rate of response and remission was similar to other SNRIs, as was the adverse effect profile. The rate of discontinuation was no greater than placebo, and a discontinuation syndrome was not observed at this dose. Higher doses were not associated with greater efficacy, but they did lead to more side effects, and the use of a taper prior to discontinuation. The most common side effects reported were insomnia, somnolence, dizziness, and nausea. Some subjects experienced clinically significant blood pressure elevation.Place in therapy: Like duloxetine, desvenlafaxine inhibits the reuptake of both norepinephrine and serotonin at the starting dose. Dual reuptake inhibitors have been shown to have small but statistically significantly greater rates of response and remission compared to selective serotonin reuptake inhibitors, and they have also shown early promise in the treatment of neuropathic pain. Desvenlafaxine may prove to be a valuable treatment option by expanding the limited number of available dual reuptake inhibitors.Keywords: desvenlafaxine, depression, reuptake inhibitors, norepinephrine, serotonin

  9. Luliconazole for the treatment of fungal infections: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Khanna D

    2014-09-01

    Full Text Available Deepshikha Khanna, Subhash Bharti Department of Dermatology, Chacha Nehru Bal Chikitsalaya (Childrens Hospital, Delhi, India Abstract: Luliconazole is an imidazole antifungal agent with a unique structure, as the imidazole moiety is incorporated into the ketene dithioacetate structure. Luliconazole is the R-enantiomer, and has more potent antifungal activity than lanoconazole, which is a racemic mixture. In this review, we summarize the in vitro data, animal studies, and clinical trial data relating to the use of topical luliconazole. Preclinical studies have demonstrated excellent activity against dermatophytes. Further, in vitro/in vivo studies have also shown favorable activity against Candida albicans, Malassezia spp., and Aspergillus fumigatus. Luliconazole, although belonging to the azole group, has strong fungicidal activity against Trichophyton spp., similar to that of terbinafine. The strong clinical antifungal activity of luliconazole is possibly attributable to a combination of strong in vitro antifungal activity and favorable pharmacokinetic properties in the skin. Clinical trials have demonstrated its superiority over placebo in dermatophytosis, and its antifungal activity to be at par or even better than that of terbinafine. Application of luliconazole 1% cream once daily is effective even in short-term use (one week for tinea corporis/cruris and 2 weeks for tinea pedis. A Phase I/IIa study has shown excellent local tolerability and a lack of systemic side effects with use of topical luliconazole solution for onychomycosis. Further studies to evaluate its efficacy in onychomycosis are underway. Luliconazole 1% cream was approved in Japan in 2005 for the treatment of tinea infections. It has recently been approved by US Food and Drug Administration for the treatment of interdigital tinea pedis, tinea cruris, and tinea corporis. Topical luliconazole has a favorable safety profile, with only mild application site reactions reported

  10. Evidence based review of type 2 diabetes prevention and management in low and middle income countries

    Institute of Scientific and Technical Information of China (English)

    Aimee; Afable; Nidhi; Shree; Karingula

    2016-01-01

    AIM:To identify the newest approaches to type 2diabetes(T2DM)prevention and control in the developingworld context.METHODS:We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries,as defined by the World Bank.We searched Pub Med using Medical Subject Headings terms.Studies needed to satisfy four criteria:(1)Must be experimental;(2)Must include patients with T2DM or focusing on prevention of T2DM;(3)Must have a lifestyle intervention component;(4)Must be written in English;and(5)Must have measurable outcomes related to diabetes.RESULTS:A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014.India contributed the largest number of trials(11/66).Of the total 66 studies reviewed,all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes.The overwhelming majority of studies reported on diabetes management(56/66),and among these more than half were structured lifestyle education programs.The evidence suggests that lifestyle education led by allied health professionals(nurses,pharmacists)were as effective as those led by physicians or a team of clinicians.The remaining diabetes management interventions focused on diet or exercise,but the evidence to recommend one approach over another was weak.CONCLUSION:Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.

  11. Pramipexole in restless legs syndrome: an evidence-based review of its effectiveness on clinical outcomes

    Directory of Open Access Journals (Sweden)

    William Winlow

    2005-03-01

    Full Text Available William WinlowCore Medical Publishing, Knutsford, UKIntroduction: Restless legs syndrome (RLS affects 5–15% of adults, but is often unrecognized and consequently misdiagnosed. The International Restless Legs Scale (IRLS has been developed and validated to assess the severity of RLS. Currently, the most common treatment for RLS is levodopa, but this may lead to augmentation of symptoms. Pramipexole has been developed as an alternative treatment for patients diagnosed with RLS.Aims: The objective of this article is to review the evidence of the effectiveness of pramipexole for the clinical management of patients with RLS.Evidence review: There is clear evidence that pramipexole reduces the leg movements associated with RLS, as measured by improvements in both the IRLS and the Clinical Global Impression (CGI score. There is also moderate evidence that the drug improves sleep quality. Pramipexole clearly improves the anxiety and depression often associated with RLS. Augmentation may be associated with pramipexole treatment, but the evidence is contradictory and augmentation may be more associated with patients pretreated with levodopa or with patients with primary RLS rather than those with secondary RLS. Pramipexole therapy appears to be well tolerated, with only mild-to-moderate adverse events reported.Outcomes summary: Pramipexole reduces leg movements in RLS, and is well tolerated. Further investigation is required to confirm the preliminary evidence that pramipexole restores normal sleep architecture and restores a normal quality of life in patients with RLS. Health economic studies would be valuable in demonstrating the true impact of pramipexole on the social burden of RLS.Key words: restless legs syndrome (RLS, pramipexole, outcomes, evidence

  12. Effectiveness of infrared thermography in the diagnosis of deep vein thrombosis: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Shaydakov ME

    2017-02-01

    Full Text Available Maxim E Shaydakov, Jose A Diaz Department of Surgery, Section of Vascular Surgery, Conrad Jobst Vascular Research Laboratories, School of Medicine, University of Michigan, MI, USA Abstract: Venous thromboembolism is a serious medical, social, and economic problem. A number of treatment options exist to decrease mortality and morbidity in patients with deep vein thrombosis (DVT. An accurate and timely diagnosis of this condition is important to improve immediate and long-term prognosis. The standard diagnostic algorithm implying assessment of the clinical probability of the disease, d-dimer test, and venous duplex ultrasound is not optimal. Infrared thermography is a relatively new diagnostic modality under clinical investigation for various medical conditions. This study aims to review the published evidence on infrared thermography as a possible alternative tool in DVT diagnosis. The authors conclude that infrared thermography is still an experimental diagnostic tool for patients with DVT, and requires more clinical research evidence to support theoretical advantages and suggest a possible clinical application. Keywords: deep vein thrombosis, venous thrombosis, venous thromboembolism, infrared thermography, thermography, diagnostics

  13. A Review of Evidence-Based Care of Symptomatic Trichomoniasis and Asymptomatic Trichomonas vaginalis Infections.

    Science.gov (United States)

    Meites, Elissa; Gaydos, Charlotte A; Hobbs, Marcia M; Kissinger, Patricia; Nyirjesy, Paul; Schwebke, Jane R; Secor, W Evan; Sobel, Jack D; Workowski, Kimberly A

    2015-12-15

    Trichomonas vaginalis is the most prevalent nonviral sexually transmitted infection, affecting an estimated 3.7 million women and men in the United States. Health disparities are prominent in the epidemiology of this infection, which affects 11% of women aged ≥40 years and a disproportionately high percentage of black women. Particularly high prevalences have been identified among sexually transmitted disease (STD) clinic patients and incarcerated individuals. This article reviews and updates scientific evidence in key topic areas used for the development of the 2015 STD Treatment Guidelines published by the Centers for Disease Control and Prevention. Current evidence is presented regarding conditions associated with Trichomonas vaginalis infection, including human immunodeficiency virus (HIV) and pregnancy complications such as preterm birth. Nucleic acid amplification tests and point-of-care tests are newly available diagnostic methods that can be conducted on a variety of specimens, potentially allowing highly sensitive testing and screening of both women and men at risk for infection. Usually, trichomoniasis can be cured with single-dose therapy of an appropriate nitroimidazole antibiotic, but women who are also infected with HIV should receive therapy for 7 days. Antimicrobial resistance is an emerging concern.

  14. Review of Select Practice Parameters, Evidence-Based Treatment Algorithms, and International Guidelines for Hereditary Angioedema.

    Science.gov (United States)

    Jose, Jaison; Zacharias, Jamie; Craig, Timothy

    2016-10-01

    Hereditary angioedema (HAE) is a rare bradykinin-mediated disease that is characterized by recurrent attacks of subcutaneous or submucosal edema, which can be life threatening. HAE affects all ethnic groups equally and does not differentiate between age, sex, or race. However, the availability of therapies varies amongst countries resulting in a lack of uniformity of care. Not only is there a disparity of medication availability, but since HAE is a rare disease, it is frequently overlooked and the diagnosis is missed. Even with diagnosis, treatment and management is often less than optimal. For these reasons, it is essential to have practice parameters and guidelines. In this chapter, we focus on recent guidelines. These guidelines deal with recognition, diagnosis, medical care, patient management, and assessment, all which are essential to provide optimal care to people with a rare and orphan disease. The intent of the guidelines, and thus this chapter, is to reduce morbidity and mortality, and restore a normal quality of life for the patient with HAE. We will review the guidelines from various regions of the world as well as international group recommendations. In addition, specific patient populations such as the pregnant, elderly, and juvenile require modified treatment regimens, and for this reason, we have included these data as well. The intent of this chapter is to aid the practitioner in holistic care of the patient with HAE in order to ultimately provide the best standard of care possible.

  15. Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review

    Science.gov (United States)

    Opperer, Mathias; Danninger, Thomas; Stundner, Ottokar; Memtsoudis, Stavros G

    2014-01-01

    Over the last decades the demand for hip surgery, be it elective or in a traumatic setting, has greatly increased and is projected to expand even further. Concurrent with demographic changes the affected population is burdened by an increase in average comorbidity and serious complications. It has been suggested that the choice of anesthesia not only affects the surgery setting but also the perioperative outcome as a whole. Therefore different approaches and anesthetic techniques have been developed to offer individual anesthetic and analgesic care to hip surgery patients. Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome, showing favorable results in the usage of regional vs general anesthesia. In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome. While there still remains a scarcity of data investigating perioperative outcomes and anesthesia, most studies concur on a positive outcome in overall mortality, thromboembolic events, blood loss and transfusion requirements when comparing regional to general anesthesia. Much of the currently available evidence suggests that a comprehensive medical approach with emphasis on regional anesthesia can prove beneficial to patients and the health care system. PMID:25035837

  16. Nurse residency programs: an evidence-based review of theory, process, and outcomes.

    Science.gov (United States)

    Anderson, Gwen; Hair, Carole; Todero, Catherine

    2012-01-01

    Nursing shortages exist worldwide while job stress, dissatisfaction, lack of peer support and limited professional opportunities still contribute to attrition. The aim of this systematic review is to describe and evaluate the quality of the science, report recommendations and lessons learned about implementing and evaluating nurse residency programs (NRPs) designed to improve new graduate transitioning. Databases were searched between 1980 and 2010 using five search terms: nurse, intern, extern, transition and residency programs. Twenty studies reporting programs for new RNs fit the inclusion criteria. Three major discoveries include: 1. Wide variation in content, teaching and learning strategies make comparison across programs difficult; 2. Lack of theory in designing the educational intervention has limited the selection and development of new instruments to measure program effectiveness; and 3. Well designed quasi-experimental studies are needed. As a major nursing education redesign, NRPs could be used to test the principles, concepts and strategies of organizational transformation and experiential-interactive learning theory. By focusing on fiscal outcomes, current administrators of NRPs are missing the opportunity to implement an organizational strategy that could improve workplace environments. Healthcare organizations need to envision NRPs as a demonstration of positive clinical learning environments that can enhance intra- and interprofessional education and practice.

  17. Cardiovascular Effects of Allium Sativum (Garlic: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Shahin Akhondzadeh

    2008-07-01

    Full Text Available Garlic has been used since time immemorial as a culinary spice and medicinal herb. Garlic has been cultivated in the Middle East for more than 5,000 years and has been an important part of traditional Chinese medicine. The region with the largest commercial garlic production is central California. China is also a supplier of commercial garlic. The bulb is used medicinally. Garlic has been touted as an herb with numerous health benefits, from treating the common cold to serving as an anticancer agent. Research has proven that garlic is beneficial for those with hypertension. By thinning the blood garlic can lower blood pressure by 5 to 10 percent. It can also lower cholesterol and discourage clot formation. The sulfur compound allicin, produced by crushing or chewing fresh garlic or by taking powdered garlic products with allicin potential, in turn produces other sulfur compounds: ajoene, allyl sulfides, and vinyldithiins. Aged garlic products lack allicin, but may have activity due to the presence of S-allylcysteine. In this review, we focused on the cardiovascular effects of garlic.

  18. Dapoxetine: an evidence-based review of its effectiveness in treatment of premature ejaculation

    Directory of Open Access Journals (Sweden)

    McCarty EJ

    2012-01-01

    Full Text Available McCarty EJ, Dinsmore WWDepartment of Genitourinary Medicine, Royal Victoria Hospital, Belfast, IrelandAbstract: Premature ejaculation (PE is a major issue in male sexual health. The global prevalence of PE is estimated to be between 20% and 40%, making it the most common sexual dysfunction in men. PE causes distress and reduced quality of life for patients and has a negative impact on interpersonal relationships. Historically, it has been treated with cognitive therapy, behavioral methods, and off-label use of selective serotonin reuptake inhibitors usually used to treat depression and other psychological disorders. Dapoxetine is a selective serotonin reuptake inhibitor specifically designed to treat PE. This paper reviews the current evidence for use of dapoxetine in the treatment of PE in adult men. There is substantial evidence that dapoxetine 30 mg or 60 mg taken “on-demand” results in a significant increase in intravaginal ejaculatory latency time when compared with placebo. Patient-reported outcomes are clearly improved relative to placebo following dapoxetine therapy, indicating greater control over ejaculation, more satisfaction with intercourse, less ejaculation-related distress, and, importantly, significantly reduced interpersonal difficulty. These data were supported by consistent reports of improvement in Clinical Global Impression of change in PE following treatment with dapoxetine. Further studies are needed to evaluate long-term efficacy and health economics. The unique pharmacology of dapoxetine makes it ideal for on-demand dosing, and the clinical evidence shows dapoxetine to be an efficacious and tolerable treatment for lifelong and acquired PE.Keywords: dapoxetine, intravaginal ejaculatory latency time, patient-reported outcomes, premature ejaculation

  19. Clinical utility of treprostinil in the treatment of pulmonary arterial hypertension: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Buckley MS

    2014-06-01

    Full Text Available Mitchell S Buckley,1 Andrew J Berry,1 Nadine H Kazem,2 Shardool A Patel,3 Paul A Librodo41Department of Pharmacy, Banner Good Samaritan Medical Center, Phoenix, AZ, USA; 2Department of Pharmacy, St Joseph’s Hospital and Medical Center, Phoenix, AZ, USA; 3Department of Pharmacy, Banner Estrella Medical Center, Phoenix, AZ, USA; 4Department of Pharmacy, San Francisco VA Medical Center, San Francisco, CA, USAAbstract: Pulmonary arterial hypertension (PAH remains a progressive disease without a cure, despite the development of several treatment options over the past several decades. Its management strategy consists of the endothelin receptor antagonists (ambrisentan, bosentan, macitentan, phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil, and prostacyclin analogs (epoprostenol, treprostinil, iloprost. Treprostinil, a stable prostacyclin analog, displays vasodilatory effects in the pulmonary vasculature, as well as antiplatelet aggregation properties. Clinical practice guidelines recommend oral endothelin receptor antagonist or phosphodiesterase inhibitor therapy in mild to moderate PAH. Epoprostenol is specifically suggested as first-line therapy in moderate to severe PAH patients (ie, World Health Organization/New York Heart Association functional class III–IV. However, treprostinil may be an alternative option in these severe PAH patients. The longer half-life and stability at room temperature with treprostinil may be associated with lower risk of pulmonary hemodynamic worsening as a result of abrupt infusion discontinuation and less frequent drug preparation. These characteristics make treprostinil an attractive alternative to continuous infusion of epoprostenol, due to convenience and patient safety. The purpose of this review is to evaluate the safety and efficacy of continuous infusion of treprostinil as well as the inhaled and oral routes of administration in PAH.Keywords: treprostinil, prostacyclin, pulmonary arterial

  20. Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Stephanie Hennigan

    2008-07-01

    Full Text Available Stephanie Hennigan, Christoph Ackermann, Arthur KavanaughCenter for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California, La Jolla, California, USAIntroduction: Ankylosing spondylitis (AS is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF. Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID-refractory patients with AS.Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis.Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS.Key words: adalimumab, ankylosing

  1. Dulaglutide: an evidence-based review of its potential in the treatment of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Edwards KL

    2015-01-01

    Full Text Available Krystal L Edwards,1 Molly G Minze2 1Ambulatory Care Division, Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX, USA; 2Ambulatory Care Division, Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, TX, USA Introduction: As the prevalence of type 2 diabetes mellitus (T2DM is anticipated to continue to rise worldwide, so too are the treatment options also continuing to expand. Current guidelines recommend individualized treatment plans which allow for provider choice and diversity of pharmacotherapeutic regimens. The glucagon-like peptide-1 receptor agonist (GLP-1 RA class is rapidly expanding, with dulaglutide (Trulicity™ as a once-weekly agent recently approved. Aims: This article examines the evidence currently available on the efficacy and safety of dulaglutide for use in T2DM. Evidence review: Dulaglutide has been shown to have similar efficacy and safety to other newer GLP-1 RAs, and better glycemic control than placebo. It lowers glycated hemoglobin (A1c, fasting and postprandial glucose levels, and promotes weight loss when used as first-, second-, or third-line therapy. It has also been shown to improve β-cell function and provide cardiovascular benefits, such as lower blood pressure and improved lipid levels. Dulaglutide also has a low risk for hypoglycemia and a similar adverse effect profile to other GLP-1 RAs in the class, with transient gastrointestinal problems and potential risk for pancreatitis. Place in therapy: While long-term data on safety and efficacy are forthcoming, dulaglutide is positioned to be placed at the same level as other GLP-1 RAs in the class: as second-line therapy in addition to diet and exercise in those patients who cannot achieve glycemic control on monotherapy metformin. It may also be useful as first-line therapy instead of metformin. Conclusion: Dulaglutide is a once-weekly GLP-1 RA

  2. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: results of a systematic review.

    Science.gov (United States)

    Stallings, Virginia A; Stark, Lori J; Robinson, Karen A; Feranchak, Andrew P; Quinton, Hebe

    2008-05-01

    The Cystic Fibrosis Foundation established a process of systematic review of evidence to inform the development of clinical care guidelines and encourage evidence-based practice. The Subcommittee on Growth and Nutrition reviewed the evidence in two areas: energy intake and dosing for pancreatic enzyme replacement therapy. Evidence-based recommendations are presented here. Also, an ad hoc working group conducted a review of the literature and performed new analyses using the Cystic Fibrosis Foundation Patient Registry to update the recommendations for growth and weight-status monitoring. These Registry data-based recommendations are presented.

  3. AstroArts

    Science.gov (United States)

    De Paulis, D.

    2014-04-01

    AstroArts is the international, online cultural platform of Astronomers Without Borders (AWB). Cofounded in 2012 by visual artist Daniela de Paulis (IT/NL) and astronomer Thilina Heenatigala (Sri Lanka), AstroArts features creative works inspired by astronomy . AstroArts is an international initiative - lead by professionals working in different fields - and includes the 'guest artist of the month' and the Global Astronomy Month programmes. For the 'guest of the month', we feature one artist through a series of weekly blog posts and a Google Hangout on the last week of each month. The Hangout usually includes guests from several of the AWB ongoing programmes, together with the artist, in order to foster collaboration and interdisciplinary discussion. The 'guest of the month' programme is currently expanding to include a virtual residency initiative, which will allow one artist at the time to develop a project in collaboration with scientists affiliated with the AWB network. The projects developed as part of the virtual residency will foster global participation, making the most of online resources. Global Astronomy Month (GAM) is the most popular project of Astronomers Without Borders: founded in 2009 as a follow up of the International Year of Astronomy, GAM is a global platform for astronomy related events that take place every year in April. During GAM, AstroArts is widely featured through online panel discussions with artists and scientists, live film screenings and live performances, often especially designed for web streaming. More information on AstroArts can be found on: http://astronomerswithoutborders.org/news.htm

  4. Survey Instruments for Knowledge, Skills, Attitudes and Behaviour Related to Evidence-based Practice in Occupational Therapy: A Systematic Review.

    Science.gov (United States)

    Buchanan, Helen; Siegfried, Nandi; Jelsma, Jennifer

    2016-06-01

    The purpose of this study was to evaluate, through a systematic review, assessment instruments for evidence-based practice (EBP). The specific objectives were to (1) identify survey instruments testing EBP knowledge, skills, attitudes and behaviour; (2) determine the attributes measured by each instrument; (3) evaluate the psychometric properties of the instruments; and (4) evaluate the methodological quality of the instruments. Using the Cochrane approach, searches were conducted in Pubmed, EBSCOHost and Scopus from inception to February 2014. Papers were screened by two independent assessors, and data were extracted by one researcher. Forty papers reporting 34 instruments met the inclusion criteria and were included in the qualitative synthesis. Most instruments measured EBP behaviour (n = 33) and attitudes (n = 21). This review provides a single source of information to enable researchers to select the most robust descriptive instruments to measure EBP learner attributes. Instruments used only with occupational therapists may have resulted in some instruments being missed. For further research, it is recommended that attention is given to developing objective instruments with a focus on knowledge and skills. Copyright © 2015 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Leenarts, Laura E W; Diehle, Julia; Doreleijers, Theo A H; Jansma, Elise P; Lindauer, Ramón J L

    2013-05-01

    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 and violent behavior, this review describes psychotherapeutic treatments which focus on former broad range of psychopathological outcomes. A total of 26 randomized controlled clinical trials and seven non-randomized controlled clinical trials published between 2000 and 2012 satisfied the inclusionary criteria and were included. These studies dealt with various kinds of samples, from sexually abused and maltreated children in child psychiatric outpatient clinics or in foster care to traumatized incarcerated boys. A total of 27 studies evaluated psychotherapeutic treatments which used trauma-focused cognitive, behavioral or cognitive-behavioral techniques; only two studies evaluated trauma-specific treatments for children and adolescents with comorbid aggressive or violent behavior; and four studies evaluated psychotherapeutic treatments that predominantly focused on other mental health problems than PTSD and used non-trauma focused cognitive, behavioral or cognitive-behavioral techniques. The results of this review suggest that trauma-focused cognitive-behavioral therapy (TF-CBT) is the best-supported treatment for children following childhood maltreatment. However, in line with increased interest in the diagnosis of complex PTSD and given the likely relationship between childhood maltreatment and aggressive and violent behavior, the authors suggest that clinical practice should address a phase-oriented approach. This review concludes with a discussion of future research directions and limitations.

  6. Canagliflozin in the treatment of type 2 diabetes: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Karagiannis T

    2017-03-01

    Full Text Available Thomas Karagiannis,1 Eleni Bekiari,1 Apostolos Tsapas1,2 1Clinical Research and Evidence‑Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Harris Manchester College, University of Oxford, Oxford, United Kingdom Introduction: Deciding on an optimal medication choice for type 2 diabetes is often challenging, due to the increasing number of treatment options. Canagliflozin is a novel glucose-lowering agent belonging to sodium–glucose co-transporter 2 (SGLT2 inhibitors. Aim: The aim of this study was to examine and summarize the evidence based on the efficacy, safety, and cost-effectiveness of canagliflozin for type 2 diabetes. Evidence review: Compared to placebo, canagliflozin 100 and 300 mg lower glycated hemoglobin (HbA1c by ~0.6%–0.8%, respectively. Canagliflozin appears to be slightly more effective than dipeptidyl peptidase-4 (DPP-4 inhibitors in reducing HbA1c. It also has a favorable effect on body weight and blood pressure, both versus placebo and most active comparators. However, treatment with canagliflozin is associated with increased incidence of genital tract infections and osmotic diuresis-related adverse events. Based on short-term data, canagliflozin is not associated with increased risk for all-cause mortality and cardiovascular outcomes. Economic evaluation studies from various countries indicate that canagliflozin is a cost-effective option in dual- or triple-agent regimens. Place in therapy: As monotherapy, canagliflozin could be used in patients for whom metformin is contraindicated or not tolerated. For patients on background treatment with metformin, canagliflozin appears to be superior to sulfonylureas with respect to body weight, blood pressure and risk for hypoglycemia, and to DPP-4 inhibitors in terms of lowering HbA1c, body weight, and blood pressure. Canagliflozin also seems to be cost-effective compared with sulfonylureas and DPP-4 inhibitors as add

  7. Dutasteride: an evidence-based review of its clinical impact in the treatment of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Andrew Thomson

    2005-06-01

    Full Text Available Andrew ThomsonCore Medical Publishing, Knutsford, UKIntroduction: Benign prostatic hyperplasia (BPH is a common condition affecting older men. Bothersome symptoms can progress to serious complications such as acute urinary retention (AUR requiring surgical intervention. Dutasteride, a dual 5-alfa-reductase (5AR inhibitor (5ARI, is a recently introduced therapy for the treatment of BPH. Aims: The objective of this article is to review the evidence for the treatment of BPH with dutasteride. Evidence review: Evidence from large clinical studies shows that men with an enlarged prostate achieve a measurable decrease in prostate volume by up to 26% after 4 years of treatment with dutasteride and urinary symptoms improve after 6 months of treatment. This is achieved by rapid suppression (through inhibition of 5AR of the principal androgen (dihydrotestosterone or DHT responsible for stimulating prostatic growth. Evidence suggests that dutasteride treatment results in a reduction in risk (rather than delay of the most serious complications including episodes of AUR and the need for BPH-related surgery. Early symptom relief has been achieved with the combination of an alfa blocker and dutasteride. There is good evidence that dutasteride is well tolerated; side effects limited to sexual dysfunction (reduced libido, impotence, and gynecomastia are more common compared with placebo but occur with a similar incidence to finasteride, another 5ARI. No pharmacoeconomic evidence from studies with dutasteride has so far been published.Clinical value: In conclusion, dutasteride is a valuable treatment option in men with moderate to severe BPH. Reductions in prostate volume lead to symptom relief and serious complications appear to be reduced.Key words: dutasteride, evidence-based review, benign prostatic hyperplasia (BPH, 5-alfa-reductase inhibitor

  8. Family functioning in children and adolescents with spina bifida: an evidence-based review of research and interventions.

    Science.gov (United States)

    Holmbeck, Grayson N; Greenley, Rachel Neff; Coakley, Rachael Millstein; Greco, Joshua; Hagstrom, Jennifer

    2006-06-01

    Research on the adjustment of families of children with spina bifida is reviewed, with a focus on delineating the impact of spina bifida on family functioning, the strengths and weaknesses of past research, and the needs for future evidence-based research on family interventions with this population. PsychINFO and MEDLINE literature searches were used to identify studies of family functioning and family-based interventions for children with spina bifida. Identified studies were empirically evaluated for the presence or absence of key methodological or analytic criteria. Thirty-two studies of family functioning were identified from 25 separate research groups; most studies displayed significant methodological limitations. No published studies of interventions to promote adaptive family functioning were identified. Methodologically sound, longitudinal, and theory-driven studies of family functioning are needed, as are randomized family-based intervention trials to promote adaptive functioning and better psychosocial outcomes in families of children with spina bifida. Specific recommendations for future work as well as clinical implications are noted.

  9. Effectiveness of interventions for adults with psychological or emotional impairment after stroke: an evidence-based review.

    Science.gov (United States)

    Hildebrand, Mary W

    2015-01-01

    This evidence-based review was conducted to evaluate the effectiveness of occupational therapy interventions to prevent or mitigate the effects of psychological or emotional impairments after stroke. Thirty-nine journal articles met the inclusion criteria. Six types of interventions were identified that addressed depression, anxiety, or mental health-related quality of life: exercise or movement based, behavioral therapy and stroke education, behavioral therapy only, stroke education only, care support and coordination, and community-based interventions that included occupational therapy. Evidence from well-conducted research supports using problem-solving or motivational interviewing behavioral techniques to address depression. The evidence is inconclusive for using multicomponent exercise programs to combat depression after stroke and for the use of stroke education and care support and coordination interventions to address poststroke anxiety. One study provided support for an intensive multidisciplinary home program in improving depression, anxiety, and health-related quality of life. The implications of the findings for practice, research, and education are discussed.

  10. The Astro-WISE

    CERN Document Server

    McFarland, J P; Valentijn, E A

    2012-01-01

    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 final catalog. The implementation of quality control mechanisms relies on the core features in this Astro-WISE Environment (AWE): an object-oriented framework, full data lineage, and both forward and backward chaining. Quality control information can be accessed via the command-line awe-prompt and the web-based Quality-WISE service. The quality control system is described and qualified using archive data from the 8-CCD Wide Field Imager (WFI) instrument (http://www.eso.org/lasilla/instruments/wfi/) on the 2.2-m MPG/ESO telescope at La Silla and (pre-)survey data from the 32-CCD OmegaCAM instrument (http://www.astro-wise.org/~omegacam/) on the VST telescope at Paranal.

  11. Evaluation of distal symmetric polyneuropathy: the role of laboratory and genetic testing (an evidence-based review).

    Science.gov (United States)

    England, J D; Gronseth, G S; Franklin, G; Carter, G T; Kinsella, L J; Cohen, J A; Asbury, A K; Szigeti, K; Lupski, J R; Latov, N; Lewis, R A; Low, P A; Fisher, M A; Herrmann, D; Howard, J F; Lauria, G; Miller, R G; Polydefkis, M; Sumner, A J

    2009-01-01

    Distal symmetric polyneuropathy (DSP) is the most common variety of neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of laboratory and genetic tests for the assessment of DSP. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyneuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Screening laboratory tests may be considered for all patients with polyneuropathy (Level C). Those tests that provide the highest yield of abnormality are blood glucose, serum B(12) with metabolites (methylmalonic acid with or without homocysteine), and serum protein immunofixation electrophoresis (Level C). If there is no definite evidence of diabetes mellitus by routine testing of blood glucose, testing for impaired glucose tolerance may be considered in distal symmetric sensory polyneuropathy (Level C). (2) Genetic testing is established as useful for the accurate diagnosis and classification of hereditary neuropathies (Level A). Genetic testing may be considered in patients with cryptogenic polyneuropathy who exhibit a hereditary neuropathy phenotype (Level C). Initial genetic testing should be guided by the clinical phenotype, inheritance pattern, and electrodiagnostic (EDX) features and should focus on the most common abnormalities, which are CMT1A duplication/HNPP deletion, Cx32 (GJB1), and MFN2 mutation screening. There is insufficient evidence to determine the usefulness of routine genetic testing in patients with cryptogenic polyneuropathy who do not exhibit a hereditary neuropathy phenotype (Level U).

  12. Evaluation of distal symmetric polyneuropathy: the role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review).

    Science.gov (United States)

    England, J D; Gronseth, G S; Franklin, G; Carter, G T; Kinsella, L J; Cohen, J A; Asbury, A K; Szigeti, K; Lupski, J R; Latov, N; Lewis, R A; Low, P A; Fisher, M A; Herrmann, D; Howard, J F; Lauria, G; Miller, R G; Polydefkis, M; Sumner, A J

    2009-01-01

    Distal symmetric polyneuropathy (DSP) is the most common variety of neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyneuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyneuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyneuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic neuropathy (Level B) and distal small fiber sensory polyneuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected amyloid neuropathy, mononeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyneuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyneuropathy.

  13. Absence of evidence for enhanced benefit of antibiotic therapy on recurrent acute rhinosinusitis episodes: a systematic review of the evidence base

    NARCIS (Netherlands)

    Kaper, N.M.; Breukel, L.; Venekamp, R.P.; Grolman, W.; van der Heijden, G.J.M.G.

    2013-01-01

    Objective To systematically review the evidence base on the effectiveness of short-course antibiotic therapy in adult patients with a recurrent episode of acute rhinosinusitis as part of a disease pattern on severity and duration of symptoms and recurrences. Data Sources PubMed, EMBASE, and the Coch

  14. Psoriasis, cardiovascular events, cancer risk and alcohol use: evidence-based recommendations based on systematic review and expert opinion.

    Science.gov (United States)

    Richard, M-A; Barnetche, T; Horreau, C; Brenaut, E; Pouplard, C; Aractingi, S; Aubin, F; Cribier, B; Joly, P; Jullien, D; Le Maître, M; Misery, L; Ortonne, J-P; Paul, C

    2013-08-01

    The relationship between psoriasis, chronic inflammation, cardiovascular risk and risk of cancer has long been debated. In addition, it has been suggested that alcohol consumption may be a risk factor for psoriasis onset and severity. The aim of this study was to develop evidence-based recommendations on the risk of comorbidities and its management for daily clinical use, focusing on cardiovascular risk, risk of cancer and alcohol use in psoriasis. A scientific committee identified and selected through the Delphi method clinically relevant questions about cardiovascular risk, risk of cancer and alcohol use in psoriasis. To address these questions, a systematic literature search was performed in Medline, Embase and the Cochrane Library databases. Systematic literature reviews including meta-analysis whenever possible were performed. Subsequently, an Expert board meeting involving 39 dermatologists took place to analyse the evidence and to elaborate recommendations on the selected questions. Recommendations were graded according to the Oxford level of evidence grading system. The degree of agreement of these recommendations was assessed on a 10-point scale, as well as their potential impact on daily clinical practice. A total of 3242 articles were identified through the systematic literature searches, among which 110 were included in the systematic reviews. Overall, 12 recommendations were elaborated regarding comorbidities management in psoriasis patients. A moderate increased risk of cardiovascular diseases (CVD), mainly myocardial infarction (MI) [meta-analysis of cohort studies: OR = 1.25 (95% CI 1.03-1.52) and of cross-sectional studies: OR = 1.57 (95% CI 1.08-2.27)], and coronary artery disease (CAD) [meta-analysis of cross-sectional: OR = 1.19 (95% CI 1.14-1.24), of cohort studies: OR = 1.20 (95% CI 1.13-1.27) and of case-control studies: OR = 1.84 (95% CI 1.09-3.09)] was acknowledged. This increased cardiovascular risk requires appropriate prevention

  15. Complementary & Alternative Management of Parkinson’s Disease: An Evidence-Based Review of Eastern Influenced Practices

    Directory of Open Access Journals (Sweden)

    Danny Bega

    2014-10-01

    Full Text Available The prevalence of Parkinson’s disease (PD appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative medicine (CAM modalities in countries like Korea may be as high as 76%. Among patients with PD, herbal medicines, health supplement foods, and acupuncture are interventions which are increasingly used throughout the world. Countries like Korea, China, India, and Japan have long embraced and incorporated traditional medicine into modern management of conditions such as PD, but research into various CAM modalities remains in its infancy limiting evidence-based recommendations for many treatments. We reviewed the literature on CAM treatments for PD, focusing on mind-body interventions and natural products. Based on evidence limited to randomized-controlled trials we found that mind-body interventions are generally effective forms of physical activity that are likely to foster good adherence and may reduce disability associated with PD. Based on the current data, modalities like Tai Chi and dance are safe and beneficial in PD, but better studies are needed to assess the effects of other frequently used modalities such as yoga and acupuncture. Furthermore, despite centuries of experience using medicinal herbs and plants in Eastern countries, and despite substantial preclinical data on the beneficial effects of nutritional antioxidants as neuroprotective agents in PD, there is insufficient clinical evidence that any vitamin, food additive, or supplement, can improve motor function or delay disease progression in PD.

  16. Reviewing the Evidence Base for the Children and Young People Safety Thermometer (CYPST: A Mixed Studies Review

    Directory of Open Access Journals (Sweden)

    Lydia Aston

    2016-01-01

    Full Text Available The objective was to identify evidence to support use of specific harms for the development of a children and young people’s safety thermometer (CYPST. We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS. Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods. A review of PEWS was identified so other studies on this issue were excluded. No relevant studies about extravasation injury were identified. The synthesized results therefore focused on pain and skin integrity. Measurement and perception of pain were complex and not always carried out according to best practice. Skin abrasions were common and mostly associated with device related injuries. The findings demonstrate a need for further work on perceptions of pain and effective communication of concerns about pain between parents and nursing staff. Strategies for reducing device-related injuries warrant further research focusing on prevention. Together with the review of PEWS, these synthesized findings support the inclusion of pain, skin integrity, and PEWS in the CYPST.

  17. Evidence-Based Practice: A Review of Theoretical Assumptions and Effectiveness of Teaching and Assessment Interventions in Health Professions

    Science.gov (United States)

    Thomas, Aliki; Saroyan, Alenoush; Dauphinee, W. Dale

    2011-01-01

    Health care professionals are expected to use a systematic approach based on evidence, professional reasoning and client preferences in order to improve client outcomes. In other words, they are expected to work within an evidence-based practice (EBP) context. This expectation has had an impact on occupational therapy academic programs' mandates…

  18. Analytics4Action Evaluation Framework: A Review of Evidence-Based Learning Analytics Interventions at the Open University UK

    Science.gov (United States)

    Rienties, Bart; Boroowa, Avinash; Cross, Simon; Kubiak, Chris; Mayles, Kevin; Murphy, Sam

    2016-01-01

    There is an urgent need to develop an evidence-based framework for learning analytics whereby stakeholders can manage, evaluate, and make decisions about which types of interventions work well and under which conditions. In this article, we will work towards developing a foundation of an Analytics4Action Evaluation Framework (A4AEF) that is…

  19. Doctors' perceptions and use of evidence-based medicine: a systematic review and thematic synthesis of qualitative studies.

    NARCIS (Netherlands)

    Swennen, M.H.J.; Heijden, G.J.M.G. van der; Boeije, H.R.; Rheenen, N. van; Verheul, F.J.M.; Graaf, Y. van der; Kalkman, C.J.

    2013-01-01

    Purpose: Many primary qualitative studies of barriers and facilitators for doctors’ use of evidence-based medicine (EBM) are available, but knowledge remains fragmented. This study sought to synthesize the results of these qualitative studies, taking the variability across context (i.e., medical dis

  20. Building the Evidence Base of Blood-Based Biomarkers for Early Detection of Cancer: A Rapid Systematic Mapping Review

    Directory of Open Access Journals (Sweden)

    Lesley Uttley

    2016-08-01

    Interpretation: This study is the first to systematically and comprehensively map blood biomarkers for early detection of cancer. Use of this rapid systematic mapping approach found a broad range of relevant biomarkers allowing an evidence-based approach to identification of promising biomarkers for development of a blood-based cancer screening test in the general population.

  1. Canagliflozin in the treatment of type 2 diabetes: an evidence-based review of its place in therapy

    Science.gov (United States)

    Karagiannis, Thomas; Bekiari, Eleni; Tsapas, Apostolos

    2017-01-01

    Introduction Deciding on an optimal medication choice for type 2 diabetes is often challenging, due to the increasing number of treatment options. Canagliflozin is a novel glucose-lowering agent belonging to sodium–glucose co-transporter 2 (SGLT2) inhibitors. Aim The aim of this study was to examine and summarize the evidence based on the efficacy, safety, and cost-effectiveness of canagliflozin for type 2 diabetes. Evidence review Compared to placebo, canagliflozin 100 and 300 mg lower glycated hemoglobin (HbA1c) by ~0.6%–0.8%, respectively. Canagliflozin appears to be slightly more effective than dipeptidyl peptidase-4 (DPP-4) inhibitors in reducing HbA1c. It also has a favorable effect on body weight and blood pressure, both versus placebo and most active comparators. However, treatment with canagliflozin is associated with increased incidence of genital tract infections and osmotic diuresis-related adverse events. Based on short-term data, canagliflozin is not associated with increased risk for all-cause mortality and cardiovascular outcomes. Economic evaluation studies from various countries indicate that canagliflozin is a cost-effective option in dual- or triple-agent regimens. Place in therapy As monotherapy, canagliflozin could be used in patients for whom metformin is contraindicated or not tolerated. For patients on background treatment with metformin, canagliflozin appears to be superior to sulfonylureas with respect to body weight, blood pressure and risk for hypoglycemia, and to DPP-4 inhibitors in terms of lowering HbA1c, body weight, and blood pressure. Canagliflozin also seems to be cost-effective compared with sulfonylureas and DPP-4 inhibitors as add-on to metformin monotherapy, and compared with DPP-4 inhibitors as add-on to metformin and sulfonylurea. Conclusion Current evidence on intermediate efficacy outcomes, short-term safety and cost-effectiveness support the use of canagliflozin in patients on background treatment with metformin

  2. Evidence based review: positive versus negative effects of livestock grazing on wildlife. What do we really know?

    Science.gov (United States)

    Schieltz, Jennifer M.; Rubenstein, Daniel I.

    2016-11-01

    More than a quarter of earth’s land surface is used for grazing domestic livestock. Livestock grazing is generally assumed to negatively affect wildlife, however, a number of studies have found positive impacts as well. We conducted an evidence-based review of the existing literature using a series of livestock- and wildlife-related search words to systematically query Google Scholar and Web of Science. A total of 807 sources were included in the final list, including 646 primary sources which reported original data. The majority of studies were conducted in North America (338) or Europe (123), with many fewer from Africa (57), Australia (54), Central/South America (43), or Asia (31). Most studies examined birds (330) and mammals (262), with fewer including reptiles (91) or amphibians (58). We extracted further information from studies that included mammals on positive, negative, and neutral effects of livestock grazing on mammals. We found that livestock change vegetation structure and cover in ways important to small mammals, while ungulates may be affected more by interference competition and changes in forage quantity and quality. Community-level total abundance of small mammals typically declines with grazing. Species richness of small mammals either declines or stays the same, as many studies found a change in species composition from ungrazed to grazed sites while the number of species remained similar. Individual species responses of small mammals vary. Voles, harvest mice, cotton rats, and shrews show consistently negative responses to grazing while deer mice, kangaroo rats, ground squirrels, and lagomorphs show positive or variable responses. In general, species adapted to open habitats are often positively affected by grazing, while species needing denser cover are negatively affected. Studies of wild ungulates are more variable in methodology and quality than those for small mammals. We found more negative (n = 86) than positive (n = 34) ungulate

  3. Evidence-Based Cancer Imaging

    Science.gov (United States)

    Khorasani, Ramin

    2017-01-01

    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.

  4. The ASTRO-H Mission

    OpenAIRE

    高橋, 忠幸; Takahashi, Tadayuki; 満田, 和久; Mitsuda, Kazuhisa; Kelley, Richard; ASTRO-H team

    2010-01-01

    The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS) The planned launch date is 2014. ASTRO-H will investigate the physics of the high-energy universe by performing high-resolution, highthroughput spectroscopy with moderate spatial resolution over the 0.3 - 600 keV energy range. ASTRO-H is a combination of wide band X-ray spectroscopy (3 - 80 keV) provided by multi-layer coating, f...

  5. Librarians' roles in evidence-based dentistry education: a review of literature and a survey in North America.

    Science.gov (United States)

    Gu, Xiao-Mei

    2010-10-01

    This study describes the current roles of dental librarians in Evidence-based Dentistry (EBD) education including their perceptions of EBD and barriers to their involvement. A Web-based survey was distributed to the dental librarians in North America, with a 71% response rate. The results showed that the majority of dental librarians are playing multiple and diverse roles in EBD education. The most frequently cited barrier to their involvement is the low level of interest from the dental faculty/student/school. Most dental librarians felt competent in supporting EBD, although continuing education needs in both EBD and teaching skills were pointed out.

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

    OpenAIRE

    Robertson, C.; Archibald, D.; Avenell, A.; Douglas, F; Hoddinott, P.; van Teijlingen, Edwin; Boyers, D.; Stewart, F.; Boachie, C.; Fioratou, E.; Wilkins, D.; Street, T.; Carroll, P.; Fowler, C

    2014-01-01

    Background\\ud 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.\\ud Objective\\ud 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 inte...

  7. Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries.

    Directory of Open Access Journals (Sweden)

    Margaret M Demment

    Full Text Available Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs.We conducted a scoping study based on the six-stage framework of Arskey and O'Malley. We searched PubMed, Cochrane Reviews, and CINAHL with the following inclusion criteria: 1 published between 2005-February 2015, 2 focused on breast or cervical cancer 3 focused on LMIC, 4 review article, and 5 published in English.Through our systematic search, 63 out of the 94 identified cervical cancer reviews met our selection criteria and 36 of the 54 in breast cancer. Cervical cancer reviews were more likely to focus upon prevention and screening, while breast cancer reviews were more likely to focus upon treatment and survivorship. Few of the breast cancer reviews referenced research and data from LMICs themselves; cervical cancer reviews were more likely to do so. Most reviews did not include elements of the PRISMA checklist.Overall, a limited evidence base supports breast and cervical cancer control in LMICs. Further breast and cervical cancer prevention and control studies are necessary in LMICs.

  8. Psychotropic Medications in Children with Autism Spectrum Disorders: A Systematic Review and Synthesis for Evidence-Based Practice

    Science.gov (United States)

    Siegel, Matthew; Beaulieu, Amy A.

    2012-01-01

    This paper presents a systematic review, rating and synthesis of the empirical evidence for the use of psychotropic medications in children with autism spectrum disorders (ASD). Thirty-three randomized controlled trials (RCTs) published in peer-reviewed journals qualified for inclusion and were coded and analyzed using a systematic evaluative…

  9. Systematic review of evidence-based guidelines on medication therapy for upper respiratory tract infection in children with AGREE instrument.

    Directory of Open Access Journals (Sweden)

    Linan Zeng

    Full Text Available OBJECTIVES: To summarize recommendations of existing guidelines on the treatment of upper respiratory tract infections (URTIs in children, and to assess the methodological quality of these guidelines. METHODS: We searched seven databases and web sites of relevant academic agencies. Evidence-based guidelines on pediatric URTIs were included. AGREE II was used to assess the quality of these guidelines. Two researchers selected guidelines independently and extracted information on publication years, institutions, target populations, recommendations, quality of evidence, and strength of recommendations. We compared the similarities and differences of recommendations and their strength. We also analyzed the reasons for variation. RESULTS: Thirteen guidelines meeting our inclusion criteria were included. Huge differences existed among these 13 guidelines concerning the categorization of evidence and recommendations. Nearly all of these guidelines lacked the sufficient involvement of stake holders. Further, the applicability of these guidelines still needs to be improved. In terms of recommendations, penicillin and amoxicillin were suggested for group A streptococcal pharyngitis. Amoxicillin and amoxicillin-clavulanate were recommended for acute bacterial rhinosinusitis (ABRS. An observation of 2-3 days prior to antibiotic therapy initiation for mild acute otitis media (AOM was recommended with amoxicillin as the suggested first choice agent. Direct evidence to support strong recommendations on the therapy for influenza is still lacking. In addition, the antimicrobial durations for pharyngitis and ABRS were still controversial. No consensus was reached for the onset of antibiotics for ABRS in children. CONCLUSIONS: Future guidelines should use a consistent grading system for the quality of evidence and strength of recommendations. More effort needs to be paid to seek the preference of stake holders and to improve the applicability of guidelines

  10. 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

    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 for answe......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...... review. Such questions can be structured by their “key elements” (e.g., for intervention questions, the population(s), intervention(s), comparator(s) and outcome(s)). Prioritisation of questions to be addressed by systematic review relies on the likely impact and related uncertainty of individual...

  11. Vaccination in adult patients with auto-immune inflammatory rheumatic diseases : A systematic literature review for the European League Against Rheumatism evidence-based recommendations for vaccination in adult patients with auto-immune inflammatory rheumatic diseases

    NARCIS (Netherlands)

    van Assen, S.; Elkayam, O.; Agmon-Levin, N.; Cervera, R.; Doran, M. F.; Dougados, M.; Emery, P.; Geborek, P.; Ioannidis, J. P. A.; Jayne, D. R. W.; Kallenberg, C. G. M.; Mueller-Ladner, U.; Shoenfeld, Y.; Stojanovich, L.; Valesini, G.; Wulffraat, N. M.; Bijl, M.

    2011-01-01

    Objectives: To present the systematic literature review (SLR), which formed the basis for the European League Against Rheumatism (EULAR) evidence-based recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD). Methods: AIIRD, vaccines and immunomodula

  12. Selective and integrated rehabilitation programs for disturbances of visual/spatial attention and executive function after brain damage: a neuropsychological evidence-based review.

    Science.gov (United States)

    Zoccolotti, P; Cantagallo, A; De Luca, M; Guariglia, C; Serino, A; Trojano, L

    2011-03-01

    The present evidence-based review systematically examines the literature on the neuropsychological rehabilitation of attentional and executive dysfunctions in patients with acquired brain lesions. Four areas are considered: 1) neuropsychological rehabilitation of attentional disorders; 2) neuropsychological rehabilitation of neglect disorders; 3) neuropsychological rehabilitation of dysexecutive disorders and 4) rehabilitation trainings for patients with mild traumatic brain injury (TBI). In each area, search and selection of papers were performed on several databases and integrated by crosschecking references from relevant and recent reviews. The literature up to 2007 was examined (in some areas the search was limited from 2000 to 2007). Class of evidence for each selected study was evaluated according to the SPREAD (2010) criteria. Based on this analysis, recommendations on the effectiveness of rehabilitation trainings are proposed separately for each rehabilitation method in each of the four areas considered. Information on follow-up data and impact on activities of daily living is provided whenever available.

  13. Implications and applications of systematic reviews for evidence-based dentistry and comparative effectiveness research: A sample study on antibiotics for oro-facial cellulitis treatment

    Directory of Open Access Journals (Sweden)

    Quyen Bach

    2015-01-01

    Full Text Available Introduction: Comparative effectiveness and efficacy research for analysis and practice (CEERAP was performed to assess the effects of penicillin-based versus erythromycin-based antibiotic treatments in patients with skin and soft tissue infections (SSTIs including cellulitis, impetigo, and erysipelas. Because SSTIs, especially orofacial cellulitis, are volatile infectious diseases of a life-threatening nature, research on the most efficacious remedies is necessary. Methods: The stringent bibliome yielded three systematic reviews, which were examined for quality of research synthesis protocol and clinical relevance. Results: The sample size of three, rendered the statistical analyses and cumulative meta-analysis problematic. Conclusion: The systematic review outlined here should aid in increasing clinical awareness, improving patient health literacy, and promoting consensus of the best evidence base (BEB to mitigate the threat of sepsis and potential death caused by cellulitis infections.

  14. Evaluating the evidence for evidence-based medicine: are randomized clinical trials less flawed than other forms of peer-reviewed medical research?

    Science.gov (United States)

    Steen, R Grant; Dager, Stephen R

    2013-09-01

    Evidence-based medicine considers randomized clinical trials (RCTs) to be the strongest form of evidence for clinical decision making. To test the hypothesis that RCTs have fewer methodological flaws than non-RCTs, limitations of 17,591 RCTs and 39,029 non-RCTs were characterized. Panels of experts assembled to write meta-analyses evaluated this literature to determine which articles should be included in 316 meta-analytic reviews. Overall, 38.7% of RCTs evaluated were excluded from review for an identified flaw. Commonly identified flaws in RCTs were as follows: insufficient data provided to evaluate the study (9.6% of 17,591 RCTs); inadequate randomization (9.0%); inadequate blinding (4.9%); and duplicative publication (4.4%). Overall, 20.2% of all published medical research has an identified methodological flaw, with RCTs having as many limitations as non-RCTs.

  15. The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review

    Science.gov (United States)

    Mimura, C; Griffiths, P

    2003-01-01

    The effectiveness of current approaches to workplace stress management for nurses was assessed through a systematic review. Seven randomised controlled trials and three prospective cohort studies assessing the effectiveness of a stress management programmes were identified and reviewed. The quality of research identified was weak. There is more evidence for the effectiveness of programmes based on providing personal support than environmental management to reduce stressors. However, since the number and quality of studies is low, the question as to which, if any, approach is more effective cannot be answered definitively. Further research is required before clear recommendations for the use of particular interventions for nursing work related stress can be made. PMID:12499451

  16. Training Teachers in Evidence-Based Practice for Individuals with Autism Spectrum Disorder: A Review of the Literature

    Science.gov (United States)

    Alexander, Jennifer L.; Ayres, Kevin M.; Smith, Katie A.

    2015-01-01

    In this review, the authors include 23 studies where researchers experimentally evaluated training for teachers of students with Autism Spectrum Disorder (ASD). Authors summarized qualitative information on study and participant characteristics. Next, variables related to teacher practice and student learning targets were categorized based on…

  17. Strategies to reduce long-term postchemoradiation dysphagia in patients with head and neck cancer: an evidence-based review.

    NARCIS (Netherlands)

    Paleri, V.; Roe, J.W.; Strojan, P.; Corry, J.; Gregoire, V.; Hamoir, M.; Eisbruch, A.; Mendenhall, W.M.; Silver, C.E.; Rinaldo, A.; Takes, R.P.; Ferlito, A.

    2014-01-01

    BACKGROUND: Swallowing dysfunction following chemoradiation for head and neck cancer is a major cause of morbidity and reduced quality of life. This review discusses 3 strategies that may improve posttreatment swallowing function. METHODS: The literature was assessed by a multiauthor team that produ

  18. AstroCom NYC: Expanding the Partnership

    Science.gov (United States)

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

    2015-01-01

    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. 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. For our second cohort, we dramatically improved the application and screening process, implemented a number of tools to evaluate their potential for grad school, and began growing a network of potential hosts for summer internships around NY State and the US. We review these implementations and outcomes, as well as plans for Year 3, when we expect many of our current students to compete for external summer REUs, and after greatly expanding the program reach through a NASA community college initiative.

  19. The ASTRO-H Mission

    CERN Document Server

    Takahashi, Tadayuki; Kelley, Richard; Aharonian, Felix; Akimoto, Fumie; Allen, Steve; Anabuki, Naohisa; Angelini, Lorella; Arnaud, Keith; Awaki, Hisamitsu; Bamba, Aya; Bando, Nobutaka; Bautz, Mark; Blandford, Roger; Boyce, Kevin; Brown, Greg; Chernyakova, Maria; Coppi, Paolo; Costantini, Elisa; Cottam, Jean; Crow, John; de Plaa, Jelle; de Vries, Cor; Herder, Jan-Willem den; DiPirro, Michael; Done, Chris; Dotani, Tadayasu; Ebisawa, Ken; Enoto, Teruaki; Ezoe, Yuichiro; Fabian, Andrew; Fujimoto, Ryuichi; Fukazawa, Yasushi; Funk, Stefan; Furuzawa, Akihiro; Galeazzi, Massimiliano; Gandhi, Poshak; Gendreau, Keith; Gilmore, Kirk; Haba, Yoshito; Hamaguchi, Kenji; Hatsukade, Isamu; Hayashida, Kiyoshi; Hiraga, Junko; Hirose, Kazuyuki; Hornschemeier, Ann; Hughes, John; Hwang, Una; Iizuka, Ryo; Ishibashi, Kazunori; Ishida, Manabu; Ishimura, Kosei; Ishisaki, Yoshitaka; Isobe, Naoki; Ito, Masayuki; Iwata, Naoko; Kaastra, Jelle; Kallman, Timothy; Kamae, Tuneyoshi; Katagiri, Hideaki; Kataoka, Jun; Katsuda, Satoru; Kawaharada, Madoka; Kawai, Nobuyuki; Kawasaki, Shigeo; Khangaluyan, Dmitry; Kilbourne, Caroline; Kinugasa, Kenzo; Kitamoto, Shunji; Kitayama, Tetsu; Kohmura, Takayoshi; Kokubun, Motohide; Kosaka, Tatsuro; Kotani, Taro; Koyama, Katsuji; Kubota, Aya; Kunieda, Hideyo; Laurent, Philippe; Lebrun, Francois; Limousin, Olivier; Loewenstein, Michael; Long, Knox; Madejski, Grzegorz; Maeda, Yoshitomo; Makishima, Kazuo; Markevitch, Maxim; Matsumoto, Hironori; Matsushita, Kyoko; McCammon, Dan; Miller, Jon; Mineshige, Shin; Minesugi, Kenji; Miyazawa, Takuya; Mizuno, Tsunefumi; Mori, Koji; Mori, Hideyuki; Mukai, Koji; Murakami, Hiroshi; Murakami, Toshio; Mushotzky, Richard; Nakagawa, Yujin; Nakagawa, Takao; Nakajima, Hiroshi; Nakamori, Takeshi; Nakazawa, Kazuhiro; Namba, Yoshiharu; Nomachi, Masaharu; Dell, Steve O'; Ogawa, Hiroyuki; Ogawa, Mina; Ogi, Keiji; Ohashi, Takaya; Ohno, Masanori; Ohta, Masayuki; Okajima, Takashi; Ota, Naomi; Ozaki, Masanobu; Paerels, Frits; Paltani, Stéphane; Parmer, Arvind; Petre, Robert; Pohl, Martin; Porter, Scott; Ramsey, Brian; Reynolds, Christopher; Sakai, Shin-ichiro; Sambruna, Rita; Sato, Goro; Sato, Yoichi; Serlemitsos, Peter; Shida, Maki; Shimada, Takanobu; Shinozaki, Keisuke; Shirron, Peter; Smith, Randall; Sneiderman, Gary; Soong, Yang; Stawarz, Lukasz; Sugita, Hiroyuki; Szymkowiak, Andrew; Tajima, Hiroyasu; Takahashi, Hiromitsu; Takei, Yoh; Tamagawa, Toru; Tamura, Takayuki; Tamura, Keisuke; Tanaka, Takaaki; Tanaka, Yasuo; Tanaka, Yasuyuki; Tashiro, Makoto; Tawara, Yuzuru; Terada, Yukikatsu; Terashima, Yuichi; Tombesi, Francesco; Tomida, Hiroshi; Tozuka, Miyako; Tsuboi, Yoko; Tsujimoto, Masahiro; Tsunemi, Hiroshi; Tsuru, Takeshi; Uchida, Hiroyuki; Uchiyama, Yasunobu; Uchiyama, Hideki; Ueda, Yoshihiro; Uno, Shinichiro; Urry, Meg; Watanabe, Shin; White, Nicholas; Yamada, Takahiro; Yamaguchi, Hiroya; Yamaoka, Kazutaka; Yamasaki, Noriko; Yamauchi, Makoto; Yamauchi, Shigeo; Yatsu, Yoichi; Yonetoku, Daisuke; Yoshida, Atsumasa

    2010-01-01

    The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe by performing high-resolution, high-throughput spectroscopy with moderate angular resolution. ASTRO-H covers very wide energy range from 0.3 keV to 600 keV. ASTRO-H allows a combination of wide band X-ray spectroscopy (5-80 keV) provided by multilayer coating, focusing hard X-ray mirrors and hard X-ray imaging detectors, and high energy-resolution soft X-ray spectroscopy (0.3-12 keV) provided by thin-foil X-ray optics and a micro-calorimeter array. The mission will also carry an X-ray CCD camera as a focal plane detector for a soft X-ray telescope (0.4-12 keV) and a non-focusing soft gamma-ray detector (40-600 keV) . The micro-calorimeter system is developed by an international collaboration led by ISAS/JAXA and NASA. The simultaneous broad bandpass, coupled with high spectral reso...

  20. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    OpenAIRE

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown.Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates.Results: Only six studies with...

  1. Systematic review and evidence-based consensus guideline on prevention of allergy and atopic eczema of the German Network on Allergy Prevention (ABAP).

    Science.gov (United States)

    Schäfer, T; Borowski, C; Reese, I; Werfel, T; Gieler, U

    2008-06-01

    Allergies are a meaningful public-health problem. Until now no evidence-based recommendations for allergy prevention exist. An evidence based guideline for primary and secondary prevention of allergies was developed in the course of the German Network on Allergy Prevention (Aktionsbündnis Allergiepräven-tion, ABAP) with support of the German Ministry of Health. Results of the systematic evidence search and the consented recommendations are presented here. After an appropriate search strategy was developed, a systematic literature search was performed in electronic databases (Cochrane library, MEDLINE, EMBASE). Furthermore four selected journals were hand-searched and reference lists of actual reviews as well as grey literature was screened. Some 3 500 references were retrieved initially and a two-stage filter process on the relevance was applied by screening titles and abstracts and subsequently full-text papers. For the critical methodological appraisal modifications of international checklists were used. A total of 323 studies were included and evaluated. These comprised 3 Cochrane Reviews, 7 meta-analyses, 37 randomized controlled trials (RCTs) as well as 102 cohort and 174 case-control-studies. The following levels of evidence were applied: 3x1a, 21x1b, 5x2a, 59x2b, 1x3a, 45x3b, 189x4. These studies were summarized in a form of a systematic review and corresponding recommendations were formulated. The latter were consented by members of the abap steering committee in two consensus meeting where the method of a nominal group process was applied. For the first time recommendations for the prevention of allergies were developed on a high methodological standard. The content and modifications reflect the existing evidence.

  2. Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks.

    Science.gov (United States)

    Danninger, Thomas; Opperer, Mathias; Memtsoudis, Stavros G

    2014-07-18

    Over the last decades, the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically. This very successful intervention, however, is associated with significant postoperative pain, and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery. The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal. Many different approaches and techniques for peripheral nerve blockades, either landmark or, more recently, ultrasound guided have been described over the last decades. This includes but is not restricted to techniques discussed in this review. The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block. Moreover, ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block. In contrast to patient controlled analgesia using opioids, patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction; this is important as hospital rankings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure. This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications, considerations and outcomes.

  3. Exubera® (inhaled insulin: an evidence-based review of its effectiveness in the management of diabetes

    Directory of Open Access Journals (Sweden)

    Louise Profit

    2005-06-01

    Full Text Available Louise ProfitCore Medical Publishing, Knutsford, UKIntroduction: Inadequate glycemic control contributes to the development and progression of complications, which are associated with a significant economic burden on healthcare systems. However, optimal glycemic control is difficult to sustain with oral antidiabetic agents and adherence to intensive insulin regimens is compromised by patient compliance to multiple daily injections. Therefore, alternative delivery systems are required to improve the acceptability of insulin therapy.Aims: This review assesses the evidence for the therapeutic value of inhaled insulin (Exubera® in the management of type 1 and type 2 diabetes.Evidence review: Evidence indicates that glycemic control, as measured by plasma HbA1c levels, with Exubera is as effective as subcutaneous insulin in patients with type 1 or type 2 diabetes. There is also good evidence that Exubera provides improved patient satisfaction and ease of use compared with subcutaneous insulin. However, the cost effectiveness of Exubera and its place in therapy compared with other inhaled insulin delivery systems currently in development remain to be determined.Outcomes summary: Exubera is an alternative treatment option for the management of diabetes which provides effective glycemic control with improved patient satisfaction.Key words: inhaled insulin, type 1 diabetes, type 2 diabetes, glycemic control, evidence, outcomes

  4. The Role of Biological Agents and Immunomodulators in Treatment Strategies for Thyroid Eye Disease: An Evidence-based Review.

    Science.gov (United States)

    Ginter, Anna; Migliori, Michael E

    2016-06-01

    Graves' Disease is an autoimmune disease where circulating antibodies bind to the thyrotropin receptors on the thyroid gland. These bound antibodies mimic thyroid stimulating hormone without the normal feedback from the anterior pituitary, causing hyperthyroidism and thyrotoxicosis. These antibodies also interact with orbital tissues and cause the characteristic orbital findings of thyroid eye disease (TED). It is not clearly understood why anatomically and physiologically distinct tissues like the thyroid gland and orbit are affected selectively, or why the orbital disease tends to be self-limited. Identifying and understanding these processes is critical to targeting therapy. In the active phase of the disease patients may experience orbital inflammation, eyelid and conjunctiva edema (chemosis), eyelid retraction, proptosis, ocular motility restriction, and optic nerve compression. Current treatment strategies for the ocular symptoms have been predominantly directed at symptomatic relief. More recently, investigators have concentrated their efforts to better understanding the underlying pathophysiologic processes to direct therapy at these processes. This review examines the current literature exploring a variety of newer therapeutic alternatives, including immunomodulative and suppressive agents, targeted at strategic points of the active-phase TED pathophysiological pathways. Specifically, biological agents including rituximab, adalimumab, intravenous immunoglobulin and others are reviewed with considerations for pathophysiology, extent of literature support, and adverse effects. [Full article available at http://rimed.org/rimedicaljournal-2016-06.asp, free with no login].

  5. Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: Evidence-based review

    Directory of Open Access Journals (Sweden)

    Ming-Kai Hsieh

    2013-08-01

    Full Text Available Vertebral compression fractures constitute a major health care problem, not only because of their high incidence but also due to both direct and indirect consequences on health-related quality of life and health care expenditures. The mainstay of management for symptomatic vertebral compression fractures is targeted medical therapy, including analgesics, bed rest, external fixation, and rehabilitation. However, anti-inflammatory drugs and certain types of analgesics can be poorly tolerated by elderly patients, and surgical fixation often fails due to the poor quality of osteoporotic bone. Balloon kyphoplasty and vertebroplasty are two minimally invasive percutaneous surgical approaches that have recently been developed for the management of symptomatic vertebral compression fractures. The purpose of this study was to perform a comprehensive review of the literature and conduct a meta-analysis to compare clinical outcomes of pain relief and function, radiographic outcomes of the restoration of anterior vertebral height and kyphotic angles, and subsequent complications associated with these two techniques.

  6. The use of biological meshes in diaphragmatic defects – An evidence-based review of the literature

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    Stavros Athanasios Antoniou

    2015-10-01

    Full Text Available The widespread use of meshes for hiatal hernia repair has emerged in the era of laparoscopic surgery, although sporadic cases of mesh augmentation of traumatic diaphragmatic rupture have been reported. The indications for biologic meshes in diaphragmatic repair are ill defined. This systematic review aims to investigate the available evidence on the role of biologic meshes in diaphragmatic rupture and hiatal hernia repair. Limited data from sporadic case reports and case series have demonstrated that repair of traumatic diaphragmatic rupture with biologic mesh is safe technique in both the acute or chronic setting. High level evidence demonstrates short-term benefits of biologic mesh augmentation in hiatal hernia repair over primary repair, although adequate long-term data are not currently available. Long-term follow-up data suggest no benefit of hiatal hernia repair using porcine small intestine submucosa over suture repair. The effectiveness of different biologic mesh materials on hernia recurrence requires further investigation.

  7. Management of suicidal and self-harming behaviors in prisons: systematic literature review of evidence-based activities.

    Science.gov (United States)

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

    2014-01-01

    The purpose of this study was to systematically analyze existing literature testing the effectiveness of programs involving the management of suicidal and self-harming behaviors in prisons. For the study, 545 English-language articles published in peer reviewed journals were retrieved using the terms "suicid*," "prevent*," "prison," or "correctional facility" in SCOPUS, MEDLINE, PROQUEST, and Web of Knowledge. In total, 12 articles were relevant, with 6 involving multi-factored suicide prevention programs, and 2 involving peer focused programs. Others included changes to the referral and care of suicidal inmates, staff training, legislation changes, and a suicide prevention program for inmates with Borderline Personality Disorder. Multi-factored suicide prevention programs appear most effective in the prison environment. Using trained inmates to provide social support to suicidal inmates is promising. Staff attitudes toward training programs were generally positive.

  8. Attributes Associated with Adherence to Glaucoma Medical Therapy and its Effects on Glaucoma Outcomes: An Evidence-Based Review and Potential Strategies to Improve Adherence.

    Science.gov (United States)

    Joseph, Arun; Pasquale, Louis R

    2017-01-01

    The treatment paradigm in glaucoma classically starts with exhausting all medical therapy prior to proceeding with laser or incisional surgery, although laser-first and surgery-first strategies have been explored in randomized clinical trials. Although glaucoma drops are proven to work well to lower intraocular pressure, slow the conversion from ocular hypertension, and slow the progression of disease in early open angle glaucoma, adherence to treatment is likely optimum in the randomized clinical trials that support these claims. In real-world scenarios, medical therapy often fails and practitioners are forced to proceed with more invasive treatment modalities to slow the progression of this blinding disease. This review aims to take an evidence-based approach to study the risk factors for poor adherence in glaucoma patients, to determine whether poor adherence is, in fact, associated with worse outcomes, and to seek potential strategies to improve adherence in these patients.

  9. An evidence-based practice-oriented review focusing on canagliflozin in the management of type 2 diabetes

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    Messana JA

    2017-02-01

    Full Text Available Joseph A Messana,1 Stanley S Schwartz,2,3 Raymond R Townsend1 1Nephrology Division, Perelman School of Medicine, University of Pennsylvania, 2Main Line Health, 3Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Caring for patients with type 2 diabetes mellitus (T2DM has entered an era with many recent additions to the regimens used to clinically control their hyperglycemia. The most recent class of agents approved by the Food and Drug Administration (FDA for T2DM is the sodium–glucose-linked transporter type 2 (SGLT2 inhibitors, which work principally in the proximal tubule of the kidney to block filtered glucose reabsorption. In the few years attending this new class arrival in the market, there has been a great deal of interest generated by the novel mechanism of action of SGLT2 inhibitors and by recent large outcome trials suggesting benefit on important clinical outcomes such as death, cardiovascular disease and kidney disease progression. In this review, we focus on canagliflozin, the first-in-class marketed SGLT2 inhibitor in the USA. In some cases, we included data from other SGLT2 inhibitors, such as outcomes in clinical trials, important insights on clinical features and benefits, and adverse effects. These agents represent a fundamentally different way of controlling blood glucose and for the first time in T2DM care to offer the opportunity to reduce glucose, blood pressure, and weight with effects sustained for at least 2 years. Important side effects include genital mycotic infections and the potential for orthostatic hypotension and rare instances of normoglycemic ketoacidosis. Active ongoing clinical trials promise to deepen our experience with the potential benefits, as well as the clinical risks attending the use of this new group of antidiabetic agents. Keywords: SGLT2, canagliflozin, review, outcomes, type 2 diabetes mellitus 

  10. An evidence-based review of linezolid for the treatment of methicillin-resistant Staphylococcus aureus (MRSA: place in therapy

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    Watkins RR

    2012-12-01

    Full Text Available Richard R Watkins,1 Tracy L Lemonovich,2 Thomas M File Jr31Division of Infectious Diseases, Akron General Medical Center, Akron, OH, USA; 2Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA; 3Division of Infectious Diseases, Summa Health System, Akron, OH, USAAbstract: Methicillin-resistant Staphylococcus aureus (MRSA, including community-associated and hospital-associated strains, is a major cause of human morbidity and mortality. Treatment options have become limited due to the emergence of MRSA strains with decreased sensitivity to vancomycin, which has long been the first-line therapy for serious infections. This has prompted the search for novel antibiotics that are efficacious against MRSA. Linezolid, an oxazolidinone class of antibiotic, was approved by the Food and Drug Administration in 2000 for treatment of MRSA infections. Since then, there have been a multitude of clinical trials and research studies evaluating the effectiveness of linezolid against serious infections, including pneumonia (both community- and hospital-acquired, skin and soft-tissue infections such as diabetic foot ulcers, endocarditis, osteomyelitis, prosthetic devices, and others. The primary aim of this review is to provide an up-to-date evaluation of the clinical evidence for using linezolid to treat MRSA infections, with a focus on recently published studies, including those on nosocomial pneumonia. Other objectives are to analyze the cost-effectiveness of linezolid compared to other agents, and to review the pharmokinetics and pharmacodynamics of linezolid, emphasizing the most current concepts.Keywords: linezolid, MRSA, clinical trials, pneumonia, skin infections

  11. The use of medicinal herbs in gynecological and pregnancy-related disorders by Jordanian women: a review of folkloric practice vs. evidence-based pharmacology.

    Science.gov (United States)

    Akour, Amal; Kasabri, Violet; Afifi, Fatma U; Bulatova, Nailya

    2016-09-01

    Context National statistical reports in Jordan indicate a decrease in the total fertility rate along with a parallel increase in contraceptive use. The folkloric use of medicinal herbs in gynecological disorders has been growing in Jordan, despite of deficient reports on the evidence-based safety and efficacy of these practices. Objective The aim of this comprehensive article is to review medicinal plants with claimed ethnonpharmacological usage in various gynecological and pregnancy-related issues in Jordan, and to assess their evidence-based pharmacological studies as well as their phytochemistry. Methods The published literature was surveyed using Google Scholar entering the terms "ethnopharmacology AND Jordan AND infertility AND gynecology OR gestation". We included ethnopharmacological surveys in Jordan with available full-text. Results Twelve articles were reviewed. Plant species which are commonly used for female gynecological issues such as Artemisia monosperma Del. and A. herba-alba Asso. (Asteraceae) have been found to exert an antifertility effect. Ricinus communis L. (Euphorbiaceae) and Citrullus colocynthis (L.) Schrad. (Cucurbitaceae) had antifertility effects in male rats, but Nigella sativa oil L. (Ranunculaceae) and Cinnamon zeylanicum J. Presl (Lauraceae) were found to enhance it. Conclusion Using plants for gynecological disorders is a common practice in Jordan. Many of them, whether utilised for gynecological or non-gynecological conditions equally, were found to have detrimental effects on female or male fertility. Thus, couples planning pregnancy should be discouraged from the consumption of these herbs. Further local studies are warranted to confirm the appreciable beneficial pharmacological effects and safety of these plants.

  12. Clinical utility of patiromer, sodium zirconium cyclosilicate, and sodium polystyrene sulfonate for the treatment of hyperkalemia: an evidence-based review

    Science.gov (United States)

    Beccari, Mario V; Meaney, Calvin J

    2017-01-01

    Introduction Hyperkalemia is a serious medical condition that often manifests in patients with chronic kidney disease and heart failure. Renin–angiotensin–aldosterone system inhibitors are known to improve outcomes in these disease states but can also cause drug-induced hyperkalemia. New therapeutic options exist for managing hyperkalemia in these patients which warrant evidence-based evaluation. Aim The objective of this article was to review the efficacy and safety evidence for patiromer, sodium zirconium cyclosilicate (ZS9), and sodium polystyrene sulfonate (SPS) for the treatment of hyperkalemia. Evidence review Current treatment options to enhance potassium excretion are SPS and loop diuretics, which are complicated by ambiguous efficacy and known toxicities. Patiromer and ZS9 are new agents designed to address this treatment gap. Both unabsorbable compounds bind potassium in the gastrointestinal (GI) tract to facilitate fecal excretion. The capacity to bind other medications in the GI tract infers high drug–drug interaction potential, which has been demonstrated with patiromer but not yet investigated with ZS9 or SPS. Phase II and III clinical trials of patiromer and ZS9 demonstrated clear evidence of a dose-dependent potassium-lowering effect and the ability to initiate, maintain, or titrate renin–angiotensin–aldosterone system inhibitors. There is limited evidence base for SPS: two small clinical trials indicated potassium reduction in chronic hyperkalemia. All agents may cause adverse GI effects, although they are less frequent with ZS9. Concerns remain for SPS to cause rare GI damage. Electrolyte abnormalities occurred with patiromer and SPS, whereas urinary tract infections, edema, and corrected QT-interval prolongations were reported with ZS9. Conclusion Patiromer and ZS9 have improved upon the age-old standard SPS for the treatment of hyperkalemia. Additional research should focus on drug–drug interactions in patients on multiple

  13. How are medical students trained to locate biomedical information to practice evidence-based medicine? a review of the 2007–2012 literature

    Science.gov (United States)

    Maggio, Lauren A.; Kung, Janice Y.

    2014-01-01

    Objectives: This study describes how information retrieval skills are taught in evidence-based medicine (EBM) at the undergraduate medical education (UGME) level. Methods: The authors systematically searched MEDLINE, Scopus, Educational Resource Information Center, Web of Science, and Evidence-Based Medicine Reviews for English-language articles published between 2007 and 2012 describing information retrieval training to support EBM. Data on learning environment, frequency of training, learner characteristics, resources and information skills taught, teaching modalities, and instructor roles were compiled and analyzed. Results: Twelve studies were identified for analysis. Studies were set in the United States (9), Australia (1), the Czech Republic (1), and Iran (1). Most trainings (7) featured multiple sessions with trainings offered to preclinical students (5) and clinical students (6). A single study described a longitudinal training experience. A variety of information resources were introduced, including PubMed, DynaMed, UpToDate, and AccessMedicine. The majority of the interventions (10) were classified as interactive teaching sessions in classroom settings. Librarians played major and collaborative roles with physicians in teaching and designing training. Unfortunately, few studies provided details of information skills activities or evaluations, making them difficult to evaluate and replicate. Conclusions: This study reviewed the literature and characterized how EBM search skills are taught in UGME. Details are provided on learning environment, frequency of training, level of learners, resources and skills trained, and instructor roles. Implications: The results suggest a number of steps that librarians can take to improve information skills training including using a longitudinal approach, integrating consumer health resources, and developing robust assessments. PMID:25031559

  14. Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians.

    Science.gov (United States)

    Bested, Alison C; Marshall, Lynn M

    2015-01-01

    This review was written from the viewpoint of the treating clinician to educate health care professionals and the public about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It includes: the clinical definition of ME/CFS with emphasis on how to diagnose ME/CFS; the etiology, pathophysiology, management approach, long-term prognosis and economic cost of ME/CFS. After reading this review, you will be better able to diagnose and treat your patients with ME/CFS using the tools and information provided. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic medical condition characterized by symptom clusters that include: pathological fatigue and malaise that is worse after exertion, cognitive dysfunction, immune dysfunction, unrefreshing sleep, pain, autonomic dysfunction, neuroendocrine and immune symptoms. ME/CFS is common, often severely disabling and costly. The Institute of Medicine (IOM) reviewed the ME/CFS literature and estimates that between 836,000 and 2.5 million Americans have ME/CFS at a cost of between 17 and 24 billion dollars annually in the US. The IOM suggested a new name for ME/CFS and called it Systemic Exertion Intolerance Disease (SEID). SEID's diagnostic criteria are less specific and do not exclude psychiatric disorders in the criteria. The 2010 Canadian Community Health Survey discovered that 29% of patients with ME/CFS had unmet health care needs and 20% had food insecurity--lack of access to sufficient healthy foods. ME/CFS can be severely disabling and cause patients to be bedridden. Yet most patients (80%) struggle to get a diagnosis because doctors have not been taught how to diagnose or treat ME/CFS in medical schools or in their post-graduate educational training. Consequently, the patients with ME/CFS suffer. They are not diagnosed with ME/CFS and are not treated accordingly. Instead of compassionate care from their doctors, they are often ridiculed by the very people from whom they seek help

  15. Capecitabine: an evidence-based review of its effectiveness in the treatment of carcinoma of the pancreas

    Directory of Open Access Journals (Sweden)

    David B. Smith

    2007-11-01

    Full Text Available David B. Smith1, John P. Neoptolemos21Clatterbridge Centre for Oncology, Bebington, Wirral, UK; 2School of Cancer Studies, University of Liverpool, Liverpool, UKIntroduction: More than 90% of patients with pancreatic cancer present either with incurable locally advanced or metastatic disease or relapse following surgery. For these patients systemic therapy offers the only prospect of salvage, but pancreatic cancer is one of the most chemoresistant of tumors; current chemotherapy can only delay progression in a limited proportion of patients and survival rates are poor. There is therefore a pressing need for more effective therapy. Capecitabine is a new oral prodrug of fluorouracil, which has shown activity in pancreatic cancer particularly when used in combination with gemcitabine.Aims: To review the emerging evidence for the clinical effectiveness of capecitabine in the management of carcinoma of the pancreas.Evidence review: There is evidence from phase II testing that capecitabine is active in pancreatic cancer. The Swiss Group for Clinical Cancer Research/Central European Cooperative Oncology Group (SAKK/CECOG phase III trial found that the combination of gemcitabine and capecitabine did not improve overall median survival as compared with gemcitabine alone (8.4 vs 7.3 months, respectively; P=0.314 but subgroup analysis in patients with good performance score [Karnofsky Performance Scores (KPS ³90] revealed a significant survival improvement with the combination arm (10.1 months compared with single-agent gemcitabine (7.5 months; P=0.033. Preliminary data from the GemCap phase III trial indicated significantly improved response rates and survival for the combination of gemcitabine with capecitabine (7.4 months compared with gemcitabine alone (6 months; P=0.026 but analysis of the mature data with adequate follow-up awaits reporting.Clinical potential: The addition of capecitabine to gemcitabine may represent a small step forward in the

  16. An Evidence-Based Review on Medicinal Plants Used as Insecticide and Insect Repellent in Traditional Iranian Medicine

    Science.gov (United States)

    Cheraghi Niroumand, Mina; Farzaei, Mohammad Hosein; Karimpour Razkenari, Elahe; Amin, Gholamreza; Khanavi, Mahnaz; Akbarzadeh, Tahmineh; Shams-Ardekani, Mohammad Reza

    2016-01-01

    Context Insects can be the cause of major ecological problems; they can transmit microbes and parasites that affect humans, and damage food crops, trees, and homes. The total economic cost of insect-related damage and disease is immeasurable. In traditional Iranian medicine (TIM), several medicinal plants have been identified as insecticides or insect repellents, but many of them are still unknown. Therefore, the aim of this study was to review the insecticidal or insect repellent activity of certain medicinal plants described in TIM. Evidence Acquisition Information about medicinal plants proposed as insecticides and insect repellents in the TIM was collected from the TIM literature, and searched in modern medical databases to find studies that confirmed their efficacy. Results Modern investigations have supported the claims of the insecticidal activity of several plants, including Allium sativum, Artemisia absinthium, Citrullus colocynthis, Laurus nobilis, Mentha pulegium, Myrtus communis, Nerium oleander, Ocimum basilicum, and Origanum majorana. However, in the cases of plants like Iris florentina and Malva sylvestris, there is not enough evidence in modern medicine to prove their effectiveness with regard to their insecticidal and insect repellent activities. Conclusions This study confirmed the Iranian traditional medicine claims of the insecticidal and insect repellent activity of certain plants. Further pharmacological and clinical studies are recommended to evaluate the overall efficacy and possible mechanisms underlying these herbs. PMID:27186389

  17. Apixaban for the prophylaxis and treatment of deep vein thrombosis and pulmonary embolism: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Mandernach MW

    2015-08-01

    Full Text Available Molly W Mandernach,1 Rebecca J Beyth,1,2 Anita Rajasekhar11Division of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, FL, USA; 2North Florida/South Georgia Veterans Health System (NF/SGVHS, Geriatric Research, Education and Clinical Center (GRECC, Gainesville, Florida Abstract: Venous thromboembolism (VTE results in significant morbidity and mortality. The prevention and treatment of VTE is managed with anticoagulant therapy, historically parenteral anticoagulants such as unfractionated heparin, low molecular weight heparin, and fondaparinux, and oral vitamin K antagonists such as warfarin. In the last few years, several target-specific oral anticoagulants have been developed, including the direct thrombin inhibitor dabigatran and anti-Xa inhibitors rivaroxaban, apixaban, and edoxaban. The target-specific oral anticoagulants have proven to be noninferior to vitamin K antagonists and heparins in the prevention and treatment of VTE. This review will focus on the pharmacology, clinical trial data, and laboratory assessment of apixaban. Moreover, perioperative management, use in special populations, and management of bleeding complications in patients taking apixaban for the prevention and treatment of VTE will also be discussed. Keywords: venous thromboembolism, apixaban, new oral anticoagulant, target-specific oral anticoagulant, thromboprophylaxis

  18. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

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    Ethy Dorrepaal

    2014-10-01

    Full Text Available Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD are well established, but their generalizability to child abuse (CA-related Complex PTSD is largely unknown. Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results: Only six studies with one or more cognitive behavior therapy (CBT treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion: Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results.

  19. Impact of 100% Fruit Juice Consumption on Diet and Weight Status of Children: An Evidence-based Review.

    Science.gov (United States)

    Crowe-White, Kristi; O'Neil, Carol E; Parrott, J Scott; Benson-Davies, Sue; Droke, Elizabeth; Gutschall, Melissa; Stote, Kim S; Wolfram, Taylor; Ziegler, Paula

    2016-01-01

    Consumption of 100% fruit juice remains controversial for its potential adverse impact on weight and displacement of essential foods in the diets of children. A systematic review of the literature published from 1995-2013 was conducted using the PubMed database to evaluate associations between intake of 100% fruit juice and weight/adiposity and nutrient intake/adequacy among children of 1 to 18 years of age. Weight status outcome measures included body mass index (BMI), BMI z-score, ponderal index, obesity, weight gain, adiposity measures, and body composition. Nutrient outcome measures included intake and adequacy of shortfall nutrients. Data extraction and analysis was conducted according to the Academy of Nutrition and Dietetics Evidence Analysis Process. Twenty-two studies on weight status provided evidence that did not support an association between 100% fruit juice consumption and weight/adiposity in children after controlling for energy intake. Limited evidence from eight studies suggests that children consuming 100% fruit juice have higher intake and adequacy of dietary fiber, vitamin C, magnesium, and potassium. Differences in methodology and study designs preclude causal determination of 100% fruit juice as sole influencer of weight status or nutrient intake/adequacy of shortfall nutrients. In context of a healthy dietary pattern, evidence suggests that consumption of 100% fruit juice may provide beneficial nutrients without contributing to pediatric obesity.

  20. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

    Science.gov (United States)

    Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

    2016-03-01

    In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results.

  1. Neuropsychological Assessment Following Concussion: an Evidence-Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion.

    Science.gov (United States)

    Kontos, Anthony P; Sufrinko, Alicia; Womble, Melissa; Kegel, Nathan

    2016-06-01

    Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a "hybrid" assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion.

  2. The therapeutic usage of botulinum toxin (Botox in non-cosmetic head and neck conditions – An evidence based review

    Directory of Open Access Journals (Sweden)

    Kamran Habib Awan

    2017-01-01

    Full Text Available Botulinum toxin (Botox is an exotoxin produced from Clostridium botulinum. It blocks the release of acetylcholine from the cholinergic nerve end plates resulting in inactivity of the muscles or glands innervated. The efficacy of Botox in facial aesthetics is well established; however, recent literature has highlighted its utilization in multiple non-cosmetic medical and surgical conditions. The present article reviews the current evidence pertaining to Botox use in the non-cosmetic head and neck conditions. A literature search was conducted using MEDLINE, EMBASE, ISI Web of Science and the Cochrane databases limited to English Language articles published from January 1980 to December 2014. The findings showed that there is level 1 evidence supporting the efficacy of Botox in the treatment of laryngeal dystonia, 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 and trigeminal. For stuttering, facial nerve paresis, Frey’s syndrome and oromandibular dystonia the evidence is level 4. Thus, there is compelling evidence in the published literature to demonstrate the beneficial role of Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence. With more and more research, the range of clinical applications and number of individuals getting Botox will doubtlessly increase. Botox appears to justify its title as ‘the poison that heals’.

  3. Multi-Target Directed Indole Based Hybrid Molecules in Cancer Therapy: An Up-To-Date Evidence-Based Review.

    Science.gov (United States)

    Sunil, Dhanya; Kamath, Pooja R

    2016-09-27

    Cancer is a multifactorial disease and most of its types still remain incurable, in spite of enormous efforts to explicate various tumor pathophysiology. The anti-cancer drug discovery paradigm "one-compound-one-target" has failed and subsequently shifted to two-drug cocktail and recently the "multi-target approach" in order to design and develop agents able to act simultaneously on multiple intracellular constituents and signaling pathways. Novel hybrid compounds are now designed by incorporating two covalently linked independently acting pharmacores, each efficient at combating cancer. They can deliver synergistic effects from the dual action of both independently acting moieties by interacting with multiple targets. These composite molecules are also less prone to drug resistance, leading to an improved pharmacological potency than each individual moiety. As indole nucleus is a central component of many natural and synthetic molecules with extensive biological activity, this review incorporates a variety of such hybrid compounds with indole moiety as one of the active units, where better therapeutic effect has been successfully achieved, by either simultaneous or sequential action of individual functional pharmacore. The current limitations and challenges encountered in the development of these hybrid agents are also discussed.

  4. Ibrutinib: an evidence-based review of its potential in the treatment of advanced chronic lymphocytic leukemia

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    Chavez JC

    2013-05-01

    Full Text Available Julio C Chavez, Eva Sahakian, Javier Pinilla-IbarzH Lee Moffitt Cancer and Research Institute, Division of Malignant Hematology, and University of South Florida, Tampa, FL, USAAbstract: Chronic lymphocytic leukemia (CLL is a heterogeneous disease with a variable course, and remains an incurable disease. Frequent relapses and eventual resistance to fludarabine characterize symptomatic CLL and portends a dismal prognosis for patients. Growing evidence has shown that signaling pathways such as the B cell receptor and NFkB are implicated in the survival and proliferation of the CLL cells which are ultimately associated with persistence of the disease. The Bruton’s tyrosine kinase pathway regulates downstream activation of the B cell receptor and has emerged as an attractive target. Ibrutinib inhibits the Bruton’s tyrosine kinase pathway, and consequently induces apoptosis of B cells. Phase I and II studies have shown impressive response rates with an excellent safety profile in patients with refractory/relapsed CLL and elderly treatment-naïve CLL patients. This paper reviews the preclinical and clinical data for ibrutinib when used in the treatment of CLL. Recent studies showing the benefit of combination therapy using ibrutinib, monoclonal antibodies, and chemoimmunotherapy are also discussed.Keywords: ibrutinib, B-cell receptor, chronic lymphocytic leukemia, Bruton’s tyrosine kinase

  5. Economic evaluations of non-communicable disease interventions in developing countries: a critical review of the evidence base

    Directory of Open Access Journals (Sweden)

    Walker Damian

    2006-04-01

    Full Text Available Abstract Background Demographic projections suggest a major increase in non-communicable disease (NCD mortality over the next two decades in developing countries. In a climate of scarce resources, policy-makers need to know which interventions represent value for money. The prohibitive cost of performing multiple economic evaluations has generated interest in transferring the results of studies from one setting to another. This paper aims to bridge the gap in the current literature by critically evaluating the available published data on economic evaluations of NCD interventions in developing countries. Methods We identified and reviewed the methodological quality of 32 economic evaluations of NCD interventions in developing countries. Developing countries were defined according to the World Bank classification for low- and lower middle-income countries. We defined NCDs as the 12 categories listed in the 1993 World Bank report Investing in Health. English language literature was searched for the period January 1984 and January 2003 inclusive in Medline, Science Citation Index, HealthStar, NHS Economic Evaluation Database and Embase using medical subheading terms and free text searches. We then assessed the quality of studies according to a set of pre-defined technical criteria. Results We found that the quality of studies was poor and resource allocation decisions made by local and global policy-makers on the basis of this evidence could be misleading. Furthermore we have identified some clear gaps in the literature, particularly around injuries and strategies for tackling the consequences of the emerging tobacco epidemic. Conclusion In the face of poor evidence the role of so-called generalised cost-effectiveness analyses has an important role to play in aiding public health decision-making at the global level. Further research is needed to investigates the causes of variation among cost, effects and cost-effectiveness data within and between

  6. An evidence-based review of ixazomib citrate and its potential in the treatment of newly diagnosed multiple myeloma

    Directory of Open Access Journals (Sweden)

    Offidani M

    2014-09-01

    Full Text Available Massimo Offidani,1 Laura Corvatta,2 Patrizia Caraffa,1 Silvia Gentili,1 Laura Maracci,1 Pietro Leoni1 1Hematology Department, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, 2Division of Medicine, Ospedale Stelluti Scala, Fabriano, Italy Abstract: Proteasome inhibition represents one of the more important therapeutic targets in the treatment of multiple myeloma (MM, since by suppressing nuclear factor-κB activity, which promotes myelomagenesis, it makes plasma cells susceptible to proapoptotic signals. Bortezomib, the first proteasome inhibitor approved for MM therapy, has been shown to increase response rate and improve outcome in patients with relapsed/refractory disease and in the frontline setting, particularly when combined with immunomodulatory drugs and alkylating agents. Among second-generation proteasome inhibitors, ixazomib (MLN9708 is the first oral compound to be evaluated for the treatment of MM. Ixazomib has shown improved pharmacokinetic and pharmacodynamic parameters compared with bortezomib, in addition to similar efficacy in the control of myeloma growth and prevention of bone loss. Ixazomib was found to overcome bortezomib resistance and to trigger synergistic antimyeloma activity with dexamethasone, lenalidomide, and histone deacetylase inhibitors. Phase I/II studies using ixazomib weekly or twice weekly in relapsed/refractory MM patients suggested antitumor activity of the single agent, but more promising results have been obtained with the combination of ixazomib, lenalidomide, and dexamethasone in newly diagnosed MM. Ixazomib has also been used in systemic amyloidosis as a single agent, showing important activity in this difficult-to-treat plasma-cell dyscrasia. More frequent side effects observed during administration of ixazomib were thrombocytopenia, nausea, vomiting, diarrhea, fatigue, and rash, whereas severe peripheral neuropathy was rare. Here, we review the chemical characteristics of ixazomib, as

  7. An evidence-based practice-oriented review focusing on canagliflozin in the management of type 2 diabetes.

    Science.gov (United States)

    Messana, Joseph A; Schwartz, Stanley S; Townsend, Raymond R

    2017-01-01

    Caring for patients with type 2 diabetes mellitus (T2DM) has entered an era with many recent additions to the regimens used to clinically control their hyperglycemia. The most recent class of agents approved by the Food and Drug Administration (FDA) for T2DM is the sodium-glucose-linked transporter type 2 (SGLT2) inhibitors, which work principally in the proximal tubule of the kidney to block filtered glucose reabsorption. In the few years attending this new class arrival in the market, there has been a great deal of interest generated by the novel mechanism of action of SGLT2 inhibitors and by recent large outcome trials suggesting benefit on important clinical outcomes such as death, cardiovascular disease and kidney disease progression. In this review, we focus on canagliflozin, the first-in-class marketed SGLT2 inhibitor in the USA. In some cases, we included data from other SGLT2 inhibitors, such as outcomes in clinical trials, important insights on clinical features and benefits, and adverse effects. These agents represent a fundamentally different way of controlling blood glucose and for the first time in T2DM care to offer the opportunity to reduce glucose, blood pressure, and weight with effects sustained for at least 2 years. Important side effects include genital mycotic infections and the potential for orthostatic hypotension and rare instances of normoglycemic ketoacidosis. Active ongoing clinical trials promise to deepen our experience with the potential benefits, as well as the clinical risks attending the use of this new group of antidiabetic agents.

  8. An evidence-based practice-oriented review focusing on canagliflozin in the management of type 2 diabetes

    Science.gov (United States)

    Messana, Joseph A; Schwartz, Stanley S; Townsend, Raymond R

    2017-01-01

    Caring for patients with type 2 diabetes mellitus (T2DM) has entered an era with many recent additions to the regimens used to clinically control their hyperglycemia. The most recent class of agents approved by the Food and Drug Administration (FDA) for T2DM is the sodium–glucose-linked transporter type 2 (SGLT2) inhibitors, which work principally in the proximal tubule of the kidney to block filtered glucose reabsorption. In the few years attending this new class arrival in the market, there has been a great deal of interest generated by the novel mechanism of action of SGLT2 inhibitors and by recent large outcome trials suggesting benefit on important clinical outcomes such as death, cardiovascular disease and kidney disease progression. In this review, we focus on canagliflozin, the first-in-class marketed SGLT2 inhibitor in the USA. In some cases, we included data from other SGLT2 inhibitors, such as outcomes in clinical trials, important insights on clinical features and benefits, and adverse effects. These agents represent a fundamentally different way of controlling blood glucose and for the first time in T2DM care to offer the opportunity to reduce glucose, blood pressure, and weight with effects sustained for at least 2 years. Important side effects include genital mycotic infections and the potential for orthostatic hypotension and rare instances of normoglycemic ketoacidosis. Active ongoing clinical trials promise to deepen our experience with the potential benefits, as well as the clinical risks attending the use of this new group of antidiabetic agents. PMID:28255241

  9. Sipuleucel-T in the treatment of prostate cancer: an evidence-based review of its place in therapy.

    Science.gov (United States)

    Graff, Julie N; Chamberlain, Erin D

    2015-01-01

    Metastatic castration-resistant prostate cancer is the lethal form of cancer of the prostate. Five new agents that prolong survival in this group have emerged in the past 5 years, and sipuleucel-T is among them. Sipuleucel-T is the only immunotherapy shown to improve survival in prostate cancer. It is currently indicated in asymptomatic or mildly symptomatic patients, as it has never shown a direct cancer effect. This paper describes the process of creating the sipuleucel-T product from the manufacturing and patient aspects. It discusses the four placebo-controlled, randomized clinical trials (RCTs) of sipuleucel-T, focusing on survival and adverse events. There are three RCTs in metastatic castration-resistant prostate cancer, all of which showed improved overall survival without meaningful decreases in symptoms, tumor volumes, or prostate-specific antigen levels. One RCT in castration-sensitive, biochemically relapsed prostate cancer attempted to find a decrease in biochemical failure, but that endpoint was not reached. Adverse events in all four of these studies centered around cytokine release. This paper also reviews a Phase II study of sipuleucel-T given neoadjuvantly that speaks to its mechanism of action. Additionally, there is a registry study of sipuleucel-T that has been used to evaluate immunological parameters of the product in men ≥80 years of age and men who had previously been treated with palliative radiation. Attempts to find early markers of response to sipuleucel-T are described. Further ongoing studies that explore the efficacy of sipuleucel-T in combination with immune checkpoint inhibitors and second-generation hormonal therapies that are summarized. Finally, the only published economic analysis of sipuleucel-T is discussed.

  10. Sipuleucel-T in the treatment of prostate cancer: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Graff JN

    2014-12-01

    Full Text Available Julie N Graff,1,2 Erin D Chamberlain31Portland VA Medical Center, 2Knight Cancer Institute, 3Department of Medicine, Oregon Health and Science University, Portland, OR, USAAbstract: Metastatic castration-resistant prostate cancer is the lethal form of cancer of the prostate. Five new agents that prolong survival in this group have emerged in the past 5 years, and sipuleucel-T is among them. Sipuleucel-T is the only immunotherapy shown to improve survival in prostate cancer. It is currently indicated in asymptomatic or mildly symptomatic patients, as it has never shown a direct cancer effect. This paper describes the process of creating the sipuleucel-T product from the manufacturing and patient aspects. It discusses the four placebo-controlled, randomized clinical trials (RCTs of sipuleucel-T, focusing on survival and adverse events. There are three RCTs in metastatic castration-resistant prostate cancer, all of which showed improved overall survival without meaningful decreases in symptoms, tumor volumes, or prostate-specific antigen levels. One RCT in castration-sensitive, biochemically relapsed prostate cancer attempted to find a decrease in biochemical failure, but that endpoint was not reached. Adverse events in all four of these studies centered around cytokine release. This paper also reviews a Phase II study of sipuleucel-T given neoadjuvantly that speaks to its mechanism of action. Additionally, there is a registry study of sipuleucel-T that has been used to evaluate immunological parameters of the product in men ≥80 years of age and men who had previously been treated with palliative radiation. Attempts to find early markers of response to sipuleucel-T are described. Further ongoing studies that explore the efficacy of sipuleucel-T in combination with immune checkpoint inhibitors and second-generation hormonal therapies that are summarized. Finally, the only published economic analysis of sipuleucel-T is discussed.Keywords: prostate

  11. The ASTRO-H Mission

    Science.gov (United States)

    Dotani, Tadayasu; Takahashi, Tadayuki

    2012-07-01

    ASTRO-H, the new Japanese X-ray Astronomy Satellite following Suzaku, is an international X-ray mission, planed for launch in 2014. ASTRO-H is a combination of wide band X-ray spectroscopy (3 - 80 keV) provided by focusing hard X-ray mirrors and hard X-ray imaging detectors, and high energy-resolution soft X-ray spectroscopy (0.3 - 10 keV) provided by thin-foil X-ray optics and a micro-calorimeter array. The mission will also carry an X-ray CCD camera as a focal plane detector for a soft X-ray telescope and a non-focusing soft gamma-ray detector based on a narrow-FOV semiconductor Compton Camera. With these instruments, ASTRO-H covers very wide energy range from 0.3 keV to 600 keV. The simultaneous broad band pass, coupled with high spectral resolution of super massive Black Holes in Active Galactic Nuclei; trace the growth history of the largest structures in the Universe; provide insights into the behavior of material in extreme gravitational fields; trace particle acceleration structures in clusters of galaxies and SNRs; and investigate the detailed physics of jets. In this presentation, we will describe the mission, scientific goal and the recent progress of the project.

  12. The AstroSat Production Line: From AstroSat 100 to AstroSat 1000

    Science.gov (United States)

    Maliet, E.; Pawlak, D.; Koeck, C.; Beaufumé, E.

    2008-08-01

    From the late 90s onward, Astrium Satellites has developed and improved several classes of high resolution optical Earth Observation satellites. The resulting product line ranges from micro-satellites (about 120 kg) type to the large satellites (in the range of 1 200 kg). They all make uses of state of the art technologies for optical payloads, as well as for avionics. Several classes of platforms have thus been defined and standardised: AstroSat 100 for satellites up to 150 kg, allowing affordable but fully operational missions, AstroSat 500 for satellites up to 800 kg, allowing complex high resolution missions, and AstroSat 1000 for satellites up to 1 200 kg, providing very high resolution and outstanding imaging and agility capabilities. A new class, AstroSat 250, has been developed by Astrium Satellites, and is now proposed, offering a state-of-the-art 3-axis agile platform for high- resolution missions, with a launch mass below 550 kg. The Astrosat platforms rely on a centralised architecture avionics based on an innovative AOCS hybridising of measurements from GPS, stellar sensors and inertial reference unit. Operational safety has been emphasised through thruster free safe modes. All optical payloads make use of all Silicon Carbide (SiC) telescopes. High performance and low consumption linear CCD arrays provide state of the art images. The satellites are designed for simple flight operations, large data collection capability, and large versatility of payload and missions. They are adaptable to a large range of performances. Astrium satellites have already been selected by various customers worldwide.

  13. Studies in using a universal exchange and inference language for evidence based medicine. Semi-automated learning and reasoning for PICO methodology, systematic review, and environmental epidemiology.

    Science.gov (United States)

    Robson, Barry

    2016-12-01

    The Q-UEL language of XML-like tags and the associated software applications are providing a valuable toolkit for Evidence Based Medicine (EBM). In this paper the already existing applications, data bases, and tags are brought together with new ones. The particular Q-UEL embodiment used here is the BioIngine. The main challenge is one of bringing together the methods of symbolic reasoning and calculative probabilistic inference that underlie EBM and medical decision making. Some space is taken to review this background. The unification is greatly facilitated by Q-UEL's roots in the notation and algebra of Dirac, and by extending Q-UEL into the Wolfram programming environment. Further, the overall problem of integration is also a relatively simple one because of the nature of Q-UEL as a language for interoperability in healthcare and biomedicine, while the notion of workflow is facilitated because of the EBM best practice known as PICO. What remains difficult is achieving a high degree of overall automation because of a well-known difficulty in capturing human expertise in computers: the Feigenbaum bottleneck.

  14. Metabolic impact of 100% fruit juice consumption on antioxidant/oxidant status and lipid profiles of adults: An Evidence-Based review.

    Science.gov (United States)

    Crowe-White, Kristi; Parrott, J Scott; Stote, Kim S; Gutschall, Melissa; Benson-Davies, Sue; Droke, Elizabeth; O'Neil, Carol E; Wolfram, Taylor; Ziegler, Paula

    2017-01-02

    One hundred percent fruit juice (FJ) contains bioactive compounds with antioxidant activity. As such, this fruit form has the potential to improve antioxidant status and mediate outcomes influenced by redox status. A systematic review of the literature published between 1995 and 2013 was conducted using PubMed database to evaluate associations between intake of 100% FJ and markers of antioxidant/oxidant status and blood lipid levels in healthy, free-living adults ≥18 years. Data extraction and analysis was conducted according to the Academy of Nutrition and Dietetics Evidence Analysis Process. Limited evidence from ten clinical trials meeting inclusion/exclusion criteria suggests potential improvements in a variety of antioxidant or oxidants biomarkers postconsumption of 100% FJ. Weak evidence from five studies suggests that one or more blood lipid measures may be positively influenced by consumption of 100% FJ. Heterogeneity in study methodology including biomarkers, 100% FJ type, dosage, and intervention duration precludes the ability to make evidence-based recommendations regarding a specific dose-duration-juice effect. Key characteristics in study designs were identified which must either be controlled or statistically adjusted for in future investigations in order to obtain a more accurate understanding of the complex relationship between metabolic outcomes and consumption of 100% FJ in context of a healthy dietary pattern.

  15. A cross-sectional evidence-based review of pharmaceutical promotional marketing brochures and their underlying studies: Is what they tell us important and true?

    Directory of Open Access Journals (Sweden)

    Taylor Lockwood G

    2006-03-01

    Full Text Available Abstract Background A major marketing technique used by pharmaceutical companies is direct-to-physician marketing. This form of marketing frequently employs promotional marketing brochures, based on clinical research, which may influence how a physician prescribes medicines. This study's objective was to investigate whether or not the information in promotional brochures presented to physicians by pharmaceutical representatives is accurate, consistent, and valid with respect to the actual studies upon which the promotional brochures are based. Methods Physicians in five clinics were asked to consecutively collect pharmaceutical promotional brochures and to send them all to a centralized location. The brochures for any class of medication were collected on a continuous basis until 20 distinct promotional brochures were received by a central location. Once the brochure was received, the corresponding original study was obtained. Two blinded reviewers performed an evidence-based review of the article, comparing data that was printed on the brochure to what was found in the original study. Results Among the 20 studies, 75% of the studies were found to be valid, 80% were funded by the pharmaceutical company, 60% of the studies and the corresponding brochures presented patient-oriented outcomes, and 40% were compared to another treatment regimen. Of the 19 brochures that presented the data as graphs, 4 brochures presented a relative risk reduction while only 1 brochure presented an absolute risk reduction. 15% of the promotional marketing brochures presented data that was different from what was in the original published study. Conclusion Given the present findings, physicians should be cautious about drawing conclusions regarding a medication based on the marketing brochures provided by pharmaceutical companies.

  16. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  17. Exploring the ambivalent evidence base of mobile health (mHealth) : A systematic literature review on the use of mobile phones for the improvement of community health in Africa

    NARCIS (Netherlands)

    de Kruijf, J.G.; Krah, E.F.M.

    2016-01-01

    Background Africa is labelled the world's fastest-growing ‘mobile region’. Considering such growth and the fragility of the continent's healthcare, mHealth has flourished. This review explores mHealth for community health in Africa in order to assess its still ambivalent evidence base. Methods Using

  18. The AstroMundus-ESO Connection

    Science.gov (United States)

    Humphreys, E.; Hussain, G.; Biggs, A.; Lu, H.-Y.; Emsellem, E.; De Cia, A.; Lavail, A.; Spyromilio, J.

    2016-03-01

    The AstroMundus Programme is an E+ Erasmus Mundus Joint Masters Degree course in astronomy and astrophysics offered by a consortium of European universities and research institutes. In 2014 and 2016, AstroMundus Masters students visited ESO and participated in proposal-writing sessions, during which groups of students speed-wrote complete ALMA proposals, before presenting them to a pseudo Time Allocation Committee providing on-the-spot feedback. The AstroMundus visit of 25-26 January 2016 is described.

  19. Evidence-based dentistry: what's new?

    Science.gov (United States)

    Ballini, A; Capodiferro, S; Toia, M; Cantore, S; Favia, G; De Frenza, G; Grassi, F R

    2007-06-06

    The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. Nowadays the practice of dentistry is becoming more complex and challenging because of the continually changing in dental materials and equipments, an increasingly litigious society, an increase in the emphasis of continuing professional development, the information explosion and the consumer movement associated with advances on the Internet. The need for reliable information and the electronic revolution have come together to allow the "paradigm shift" towards evidence-based health care. Recent years have seen an increase in the importance of evidence-based dentistry, aiming to reduce to the maximum the gap between clinical research and real world dental practice. Aim of evidence-based practice is the systematic literature review, which synthesizes the best evidences and provides the basis for clinical practice guidelines. These practice guidelines give a brief review of what evidence-based dentistry is and how to use it.

  20. Evidence-Based Dentistry: What's New?

    Directory of Open Access Journals (Sweden)

    A. Ballini, S. Capodiferro, M. Toia, S. Cantore, G. Favia, G. De Frenza, F.R. Grassi

    2007-01-01

    Full Text Available The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. Nowadays the practice of dentistry is becoming more complex and challenging because of the continually changing in dental materials and equipments, an increasingly litigious society, an increase in the emphasis of continuing professional development, the information explosion and the consumer movement associated with advances on the Internet. The need for reliable information and the electronic revolution have come together to allow the “paradigm shift” towards evidence-based health care. Recent years have seen an increase in the importance of evidence-based dentistry, aiming to reduce to the maximum the gap between clinical research and real world dental practice. Aim of evidence-based practice is the systematic literature review, which synthesizes the best evidences and provides the basis for clinical practice guidelines. These practice guidelines give a brief review of what evidence-based dentistry is and how to use it.

  1. A workshop report on HIV mHealth synergy and strategy meeting to review emerging evidence-based mHealth interventions and develop a framework for scale-up of these interventions

    OpenAIRE

    Sarah Karanja; Lawrence Mbuagbaw; Paul Ritvo; Judith Law; Catherine Kyobutungi; Graham Reid; Ravi Ram; Benson Estambale; Richard Lester

    2011-01-01

    mHealth is a term used to refer to mobile technologies such as personal digital assistants and mobile phones for healthcare. mHealth initiatives to support care and treatment of patients are emerging globally and this workshop brought together researchers, policy makers, information, communication and technology programmers, academics and civil society representatives for one and a half days synergy meeting in Kenya to review regional evidence based mHealth research for HIV care and treatment...

  2. Evidence-based dentistry.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

  3. Evidence-Based Classroom Behaviour Management Strategies

    Science.gov (United States)

    Parsonson, Barry S.

    2012-01-01

    This paper reviews a range of evidence-based strategies for application by teachers to reduce disruptive and challenging behaviours in their classrooms. These include a number of antecedent strategies intended to help minimise the emergence of problematic behaviours and a range of those which provide positive consequences for appropriate student…

  4. Evidence Based Education Request Desk. EBE #798

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

    Evidence Based Education (EBE) #555 was in response to the request "Is there any new compelling research for turning around low-performing schools?" The articles included in that document are on target, but include articles through 2009. This EBE Request seeks to provide an updated review of recent research (2009-present) regarding school…

  5. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

    2015-01-01

    diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

  6. Crime prevention: more evidence-based analysis.

    Science.gov (United States)

    Garrido Genovés, Vicente; Farrington, David P; Welsh, Brandon C

    2008-02-01

    This paper introduces a new section of Psicothema dedicated to the evidence-based approach to crime prevention. Along with an original sexual-offender-treatment programme implemented in Spain, this section presents four systematic reviews of important subjects in the criminological arena, such as sexual offender treatment, the well-known programme, the effectiveness of custodial versus non-custodial sanctions in reoffending and the fight against terrorism. We also highlight some of the focal points that scientists, practitioners and governments should take into account in order to support this evidence-based viewpoint of crime prevention.

  7. 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…

  8. A workshop report on HIV mHealth synergy and strategy meeting to review emerging evidence-based mHealth interventions and develop a framework for scale-up of these interventions.

    Science.gov (United States)

    Karanja, Sarah; Mbuagbaw, Lawrence; Ritvo, Paul; Law, Judith; Kyobutungi, Catherine; Reid, Graham; Ram, Ravi; Estambale, Benson; Lester, Richard

    2011-01-01

    mHealth is a term used to refer to mobile technologies such as personal digital assistants and mobile phones for healthcare. mHealth initiatives to support care and treatment of patients are emerging globally and this workshop brought together researchers, policy makers, information, communication and technology programmers, academics and civil society representatives for one and a half days synergy meeting in Kenya to review regional evidence based mHealth research for HIV care and treatment, review mHealth technologies for adherence and retention interventions in anti-retroviral therapy (ART) programs and develop a framework for scale up of evidence based mHealth interventions. The workshop was held in May 2011 in Nairobi, Kenya and was funded by the Canadian Global Health Research Initiatives (GHRI) and the US Centre for Disease Control and Prevention (CDC). At the end of the workshop participants came up with a framework to guide mHealth initiatives in the region and a plan to work together in scaling up evidence based mHealth interventions. The participants acknowledged the importance of the meeting in setting the pace for strengthening and coordinating mHealth initiatives and unanimously agreed to hold a follow up meeting after three months.

  9. Evidence-Based Laboratory Medicine

    Institute of Scientific and Technical Information of China (English)

    Christopher P Price

    2004-01-01

    @@ Whilst there have been several definitions of Evidence-Based Medicine (EBM), the one given by David Sackett is probably the most accurate and well accepted; he stated that "evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients"[1].

  10. Spontaneous occlusion of the circle of Willis in children: pediatric moyamoya summary with proposed evidence-based practice guidelines. A review.

    Science.gov (United States)

    Smith, Edward R; Scott, R Michael

    2012-04-01

    Moyamoya is a progressive arteriopathy of unknown origin affecting the branches of the internal carotid artery (ICA). The arteriopathy can present as an isolated medical condition, affecting both sides of the brain ("moyamoya disease") or can be unilateral or found in association with systemic disorders ("moyamoya syndrome"). The ischemia resulting from luminal narrowing predisposes children to transient ischemic attacks and stroke-the primary presentations of affected patients. Although it is rare-affecting 1 in 1 million children in the US-moyamoya is implicated in 6% of all childhood strokes. Diagnosis is defined by characteristic findings on arteriograms, including stenosis of the branches of the ICA and a pathognomonic spray of small collateral vessels in this region, descriptively likened to a "puff of smoke" ("moyamoya" in Japanese). Treatment is predicated on restoration of cerebral blood flow by surgical revascularization. The rarity of this disorder has limited research and the development of evidence-based clinical management. While acknowledging these limitations, in this article the authors aim to summarize current studies of pediatric moyamoya, with the objective of providing a framework for construction of evidence-based guidelines for treatment. The compilation of current data in these guidelines should serve as a resource to aid pediatric neurosurgeons in their role as advocates for providing appropriate care to affected children.

  11. The next-generation microcalorimeter array of XRS on Astro-E2

    Energy Technology Data Exchange (ETDEWEB)

    Stahle, C.K. E-mail: cak@lheapop.gsfc.nasa.gov; Allen, C.A.; Boyce, K.R.; Brekosky, R.P.; Brown, G.V.; Cottam, J.; Figueroa-Feliciano, E.; Galeazzi, M.; Gygax, J.D.; Jacobson, M.B.; Kelley, R.L.; Liu, D.; McCammon, D.; McClanahan, R.A.; Moseley, S.H.; Porter, F.S.; Rocks, L.E.; Szymkowiak, A.E.; Vaillancourt, J.E

    2004-03-11

    The square-format 32-pixel microcalorimeter array at the focal plane of the high-resolution X-ray spectrometer on the Astro-E2 X-ray Observatory is the first of a new generation of silicon-based microcalorimeters. This array has numerous advantages over its predecessor, the bilinear array that was launched on Astro-E. Foremost among its benefits are: (1) the energy resolution is improved by a factor of two at 6 keV (now 6 eV FWHM), (2) the thermal time constant is a factor of two faster, and (3) each pixel has a Gaussian line response. We will discuss the design changes that have led to these and other advantages.

  12. The Astro-WISE datacentric information system

    NARCIS (Netherlands)

    Valentijn, E; Belikov, Andrey; Begeman, Kornelis; Boxhoorn, Danny

    2013-01-01

    In this paper we present the various concepts behind the Astro-WISE Information System. The concepts form a blueprint for general scientific information systems (WISE) which can satisfy a wide and challenging range of requirements for the data dissemination, storage and processing for various fields

  13. Astro Talk in Social Media - Indonesia

    Science.gov (United States)

    Yamani, A.; Soegijoko, W.

    2015-03-01

    Social media is a new trend in communicating and connecting to people. It is also a good choice to build awareness of astronomy as issues spread easily and quickly, creating hot topics. This paper will analyze the trend of astro talk in Indonesia and hope to inspire astronomers to use social media in raising awareness.

  14. Vsop2/Astro-G Project

    CERN Document Server

    Tsuboi, Masato

    2008-01-01

    We introduce a new space VLBI project, the Second VLBI Space Observatory Program (VSOP2), following the success of the VLBI Space Observatory Program (VSOP1). VSOP2 has 10 times higher angular resolution, up to about 40 micro arcseconds, 10 times higher frequency up to 43 GHz, and 10 times higher sensitivity compared to VSOP1. Then VSOP2 should become a most powerful tool to observe innermost regions of AGN and astronomical masers. ASTRO-G is a spacecraft for VSOP2 project constructing in ISAS/JAXA since July 2007. ASTRO-G will be launched by JAXA H-IIA rocket in fiscal year 2012. ASTRO-G and ground-based facilities are combined as VSOP2. To achieve the good observation performances, we must realize new technologies. They are large precision antenna, fast-position switching capability, new LNAs, and ultra wide-band down link, etc.. VSOP2 is a huge observation system involving ASTRO-G, ground radio telescopes, tracking stations, and correlators, one institute can not prepare a whole system of VSOP2. Then we mu...

  15. X-ray telescope onboard Astro-E: optical design and fabrication of thin foil mirrors.

    Science.gov (United States)

    Kunieda, H; Ishida, M; Endo, T; Hidaka, Y; Honda, H; Imamura, K; Ishida, J; Maeda, M; Misaki, K; Shibata, R; Furuzawa, A; Haga, K; Ogasaka, Y; Okajima, T; Tawara, Y; Terashima, Y; Watanabe, M; Yamashita, K; Yoshioka, T; Serlemitsos, P J; Soong, Y; Chan, K W

    2001-02-01

    X-ray telescopes (XRT's) of nested thin foil mirrors are developed for Astro-E, the fifth Japanese x-ray astronomy satellite. Although the launch was not successful, the design concept, fabrication, and alignment procedure are summarized. The main purpose of the Astro-E XRT is to collect hard x rays up to 10 keV with high efficiency and to provide medium spatial resolution in limited weight and volume. Compared with the previous mission, Advanced Satellite for Cosmology and Astrophysics (ASCA), a slightly longer focal length of 4.5-4.75 m and a larger diameter of 40 cm yields an effective area of 1750 cm2 at 8 keV with five telescopes. The image quality is also improved to 2-arc min half-power diameter by introduction of a replication process. Platinum is used instead of gold for the reflectors of one of the five telescopes to enhance the high-energy response. The fabrication and alignment procedure is also summarized. Several methods for improvement are suggested for the reflight Astro-E II mission and for other future missions. Preflight calibration results will be described in a forthcoming second paper, and a detailed study of images will be presented in a third paper.

  16. Evidence-based management of ANCA vasculitis.

    Science.gov (United States)

    Carruthers, David; Sherlock, Jonathan

    2009-06-01

    The vasculitides associated with antineutrophil cytoplasmic antibodies (ANCAs) present to and are managed by a wide spectrum of physicians, reflecting the multi-organ nature of the conditions. Treatment strategies for these primary inflammatory vascular diseases have varied based on the outcomes of different clinical trials and practice reviews. The individual drugs used and their route of administration, dose, and duration of therapy have varied and have been the source of much debate. Advances in our understanding of disease immunopathogenesis, clinical assessment and outcome have formed the basis for several recent good-quality clinical trials. Now, with the results of these large-scale multicentre collaborative studies, there is a firmer evidence base to guide management decisions for individual patients. This evidence base, reviewed here, has led to the publication of treatment guidelines which importantly encompass many of the broader aspects of disease management.

  17. Teaching Evidence-Based Physical Diagnosis: Six Bedside Lessons.

    Science.gov (United States)

    McGee, Steven

    2016-12-01

    Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.

  18. Evidence-Based Treatment and Stuttering--Historical Perspective

    Science.gov (United States)

    Prins, David; Ingham, Roger J.

    2009-01-01

    Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…

  19. Inconclusive evidence that age predicts a prolonged or chronic course of acute rhinosinusitis in adults: a systematic review of the evidence base

    NARCIS (Netherlands)

    Broeder, T.P.; Grooteman, K.V.; Overdijkink, S.B.; Selhorst, C.E.; Kaper, N.M.; Grolman, W.; van der Heijden, G.J.M.G.

    2014-01-01

    Objective To review the evidence whether the risk for a prolonged or chronic course increases with age in adult patients with acute rhinosinusitis. Data Sources PubMed, EMBASE, and the Cochrane Library. Review Methods A comprehensive literature search was performed on March 24, 2013, and articles we

  20. Inconclusive evidence that age predicts a prolonged or chronic course of acute rhinosinusitis in adults: a systematic review of the evidence base

    NARCIS (Netherlands)

    Broeder, T.P.; Grooteman, K.V.; Overdijkink, S.B.; Selhorst, C.E.; Kaper, N.M.; Grolman, W.; Heijden, G.J. van der

    2014-01-01

    OBJECTIVE: To review the evidence whether the risk for a prolonged or chronic course increases with age in adult patients with acute rhinosinusitis. DATA SOURCES: PubMed, EMBASE, and the Cochrane Library. REVIEW METHODS: A comprehensive literature search was performed on March 24, 2013, and articles

  1. Autopsy practice in forensic pathology - evidence-based or experience-based? a review of autopsies performed on victims of traumatic asphyxia in a mass disaster.

    Science.gov (United States)

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte; Lynnerup, Niels

    2014-02-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts.

  2. Association of pregnant women periodontal status to preterm and low-birth weight babies: A systematic and evidence-based review

    Directory of Open Access Journals (Sweden)

    Vanka Shanthi

    2012-01-01

    Full Text Available The mouth serves as a mirror to general health and also as a portal for disease to the rest of the body. Since the old wives′ tale of "the loss of a tooth for every pregnancy", oral health during pregnancy has long been a focus of interest. In the past decade, there has been mounting scientific evidence suggesting that periodontal disease may play an important role as a risk factor for adverse pregnancy outcomes. Considering all the above stated factors this systematic review is aimed to focus on the association of periodontal diseases to preterm and low-birth weight (LBW babies. In view of the large body of literature the review is limited to studies identified by computer searching. Hand searching of journals and gathering of unpublished reports and conference proceedings was outside the scope of the review. The PubMed database was searched using the search terms: periodontitis, preterm, LBW. The titles, authors, and abstracts from all studies identified by the electronic search were printed and reviewed independently on the basis of keywords, title and abstract, to determine whether these met the inclusion criteria. The electronic search identified 68 papers. After review of the study title, keywords and abstracts, 62 papers were identified potentially meeting inclusion criteria. Generally, all the studies reviewed in the paper suggest that periodontal disease may be a potential risk factor for preterm LBW babies.

  3. Evidence based psychosocial interventions in substance use

    Directory of Open Access Journals (Sweden)

    Sonali Jhanjee

    2014-01-01

    Full Text Available In recent years, there has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence. A literature review was undertaken using the several electronic databases (PubMed, Cochrane Database of systemic reviews and specific journals, which pertain to psychosocial issues in addictive disorders and guidelines on this topic. Overall psychosocial interventions have been found to be effective. Some interventions, such as cognitive behavior therapy, motivational interviewing and relapse prevention, appear to be effective across many drugs of abuse. Psychological treatment is more effective when prescribed with substitute prescribing than when medication or psychological treatment is used alone, particularly for opiate users. The evidence base for psychological treatment needs to be expanded and should also include research on optimal combinations of psychological therapies and any particular matching effects, if any. Psychological interventions are an essential part of the treatment regimen and efforts should be made to integrate evidence-based interventions in all substance use disorder treatment programs.

  4. Evidence-based equine dentistry: preventive medicine.

    Science.gov (United States)

    Carmalt, James L

    2007-08-01

    Dental problems are some of the most common reasons for a horse to be presented to an equine veterinarian. Despite the importance of anecdotal evidence as a starting point, the science of equine dentistry (especially prophylactic dentistry) has remained poorly supported by evidence-based approaches to diagnosis and treatment. In the 21st century, veterinarians have an ethical responsibility to promote and use the results of evidence-based research and not propagate statements attesting to the purported benefits of intervention without supporting research. Consider also that society is becoming more litigious and therefore is basing treatment plans and advice on published research, which protects the profession from legal challenges concerning our professional conduct. This article reviews the current published evidence concerning the role of equine dentistry in feed digestibility and performance.

  5. The religion of evidence-based practice

    DEFF Research Database (Denmark)

    Wigram, Tony; Gold, Christian

    2012-01-01

    , and discusses autism spectrum disorders and EBP. The chapter concludes that, based on last sixty years of the development of music therapy as a recognized and relevant intervention, there is no doubt that the honeymoon period is over, and EBP is here to stay. Despite examples of attrition in music therapy......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....

  6. Evidence-based Management of Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Yangfan Yang; Minbin Yu

    2005-01-01

    Purpose: The evidence-based medicine (EBM) is a new medical mode that is completely different from traditional experience-based medicine. The core of EBM is that decision-making during clinical practices must be based on objective research results.With the rapid development of modern ophthalmology, some former viewpoints according to experience-based medicine face challenges. Evidence-based ophthalmology (EBO) is imperative under the situation. Glaucoma, as a disease resulting in blindness, which can not be cured by operation, is thought more and more of by medical management officials and doctors. One challenge for ophthalmologists entering the 21st century will be to make clinical decisions based on valid information or evidence rather than intuition, hearsay, or peer practice. How can we do? Here reviews the application of EBM in medical management of glaucoma since EBM' s naissance and give a reference.

  7. 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...

  8. No evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent rhinorrhea: a systematic review of the evidence base

    NARCIS (Netherlands)

    van den Broek, M.F.M.; Gudden, C.; Kluijfhout, W.P.; Stam-Slob, M.C.; Aarts, M.C.J.; Kaper, N.M.; van der Heijden, G.J.M.G.

    2014-01-01

    OBJECTIVE: To evaluate the diagnostic value of symptom duration and purulent rhinorrhea in adults suspected of having acute bacterial rhinosinusitis. DATA SOURCES: PubMed, EMBASE, and the Cochrane Library. REVIEW METHODS: We performed a comprehensive systematic search on March 28, 2013. We included

  9. No evidence for distinguishing bacterial from viral acute rhinosinusitis using fever and facial/dental pain: a systematic review of the evidence base

    NARCIS (Netherlands)

    Hauer, A.J.; Luiten, E.L.; van Erp, N.F.; Blase, P.E.; Aarts, M.C.J.; Kaper, N.M.; van der Heijden, G.J.M.G.

    2014-01-01

    Objective To assess the diagnostic value of fever and facial and dental pain in adults suspected of acute bacterial rhinosinusitis. Data Sources PubMed, EMBASE, and the Cochrane Library. Review Methods A comprehensive systematic search was performed on March 18, 2013. We included articles reporting

  10. Evidence-Based Systematic Review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals with Stroke-Induced Aphasia

    Science.gov (United States)

    Cherney, Leora R.; Patterson, Janet P.; Raymer, Anastasia; Frymark, Tobi; Schooling, Tracy

    2008-01-01

    Purpose: This systematic review summarizes evidence for intensity of treatment and constraint-induced language therapy (CILT) on measures of language impairment and communication activity/participation in individuals with stroke-induced aphasia. Method: A systematic search of the aphasia literature using 15 electronic databases (e.g., PubMed,…

  11. AstroVis: Visualizing astronomical data cubes

    Science.gov (United States)

    Finniss, Stephen; Tyler, Robin; Questiaux, Jacques

    2016-08-01

    AstroVis enables rapid visualization of large data files on platforms supporting the OpenGL rendering library. Radio astronomical observations are typically three dimensional and stored as data cubes. AstroVis implements a scalable approach to accessing these files using three components: a File Access Component (FAC) that reduces the impact of reading time, which speeds up access to the data; the Image Processing Component (IPC), which breaks up the data cube into smaller pieces that can be processed locally and gives a representation of the whole file; and Data Visualization, which implements an approach of Overview + Detail to reduces the dimensions of the data being worked with and the amount of memory required to store it. The result is a 3D display paired with a 2D detail display that contains a small subsection of the original file in full resolution without reducing the data in any way.

  12. 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.

  13. Evidence-Based Psychological Assessment.

    Science.gov (United States)

    Bornstein, Robert F

    2016-11-03

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

  14. Evidence-based playground design

    DEFF Research Database (Denmark)

    Refshauge, Anne Dahl; Stigsdotter, Ulrika K.; Lamm, Bettina;

    2015-01-01

    This paper develops, explores and evaluates an evidence-based approach to playground design, with a public park playground (playlab Cph) in Copenhagen as a case study. In the increasingly urbanised world, park playgrounds are valuable places that support healthy child development by providing opp...

  15. Evidence-Based IT Development

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten

    2005-01-01

    Evidence-based IT development aims at developing a new commercial contract model for IT projects where the cus-tomers payment is dependent on measurable effects of using the vendors system. The idea is to establish a strategic part-nership in which customer and IT vendor share the responsi-bility...

  16. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may be...

  17. Teaching ASTRO 101 Students the Art of Scientific Argumentation

    Science.gov (United States)

    Schleigh, Sharon P.; Slater, Stephanie; Slater, Timothy F.

    2016-01-01

    Going beyond asking students to simply memorize facts about the universe, a longstanding challenge in teaching astronomy centers on successfully teaching students about the nature of science. As introductory astronomy survey courses, known widely as ASTRO 101, can sometimes be the last science course non-science majoring undergraduates take, many faculty hope to emphasize the scientific enterprise as a broad field in inquiry making valuable contributions to civilization as a whole, rather than as an isolated study of objects far from Earth. Scholars have long proposed that an understanding of the nature of science as a human endeavor requires explicit instruction. In other words, students successfully learning the facts of astronomy does not in any way ensure that students will learn anything about the nature of how astronomy is done. In a purposeful effort to improve students' understanding about the practices and discourse of astronomy, scholars working with the CAPER Center for Astronomy & Physics Education research are developing a suite of carefully designed instructional sequences—called Scientific Argumentation—focused on teaching students the differences between data and evidence, how to communicate and defend evidence-based conclusions, and how to be informed skeptics of scientific claims. Early results show students moving from naïve understandings of scientific practices to more informed understandings as well as demonstrating enhanced value for science in general as an worthwhile human endeavor with far reaching benefits.

  18. 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.

  19. The Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder in Adults—An Update for 2012: Practice Parameters with an Evidence-Based Systematic Review and Meta-Analyses

    Science.gov (United States)

    Aurora, R. Nisha; Kristo, David A.; Bista, Sabin R.; Rowley, James A.; Zak, Rochelle S.; Casey, Kenneth R.; Lamm, Carin I.; Tracy, Sharon L.; Rosenberg, Richard S.

    2012-01-01

    A systematic literature review and meta-analyses (where appropriate) were performed to update the previous AASM practice parameters on the treatments, both dopaminergic and other, of RLS and PLMD. A considerable amount of literature has been published since these previous reviews were performed, necessitating an update of the corresponding practice parameters. Therapies with a STANDARD level of recommendation include pramipexole and ropinirole. Therapies with a GUIDELINE level of recommendation include levodopa with dopa decarboxylase inhibitor, opioids, gabapentin enacarbil, and cabergoline (which has additional caveats for use). Therapies with an OPTION level of recommendation include carbamazepine, gabapentin, pregabalin, clonidine, and for patients with low ferritin levels, iron supplementation. The committee recommends a STANDARD AGAINST the use of pergolide because of the risks of heart valve damage. Therapies for RLS secondary to ESRD, neuropathy, and superficial venous insufficiency are discussed. Lastly, therapies for PLMD are reviewed. However, it should be mentioned that because PLMD therapy typically mimics RLS therapy, the primary focus of this review is therapy for idiopathic RLS. Citation: Aurora RN; Kristo DA; Bista SR; Rowley JA: Zak RS; Casey KR; Lamm CI; Tracy SL; Rosenberg RS. The treatment of restless legs syndrome and periodic limb movement disorder in adults—an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses. SLEEP 2012;35(8):1039-1062. PMID:22851801

  20. AstroSat - a multi-wavelength astronomy satellite

    CERN Document Server

    Rao, A R; Bhattacharya, D

    2016-01-01

    AstroSat is a multi-wavelength astronomy satellite, launched on 2015 September 28. It carries a suite of scientific instruments for multi-wavelength observations of astronomical sources. It is a major Indian effort in space astronomy and the context of AstroSat is examined in a historical perspective. The Performance Verification phase of AstroSat has been completed and all instruments are working flawlessly and as planned. Some brief highlights of the scientific results are also given here.

  1. An evidence-based review of the potential role of icatibant in the treatment of acute attacks in hereditary angioedema type I and II

    Directory of Open Access Journals (Sweden)

    Floccard B

    2012-09-01

    Full Text Available Bernard Floccard,1 Etienne Hautin,1 Laurence Bouillet,2 Brigitte Coppere,3 Bernard Allaouchiche11Département d'Anesthésie Réanimation, Centre de Référence des Angiœdèmes à Bradykinine, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, 2Clinique Universitaire de Médecine Interne, Centre National de Référence des Angiœdèmes à Bradykinine, CHU de Grenoble, Grenoble, 3Service de Médecine Interne, Centre de Référence des Angiœdèmes à Bradykinine, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, FranceIntroduction: Icatibant, a first-in-class B2 bradykinin receptor antagonist, appears to have a favorable efficacy and safety profile for the treatment of acute attacks of hereditary angioedema in adults.Aims: To update the evidence and provide an overview of the available data on icatibant.Evidence review: Peer reviewed articles published and listed in Medline Search and published updated guidelines for the treatment of acute attacks in hereditary angioedema type I and II in adults were reviewed. The validity and quality of evidence were evaluated.Place in therapy: Clinical evidence for the treatment of acute hereditary angioedema attacks with icatibant is strong. Approximately 10% of the patients require a second dose. No serious adverse reactions have been reported. The only significant side effects consistently registered by 90% of patients are transient local pain, swelling, and erythema at the local injection site.Conclusion: Subcutaneously administered 30 mg icatibant has been shown to be a safe and efficacious treatment in clinical trials. It is the only specific treatment authorized for self-administration by the subcutaneous route offering increased patient independence.Keywords: icatibant, hereditary angioedema, self-administration, acute attacks

  2. Tigecycline: an evidence-based review of its antibacterial activity and effectiveness in complicated skin and soft tissue and intraabdominal infections

    Directory of Open Access Journals (Sweden)

    Christopher J. Dunn

    2006-03-01

    Full Text Available Christopher J. DunnCatalyst Communications Ltd, Auckland, New ZealandIntroduction: There is an urgent need for novel agents to manage serious bacterial infections, particularly those contracted in healthcare facilities. Tigecycline is a novel broad-spectrum glycylcycline with good activity against Gram-positive, many Gram-negative, anaerobic, and some atypical pathogens that has been developed to address this need.Aims: To review the evidence for the use of tigecycline in serious and complicated skin and soft tissue and intraabdominal infections.Evidence review: There is substantial evidence that tigecycline is as effective as vancomycin plus aztreonam in complicated skin and skin structure infections (SSSIs and as effective as imipenem plus cilastatin in intraabdominal infections. Limited evidence shows effectiveness in patients with resistant Acinetobacter infection in an intensive care unit, and the possibility that the use of tigecycline may reduce length of hospital stay. The drug is well tolerated, with nausea and vomiting as the major adverse effects.Outcomes summary: The introduction of tigecycline should be beneficial at a time of increasing problems with bacterial resistance, and evidence to date has been sufficient for regulatory approval for complicated SSSIs and intraabdominal infections. Research into tigecycline’s efficacy in other infectious diseases (notably pneumonia and bacteremia is ongoing. Further good quality studies and ongoing surveillance for any emerging bacterial resistance will be needed to determine outcomes with tigecycline relative to other novel antibacterial agents, and to explore the economic implications of its adoption.Key words: antibiotic resistance, bacterial infections, glycylcycline, nosocomial infections, review, tigecycline

  3. 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.

  4. The role of self-help in the treatment of mild anxiety disorders in young people: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Bradford S

    2012-02-01

    Full Text Available Debra Rickwood1,2, Sally Bradford31Faculty of Health, University of Canberra, Canberra, ACT, Australia; 2headspace: National Youth Mental Health Foundation, North Melbourne, VIC, Australia; 3Faculty of Health, University of Canberra, Canberra, ACT, AustraliaAbstract: Anxiety disorders are the most common mental health problems experienced by young people, and even mild anxiety can significantly limit social, emotional, and cognitive development into adulthood. It is, therefore, essential that anxiety is treated as early and effectively as possible. Young people are unlikely, however, to seek professional treatment for their problems, increasing their chance of serious long-term problems such as impaired peer relations and low self-esteem. The barriers young people face to accessing services are well documented, and self-help resources may provide an alternative option to respond to early manifestations of anxiety disorders. This article reviews the potential benefits of self-help treatments for anxiety and the evidence for their effectiveness. Despite using inclusive review criteria, only six relevant studies were found. The results of these studies show that there is some evidence for the use of self-help interventions for anxiety in young people, but like the research with adult populations, the overall quality of the studies is poor and there is need for further and more rigorous research.Keywords: adolescent, young adult, children, mental disorder, self-administered, bibliotherapy, therapist-guided

  5. 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.

  6. Evidence-based Medicine in Animal Reproduction.

    Science.gov (United States)

    Arlt, S P; Heuwieser, W

    2014-09-01

    With new knowledge being generated and published daily, the importance of evidence-based approaches in veterinary medicine is obvious. Clinicians must stay current or risk making poor decisions that clients may challenge. Especially in animal reproduction, several new substances and procedures to diagnose or treat reproductive disorders have been introduced in the last years. On the other hand, a closer look at the quality of published literature on animal reproduction reveals major deficits in methodology and reporting of many clinical trials. We strongly recommend systematically assessing the quality of scientific information when reading journal papers before using the given information in practice. The aim of evidence-based medicine (EBM) is to base the decisions in the practice of medicine on valid, clinically relevant research data. Therefore, we suggest that students should become familiar with the concepts of evidence-based veterinary medicine (EBVM) at the beginning of their veterinary education. Concepts and supporting tools such as checklists for literature assessment have been developed and validated. The purpose of this article is to review and discuss the importance of incorporating EBVM in animal reproduction. The need for further research that produces strong evidence in different fields of animal reproduction and better reporting of relevant study information is obvious.

  7. [Forensic evidence-based medicine in computer communication networks].

    Science.gov (United States)

    Qiu, Yun-Liang; Peng, Ming-Qi

    2013-12-01

    As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks.

  8. School Librarianship and Evidence Based Practice: Progress, Perspectives, and Challenges

    Directory of Open Access Journals (Sweden)

    Ross J. Todd

    2009-06-01

    Full Text Available Objective – This paper provides an overview of progress and developments surrounding evidence based practice in school librarianship, and seeks to provide a picture of current thinking about evidence based practice as it relates to the field. It addresses current issues and challenges facing the adoption of evidence based practice in school librarianship.Methods – The paper is based on a narrative review of a small but growing body of literature on evidence based practice in school librarianship, set within a broader perspective of evidence based education. In addition, it presents the outcomes of a collaborative process of input from 200 school libraries leaders collected at a School Library summit in 2007 specifically to address the emerging arena of evidence based practice in this field.Results – A holistic model of evidence based practice for school libraries is presented, centering on three integrated dimensions of evidence: evidence for practice, evidence in practice, and evidence of practice.Conclusion – The paper identifies key challenges ahead if evidence based school librarianship is to develop further. These include: building research credibility within the broader educational environment; the need for ongoing review and evaluation of the diverse body of research in education, librarianship and allied fields to make quality evidence available in ways that can enable practicing school librarians to build a culture of evidence based practice; development of tools, strategies, and exemplars to use to facilitate evidence based decision-making; and, ensuring that the many and diverse advances in education and librarianship become part of the practice of school librarianship.

  9. Palonosetron in the prevention of chemotherapy-induced nausea and vomiting: an evidence-based review of safety, efficacy, and place in therapy

    Directory of Open Access Journals (Sweden)

    Celio L

    2015-08-01

    Full Text Available Luigi Celio, Monica Niger, Francesca Ricchini, Francesco Agustoni Medical Oncology Unit 1, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy Introduction: The second-generation 5-hydroxytryptamine-3 (5-HT3 receptor antagonist palonosetron is effective in the prevention of chemotherapy-induced nausea and vomiting (CINV associated with highly and moderately emetogenic chemotherapy (HEC and MEC, respectively. In addition, palonosetron has been the first and, at present, the only 5-HT3 receptor antagonist to have a specific indication for the prevention of delayed CINV associated with MEC. The unique pharmacology of this antagonist is thought to partly explain its improved efficacy against delayed symptoms. Aims: To review the evidence underlying the use of palonosetron in preventing CINV. Evidence review: A recent meta-analysis consistently showed that palonosetron significantly increases the control of both emesis and nausea during the acute and delayed phases after single-day HEC or MEC. Consistent with these findings from trials that did not include an neurokinin-1 (NK-1 receptor antagonist, randomized controlled trials recently showed that a triple combination with palonosetron achieves significantly better control of delayed CINV, particularly delayed nausea, in patients undergoing HEC or the high-risk combination of an anthracycline and cyclophosphamide (AC. Evidence from randomized studies also supports palonosetron as a valuable option to reduce the total corticosteroid dose administered in patients undergoing multiple cycles of MEC or AC chemotherapy. Additional benefits of palonosetron include the lack of a warning on cardiac safety and no known clinically significant drug–drug interactions. Place in therapy and conclusion: Evidence currently available indicates that palonosetron significantly adds to the clinician’s ability to effectively control CINV in patients undergoing HEC or MEC. It is

  10. Ceftazidime–avibactam: an evidence-based review of its pharmacology and potential use in the treatment of Gram-negative bacterial infections

    Directory of Open Access Journals (Sweden)

    Lagacé-Wiens P

    2014-01-01

    Full Text Available Philippe Lagacé-Wiens,1,2 Andrew Walkty,1,2 James A Karlowsky1,2 1Clinical Microbiology, Diagnostic Services Manitoba, 2Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada Abstract: Avibactam (NXL104, AVE1330A is a semi-synthetic, non-β-lactam, β-lactamase inhibitor that is active against Ambler class A, class C, and some class D serine β-lactamases. In this review, we summarize the in vitro data, pharmacology, mechanisms of action and resistance, and clinical trial data relating to the use of this agent combined with ceftazidime for the treatment of Gram-negative bacterial infections. The addition of avibactam to ceftazidime improves its in vitro activity against Enterobacteriaceae and Pseudomonas aeruginosa. Avibactam does not improve the activity of ceftazidime against Acinetobacter spp., Burkholderia spp., or most anaerobic Gram-negative rods. Pharmacodynamic data indicate that ceftazidime–avibactam is bactericidal at concentrations achievable in human serum. Animal studies demonstrate that ceftazidime–avibactam is effective in ceftazidime-resistant Gram-negative septicemia, meningitis, pyelonephritis, and pneumonia. Limited clinical trials published to date have reported that ceftazidime–avibactam is as effective as therapy with a carbapenem in complicated urinary tract infection and complicated intra-abdominal infection (combined with metronidazole including infection caused by cephalosporin-resistant Gram-negative isolates. Safety and tolerability of ceftazidime–avibactam in clinical trials has been excellent, with few serious drug-related adverse events reported. Given the abundant clinical experience with ceftazidime and the significant improvement that avibactam provides in its activity against contemporary β-lactamase-producing Gram-negative pathogens, it is likely this new combination agent will play a role in the empiric treatment of complicated

  11. Toward an evidence-based toxicology.

    Science.gov (United States)

    Hoffmann, S; Hartung, T

    2006-09-01

    The increasing demands on toxicology of large-scale risk assessment programmes for chemicals and emerging or expanding areas of chemical use suggest it is timely to review the toxicological toolbox. Like in clinical medicine, where an evidence-based medicine (EBM) is critically reviewing traditional approaches, toxicology has the opportunity to reshape and enlarge its methodology and approaches on the basis of compounded scientific knowledge. Such revision would have to be based on structured reviews of current practice, ie, assessment of test performance characteristics, mechanistic understanding, extended quality assurance, formal validation and the use of integrated testing strategies. This form of revision could optimize the balance between safety, costs and animal welfare, explicitly stating and, where possible, quantifying uncertainties. After a self-critical reassessment of current practices and evaluation of the thus generated information, such an evidence-based toxicology (EBT) promises to make better use of resources and to increase the quality of results, facilitating their interpretation. It shall open up hazard and also risk assessments to new technologies, flexibly accommodating current and future mechanistic understanding. An EBT will be better prepared to answer the continuously growing safety demands of modern societies.

  12. Colistimethate sodium for the treatment of chronic pulmonary infection in cystic fibrosis: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Koerner-Rettberg C

    2014-09-01

    Full Text Available Cordula Koerner-Rettberg, Manfred Ballmann Department of Pediatric Pneumology, University Children’s Hospital of Ruhr University Bochum at St Josef-Hospital, Bochum, Germany Abstract: Chronic bacterial respiratory-tract infections are a major driving force in the pathogenesis of cystic fibrosis (CF lung disease and promote chronic lung-function decline, destruction, and progression to respiratory failure at a premature age. Gram-negative bacteria colonizing the airways in CF are a major problem in CF therapy due to their tendency to develop a high degree of resistance to antibiotic agents over time. Pseudomonas aeruginosa is the dominating bacterial strain infecting the CF lung from early childhood on, and multiresistant strains frequently develop after years of therapy. Colistin has been used for treating pulmonary bacterial infections in CF for decades due to its very good Gram-negative activity. However, drawbacks include concerns regarding toxicity when being applied systemically, and the lack of approval for application by inhalation in the USA for many years. Other antibiotic substances for systemic use are available with good to excellent Gram-negative and anti-Pseudomonas activity, while there are only three substances approved for inhalation use in the treatment of chronic pulmonary infection with proven benefit in CF. The emergence of multiresistant strains leaving nearly no antibiotic substance as a treatment option, the limited number of antibiotics with high activity against P. aeruginosa, the concerns about increasing the risk of antibiotic resistance by continuous antibiotic therapy, the development of new drug formulations and drug-delivery devices, and, finally, the differing treatment strategies used in CF centers call for defining the place of this “old” drug, colistimethate, in today’s CF therapy. This article reviews the available evidence to reflect on the place of colistimethate sodium in the therapy of chronic

  13. Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review)

    Science.gov (United States)

    Miller, R G.; Jackson, C E.; Kasarskis, E J.; England, J D.; Forshew, D; Johnston, W; Kalra, S; Katz, J S.; Mitsumoto, H; Rosenfeld, J; Shoesmith, C; Strong, M J.; Woolley, S C.

    2009-01-01

    Objective: To systematically review evidence bearing on the management of patients with amyotrophic lateral sclerosis (ALS). Methods: The authors analyzed studies from 1998 to 2007 to update the 1999 practice parameter. Topics covered in this section include slowing disease progression, nutrition, and respiratory management for patients with ALS. Results: The authors identified 8 Class I studies, 5 Class II studies, and 43 Class III studies in ALS. Important treatments are available for patients with ALS that are underutilized. Noninvasive ventilation (NIV), percutaneous endoscopic gastrostomy (PEG), and riluzole are particularly important and have the best evidence. More studies are needed to examine the best tests of respiratory function in ALS, as well as the optimal time for starting PEG, the impact of PEG on quality of life and survival, and the effect of vitamins and supplements on ALS. Recommendations: Riluzole should be offered to slow disease progression (Level A). PEG should be considered to stabilize weight and to prolong survival in patients with ALS (Level B). NIV should be considered to treat respiratory insufficiency in order to lengthen survival (Level B), and may be considered to slow the decline of forced vital capacity (Level C) and improve quality of life (Level C). Early initiation of NIV may increase compliance (Level C), and insufflation/exsufflation may be considered to help clear secretions (Level C). GLOSSARY AAN = American Academy of Neurology; ALS = amyotrophic lateral sclerosis; FVC = forced vital capacity; HFCWO = high frequency chest wall oscillation; MIE = mechanical insufflation/exsufflation; MIP = maximal inspiratory pressure; NIV = noninvasive ventilation; PCEF = peak cough expiratory flow; Pdi = transdiaphragmatic pressure; PEG = percutaneous endoscopic gastrostomy; QOL = quality of life; RIG = radiologically inserted device; SNP = sniff nasal pressure; TIV = tracheostomy invasive ventilation. PMID:19822872

  14. The academic, economic and societal impacts of Open Access: an evidence-based review [version 3; referees: 3 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jonathan P. Tennant

    2016-09-01

    Full Text Available Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for

  15. The academic, economic and societal impacts of Open Access: an evidence-based review [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jonathan P. Tennant

    2016-04-01

    Full Text Available Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the advantages or disadvantages of Open Access at multiple levels. This review aims to to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas of impact: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic case for Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save publishers and research funders considerable amounts of financial resources. The social case for Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. Open Access remains only one of the multiple challenges that the scholarly publishing system is currently facing. Yet, it provides one foundation for

  16. The academic, economic and societal impacts of Open Access: an evidence-based review [version 2; referees: 4 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jonathan P. Tennant

    2016-06-01

    Full Text Available Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for

  17. Direct oral anticoagulants in the treatment of venous thromboembolism, with a focus on patients with pulmonary embolism: an evidence-based review.

    Science.gov (United States)

    Gómez-Outes, Antonio; Suárez-Gea, M Luisa; Lecumberri, Ramón; Terleira-Fernández, Ana Isabel; Vargas-Castrillón, Emilio

    2014-01-01

    Pulmonary embolism (PE) is a relatively common cardiovascular emergency. PE and deep vein thrombosis (DVT) are considered expressions of the same disease, termed as venous thromboembolism (VTE). In the present review, we describe and meta-analyze the efficacy and safety data available with the direct oral anticoagulants (DOAC; dabigatran, rivaroxaban, apixaban, edoxaban) in clinical trials testing these new compounds in the acute/long-term and extended therapy of VTE, providing subgroup analyses in patients with index PE. We analyzed ten studies in 35,019 randomized patients. A total of 14,364 patients (41%) had index PE. In the acute/long-term treatment of VTE, the DOAC showed comparable efficacy in preventing recurrent VTE to standard treatment in patients with index PE (risk ratio [RR]: 0.88; 95% confidence interval [CI]: 0.70-1.11) and index DVT (RR: 0.93; 95% CI: 0.75-1.16) (P for subgroup differences =0.76). VTE recurrence depending on PE anatomical extension and presence/absence of right ventricular dysfunction was only reported in two trials, with results being consistent with those obtained in the overall study populations. In the single trial comparing extended therapy of VTE with DOAC versus warfarin, the point estimate for recurrent VTE tended to disfavor the DOAC in patients with index PE (RR: 2.05; 95% CI: 0.83-5.03) and in patients with index DVT (RR: 1.11; 95% CI: 0.49-2.50) (P for subgroup differences =0.32). In trials that compared DOAC versus placebo for extended therapy, the reduction in recurrent VTE was consistent in patients with PE (RR: 0.15; 95% CI: 0.01-1.82) and in patients with DVT (RR: 0.25; 95% CI: 0.10-0.61) (P for subgroup differences =0.71). The DOAC were associated with a consistently lower risk of clinically relevant bleeding (CRB) than standard treatment of acute VTE and higher risk of CRB than placebo for extended therapy of VTE regardless of index event. In summary, the DOAC were as effective as, and safer than, standard

  18. Direct oral anticoagulants in the treatment of venous thromboembolism, with a focus on patients with pulmonary embolism: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Gómez-Outes A

    2014-11-01

    Full Text Available Antonio Gómez-Outes,1 Mª Luisa Suárez-Gea,1 Ramón Lecumberri,2 Ana Isabel Terleira-Fernández,3,4 Emilio Vargas-Castrillón3,41Division of Pharmacology and Clinical Evaluation, Medicines for Human Use, Spanish Agency for Medicines and Medical Devices (AEMPS, Madrid, Spain; 2Department of Hematology, University Clinic of Navarra, Pamplona, Spain; 3Department of Clinical Pharmacology, Hospital Clínico, Madrid, Spain; 4Department of Pharmacology, Universidad Complutense, Madrid, SpainAbstract: Pulmonary embolism (PE is a relatively common cardiovascular emergency. PE and deep vein thrombosis (DVT are considered expressions of the same disease, termed as venous thromboembolism (VTE. In the present review, we describe and meta-analyze the efficacy and safety data available with the direct oral anticoagulants (DOAC; dabigatran, rivaroxaban, apixaban, edoxaban in clinical trials testing these new compounds in the acute/long-term and extended therapy of VTE, providing subgroup analyses in patients with index PE. We analyzed ten studies in 35,019 randomized patients. A total of 14,364 patients (41% had index PE. In the acute/long-term treatment of VTE, the DOAC showed comparable efficacy in preventing recurrent VTE to standard treatment in patients with index PE (risk ratio [RR]: 0.88; 95% confidence interval [CI]: 0.70–1.11 and index DVT (RR: 0.93; 95% CI: 0.75–1.16 (P for subgroup differences =0.76. VTE recurrence depending on PE anatomical extension and presence/absence of right ventricular dysfunction was only reported in two trials, with results being consistent with those obtained in the overall study populations. In the single trial comparing extended therapy of VTE with DOAC versus warfarin, the point estimate for recurrent VTE tended to disfavor the DOAC in patients with index PE (RR: 2.05; 95% CI: 0.83–5.03 and in patients with index DVT (RR: 1.11; 95% CI: 0.49–2.50 (P for subgroup differences =0.32. In trials that compared DOAC

  19. Evidence-based dentistry resources for dental practitioners.

    Science.gov (United States)

    Scarbecz, Mark

    2008-01-01

    The American Dental Association has taken an active role in support of an evidence-based approach to the practice of dentistry. This concept integrates clinically relevant scientific evidence into a clinician's decision-making process, along with the patient's oral and medical history, the dentist's own expertise and the patient's treatment needs and preferences. The purpose of this article is to assist dentists in locating and retrieving quality research reports and research evidence which can be integrated into the clinical decision making process. The research methodologies which constitute the foundation of evidence-based dentistry are described. The advantages and disadvantages associated with literature that summarizes research, such as the literature review, the systematic review and meta-analysis are described. Evidence-based resources for dentists are described, such as journals specializing in an evidence-based approach, online resources such as PubMed and the Cochrane Collaboration.

  20. Evidence-based medicine in health care reform.

    Science.gov (United States)

    Hughes, Gordon B

    2011-10-01

    The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care.

  1. Can Scholarly Communication be Evidence Based? (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2010-12-01

    disseminate their work, the role of research funding bodies that use public funds, the added value brought to the work by publishers, the role of peer reviewers, the economics of various models, and simply what works best.Research has been done on many of these issuesii and much of that work has then been critically appraised and debated post-publication on mailing listsiii and social networking media such as blogs.ivThe BMJ is one scholarly publication that has committed itself to becoming an “evidence based publisher” and is carrying out research on aspects of scholarly publishing to help guide their processes (Schroter, n.d.. Research on scholarly communication is a hot topic indeed; and for librarians, an area of information overload if there ever was one. How to sort out the good from the bad; the research that is high quality from that which is biased?At this point in time, it is my view that the research does not yet provide a definitive answer for how libraries should approach new models of scholarly communication. We are in the middle of a debate, in the middle of a surge of research, and an ever-changing lens in which we view and approach this topic. But evidence based practice has always been about more than just research – it considers what is needed by our users, and is guided by our professional judgement. Putting those elements together allows us to sort through the research and make informed decisions about our approach to collections, and how we do liaison work. For anyone looking for a research idea, there are certainly a couple of systematic reviews possible on these issues that would benefit practitioners immensely.The decision to start EBLIP was not an evidence based one. It was based in a desire to give the topic a home for discussion, and that in order to facilitate discussion, the widest audience possible must be reached. Hence, barriers such as cost needed to be reduced, and the decision to be open access was made. This was a decision based on

  2. ASTRO-H White Paper - AGN Winds

    CERN Document Server

    Kaastra, J S; Kallman, T; Haba, Y; Costantini, E; Gallo, L; Fukazawa, Y; Tombesi, F; Anabuki, N; Awaki, H; Brown, G; di Gesu, L; Ebisawa, K; Ebrero, J; Eckart, M; Hagino, K; Long, K S; Miller, J; Miyazawa, T; Paltani, S; Reynolds, C; Ricci, C; Sameshima, H; Seta, H; Ueda, Y; Urry, M

    2014-01-01

    In this white paper we describe the prospects for ASTRO-H for the study of outflows from active galactic nuclei. The most important breakthroughs in this field are expected to arise from the high spectral resolution and sensitivity in the Fe-K band, combined with broad-band sensitivity over the full X-ray band and spectral capabilities also at lower energies. The sensitivity in the Fe-K region allows to extend the absorption measure distribution of the outflow out to the highest ionisation states accessible, where observations with current X-ray missions indicate that most of the outflowing gas is to be found. Due to the high-resolution and sensitivity it will also be able to give the definitive proof for the existence of ultra-fast outflows, and if so, characterise their physical properties in great detail. These ultra-fast outflows carry very large amounts of energy and momentum, and are of fundamental importance for feedback studies. We show how the ASTRO-H observations in general can help to constrain num...

  3. Evidence-Based Radiology (EBR

    Directory of Open Access Journals (Sweden)

    Mansoor Fatehi

    2009-01-01

    Full Text Available   "nRecent increase in scientific advancements has led to inability to cover many scientific data and remain “up-to-date”. Nowadays doubling time of scientific data production is remarkably reduced, so that there is no adequate time to find this information and it seems inevitable to use resources which periodically assess most published papers or web-based data in that particular field to finally provide evidence-based knowledge, namely “Evidence-Based Medicine (EBM” in medical sciences. EBM is the systematic, scientific and explicit use of current best evidence in making decisions about the care of individual patients. Medical practice is largely based on clinical anecdotes, uncontrolled investigations and expert opinion. In radiology, the situation is especially problematic. "nRadiologists require to be able to evaluate studies in the literature, i.e., how reliable is this information and does it apply to patients in the radiologist’s practice? "nWe may find that our textbooks are out of date, guidelines are non-specific and there are conflicting "nor unreliable reports in the literature. Expert opinions vary from centre to centre. "nWhen we go to the literature ourselves, the first problem we encounter is the volume of literature being published and the next (at least for most of us is lack of training in how to separate good studies from weak ones. Evidence-based radiology (EBR can be a solution. "nThere are 5 steps in applying an approach as a solution: "n1. Ask - Information needs relevant to individual patients are converted into ‘answerable’ or ‘focused’ questions. "n2. Search - A comprehensive literature search is performed to find the best evidence to help answer these questions. "n3. Appraise - The evidence must then be critically appraised, in an explicit and structured manner, in order to establish its validity, reliability and usefulness in practice. "n4. Apply - The results of this critical appraisal are then

  4. Evidence-based Science Communication

    Science.gov (United States)

    Kahan, D.

    2012-12-01

    This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.

  5. Quantum efficiency of the CCD camera (XIS) for the ASTRO-E mission

    CERN Document Server

    Katayama, H; Kohmura, T; Katayama, K; Yoshita, K; Tsunemi, H; Kitamoto, S; Hayashida, K; Miyata, E; Hashimotodani, K; Koyama, K; Ricker, G; Bautz, M W; Foster, R; Kissel, S

    1999-01-01

    We measured the optical and the X-ray transmission of the optical blocking filters for the X-ray Imaging Spectrometers (XISs) which are the X-ray CCD cameras of the ASTRO-E satellite. We conclude that the oxidation of the aluminum reduces the optical transmission down to approx 60-70% of the theoretical value of the aluminum. We achieved optical transmission below 5x10 sup - sup 5 in the range from 4000 to 9500 A by using aluminum thickness of 1200 A, while the theoretical calculation requires 800 A. The measurement of absolute quantum efficiency of XIS is also performed at several particular energies. We confirmed 20% quantum efficiency at 0.5 keV for the XIS engineering model (XIS EM).

  6. The physics and the optimization of the XRS calorimeters on Astro-E

    CERN Document Server

    Stahle, C K; Dutta, S B; Gendreau, K C; Kelley, R L; McCammon, D; McClanahan, R A; Moseley, S H; Mott, D B; Porter, F S; Szymkowiak, A E

    1999-01-01

    The X-Ray Spectrometer (XRS) instrument, scheduled to be launched as part of the Japanese X-ray astronomy satellite Astro-E in February 2000, has an array of 32 microcalorimeters at the focal plane. These calorimeters consist of ion-implanted silicon thermistors and HgTe thermalizing X-ray absorbers. These devices provide spectral resolution of 9 eV at 3 keV and 11 eV at 6 keV. The process of determining the detector parameters for this instrument will be discussed. This will include discussion of the array layout, thermal conductance of the link to the heat sink, operating temperature, thermistor size, absorber choice, and means of attaching the absorber to the thermistor bearing element. We consider the XRS calorimeters to be operating in a local optimum, with the absolute optimization yet to be performed, thus we will discuss directions for future development of this sensor technology.

  7. Discovery & Interaction in Astro 101 Laboratory Experiments

    Science.gov (United States)

    Maloney, Frank Patrick; Maurone, Philip; DeWarf, Laurence E.

    2016-01-01

    The availability of low-cost, high-performance computing hardware and software has transformed the manner by which astronomical concepts can be re-discovered and explored in a laboratory that accompanies an astronomy course for arts students. We report on a strategy, begun in 1992, for allowing each student to understand fundamental scientific principles by interactively confronting astronomical and physical phenomena, through direct observation and by computer simulation. These experiments have evolved as :a) the quality and speed of the hardware has greatly increasedb) the corresponding hardware costs have decreasedc) the students have become computer and Internet literated) the importance of computationally and scientifically literate arts graduates in the workplace has increased.We present the current suite of laboratory experiments, and describe the nature, procedures, and goals in this two-semester laboratory for liberal arts majors at the Astro 101 university level.

  8. 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.

  9. Evidence-based practice: management of adult sensorineural hearing loss.

    Science.gov (United States)

    Chau, Justin K; Cho, John J W; Fritz, Dieter K

    2012-10-01

    Sensorineural hearing loss is a complex disease state influenced by genetics, age, noise, and many other factors. This article reviews our current knowledge regarding the causes of sensorineural hearing loss and reviews the more challenging clinical presentations of sensorineural hearing loss. We have reviewed the latest medical literature in an attempt to provide an evidence-based strategy for the assessment and management of sudden sensorineural hearing loss, rapidly progressive sensorineural hearing loss, and asymmetric/unilateral sensorineural hearing loss.

  10. [Evidence-based orthodontics, still a long way to go].

    Science.gov (United States)

    Kuijpers-Jagtman, A M

    2003-01-01

    Clinical performance can be kept up to date by learning how to practice evidence-based orthodontics, by seeking and appraising evidence-based summaries from the literature and by applying evidence-based strategies to change clinical behaviour. A MEDLINE search over the period 1990-2000 identified 8345 publications on clinical orthodontic subjects. Of these articles 49.5% was published in five specific orthodontic journals, while the others were published in about seventy other journals making it difficult for the clinician to stay current easily. Systematic reviews are an efficient and reliable source of information, but due to a lack of well-designed randomised clinical trials systematic reviews in orthodontics are still rare.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. Single-Subject Experimental Design for Evidence-Based Practice

    Science.gov (United States)

    Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.

    2012-01-01

    Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors…

  17. Application of Evidence-based Prosthodontics in Practice

    Institute of Scientific and Technical Information of China (English)

    雷雨; 朱智敏; CHAO Yong-lie; SHI Zong-dao; MENG Yu-kun

    2006-01-01

    The concepts and progress of evidence-based dentistry were introduced in this critical review. An extensive PubMed search was conducted to provide sound evidences for some frequently encountered problems in prosthodontic daily practice. Conlusively, it is important for prosthodontists to keep current by looking for efficient ways of interpreting high quality evidences to clinical practice.

  18. Evidence-Based Library Management: The Leadership Challenge

    Science.gov (United States)

    Lakos, Amos

    2007-01-01

    This paper is an extension of the author's earlier work on developing management information services and creating a culture of assessment in libraries. The author will focus observations on the use of data in decision-making in libraries, specifically on the role of leadership in making evidence-based decision a reality, and will review new…

  19. Determining Evidence-Based Practices in Special Education

    Science.gov (United States)

    Cook, Bryan G.; Tankersley, Melody; Landrum, Timothy J.

    2009-01-01

    Determining evidence-based practices is a complicated enterprise that requires analyzing the methodological quality and magnitude of the available research supporting specific practices. This article reviews criteria and procedures for identifying what works in the fields of clinical psychology, school psychology, and general education; and it…

  20. Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

    Science.gov (United States)

    Huey, Stanley J., Jr.; Polo, Antonio J.

    2008-01-01

    This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Although no "well-established" treatments were identified, "probably efficacious" or "possibly efficacious" treatments were found for ethnic minority…

  1. Can colonoscopy diagnose transmural ischaemic colitis after abdominal aortic surgery? An evidence-based approach

    DEFF Research Database (Denmark)

    Houe, T; Thorböll, J E; Sigild, U;

    2000-01-01

    to assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based medicine.......to assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based medicine....

  2. Evidence Based Nursing. A new perspective for Greek Nursing

    Directory of Open Access Journals (Sweden)

    Christina Ouzouni

    2008-07-01

    Full Text Available Despite the fact that nursing research has been developed in Greece, nevertheless the provision of nursing care is not based on current research findings, but rather on the knowledge gained by nurses during their undergraduate education. The transition of medicine in the last decade towards evidence based practice had definitely an impact on the nursing profession.The aim of this article is to briefly present evidence based nursing as a process and perspective to Greek nurses.Method: A literature search was performed in order to identify and review relevant articles concerning evidence based nursing.Conclusions: It has been supported that in the practice of evidence based nursing, a nurse has to decide whether the evidence is relevant for the individual patient. The incorporation of clinical expertise should balance the risks and benefits of a possible treatment and take into consideration the patient’s unique clinical circumstances and preferences. The stages to identify evidence for nursing practice follow firstly a question which must be addressed for a particular clinical problem. Then, a literature search is performed in order to access the evidence and critically appraise it and finally the best available evidence that fits into a particular case is utilized. Evidence based nursing bears benefits for patients, nurses and health care services, as well. In the process of implementing evidence based nursing in Greece there are several constraints. Taking these difficulties into consideration and until Greek nurses familiarize themselves with evidence based nursing care, it is necessary to constitute workgroups of nurse researchers aiming at forming clinical guidelines for nursing practice, which will based on the best available evidence.

  3. ASTRO-H White Paper - AGN Reflection

    CERN Document Server

    Reynolds, C; Awaki, H; Gallo, L; Gandhi, P; Haba, Y; Kawamuro, T; LaMassa, S; Lohfink, A; Ricci, C; Tazaki, F; Zoghbi, A

    2014-01-01

    X-ray observations provide a powerful tool to probe the central engines of active galactic nuclei (AGN). A hard X-ray continuum is produced from deep within the accretion flow onto the supermassive black hole, and all optically thick structures in the AGN (the dusty torus of AGN unification schemes, broad emission line clouds, and the black hole accretion disk) "light up" in response to irradiation by this continuum. This White Paper describes the prospects for probing AGN physics using observations of these X-ray reflection signatures. High-resolution SXS spectroscopy of the resulting fluorescent iron line in type-2 AGN will give us an unprecedented view of the obscuring torus, allowing us to assess its dynamics (through line broadening) and geometry (through the line profile as well as observations of the "Compton shoulder"). The broad-band view obtained by combining all of the ASTRO-H instruments will fully characterize the shape of the underlying continuum (which may be heavily absorbed) and reflection/sc...

  4. AMICA, an astro-mapper for AMS

    CERN Document Server

    Monfardini, A; Battiston, R; Gargiulo, C

    2005-01-01

    The Alpha Magnetic Spectrograph (AMS) is a composite particle detector to be accommodated on the International Space Station (ISS) in 2008. AMS is mainly devoted to galactic, charged Cosmic Rays studies, Antimatter and Dark Matter searches. Besides the main, classical physics goals, capabilities in the field of GeV and multi-GeV gamma astrophysics have been established and are under investigation by a number of groups. Due to the unsteadiness of the ISS platform, a star-mapper device is required in order to fully exploit the intrinsic arc-min angular resolution provided by the Silicon Tracker. A star-mapper is conceptually an imaging, optical instrument able to autonomously recognize a stellar field and to calculate its own orientation with respect to an inertial reference frame. AMICA (Astro Mapper for Instruments Check of Attitude) on AMS is responsible for providing real-time information that is going to be used off-line for compensating the large uncertainties in the ISS flight attitude and the structural...

  5. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  6. Building the evidence base for postoperative and postpartum advice.

    Science.gov (United States)

    Minig, Lucas; Trimble, Edward L; Sarsotti, Carlos; Sebastiani, Mario M; Spong, Catherine Y

    2009-10-01

    Recommendations for activity after obstetric and gynecologic procedures remain based on tradition and anecdote. After reviewing the current evidence base, guidelines, and practice for postdischarge instructions related to physical activity after the most common obstetric and gynecologic surgical procedures, we conclude that the available data do not support many of the recommendations currently provided. Restrictions on lifting and climbing stairs should likely be abandoned. Guidance on driving should focus on the concern regarding cognitive function and analgesics rather than concerns of wound separation/dehiscence. Given the impact of these recommendations on daily life events, consistent, evidence-based advice on when and how women can safely resume exercise, driving, working, and sexual intercourse is critical. The evidence base informing advice for most of these issues is minimal; we need prospective, well-designed studies to help guide us and our patients.

  7. 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.

  8. Evidence-Based Practice: Management of Vertigo

    OpenAIRE

    Nguyen-Huynh, Anh T.

    2012-01-01

    The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented.

  9. Evidence-based practice voor verpleegkundigen

    NARCIS (Netherlands)

    Cox, C.M.M.; Louw, D.C.P. de; Verhoef, J.; Kuiper, C.

    2004-01-01

    Om goede en verantwoorde zorg te kunnen bieden, streeft de verpleegkundige naar evidence-based practice. Evidence-based practice is het gewetensvol, expliciet en oordeelkundig gebruik van het huidige beste bewijsmateriaal om beslissingen te nemen voor individuele patiënten. De praktijk van evidence-

  10. Evidence-based treatment of metabolic myopathy

    Directory of Open Access Journals (Sweden)

    Yan LIN

    2014-05-01

    Full Text Available Objective To evaluate the current treatments and possible adverse reactions of metabolic myopathy, and to develop the best solution for evidence-based treatment.  Methods Taking metabolic myopathy, mitochondrial myopathy, lipid storage myopathy, glycogen storage diseases, endocrine myopathy, drug toxicity myopathy and treatment as search terms, retrieve in databases such as PubMed, Cochrane Library, ClinicalKey database, National Science and Technology Library (NSTL, in order to collect the relevant literature database including clinical guidelines, systematic reviews (SR, randomized controlled trials (RCT, controlled clinical trials, retrospective case analysis and case study. Jadad Scale was used to evaluate the quality of literature.  Results Twenty-eight related articles were selected, including 6 clinical guidelines, 5 systematic reviews, 10 randomized controlled trials and 7 clinical controlled trials. According to Jadad Scale, 23 articles were evaluated as high-quality literature (≥ 4, and the remaining 5 were evaluated as low-quality literature (< 4. Treatment principles of these clinical trials, efficacy of different therapies and drug safety evaluation suggest that: 1 Acid α-glycosidase (GAA enzyme replacement therapy (ERT is the main treatment for glycogen storage diseases, with taking a high-protein diet, exercising before taking a small amount of fructose orally and reducing the patient's physical activity gradually. 2 Carnitine supplementation is used in the treatment of lipid storage myopathy, with carbohydrate and low fat diet provided before exercise or sports. 3 Patients with mitochondrial myopathy can take coenzyme Q10, vitamin B, vitamin K, vitamin C, etc. Proper aerobic exercise combined with strength training is safe, and it can also enhance the exercise tolerance of patients effectively. 4 The first choice to treat the endocrine myopathy is treating primary affection. 5 Myopathies due to drugs and toxins should

  11. Evidence-based Guidelines on Medication Therapy for Purulent Meningitis in Children:A Systematic Review%儿童化脓性脑膜炎药物治疗循证指南的系统评价

    Institute of Scientific and Technical Information of China (English)

    张宏亮; 李南; 黄振光; 廖乙媚; 刘滔滔

    2016-01-01

    OBJECTIVE:To systematically review the related evidence-based guidelines of purulent meningitis in children,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,CBM,Wanfang Data-base,CJFD and VIP,NGC,GIN,TRIP and websites of domestic and international medical associations and industry bodies,the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extrac-tion and quality evaluation. RESULTS:Finally 3 guidelines were enrolled in total,with development time ranging from 2004 to 2012,from USA,Britain and Australia,respectively. All of the recommendations were level B,"scope and purpose" and "clarity"showed the higher scores in AGREEⅡ,more than 70%,and "applicability" showed generally low scores. Penicillin and cefotaxi-me were recommended in purulent meningitis of neonates,and vancomycin combined with cefotaxime or ceftriaxone were recom-mended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different,and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS:The recommendations of medicines for the treatment of pu-rulent meningitis are basically unanimous,with no regional difference,but there are some differences about dose and the course of treatment. In addition,the classification criteria of the levels of evidence and recommendation are still suboptimal,which needs fur-ther improvement. And guidelines on purulent meningitis should be improved in"rigour"and"applicability"in future.%目的:系统评价儿童化脓性脑膜炎药物治疗的相关循证指南,为临床治疗提供循证参考。方法:计算机检索PubMed、EMBase、中国生物医学文献数据库、万方数据库、中文科技期刊数据库、中国期刊全文数据库、

  12. Evidence-based dentistry: a clinician's perspective.

    Science.gov (United States)

    Bauer, Janet; Spackman, Sue; Chiappelli, Francesco; Prolo, Paolo; Stevenson, Richard

    2006-07-01

    Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

  13. A workshop report on HIV mHealth synergy and strategy meeting to review emerging evidence-based mHealth interventions and develop a framework for scale-up of these interventions

    Directory of Open Access Journals (Sweden)

    Sarah Karanja

    2011-11-01

    Full Text Available g up evidence based mHealth interventions. The participants acknowledged the importance of the meeting in setting the pace for strengthening and coordinating mHealth initiatives and unanimously agreed to hold a follow up meeting after three months.

  14. AstroPAL: A Mentoring Program for Grad Students

    Science.gov (United States)

    Cabrera, Nicole

    2016-01-01

    The Astronomy Peer Advising Leaders program (AstroPAL) provides guidance for incoming grad students from a team of student volunteers who have passed their 2nd year Qualifier Exam. The purpose is to pair first years with a mentor who can help them through some of the stresses or difficulties that come with being a new grad student. AstroPALs and mentees meet privately about once a month in a casual setting to talk about how they're adjusting to the new surroundings, how they're handling the workload, etc. New students can join AstroPAL at any time during their first two years, and can stop receiving guidance once they feel comfortable in the program. Mentees will be assigned an AstroPAL based on preference and availability, and an AstroPAL Liason will always be in place to facilitate mentor reassignments or other issues if necessary. After passing the 2nd year Qualifier Exam, mentees are eligible to serve as mentors to incoming students.

  15. Free Access Does Not Necessarily Encourage Practitioners to Use Online Evidence Based Information Tools. A Review of: Buchan, H., Lourey, E., D’Este, C., & Sanson-Fisher, R. (2009. Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: A randomised controlled trial. Implementation Science, 4, article 68.

    Directory of Open Access Journals (Sweden)

    Heather Ganshorn

    2010-12-01

    Full Text Available Objectives – To determine which strategies were most effective for encouraging general practitioners (GPs to sign up for free access to an online evidence based information resource; and to determine whether those who accepted the offer differed in their sociodemographic characteristics from those who did not.Design – Descriptive marketing research study.Setting – Australia’s public healthcare system.Subjects – 14,000 general practitioners (GPs from all regions of Australia.Methods – Subjects were randomly selected by Medicare Australia from its list of GPs that bill it for services. Medicare Australia had 18,262 doctors it deemed eligible; 14,000 of these were selected for a stratified random sample. Subjects were randomized to one of 7 groups of 2,000 each. Each group received a different letter offering two years of free access to BMJ Clinical Evidence, an evidence based online information tool. Randomization was done electronically, and the seven groups were stratified by age group, gender, and location. The interventions given to each group differed as follows:• Group 1: Received a letter offering 2 years of free access, with no further demands on the recipient.• Group 2: Received a letter offering 2 years of free access, but on the condition that they complete an initial questionnaire and another one at 12 months, as well as allowing the publisher to provide de-personalized usage data to the researchers.• Group 3: Same as Group 2, but with the additional offer of an online tutorial to assist them with using the resource.• Group 4: Same as Group 2, but with an additional pamphlet with positive testimonials about the resource from Australian medical opinion leaders.• Group 5: Same as Group 2, but with an additional offer of professional development credits towards their required annual totals.• Group 6: Same as Group 2, but with an additional offer to be entered to win a prize of $500 towards registration at a

  16. [Evidence based medicine and mobbing].

    Science.gov (United States)

    Tomei, G; Cinti, M E; Sancini, A; Cerratti, D; Pimpinella, B; Ciarrocca, M; Tomei, F; Fioravanti, M

    2007-01-01

    The phenomenon of the physical, moral or psychical violence in the working environment, variously indicated as "mobbing", "workplace bullying" or "workplace harassment", is to date object of numerous studies, mostly of epidemiological type, which are yet to clear, in a sufficient way, the aspects of that phenomenon, the possible causes, risk factors, constituent characteristics and consequences. Our search, a systematic review of the existing studies in literature and a meta-analysis of the jobs chosen to such scope, has shown that only a small percentage of the researches conducted on the topic is represented from studies that collected original information on the subject. The results of the meta-analysis show that in the category of the mobbed workers the psychosomatic disturbs, stress, and anxiety are greater than in the group of controls and that the perception of the surrounding environment is more negative in the victims of mobbing compared with the not mobbed workers. The value of such results is reduced by the characteristics and the heterogeneity of the studies.

  17. The Astro-WISE Optical Image Pipeline: Development and Implementation

    CERN Document Server

    McFarland, J P; Sikkema, G; Helmich, E M; Boxhoorn, D R; Valentijn, E A

    2011-01-01

    We have designed and implemented a novel way to process wide-field astronomical data within a distributed environment of hardware resources and humanpower. The system is characterized by integration of archiving, calibration, and post-calibration analysis of data from raw, through intermediate, to final data products. It is a true integration thanks to complete linking of data lineage from the final catalogs back to the raw data. This paper describes the pipeline processing of optical wide-field astronomical data from the WFI (http://www.eso.org/lasilla/instruments/wfi/) and OmegaCAM (http://www.astro-wise.org/~omegacam/) instruments using the Astro-WISE information system (the Astro-WISE Environment or simply AWE). This information system is an environment of hardware resources and humanpower distributed over Europe. AWE is characterized by integration of archiving, data calibration, post-calibration analysis, and archiving of raw, intermediate, and final data products. The true integration enables a complet...

  18. 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

  19. Statistical Computations with AstroGrid and the Grid

    CERN Document Server

    Nichol, R C; Miller, C J; Genovese, C; Wasserman, L; Bryan, B; Gray, A; Schneider, J; Moore, A W; Nichol, Robert C; Smith, Garry; Miller, Christopher J; Genovese, Chris; Wasserman, Larry; Bryan, Brent; Gray, Alexander; Schneider, Jeff; Moore, Andrew W

    2005-01-01

    We outline our first steps towards marrying two new and emerging technologies; the Virtual Observatory (e.g, AstroGrid) and the computational grid. We discuss the construction of VOTechBroker, which is a modular software tool designed to abstract the tasks of submission and management of a large number of computational jobs to a distributed computer system. The broker will also interact with the AstroGrid workflow and MySpace environments. We present our planned usage of the VOTechBroker in computing a huge number of n-point correlation functions from the SDSS, as well as fitting over a million CMBfast models to the WMAP data.

  20. Update of the China-VO AstroCloud

    CERN Document Server

    Cui, Chenzhou; Xiao, Jian; He, Boliang; Li, Changhua; Fan, Dongwei; Wang, Chuanjun; Hong, Zhi; Li, Shanshan; Mi, Linying; Wan, Wanghui; Cao, Zihuang; Wang, Jiawei; Yin, Shucheng; Fan, Yufeng; Wang, Jianguo; Yang, Sisi; Ling, Yin; Zhang, Hailong; Chen, Junyi; Liu, Liang; Chen, Xiao

    2016-01-01

    As the cyber-infrastructure for Astronomical research from Chinese Virtual Observatory (China-VO) project, AstroCloud has been archived solid progresses during the last one year. Proposal management system and data access system are re-designed. Several new sub-systems are developed, including China-VO PaperData, AstroCloud Statics and Public channel. More data sets and application environments are integrated into the platform. LAMOST DR1, the largest astronomical spectrum archive was released to the public using the platform. The latest progresses will be introduced.

  1. 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.

  2. ASTRO-H White Paper - Young Supernova Remnants

    CERN Document Server

    Hughes, J P; Bamba, A; Katsuda, S; Leutenegger, M; Long, K S; Maeda, Y; Mori, K; Nakajima, H; Sawada, M; Tanaka, T; Uchida, H; Yamaguchi, H; Aharonian, F; Funk, S; Hiraga, J; Ishida, M; Koyama, K; Matsumoto, H; Nobukawa, M; Ozaki, M; Tamagawa, T; Tsunemi, H; Tomida, H; Uchiyama, Y; Uno, S

    2014-01-01

    Thanks to the unprecedented spectral resolution and sensitivity of the Soft X-ray Spectrometer (SXS) to soft thermal X-ray emission, ASTRO-H will open a new discovery window for understanding young, ejecta-dominated, supernova remnants (SNRs). In particular we study how ASTRO-H observations will address, comprehensively, three key topics in SNR research: (1) using abundance measurements to unveil SNR progenitors, (2) using spatial and velocity distribution of the ejecta to understand supernova explosion mechanisms, (3) revealing the link between the thermal plasma state of SNRs and the efficiency of their particle acceleration.

  3. American Dental Association's Resources to Support Evidence-Based Dentistry.

    Science.gov (United States)

    Aravamudhan, K; Frantsve-Hawley, Julie

    2009-09-01

    Time and access have often been cited as barriers to implementing Evidence-Based Dentistry (EBD). This paper describes a new web-based resource launched by the American Dental Association to enable practitioners to incorporate evidence into treatment planning. The website offers a database of systematic reviews, critical summaries of systematic reviews, evidence-based clinical recommendations and links to external resources to enable practitioners to access evidence at the point of care. In addition the site offers an online space for clinicians to suggest clinical scenarios where evidence is lacking. This could potentially be a source of topics to drive future research. With the explosion in the use of information technology within a dental office, this web-site will serve as the one-stop resource for credible scientific information for practitioners.

  4. Bridging Ayurveda with evidence-based scientific approaches in medicine.

    Science.gov (United States)

    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).

  5. Creating Synergy in Practice: Promoting Complementarity between Evidence-Based and Postmodern Approaches

    Science.gov (United States)

    Jacobs, Stephanie; Kissil, Karni; Scott, Dalesa; Davey, Maureen

    2010-01-01

    Postmodern and evidence-based practice (EBP) are compared and contrasted with the primary aim of adapting evidence-based practice with a more flexible epistemological lens. We begin by reviewing the epistemological underpinnings of postmodern and EBP within the field of marriage and family therapy (MFT). We next discuss how these contrasting…

  6. Data federations: AstroWise and its applications

    NARCIS (Netherlands)

    Valentijn, Edwin A.

    2015-01-01

    The AstroWise information system is operational for the production of the results of a number astronomical survey programmes with OmegaCAM@VST and MUSE@VLT. In different forms it has also been applied to the Lofar radiotelescope, life science projects and business applications. I will discuss the co

  7. New Frontiers in Galaxy Clusters with ASTRO-H

    Science.gov (United States)

    Miller, Eric D.; Kitayama, Tetsu; Bautz, Marshall; Markevitch, Maxim; Matsushita, Kyoko; Allen, Steven; Kawaharada, Madoka; McNamara, Brian; Ota, Naomi; Akamatsu, Hiroki; de Plaa, Jelle; Galeazzi, Massimiliano; Madejski, Grzegorz; Nakazawa, Kazuhiro; Russell, Helen; Sato, Kosuke; Sekiya, Norio; Simionescu, Aurora; Tamura, Takayuki; Uchida, Yuusuke; Ursino, Eugenio; Werner, Norbert; Zhuravleva, Irina; ZuHone, John; ASTRO-H Team

    2015-08-01

    The next generation X-ray observatory ASTRO-H will open up a new dimension in the study of galaxy clusters. For the first time, the focal plane calorimeter aboard ASTRO-H will achieve the spectral resolution required to measure velocities of the intracluster plasma. At the same time, the Hard X-ray Imager (HXI) will extend the simultaneous spectral coverage to energies well above 10 keV, critical for studying both thermal and non-thermal gas in clusters. We present an overview of the capabilities of ASTRO-H for exploring gas motions in galaxy clusters, including their cosmological implications, the physics of AGN feedback, the dynamics of cluster mergers and associated high-energy processes, the chemical enrichment of the intracluster medium, and the nature of missing baryons and unidentified dark matter. By demonstrating these capabilities explicitly on representative galaxy clusters, we hope to aid and encourage the broader astrophysical community in developing ASTRO-H science.

  8. The ASTRO-H X-ray Observatory

    Science.gov (United States)

    Takahashi, Tadayuki

    2016-04-01

    ASTRO-H, the new Japanese X-ray Astronomy Satellite following Suzaku, is an international X-ray mission, planed for launch in Feb, 2016. ASTRO-H is a combination of high energy-resolution soft X-ray spectroscopy (0.3 - 10 keV) provided by thin-foil X-ray optics and a micro-calorimeter array, and wide band X-ray spectroscopy (3 - 80 keV) provided by focusing hard X-ray mirrors and hard X-ray imaging detectors. Imaging spectroscopy of extended sources by the micro-calorimeter with spectral resolution of X-ray CCD camera as a focal plane detector for a soft X-ray telescope and a non-focusing soft gamma-ray detector based on a narrow-FOV semiconductor Compton Camera. With these instruments, ASTRO-H covers very wide energy range from 0.3 keV to 600 keV. The simultaneous broad band pass, coupled with high spectral resolution by the micro-calorimeter will enable a wide variety of important science themes to be pursued.The ASTRO-H mission objectives are to study the evolution of yet-unknown obscured super massive Black Holes in Active Galactic Nuclei; trace the growth history of the largest structures in the Universe; provide insights into the behavior of material in extreme gravitational fields; trace particle acceleration structures in clusters of galaxies and SNRs; and investigate the detailed physics of jets.ASTRO-H will be launched into a circular orbit with altitude of about 575 km, and inclination of 31 degrees.ASTRO-H is in many ways similar to Suzaku in terms of orbit, pointing, and tracking capabilities. After we launch the satellite, the current plan is to use the first three months for check-out and start the PV phase with observations proprietary to the ASTRO-H team. Guest observing time will start from about 10 months after the launch. About 75 % of the satellite time will be devoted to GO observations after the PV phase is completed.In this presentation, we will describe the mission, scientific goal and report the initial performance on the orbit.

  9. Evidence-based policymaking: a critique.

    Science.gov (United States)

    Greenhalgh, Trisha; Russell, Jill

    2009-01-01

    The idea that policy should be based on best research evidence might appear to be self-evident. But a closer analysis reveals a number of problems and paradoxes inherent in the concept of "evidence-based policymaking." The current conflict over evidence-based policymaking parallels a long-standing "paradigm war" in social research between positivist, interpretivist, and critical approaches. This article draws from this debate in order to inform the discussions over the appropriateness of evidence- based policymaking and the related question of what is the nature of policymaking. The positivist, empiricist worldview that underpins the theory and practice of evidence-based medicine (EBM) fails to address key elements of the policymaking process. In particular, a narrowly "evidence-based" framing of policymaking is inherently unable to explore the complex, context-dependent, and value-laden way in which competing options are negotiated by individuals and interest groups. Sociolinguistic tools such as argumentation theory offer opportunities for developing richer theories about how policymaking happens. Such tools also have potential practical application in the policymaking process: by enhancing participants' awareness of their own values and those of others, the quality of the collective deliberation that lies at the heart of policymaking may itself improve.

  10. AstroJazz: Integrating Live Jazz and Astronomy Education

    Science.gov (United States)

    Morrow, C. A.

    2005-12-01

    AstroJazz is an innovative public education program in astronomy that blends stunning imagery with live jazz music and a touch of humor to awaken the cosmic curiosity of both adults and children. The program debuted in February 2005 at the Fiske Planetarium on the campus of the University of Colorado, Boulder with an astronomer-chanteuse (the author), a pianist, bassist, drummer, and technical assistant who created dome effects to compliment the PowerPoint slides associated with each song. This AstroJazz quartet played ten songs, five original tunes (Look Up!, Are We Alone? Andromeda Affaire, StarMan Blues, Star Kissed)), and five standard tunes with lyrical twists toward astronomy & astrobiology (e.g. Stormy Weather - Solar Style and Stardust a la SETI.) The hour-long program also includes educational interludes where the astronomy chanteuse interacts with the audience, providing insights and perspective into the wonders of our universe. The performance program that is handed to all audience members contains additional "gee-whiz" facts and provides leads to websites like Astronomy Picture of the Day and spaceweather.com that provide ongoing points of contact for public interest in astronomy. AstroJazz was very well received in its debut performance and now has several new opportunities to perform. Anecdotal evidence suggests that the AstroJazz program is engaging and educational for a very broad audience, including families with young children, world-class astronomers, and spouses of musicians who had never before been exposed to astronomy. This paper will describe the origins and intended evolution of AstroJazz, and offer a mini-sample of the music and slides used in the program. It will also discuss strategies for how the impact on audiences might be assessed.

  11. ASTRO's 2007 core physics curriculum for radiation oncology residents.

    Science.gov (United States)

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

    2007-08-01

    In 2004, the 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 the 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, the American Board of Radiology, for its written examination. The 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

  12. Professionalism and evidence-based practice

    DEFF Research Database (Denmark)

    Rasmussen, Palle

    2015-01-01

    The idea of evidence- based practice is influential in public welfare services, including education. The idea is controversial, however, not least because it involves a poten tial redefinition of the relation ship between knowledge, authority and professionalism. This is discussed based on a study...... of evidence- based methods in Danish pre-school education and care. The management sees the use of these methods as strengthening pre- school teacher professionalism, but the actual practices in the day-careinstitutions are ambiguous. In some cases, using the methods becomes an end in itself and tends...

  13. Evidence-Based Medicine in the Treatment of Infantile Hemangiomas.

    Science.gov (United States)

    Keller, Robert G; Patel, Krishna G

    2015-08-01

    Over the past decade, the treatment of infantile hemangiomas has undergone dramatic breakthroughs. This review critically evaluates the latest literature that supports the myriad treatment options for infantile hemangiomas. It chronicles the fading role of steroid therapy and evolution of propranolol use as the major treatment modality. Although propranolol is helping this disease become more of a medical disease and less of a surgical dilemma, the report also reveals a continued search to find nonsystemic treatment options. In summary, this is an evidence-based medicine review for the treatment of infantile hemangiomas.

  14. Evidence-based practices in preconception period and pregnancy

    Directory of Open Access Journals (Sweden)

    Şükran Başgöl

    2012-11-01

    Full Text Available Pregnancy is a special period which affects the women’s life aspect bio-psycho- social. In this period, pregnant reguires medical care and psychosocial support. It begins with the preconception period. Providing quality care during preconception period, will affect pregnancy and other periods. Quality of care and avoiding unnecessary applications will be with evidence-based practices. The purpose of health professionals is to take control/ prevent maternal and fetal health risks, protect and promote health in the period of pregnancy by physical, psychological and social holistic care. When they provide care, they should be guided by evidence based practices and integrate them with the clinical practices. The purpose of this review is to evaluate the degree of evidence of the interventions that are often applied preconception period and during pregnancy.     

  15. Evidence Locator: sources of evidence-based dentistry information.

    Science.gov (United States)

    Frantsve-Hawley, Julie

    2008-09-01

    Multiple resources are available to help practitioners access the latest scientific evidence. Evidence-based dentistry (EBD) is an approach to clinical decision making that incorporates the most current and comprehensive scientific evidence with the practitioner's judgment and the patient's needs and preferences. One challenge in implementing this approach is access to evidence, and there are multiple online resources that can be used in this endeavor. This article presents the Evidence Locator, a list of Web sites that provide access to "secondary sources" of evidence. Such "secondary sources" are typically summaries of systematic reviews and evidence-based clinical recommendations or guidelines. Also presented is a list of other Web sites that may be useful to the practitioner in implementing EBD.

  16. Evidence-based practices in preconception period and pregnancy

    Directory of Open Access Journals (Sweden)

    Ümran Oskay

    2012-11-01

    Full Text Available Pregnancy is a special period which affects the women’s life aspect bio-psycho- social. In this period, pregnant reguires medical care and psychosocial support. It begins with the preconception period. Providing quality care during preconception period, will affect pregnancy and other periods. Quality of care and avoiding unnecessary applications will be with evidence-based practices. The purpose of health professionals is to take control/ prevent maternal and fetal health risks, protect and promote health in the period of pregnancy by physical, psychological and social holistic care. When they provide care, they must guide evidence based practices and integrate them with the clinical practices.The purpose of this review is to evaluate the degree of evidence of the interventions that are often applied preconception period and during pregnancy.

  17. Patient autonomy in evidence-based dentistry.

    Science.gov (United States)

    Ritwik, Priyanshi

    2014-01-01

    Evidence-based dentistry is the judicious integration of scientific information relating to the patient's oral health and medical condition with the dentist's clinical expertise and the patient's own treatment needs and preferences. In this triad of factors, we (the dentists) are least likely to be formally trained in recognizing our patient's preferences. Do we understand what shapes these preferences?

  18. Evidence-based diagnosis in patch testing

    NARCIS (Netherlands)

    van der Valk, PGM; Devos, SA; Coenraads, PJ

    2003-01-01

    Evidence-based medicine (EBM) is defined as the integration of the best research evidence with clinical expertise and patient values. Based on the principles of EBM, we can conclude that patch testing is cost-effective only if patients are selected on the basis of a clear-cut clinical suspicion of c

  19. Evidence Based Education Request Desk. EBE #359

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2008

    2008-01-01

    This Evidence Based Education (EBE) response describes characteristics of graduation coach initiatives in three states (Georgia, Alabama, and California). Regional Educational Laboratory (REL) Southeast has received over 19 requests for information on various initiatives, programs or research related to improving graduation rates. For example, the…

  20. Evidence Based Education Request Desk. EBE #555

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

    This Evidence Based Education (EBE) Request seeks to provide an overview of recent research regarding school improvement and reform with special concentration on turning around chronically low-performing schools. The response is divided into four main sections: Research on Effective Methods for Turning Around Low-Performing Schools, Frameworks for…

  1. Evidence Based Education Request Desk. EBE #510

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

    This Evidence Based Education (EBE) request focused on research-supported vocabulary interventions for middle elementary students. Limited vocabulary is an important factor in underachievement of children in disadvantaged homes. Children with larger vocabularies find reading easier, read more widely, and do better in school (Lubliner & Smetana,…

  2. Evidence Based Education Request Desk. EBE #741

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2010

    2010-01-01

    This Evidence Based Education (EBE) request asks for information relating to funding for virtual schools. The EBE Request Desk was asked to provide a scan of states for information on how they fund virtual schools and what the current funding levels are (most current year for which such data is available). This paper provides answers to this…

  3. Evidence-based Review for the Influence of NSAIDs on Female Fertility%非甾体抗炎药对女性生育影响的循证评价

    Institute of Scientific and Technical Information of China (English)

    杨敏; 牟金金; 蒋学华

    2012-01-01

    OBJECTIVE: To conduct evidence-based evaluation for the influence of NSAIDs on female fertility. METHODS: We searched Pubmed, Cochrane laboratory, EMbase, SCI, CNKI, collect relevant literature, classify and evaluate the evidence by the methods of evidence-based medicine. RESULTS: A total of 8 NSAIDs were collected. The current evidence revealed that NSAIDs could inhibit ovulation in female reversibly. Ibuprofen and meloxicam were A class, indometacin and rofecoxib were B class and etoricoxib, diclofenac, piroxicam and naproxen were C class. CONCLUSION: NSAIDs could inhibit ovulation in female reversibly, and women willing for a baby should avoid NSAIDs.%目的:对非甾体抗炎药对女性生育的影响进行循证评价.方法:计算机检索Pubmed、Cochrane图书馆、EMBase、SCI、中国期刊全文数据库等,全面收集相关文献,并应用循证医学的方法,对证据进行分类评价.结果:共检索到8个非甾体抗炎药,结果均表明其对女性生育有可逆性的抑制作用,其中布洛芬、美洛昔康为A级,吲哚美辛、罗非昔布为B级,依托昔布、双氯芬酸、吡罗昔康、萘普生为C级.结论:非甾体抗炎药对女性生育有可逆性的抑制作用,有生育计划的女性应尽量避免非甾体抗炎药的应用.

  4. AstroBlend: An Astrophysical Visualization Package for Blender

    CERN Document Server

    Naiman, J P

    2016-01-01

    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 {\\it AstroBlend}, an open-source Python library for use within the three dimensional modeling software, {\\it Blender}. While {\\it 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. {\\it AstroBlend} combines the three dimensional capabilities of {\\it Blender} with the analysis tools of the widely used astrophysical toolset, {\\it 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 incl...

  5. In-orbit performance of AstroSat CZTI

    CERN Document Server

    Vadawale, Santosh V; Bhattacharya, Dipankar; Bhalerao, Varun B; Dewangan, Gulab Chand; Vibute, Ajay M; S., Mithun N P; Chattopadhyay, Tanmoy; Sreekumar, S

    2016-01-01

    Cadmium-Zinc-Telluride Imager (CZTI) is one of the fi?ve payloads on-board recently launched Indian astronomy satellite AstroSat. CZTI is primarily designed for simultaneous hard X-ray imaging and spectroscopy of celestial X-ray sources. It employs the technique of coded mask imaging for measuring spectra in the energy range of 20 - 150 keV. It was the ?first scientifi?c payload of AstroSat to be switched on after one week of the launch and was made operational during the subsequent week. Here we present preliminary results from the performance verification phase observations and discuss the in-orbit performance of CZTI.

  6. Evidence-based dentistry as it relates to dental materials.

    Science.gov (United States)

    Bayne, Stephen C; Fitzgerald, Mark

    2014-01-01

    Evidence-based dentistry (EBD) is reviewed in depth to underscore the limitations for evidence-based dental materials information that exist at this time. Anecdotal estimates of evidence for dental practice are in the range of 8 percent to 10 percent. While the process of evaluating the literature base for dental evidence began 20 years ago, it was not practical to implement it until high-speed wireless connections, open access to journals, and omnipresent connections via smart phones became a reality. EBD includes five stages of information collection and analysis, starting with a careful definition of a clinical question using the PICO(T) approach. Clinical evidence in randomized control trials is considered the best. Clinical trial perspectives (prospective, cross-sectional, retrospective) and outcome designs (RCTs, SCTs, CCTs, cohort studies, case-control studies) are quite varied. Aggregation techniques (including meta-analyses) allow meaningful combinations of clinical data from trials with similar designs but with fewer rigors. Appraisals attempt to assess the entire evidence base without bias and answer clinical questions. Varying intensities to these approaches, Cochrane Collaboration, ADA-EBD Library, UTHSCSA CATs Library, are used to answer questions. Dental materials evidence from clinical trials is infrequent, short-term, and often not compliant with current guidelines (registration, CONSORT, PRISMA). Reports in current evidence libraries indicate less than 5 percent of evidence is related to restorative dental materials.

  7. Data federations: AstroWise and its applications

    Science.gov (United States)

    Valentijn, Edwin A.

    2015-12-01

    The AstroWise information system is operational for the production of the results of a number astronomical survey programmes with OmegaCAM@VST and MUSE@VLT. In different forms it has also been applied to the Lofar radiotelescope, life science projects and business applications. I will discuss the common "data federation"aspects of these projects, and the data federation aspects of the Euclid Archive System.

  8. AstroAsciiData: ASCII table Python module

    Science.gov (United States)

    Kümmel, Martin; Haase, Jonas

    2013-11-01

    ASCII tables continue to be one of the most popular and widely used data exchange formats in astronomy. AstroAsciiData, written in Python, imports all reasonably well-formed ASCII tables. It retains formatting of data values, allows column-first access, supports SExtractor style headings, performs column sorting, and exports data to other formats, including FITS, Numpy/Numarray, and LaTeX table format. It also offers interchangeable comment character, column delimiter and null value.

  9. AstroGrid-D: Grid Technology for Astronomical Science

    CERN Document Server

    Enke, Harry; Adorf, Hans-Martin; Beck-Ratzka, Alexander; Breitling, Frank; Bruesemeister, Thomas; Carlson, Arthur; Ensslin, Torsten; Hoegqvist, Mikael; Nickelt, Iliya; Radke, Thomas; Reinefeld, Alexander; Reiser, Angelika; Scholl, Tobias; Spurzem, Rainer; Steinacker, Juergen; Voges, Wolfgang; Wambsganss, Joachim; White, Steve

    2010-01-01

    We present status and results of AstroGrid-D, a joint effort of astrophysicists and computer scientists to employ grid technology for scientific applications. AstroGrid-D provides access to a network of distributed machines with a set of commands as well as software interfaces. It allows simple use of computer and storage facilities and to schedule or monitor compute tasks and data management. It is based on the Globus Toolkit middleware (GT4). Chapter 1 describes the context which led to the demand for advanced software solutions in Astrophysics, and we state the goals of the project. We then present characteristic astrophysical applications that have been implemented on AstroGrid-D in chapter 2. We describe simulations of different complexity, compute-intensive calculations running on multiple sites, and advanced applications for specific scientific purposes, such as a connection to robotic telescopes. We can show from these examples how grid execution improves e.g. the scientific workflow. Chapter 3 explai...

  10. Cherenkov light imaging in astro-particle physics

    Energy Technology Data Exchange (ETDEWEB)

    Mirzoyan, Razmik, E-mail: Razmik.Mirzoyan@mpp.mpg.de

    2014-12-01

    Cherenkov light emission plays a key role in contemporary science; it is widely used in high energy, nuclear, and numerous astro-particle physics experiments. Most astro-particle physics experiments are based on the detection of light, and a vast majority of them on the measurement of Cherenkov light. Cherenkov light emission is measured in gases (used in air-Cherenkov technique), in water (for example, neutrino experiments BAIKAL, Super-Kamiokande, NESTOR, ANTARES, future KM3NeT; cosmic and γ-ray experiments Milagro, HAWC, AUGER) and in ice (IceCube). In this report our goal is not limited to simply listing the multitude of experiments that are based on using Cherenkov emission, but we will clarify the reasons making this emission so important and so frequently used. For completeness we will first give a short historical overview on the discovery and evolution of Cherenkov emission and then we will dwell on its main features and numerous applications in astro-particle physics experiments. - Highlights: • We explain why Cherenkov emission is so important and why it is so widely used. • A brief historical excursion is made to the very beginning of Cherenkov emission. • Imaging of the Cherenkov light emission is discussed in a great detail. • The principle of Cherenkov light imaging in diverse experiments is the same.

  11. Cherenkov light imaging in astro-particle physics

    Science.gov (United States)

    Mirzoyan, Razmik

    2014-12-01

    Cherenkov light emission plays a key role in contemporary science; it is widely used in high energy, nuclear, and numerous astro-particle physics experiments. Most astro-particle physics experiments are based on the detection of light, and a vast majority of them on the measurement of Cherenkov light. Cherenkov light emission is measured in gases (used in air-Cherenkov technique), in water (for example, neutrino experiments BAIKAL, Super-Kamiokande, NESTOR, ANTARES, future KM3NeT; cosmic and γ-ray experiments Milagro, HAWC, AUGER) and in ice (IceCube). In this report our goal is not limited to simply listing the multitude of experiments that are based on using Cherenkov emission, but we will clarify the reasons making this emission so important and so frequently used. For completeness we will first give a short historical overview on the discovery and evolution of Cherenkov emission and then we will dwell on its main features and numerous applications in astro-particle physics experiments.

  12. The Astro-WISE optical image pipeline. Development and implementation

    Science.gov (United States)

    McFarland, John P.; Verdoes-Kleijn, Gijs; Sikkema, Gert; Helmich, Ewout M.; Boxhoorn, Danny R.; Valentijn, Edwin A.

    2013-01-01

    We have designed and implemented a novel way to process wide-field astronomical data within a distributed environment of hardware resources and humanpower. The system is characterized by integration of archiving, calibration, and post-calibration analysis of data from raw, through intermediate, to final data products. It is a true integration thanks to complete linking of data lineage from the final catalogs back to the raw data. This paper describes the pipeline processing of optical wide-field astronomical data from the WFI (http://www.eso.org/lasilla/instruments/wfi/) and OmegaCAM (http://www.astro-wise.org/~omegacam/) instruments using the Astro-WISE information system (the Astro-WISE Environment or simply AWE). This information system is an environment of hardware resources and humanpower distributed over Europe. AWE is characterized by integration of archiving, data calibration, post-calibration analysis, and archiving of raw, intermediate, and final data products. The true integration enables a complete data processing cycle from the raw data up to the publication of science-ready catalogs. The advantages of this system for very large datasets are in the areas of: survey operations management, quality control, calibration analyses, and massive processing.

  13. The ASTRO-H X-ray Astronomy Satellite

    CERN Document Server

    Takahashi, Tadayuki; Kelley, Richard; Aharonian, Felix; Akamatsu, Hiroki; Akimoto, Fumie; Allen, Steve; Anabuki, Naohisa; Angelini, Lorella; Arnaud, Keith; Asai, Makoto; Audard, Marc; Awaki, Hisamitsu; Azzarello, Philipp; Baluta, Chris; Bamba, Aya; Bando, Nobutaka; Bautz, Marshall; Bialas, Thomas; Blandford, Roger; Boyce, Kevin; Brenneman, Laura; Brown, Greg; Cackett, Edward; Canavan, Edgar; Chernyakova, Maria; Chiao, Meng; Coppi, Paolo; Costantini, Elisa; de Plaa, Jelle; Herder, Jan-Willem den; DiPirro, Michael; Done, Chris; Dotani, Tadayasu; Doty, John; Ebisawa, Ken; Eckart, Megan; Enoto, Teruaki; Ezoe, Yuichiro; Fabian, Andrew; Ferrigno, Carlo; Foster, Adam; Fujimoto, Ryuichi; Fukazawa, Yasushi; Funk, Stefan; Furuzawa, Akihiro; Galeazzi, Massimiliano; Gallo, Luigi; Gandhi, Poshak; Gilmore, Kirk; Guainazzi, Matteo; Haas, Daniel; Haba, Yoshito; Hamaguchi, Kenji; Harayama, Atsushi; Hatsukade, Isamu; Hayashi, Takayuki; Hayashi, Katsuhiro; Hayashida, Kiyoshi; Hiraga, Junko; Hirose, Kazuyuki; Hornschemeier, Ann; Hoshino, Akio; Hughes, John; Hwang, Una; Iizuka, Ryo; Inoue, Yoshiyuki; Ishibashi, Kazunori; Ishida, Manabu; Ishikawa, Kumi; Ishimura, Kosei; Ishisaki, Yoshitaka; Ito, Masayuki; Iwata, Naoko; Iyomoto, Naoko; Jewell, Chris; Kaastra, Jelle; Kallman, Timothy; Kamae, Tuneyoshi; Kataoka, Jun; Katsuda, Satoru; Katsuta, Junichiro; Kawaharada, Madoka; Kawai, Nobuyuki; Kawano, Taro; Kawasaki, Shigeo; Khangulyan, Dmitry; Kilbourne, Caroline; Kimball, Mark; Kimura, Masashi; Kitamoto, Shunji; Kitayama, Tetsu; Kohmura, Takayoshi; Kokubun, Motohide; Konami, Saori; Kosaka, Tatsuro; Koujelev, Alex; Koyama, Katsuji; Krimm, Hans; Kubota, Aya; Kunieda, Hideyo; LaMassa, Stephanie; Laurent, Philippe; Lebrun, Franccois; Leutenegger, Maurice; Limousin, Olivier; Loewenstein, Michael; Long, Knox; Lumb, David; Madejski, Grzegorz; Maeda, Yoshitomo; Makishima, Kazuo; Markevitch, Maxim; Masters, Candace; Matsumoto, Hironori; Matsushita, Kyoko; McCammon, Dan; Mcguinness, Daniel; McNamara, Brian; Miko, Joseph; Miller, Jon; Miller, Eric; Mineshige, Shin; Minesugi, Kenji; Mitsuishi, Ikuyuki; Miyazawa, Takuya; Mizuno, Tsunefumi; Mori, Koji; Mori, Hideyuki; Moroso, Franco; Muench, Theodore; Mukai, Koji; Murakami, Hiroshi; Murakami, Toshio; Mushotzky, Richard; Nagano, Housei; Nagino, Ryo; Nakagawa, Takao; Nakajima, Hiroshi; Nakamori, Takeshi; Nakashima, Shinya; Nakazawa, Kazuhiro; Namba, Yoshiharu; Natsukari, Chikara; Nishioka, Yusuke; Nobukawa, Masayoshi; Noda, Hirofumi; Nomachi, Masaharu; Dell, Steve O'; Odaka, Hirokazu; Ogawa, Hiroyuki; Ogawa, Mina; Ogi, Keiji; Ohashi, Takaya; Ohno, Masanori; Ohta, Masayuki; Okajima, Takashi; Okamoto, Atsushi; Okazaki, Tsuyoshi; Ota, Naomi; Ozaki, Masanobu; Paerels, Frits; Paltani, St'ephane; Parmar, Arvind; Petre, Robert; Pinto, Ciro; Pohl, Martin; Pontius, James; Porter, F Scott; Pottschmidt, Katja; Ramsey, Brian; Reis, Rubens; Reynolds, Christopher; Ricci, Claudio; Russell, Helen; Safi-Harb, Samar; Saito, Shinya; Sakai, Shin-ichiro; Sameshima, Hiroaki; Sato, Goro; Sato, Yoichi; Sato, Kosuke; Sato, Rie; Sawada, Makoto; Serlemitsos, Peter; Seta, Hiromi; Shibano, Yasuko; Shida, Maki; Shimada, Takanobu; Shinozaki, Keisuke; Shirron, Peter; Simionescu, Aurora; Simmons, Cynthia; Smith, Randall; Sneiderman, Gary; Soong, Yang; Stawarz, Lukasz; Sugawara, Yasuharu; Sugita, Hiroyuki; Sugita, Satoshi; Szymkowiak, Andrew; Tajima, Hiroyasu; Takahashi, Hiromitsu; Takahashi, Hiroaki; Takeda, Shin-ichiro; Takei, Yoh; Tamagawa, Toru; Tamura, Takayuki; Tamura, Keisuke; Tanaka, Takaaki; Tanaka, Yasuo; Tanaka, Yasuyuki; Tashiro, Makoto; Tawara, Yuzuru; Terada, Yukikatsu; Terashima, Yuichi; Tombesi, Francesco; Tomida, Hiroshi; Tsuboi, Yohko; Tsujimoto, Masahiro; Tsunemi, Hiroshi; Tsuru, Takeshi; Uchida, Hiroyuki; Uchiyama, Yasunobu; Uchiyama, Hideki; Ueda, Yoshihiro; Ueda, Shutaro; Ueno, Shiro; Uno, Shinichiro; Urry, Meg; Ursino, Eugenio; de Vries, Cor; Wada, Atsushi; Watanabe, Shin; Watanabe, Tomomi; Werner, Norbert; White, Nicholas; Wilkins, Dan; Yamada, Takahiro; Yamada, Shinya; Yamaguchi, Hiroya; Yamaoka, Kazutaka; Yamasaki, Noriko; Yamauchi, Makoto; Yamauchi, Shigeo; Yaqoob, Tahir; Yatsu, Yoichi; Yonetoku, Daisuke; Yoshida, Atsumasa; Yuasa, Takayuki; Zhuravleva, Irina; Zoghbi, Abderahmen; ZuHone, John

    2014-01-01

    The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions developed by the Institute of Space and Astronautical Science (ISAS), with a planned launch in 2015. The ASTRO-H mission is equipped with a suite of sensitive instruments with the highest energy resolution ever achieved at E > 3 keV and a wide energy range spanning four decades in energy from soft X-rays to gamma-rays. The simultaneous broad band pass, coupled with the high spectral resolution of Delta E < 7 eV of the micro-calorimeter, will enable a wide variety of important science themes to be pursued. ASTRO-H is expected to provide breakthrough results in scientific areas as diverse as the large-scale structure of the Universe and its evolution, the behavior of matter in the gravitational strong field regime, the physical conditions in sites of cosmic-ray acceleration, and the distribution of dark matter in galaxy clusters at different redshifts.

  14. AstroStat - A VO Tool for Statistical Analysis

    CERN Document Server

    Kembhavi, Ajit K; Kale, Tejas; Jagade, Santosh; Vibhute, Ajay; Garg, Prerak; Vaghmare, Kaustubh; Navelkar, Sharmad; Agrawal, Tushar; Nandrekar, Deoyani; Shaikh, Mohasin

    2015-01-01

    AstroStat is an easy-to-use tool for performing statistical analysis on data. It has been designed to be compatible with Virtual Observatory (VO) standards thus enabling it to become an integral part of the currently available collection of VO tools. A user can load data in a variety of formats into AstroStat and perform various statistical tests using a menu driven interface. Behind the scenes, all analysis is done using the public domain statistical software - R and the output returned is presented in a neatly formatted form to the user. The analyses performable include exploratory tests, visualizations, distribution fitting, correlation & causation, hypothesis testing, multivariate analysis and clustering. The tool is available in two versions with identical interface and features - as a web service that can be run using any standard browser and as an offline application. AstroStat will provide an easy-to-use interface which can allow for both fetching data and performing power statistical analysis on ...

  15. Evidence Based Education: un quadro storico

    Directory of Open Access Journals (Sweden)

    Giuliano Vivanet

    2013-08-01

    Full Text Available Nel corso dell’ultimo decennio, nel pensiero pedagogico anglosassone, si è affermata una cultura dell’evidenza cui ci si riferisce con l’espressione “evidence based education” (EBE. Secondo tale prospettiva, le decisioni in ambito educativo dovrebbero essere assunte sulla base delle conoscenze che la ricerca empirica offre in merito alla minore o maggiore efficacia delle differenti opzioni didattiche. Si tratta di un approccio (denominato “evidence based practice” che ha origine in ambito medico e che in seguito ha trovato applicazione in differenti domini delle scienze sociali. L’autore presenta un quadro introduttivo all’EBE, dando conto delle sue origini e dei differenti significati di cui è portatrice.

  16. The fallacy of evidence based policy

    CERN Document Server

    Saltelli, Andrea

    2016-01-01

    The use of science for policy is at the core of a perfect storm generated by the insurgence of several concurrent crises: of science, of trust, of sustainability. The modern positivistic model of science for policy, known as evidence based policy, is based on dramatic simplifications and compressions of available perceptions of the state of affairs and possible explanations (hypocognition). This model can result in flawed prescriptions. The flaws become more evident when dealing with complex issues characterized by concomitant uncertainties in the normative, descriptive and ethical domains. In this situation evidence-based policy may concur to the fragility of the social system. Science plays an important role in reducing the feeling of vulnerability of humans by projecting a promise of protection against uncertainties. In many applications quantitative science is used to remove uncertainty by transforming it into probability, so that mathematical modelling can play the ritual role of haruspices. This epistem...

  17. A Corpus for Evidence Based Medicine Summarisation

    Directory of Open Access Journals (Sweden)

    Diego Mollá Aliod

    2012-09-01

    Full Text Available Background Automated text summarisers that find the best clinical evidence reported in collections of medical literature are of potential benefit for the practice of Evidence Based Medicine (EBM. Research and development of text summarisers for EBM, however, is impeded by the lack of corpora to train and test such systems. Aims To produce a corpus for research in EBM summarisation. Method We sourced the “Clinical Inquiries” section of the Journal of Family Practice (JFP and obtained a sizeable sample of questions and evidence based summaries. We further processed the summaries by combining automated techniques, human annotations, and crowdsourcing techniques to identify the PubMed IDs of the references. Results The corpus has 456 questions, 1,396 answer components, 3,036 answer justifications, and 2,908 references. Conclusion The corpus is now available for the research community at http://sourceforge.net/projects/ebmsumcorpus.

  18. Creative teaching an evidence-based approach

    CERN Document Server

    Sale, Dennis

    2015-01-01

    This book contains an evidence-based pedagogic guide to enable any motivated teaching/training professional to be able to teach effectively and creatively. It firstly summarises the extensive research field on human psychological functioning relating to learning and how this can be fully utilised in the design and facilitation of quality learning experiences. It then demonstrates what creativity actually 'looks like' in terms of teaching practices, modelling the underpinning processes of creative learning design and how to apply these in lesson planning. The book, having established an evidence-based and pedagogically driven approach to creative learning design, extensively focuses on key challenges facing teaching professionals today. These include utilising information technologies in blended learning formats, differentiating instruction, and developing self-directed learners who can think well. The main purpose of the book is to demystify what it means to teach creatively, explicitly demonstrating the pr...

  19. Evidence-Based Dentistry: What's New?

    OpenAIRE

    A. Ballini, S. Capodiferro, M. Toia, S. Cantore, G. Favia, G. De Frenza, F.R. Grassi

    2007-01-01

    The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care ...

  20. Evidence-based practice of periodontics.

    Science.gov (United States)

    Cobb, Charles M; MacNeill, Simon R; Satheesh, Keerthana

    2010-01-01

    Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

  1. Astro-WISE processing of wide-field images and other data

    CERN Document Server

    Buddelmeijer, Hugo; McFarland, John P; Belikov, Andrey

    2011-01-01

    Astro-WISE is the Astronomical Wide-field Imaging System for Europe. It is a scientific information system which consists of hardware and software federated over about a dozen institutes throughout Europe. It has been developed to exploit the ever increasing avalanche of data produced by astronomical surveys and data intensive scientific experiments in general. The demo explains the architecture of the Astro-WISE information system and shows the use of Astro-WISE interfaces. Wide-field astronomical images are derived from the raw image to the final catalog according to the user's request. The demo is based on the standard Astro-WISE guided tour, which can be accessed from the Astro-WISE website. The typical Astro-WISE data processing chain is shown, which can be used for data handling for a variety of different instruments, currently 14, including OmegaCAM, MegaCam, WFI, WFC, ACS/HST, etc.

  2. Evidence based abreactive ego state therapy for PTSD.

    Science.gov (United States)

    Barabasz, Arreed

    2013-07-01

    A single 5-6 hours manualized abreactive ego state therapy session has recently been subjected to two placebo-controlled investigations meeting evidence-based criteria. Ego state therapy was found to be a highly effective and durable treatment for posttraumatic stress disorder. Apparently, ego state therapy works because it is emotion focused, activates sub-cortical structures, and because the supportive, interpretive therapist reconstructs the patient's personality to be resilient and adaptive. In this article the author reviews the treatment procedures and presents the findings of both studies.

  3. The Evidence-Based Evaluation of Iron Deficiency Anemia.

    Science.gov (United States)

    Hempel, Eliana V; Bollard, Edward R

    2016-09-01

    Anemia is a prevalent disease with multiple possible etiologies and resultant complications. Iron deficiency anemia is a common cause of anemia and is typically due to insufficient intake, poor absorption, or overt or occult blood loss. Distinguishing iron deficiency from other causes of anemia is integral to initiating the appropriate treatment. In addition, identifying the underlying cause of iron deficiency is also necessary to help guide management of these patients. We review the key components to an evidence-based, cost-conscious evaluation of suspected iron deficiency anemia.

  4. Evidence-based quality improvement: the state of the science.

    Science.gov (United States)

    Shojania, Kaveh G; Grimshaw, Jeremy M

    2005-01-01

    Routine practice fails to incorporate research evidence in a timely and reliable fashion. Many quality improvement (QI) efforts aim to close these gaps between clinical research and practice. However, in sharp contrast to the paradigm of evidence-based medicine, these efforts often proceed on the basis of intuition and anecdotal accounts of successful strategies for changing provider behavior or achieving organizational change. We review problems with current approaches to QI research and outline the steps required to make QI efforts based as much on evidence as the practices they seek to implement.

  5. Evidence-Based Parenting Interventions to Promote Secure Attachment

    Science.gov (United States)

    Wright, Barry; Edginton, Elizabeth

    2016-01-01

    Various interventions are used in clinical practice to address insecure or disorganized attachment patterns and attachment disorders. The most common of these are parenting interventions, but not all have a robust empirical evidence base. We undertook a systematic review of randomized trials comparing a parenting intervention with a control, where these used a validated attachment instrument, in order to evaluate the clinical and cost-effectiveness of interventions aiming to improve attachment in children with severe attachment problems (mean age <13 years). This article aims to inform clinicians about the parenting interventions included in our systematic review that were clinically effective in promoting secure attachment. For completeness, we also briefly discuss other interventions without randomized controlled trial evidence, identified in Patient Public Involvement workshops and expert groups at the point our review was completed as being used or recommended. We outline the key implications of our findings for clinical practice and future research. PMID:27583298

  6. Do evidence-based interventions work when tested in the "real world?" A systematic review and meta-analysis of parent management training for the treatment of child disruptive behavior.

    Science.gov (United States)

    Michelson, Daniel; Davenport, Clare; Dretzke, Janine; Barlow, Jane; Day, Crispin

    2013-03-01

    Evidence-based interventions are often unavailable in everyday clinical settings. This may partly reflect practitioners' assumptions that research evidence does not reflect "real-world" conditions. To examine this further, we systematically assessed the clinical effectiveness of parent management training (PMT) for the treatment of child disruptive behavior across different real-world practice contexts. We identified 28 relevant randomized controlled trials from a systematic search of electronic bibliographic databases and conducted a meta-analysis of child outcomes across trials. Planned subgroup analyses involved comparisons between studies grouped according to individual real-world practice criteria and total real-world practice criteria scores, reflecting the extent to which PMT was delivered by non-specialist therapists, to a clinic-referred population, in a routine setting, and as part of a routine service. Meta-analysis revealed a significant overall advantage for PMT compared with waitlist control conditions. Subgroup analyses did not demonstrate significant differences in effect size estimates according to the total number of real-world practice criteria met by studies. Moreover, no consistent relationships were found between specific practice criteria and effect size estimates. In conclusion, PMT appears to be an effective treatment for children with disruptive behavior problems. There was no clear evidence that conducting PMT in real-world practice contexts is a deterrent to achieving effective child behavior outcomes, although relative advantage to "usual care" was not directly examined and the power of the analysis was limited as a result of significant heterogeneity. More research is needed to investigate whether this finding is generalizable to other psychological interventions. Suggestions are also made for developing more differentiated criteria to assist with evaluating the specific applicability of research evidence to different care providers.

  7. Application of journal club in the evidence-based practice:a systematic review%循证实践中杂志俱乐部应用的文献分析

    Institute of Scientific and Technical Information of China (English)

    杨如美; 蒋银芬; 朱琴华; 朱蓓; 汪暑萍; 唐四元

    2010-01-01

    目的 了解杂志俱乐部在循证实践中的应用效果,为循证实践教育干预提供参考.方法 对1975年1月至2009年10月在中国生物医学文献数据库、中国学术期刊网全文数据库(CNKI)、万方数据库、维普中文科技期刊数据库、PubMed、Cochrane Library等数据库发表的文献,以teaching、journal club、critical appraisal、education、evidence-based practice、循证实践、教育等为检索词进行检索, 对所得文献进行系统复习及评价.结果 5篇文献被纳入,其Jadad得分为3~4分;研究对象517名.开展杂志俱乐部可有效提高患者生活质量、自尊,有效促进溃疡创口的恢复,有效减轻伤口疼痛.杂志俱乐部对医学生和临床医护人员的知识、态度、文献阅读习惯产生影响,而对循证实践技能及对干预对象运用证据的影响还需进一步考证.结论 杂志俱乐部可以促进患者康复,提高临床医护人员的知识、态度、文献阅读习惯,杂志俱乐部是循证实践教育的有效途径.

  8. Evidence Based Practice: Science? Or Art? (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-03-01

    Full Text Available Evidence based library and information practice (EBLIP is a strategy to bridge research and practice. Generally EBLIP is seen as a movement to encourage and give practitioners the means to incorporate research into their practice, where it previously may have been lacking. The widely accepted definition of EBLIP (Booth, 2000 stresses three aspects that contribute to a practice that is evidence based: 1 "the best available evidence;" 2 "moderated by user needs and preferences;" 3 "applied to improve the quality of professional judgements." The area that the EBLIP movement has focused on is how to create and understand the best available research evidence. CE courses, critical appraisal checklists, and many articles have been written to address a need for librarian education in this area, and it seems that strides have been made.But very little in the EBLIP literature talks about how we make professional judgements, or moderate evidence based on our user needs and preferences. Likewise, how do we make good evidence based decisions when our evidence base is weak. These things seem to be elements we just take for granted or can’t translate into words. It is in keeping with tacit knowledge that librarians just seem to have or acquire skills with education and on the job experience. Tacit knowledge is "knowledge that is not easily articulated, and frequently involves knowledge of how to do things. We can infer its existence only by observing behaviour and determining that this sort of knowledge is a precondition for effective performance" (Patel, Arocha, & Kaufman, 1999, p.78. It is something that is difficult to translate into an article or guideline for how we work. I think of this area as the "art" of evidence based practice. And the art is crucial to being an evidence based practitioner.Science = systematized knowledge, explicit research, methodological examination, investigation, dataArt = professional knowledge of your craft, intuition

  9. The Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder in Adults—An Update for 2012: Practice Parameters with an Evidence-Based Systematic Review and Meta-Analyses: An American Academy of Sleep Medicine Clinical Practice Guideline

    OpenAIRE

    Aurora, R. Nisha; Kristo, David A.; Bista, Sabin R.; Rowley, James A.; Zak, Rochelle S.; Casey, Kenneth R.; Lamm, Carin I.; Tracy, Sharon L.; Rosenberg, Richard S.

    2012-01-01

    A systematic literature review and meta-analyses (where appropriate) were performed to update the previous AASM practice parameters on the treatments, both dopaminergic and other, of RLS and PLMD. A considerable amount of literature has been published since these previous reviews were performed, necessitating an update of the corresponding practice parameters. Therapies with a STANDARD level of recommendation include pramipexole and ropinirole. Therapies with a GUIDELINE level of recommendati...

  10. Introduction to the basics of evidence-based dentistry: concepts and skills.

    Science.gov (United States)

    Forrest, Jane L

    2009-09-01

    The purpose of this section of the ADA Champions Pre-Conference is to review the basics of Evidence-based dentistry (EBD), research designs and levels of evidence, and identify the skills necessary for clinicians to efficiently use an evidence-based approach in practice. This session of the pre-conference preceded the session on the skills needed to define a clinical question and search for the evidence to answer that question.

  11. Evidence-based practice in Occupational Health Psychology. Current status and further developments

    Directory of Open Access Journals (Sweden)

    Maricutoiu, Laurentiu P.

    2012-04-01

    Full Text Available The present paper discusses the status of evidence-based practice in Occupational Health Psychology (OHP. After several searches on large online databases, we have found that OHP papers that discuss interventions are less than 10% of the overall literature. Furthermore, quantitative reviews research that reports interventions on major OHP topics are generally absent. In the last part of the paper, we formulate some reccomendations for increasing the number of papers relevant for evidence-based practice in OHP.

  12. Observation, Sherlock Holmes, and Evidence Based Medicine.

    Science.gov (United States)

    Osborn, John

    2002-01-01

    Sir Arthur Conan Doyle, the creator of the fictional detective Sherlock Holmes, studied medicine at the University of Edinburgh between 1876 and 1881 under Doctor Joseph Bell who emphasised in his teaching the importance of observation, deduction and evidence. Sherlock Holmes was modelled on Joseph Bell. The modern notions of Evidence Based Medicine (EBM) are not new. A very brief indication of some of the history of EBM is presented including a discussion of the important and usually overlooked contribution of statisticians to the Popperian philosophy of EBM.

  13. 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.

  14. Management of the infertile couple: an evidence-based protocol

    Directory of Open Access Journals (Sweden)

    Kamel Remah M

    2010-03-01

    Full Text Available Abstract Background Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. Evaluation usually starts after 12 months; however it may be indicated earlier. The most common causes of infertility are: male factor such as sperm abnormalities, female factor such as ovulation dysfunction and tubal pathology, combined male and female factors and unexplained infertility. Objectives The aim of this study is to provide the healthcare professionals an evidence-based management protocol for infertile couples away from medical information overload. Methods A comprehensive review where the literature was searched for "Management of infertility and/or infertile couples" at library website of University of Bristol (MetaLib by using a cross-search of different medical databases besides the relevant printed medical journals and periodicals. Guidelines and recommendations were retrieved from the best evidence reviews such as that from the American College of Obstetricians and Gynaecologists (ACOG, American Society for Reproductive Medicine (ASRM, Canadian Fertility and Andrology Society (CFAS, and Royal College of Obstetricians and Gynaecologists (RCOG. Results A simple guide for the clinicians to manage the infertile couples. Conclusions The study deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. It is an approach to disseminate the recommended medical care for infertile couple to the practicing clinicians.

  15. Evidence-Based Chinese Medicine for Hypertension

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    Full Text Available Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM. Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go.

  16. Time for evidence-based cytology

    Directory of Open Access Journals (Sweden)

    Dey Pranab

    2007-01-01

    Full Text Available Abstract Evidence-based medicine (EBM is a fashionable and an extremely hot topic for clinicians, patients and the health service planners. Evidence-based cytology (EBC is an offshoot of EBM. The EBC is concerned with generating a reproducible, high quality and clinically relevant test result in the field of cytology. This is a rapidly evolving area with high practical importance. EBC is based entirely on research data. The various professional bodies on cytology design and recommend guidelines on the basis of evidences. Once the guideline is implemented and practiced then the experiences of the practicing cytopathologists may be used as a feed back to alter the existing guideline. The various facets of EBC are sampling and specimen adequacy, morphological identification and computer based expert system, integrated reporting, identification of the controversial areas and high quality researches for evidences. It is the duty of the individuals and institutions to practice EBC for better diagnosis and management of the patients. In this present paper, the various aspects of EBC have been discussed.

  17. [Acupressure and Evidence-Based Nursing].

    Science.gov (United States)

    Chen, Li-Li; Lin, Jun-Dai

    2015-12-01

    Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice.

  18. The treatment of restless legs syndrome and periodic limb movement disorder in adults--an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline.

    Science.gov (United States)

    Aurora, R Nisha; Kristo, David A; Bista, Sabin R; Rowley, James A; Zak, Rochelle S; Casey, Kenneth R; Lamm, Carin I; Tracy, Sharon L; Rosenberg, Richard S

    2012-08-01

    A systematic literature review and meta-analyses (where appropriate) were performed to update the previous AASM practice parameters on the treatments, both dopaminergic and other, of RLS and PLMD. A considerable amount of literature has been published since these previous reviews were performed, necessitating an update of the corresponding practice parameters. Therapies with a STANDARD level of recommendation include pramipexole and ropinirole. Therapies with a GUIDELINE level of recommendation include levodopa with dopa decarboxylase inhibitor, opioids, gabapentin enacarbil, and cabergoline (which has additional caveats for use). Therapies with an OPTION level of recommendation include carbamazepine, gabapentin, pregabalin, clonidine, and for patients with low ferritin levels, iron supplementation. The committee recommends a STANDARD AGAINST the use of pergolide because of the risks of heart valve damage. Therapies for RLS secondary to ESRD, neuropathy, and superficial venous insufficiency are discussed. Lastly, therapies for PLMD are reviewed. However, it should be mentioned that because PLMD therapy typically mimics RLS therapy, the primary focus of this review is therapy for idiopathic RLS.

  19. Cure-WISE: HETDEX Data Reduction with Astro-WISE

    Science.gov (United States)

    Snigula, J. M.; Drory, N.; Fabricius, M.; Landriau, M.; Montesano, F.; Hill, G. J.; Gebhardt, K.; Cornell, M. E.

    2014-05-01

    The Hobby-Eberly Telescope Dark Energy Experiment (HETDEX, Hill et al. 2012b) is a blind spectroscopic survey to map the evolution of dark energy using Lyman-alpha emitting galaxies at redshifts 1.9currently receives a wide-field upgrade (Hill et al. 2012a) to accomodate the spectrographs and to provide the needed field of view. Over the projected five year run of the survey we expect to obtain approximately 170 GB of data each night. For the data reduction we developed the Cure pipeline, to automatically find and calibrate the observed spectra, subtract the sky background, and detect and classify different types of sources. Cure employs rigorous statistical methods and complete pixel-level error propagation throughout the reduction process to ensure Poisson-limited performance and meaningful significance values. To automate the reduction of the whole dataset we implemented the Cure pipeline in the Astro-WISE framework. This integration provides for HETDEX a database backend with complete dependency tracking of the various reduction steps, automated checks, and a searchable interface to the detected sources and user management. It can be used to create various web interfaces for data access and quality control. Astro-WISE allows us to reduce the data from all the IFUs in parallel on a compute cluster. This cluster allows us to reduce the observed data in quasi real time and still have excess capacity for rerunning parts of the reduction. Finally, the Astro-WISE interface will be used to provide access to reduced data products to the general community.

  20. Evidence-Based Practice: The Psychology of EBP Implementation.

    Science.gov (United States)

    Rousseau, Denise M; Gunia, Brian C

    2016-01-01

    Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation.

  1. In-orbit operation of the ASTRO-H SXS

    Science.gov (United States)

    Tsujimoto, Masahiro; Mitsuda, Kazuhisa; Kelley, Richard L.; den Herder, Jan-Willem A.; Akamatsu, Hiroki; Bialas, Thomas G.; Boyce, Kevin R.; Brown, Gregory V.; Chiao, Meng P.; Costantini, Elisa; de Vries, Cor P.; DiPirro, Michael J.; Eckart, Megan E.; Ezoe, Yuichiro; Fujimoto, Ryuichi; Haas, Daniel; Hoshino, Akio; Ishikawa, Kumi; Ishisaki, Yoshitaka; Iyomoto, Naoko; Kilbourne, Caroline A.; Kitamoto, Shunji; Koyama, Shu; Leutenegger, Maurice A.; McCammon, Dan; Mitsuishi, Ikuyuki; Murakami, Hiroshi; Murakami, Masahide; Noda, Hirofumi; Ogawa, Mina; Ota, Naomi; Paltani, Stéphane; Porter, Frederick S.; Sato, Kosuke; Sato, Yoichi; Sawada, Makoto; Seta, Hiromi; Shinozaki, Keisuke; Shirron, Peter J.; Sneiderman, Gary A.; Sugita, Hiroyuki; Szymkowiak, Andrew E.; Takei, Yoh; Tamagawa, Toru; Tashiro, Makoto S.; Terada, Yukikatsu; Yamada, Shinya; Yamasaki, Noriko Y.; Yatsu, Yoichi

    2016-07-01

    We summarize all the in-orbit operations of the Soft X-ray Spectrometer (SXS) onboard the ASTRO-H (Hit- omi) satellite. The satellite was launched on 2016/02/17 and the communication with the satellite ceased on 2016/03/26. The SXS was still in the commissioning phase, in which the setups were progressively changed. This article is intended to serve as a reference of the events in the orbit to properly interpret the SXS data taken during its short life time, and as a test case for planning the in-orbit operation for future micro-calorimeter missions.

  2. ASTRO-H White Paper - New Spectral Features

    CERN Document Server

    Smith, R K; Audard, M; Brown, G V; Eckart, M E; Ezoe, Y; Foster, A; Galeazzi, M; Hamaguchi, K; Ishibashi, K; Ishikawa, K; Kaastra, J; Katsuda, S; Leutenegger, M; Miller, E; Mitsuishi, I; Nakajima, H; Ogawa, T; Paerels, F; Porter, F S; Sakai, K; Sawada, M; Takei, Y; Tanaka, Y; Tsuboi, Y; Uchida, H; Ursino, E; Watanabe, S; Yamaguchi, H; Yamasaki, N

    2014-01-01

    This white paper addresses selected new (to X-ray astronomy) physics and data analysis issues that will impact ASTRO-H SWG observations as a result of its high-spectral-resolution X-ray microcalorimeter, the focussing hard X-ray optics and corresponding detectors, and the low background soft gamma-ray detector. We concentrate on issues of atomic and nuclear physics, including basic bound-bound and bound-free transitions as well as scattering and radiative transfer. The major topic categories include the physics of charge exchange, solar system X-ray sources, advanced spectral model, radiative transfer, and hard X-ray emission lines and sources.

  3. Evidence-based evaluation of therapeutic measures for sleep disorders

    Directory of Open Access Journals (Sweden)

    LI Juan

    2013-05-01

    Full Text Available Objective To evaluate the therapeutic efficacy and side effects of various treatment for sleep disorders in order to provide the best therapeutic regimen for the evidence-based treatment of sleep disorders. Methods Sleep disorder, insomnia, restless legs syndrome or RLS, obstructive sleep apnea or OSA, narcolepsy, REM behaviour disorder or RBD, treatment or therapy were used as retrieval words. Cochrane Library, MEDLINE, ScienceDirect were used for retrieval, and manual searching was also used. Related clinical guidelines, systematic reviews, randomized controlled clinical trials, retrospective case analysis, case-observation studies and reviews were collected and evaluated by Jadad Scale. Results Forty related articles were selected as following: 6 clinical guidelines, 12 systematic reviews, 5 randomized controlled trials, 2 retrospective case analysis, 1 case-observation study and 14 reviews. Thirty-three were of high quality, while 7 were of low quality with score. According to the evaluation of therapeutic efficacy and side effects of various therapies, it is suggested as following: 1 insomnia is the most common in sleep disorders; the treatment methods of insomnia mainly include drug therapy and cognitive behavioral treatment (CBT; the two kinds of therapy have their own advantages and disadvantages, and the combination therapy of drugs and CBT is the best treatment plan. 2 The first-line treatment of primary RLS is dopamine agonists and anti-seizure drugs; however, the treatment of secondary RLS is mainly etiologic treatment. 3 The main treatments of OSAS are nasal continuous positive airway pressure (nCPAP, oral orthotics and surgery, and nCPAP is the first-line treatments. 4 The medication of narcolepsy is mainly modafinil, hydroxy butyric acid sodium and antidepressants, and the specific choosingshould accord to clinical classifications. 5 The main treatments of RBD include general treatments such as avoiding triggers, insuring the

  4. Recommendations for Prevention of Physical Training (PT)-Related Injuries: Results of a Systematic Evidence-Based Review by the Joint Services Physical Training Injury Prevention Work Group (JSPTIPWG)

    Science.gov (United States)

    2003-10-01

    the use of forearm or elbow straps to prevent medial or lateral epicondylitis ( elbow tendonitis). Reasons for pursuing this theory and a summary of... epicondyles of the elbow . The expedited review of this intervention revealed that neither of these devices, or anything similar, has been tested in...sustaining lateral or medial epicondylitis or epicondylalgia ( elbow pain). 3. Recommendation. The JSPTIPWG cannot recommend for or against the

  5. The evidence-base for conceptual approaches and additional therapies targeting lower limb function in children with cerebral palsy: a systematic review using the International Classification of Functioning, Disability and Health as a framework

    OpenAIRE

    Franki, Inge; Desloovere, Kaat; De Cat, Josse; Feys, Hilde; Molenaers, Guy; Calders, Patrick; Vanderstraeten, Guy; Himpens, Eveline; Van den Broeck, Christine

    2012-01-01

    Objective: This systematic review provides an overview of the effectiveness of conceptual approaches and additional therapies used in lower limb physical therapy of children with cerebral palsy and supports the development of clinical guidelines. Data sources and study selection: A literature search in 5 electronic databases was performed, extracting literature published between 1995 and 2009. Studies were evaluated using the framework recommended by the American Academy for Cerebral Pals...

  6. Evidence-based neuroethics for neurodevelopmental disorders.

    Science.gov (United States)

    Racine, Eric; Bell, Emily; Di Pietro, Nina C; Wade, Lucie; Illes, Judy

    2011-03-01

    Many neurodevelopmental disorders affect early brain development in ways that are still poorly understood; yet, these disorders can place an enormous toll on patients, families, and society as a whole and affect all aspects of daily living for patients and their families. We describe a pragmatic, evidence-based framework for engaging in empiric ethics inquiry for a large consortium of researchers in neurodevelopmental disorders and provide relevant case studies of pragmatic neuroethics. The 3 neurodevelopmental disorders that are at the focus of our research, cerebral palsy (CP), autism spectrum disorder (ASD), and fetal alcohol spectrum disorder (FASD), bring unique and intersecting challenges of translating ethically research into clinical care for children and neonates. We identify and discuss challenges related to health care delivery in CP; neonatal neurological decision making; alternative therapies; and identity, integrity, and personhood.

  7. Evidence-Based Education in Plastic Surgery.

    Science.gov (United States)

    Johnson, Shepard P; Chung, Kevin C; Waljee, Jennifer F

    2015-08-01

    Educational reforms in resident training have historically been driven by reports from medical societies and organizations. Although educational initiatives are well intended, they are rarely supported by robust evidence. The Accreditation Council for Graduate Medical Education recently introduced competency-based training, a form of outcomes-based education that has been used successfully in nonmedical professional vocations. This initiative has promise to advance the quality of resident education, but questions remain regarding implementation within plastic surgery. In particular, how will competency-based training impact patient outcomes, and will the methodologies used to assess competencies (i.e., milestones) be accurate and validated by literature? This report investigates resident educational reform and the need for more evidence-based educational initiatives in plastic surgery training.

  8. EVIDENCE-BASED USE OF EPLERENONE

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevski

    2012-01-01

    Full Text Available Data of the negative effect of high concentrations of aldosterone in the blood for cardiovascular disease, which served as the theoretical basis for wider use in clinical practice of the drugs belonging to the class of aldosterone receptor blockers is presented. Evidence-based data on efficacy and safety of aldosterone receptor blockers, which were obtained in the course of several randomized clinical trials is performed. Particular attention is paid to aspects of the clinical use of selective aldosterone receptor blocker eplerenone, including current data, which makes reasonable extension of indications for its use in treating patients with chronic heart failure. Data on indications of eplerenone use in patients with hypertension, especially in the case of associated target organ damage is presented.

  9. Sepsis management: An evidence-based approach.

    Science.gov (United States)

    Baig, Muhammad Akbar; Shahzad, Hira; Jamil, Bushra; Hussain, Erfan

    2016-03-01

    The Surviving Sepsis Campaign (SSC) guidelines have outlined an early goal directed therapy (EGDT) which demonstrates a standardized approach to ensure prompt and effective management of sepsis. Having said that, there are barriers associated with the application of evidence-based practice, which often lead to an overall poorer adherence to guidelines. Considering the global burden of disease, data from low- to middle-income countries is scarce. Asia is the largest continent but most Asian countries do not have a well-developed healthcare system and compliance rates to resuscitation and management bundles are as low as 7.6% and 3.5%, respectively. Intensive care units are not adequately equipped and financial concerns limit implementation of expensive treatment strategies. Healthcare policy-makers should be notified in order to alleviate financial restrictions and ensure delivery of standard care to septic patients.

  10. 循证医学在眼视光学的应用(Ⅱ)系统评价的临床应用%Evidence-based medicime in optometry and ophthalmology( Ⅱ The clinical study of systematic review)

    Institute of Scientific and Technical Information of China (English)

    姜丽萍; 瞿佳

    2002-01-01

    @@ 系统评价(systematic review)是循证医学的重要方法,即根据某一具体的临床问题(如疾病的治疗、诊断),采用系统、明确的方法来收集、选择和评估相关的临床原始研究,并从中提取信息和分析数据,进行定性或定量合成,为疾病的诊治和临床决策提供科学的依据[1].

  11. Ethical reflections on Evidence Based Medicine

    Directory of Open Access Journals (Sweden)

    S. Corrao

    2013-05-01

    Full Text Available BACKGROUND According to Potter’s point of view, medical ethics is the science of survival, a bridge between humanistic and scientific culture. The working out of judgements on right or wrong referred to the human being are studied by this science. Methodological quality is fundamental in clinical research, and several technical issues are of paramount importance in trying to answer to the final question “what is the true, the right thing?”. We know they are essential aspects as in medical ethics as in evidence based practice. AIM OF THE STUDY The aim of this paper is to talk about relationships and implications between ethical issues and Evidence Based Medicine (EBM. DISCUSSION EBM represents a new paradigm that introduces new concepts to guide medical-decision making and health-care planning. Its principles are deeply rooted in clinical research methodology since information are derived from sound studies of strong quality. Health-care professionals have to deal with methodological concepts for critical appraisal of literature and implementation of evidences in clinical practice and healthcare planning. The central role of EBM in medical ethics is obvious, but a risk could be possible. The shift from Hippocratic point of view to community-centred one could lose sight of the centrality of the patient. CONCLUSION Both EBM principles and the needs to adequately response to economic restrictions urge a balance between individual and community ethics. All this has to represent an opportunity to place the patient at the centre of medical action considering at the same time community ethics as systemic aim, but without forgetting the risk that economic restrictions push towards veterinary ethics where herd is central and individual needs do not exist.

  12. How to teach evidence-based surgery.

    Science.gov (United States)

    Fingerhut, Abe; Borie, Frédéric; Dziri, Chadli

    2005-05-01

    The objectives of teaching evidence-based surgery (EBS) are to inform and convince that EBS is a method of interrogation, reasoning, appraisal, and application of information to guide physicians in their decisions to best treat their patients. Asking the right, answerable questions, translating them into effective searches for the best evidence, critically appraising evidence for its validity and importance, and then integrating EBS with their patients' values and preferences are daily chores for all surgeons. Teaching and learning EBS should be patient-centered, learner-centered, and active and interactive. The teacher should be a model for students to become an expert clinician who is able to match and take advantage of the clinical setting and circumstances to ask and to answer appropriate questions. The process is multistaged. Teaching EBS in small groups is ideal. However, it is time-consuming for the faculty and must be clearly and formally structured. As well, evidence-based medicine (EBM) courses must cater to local institutional needs, must receive broad support from the instructors and the providers of information (librarians and computer science faculty), use proven methodologies, and avoid scheduling conflicts. In agreement with others, we believe that the ideal moment to introduce the concepts of EBM into the curriculum of the medical student is early, during the first years of medical school. Afterward, it should be continued every year. When this is not the case, as in many countries, it becomes the province of the surgeon in teaching hospitals, whether they are at the university, are university-affiliated, or not, to fulfill this role.

  13. Operationalizing Evidence-Based Practice: The Development of an Institute for Evidence-Based Social Work

    Science.gov (United States)

    Regehr, Cheryl; Stern, Susan; Shlonsky, Aron

    2007-01-01

    Although evidence-based practice (EBP) has received increasing attention in social work in the past few years, there has been limited success in moving from academic discussion to engaging social workers in the process of implementing EBP in practice. This article describes the challenges, successes, and future aims in the process of developing a…

  14. Evidence Based Dental Care: Integrating Clinical Expertise with Systematic Research

    OpenAIRE

    2014-01-01

    Clinical dentistry is becoming increasingly complex and our patients more knowledgeable. Evidence-based care is now regarded as the “gold standard” in health care delivery worldwide. The basis of evidence based dentistry is the published reports of research projects. They are, brought together and analyzed systematically in meta analysis, the source for evidence based decisions. Activities in the field of evidence-based dentistry has increased tremendously in the 21st century, more and more p...

  15. Evidence-based practice. The role of staff development.

    Science.gov (United States)

    Krugman, Mary

    2003-01-01

    Knowledge and use of evidence-based practice are essential to ensure best practices and safe patient outcomes. Staff development specialists must be leaders in this initiative to support clinical nurses toward improved practice outcomes. This article describes the background for understanding the historical evolution from research utilization to evidence-based practice, defines some key concepts related to evidence-based practice, and suggests essential components for building evidence-based practice programs in healthcare institutions.

  16. Reality of evidence-based practice in palliative care

    Institute of Scientific and Technical Information of China (English)

    Claire Visser; Gina Hadley; Bee Wee

    2015-01-01

    hTere has been a paradigm shitf in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically signiifcant beneifts may be marginal and may not be related to clinical meaningfulness. hTe typical treatmentvs. placebo comparison necessitated by ‘gold standard’ randomised controlled trials (RCTs) is not necessarily applicable. hTe complex multimorbidity of end of life care involves considerations of the patient’s physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be diffcult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. hTis review uses examples of the management of cancer-related fatigue and death rattle (noisy breathing) to demonstrate the current state of EBM in palliative care. hTe future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a ‘mixed methods approach’ are likely to pose the correct clinical questions and derive evidence-based yet clinically relevant outcomes.

  17. Evidence-based practice in group work with incarcerated youth.

    Science.gov (United States)

    Quinn, Ashley; Shera, Wes

    2009-01-01

    As a result of the Youth Criminal Justice Act's increased focus on restorative justice, treatment, rehabilitation, and reintegration of youth, many more juvenile offenders require mental health services while resident in youth detention facilities [Youth Criminal Justice Act (2002, c.1). Ottawa: Department of Justice Canada. Retrieved September 19, 2008 from http://laws.justice.gc.ca/en/Y-1.5]. Several common characteristics such as violence, aggression, and other antisocial behaviors, associated with criminal behavior, have been identified among male and female offenders. Dialectical behavior therapy, originally developed by Linehan [Linehan, M. M., 1993a. Cognitive-behavioural treatment of borderline personality disorder. New York: Guildford Press] for chronically parasuicidal women diagnosed with borderline personality disorder, has been successfully modified for use with other populations, including violent and impulse-oriented male and female adolescents residing in correctional facilities. The intent of this article is to encourage the wider use of dialectical behavior therapy (DBT) with young offenders. It includes an extensive review of the evidence-base to date and describes some of the creative modifications that have been made to standard DBT program format to meet the particular needs of various groups in both Canada and the United States. In keeping with the movement toward more evidence-based practice, the authors argue that DBT is a promising approach in group work with incarcerated adolescents and should be more widely used.

  18. ASTRO 101 Labs and the Invasion of the Cognitive Scientists

    Science.gov (United States)

    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.

  19. 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.

  20. The ASTRO-H X-ray Observatory

    CERN Document Server

    Takahashi, Tadayuki; Kelley, Richard; Aharonian, Henri AartsFelix; Akamatsu, Hiroki; Akimoto, Fumie; Allen, Steve; Anabuki, Naohisa; Angelini, Lorella; Arnaud, Keith; Asai, Makoto; Audard, Marc; Awaki, Hisamitsu; Azzarello, Philipp; Baluta, Chris; Bamba, Aya; Bando, Nobutaka; Bautz, Mark; Blandford, Roger; Boyce, Kevin; Brown, Greg; Cackett, Ed; Chernyakova, Maria; Coppi, Paolo; Costantini, Elisa; de Plaa, Jelle; Herder, Jan-Willem den; DiPirro, Michael; Done, Chris; Dotani, Tadayasu; Doty, John; Ebisawa, Ken; Eckart, Megan; Enoto, Teruaki; Ezoe, Yuichiro; Fabian, Andrew; Ferrigno, Carlo; Foster, Adam; Fujimoto, Ryuichi; Fukazawa, Yasushi; Funk, Stefan; Furuzawa, Akihiro; Galeazzi, Massimiliano; Gallo, Luigi; Gandhi, Poshak; Gendreau, Keith; Gilmore, Kirk; Haas, Daniel; Haba, Yoshito; Hamaguchi, Kenji; Hatsukade, Isamu; Hayashi, Takayuki; Hayashida, Kiyoshi; Hiraga, Junko; Hirose, Kazuyuki; Hornschemeier, Ann; Hoshino, Akio; Hughes, John; Hwang, Una; Iizuka, Ryo; Inoue, Yoshiyuki; Ishibashi, Kazunori; Ishida, Manabu; Ishimura, Kosei; Ishisaki, Yoshitaka; Ito, Masayuki; Iwata, Naoko; Iyomoto, Naoko; Kaastra, Jelle; Kallman, Timothy; Kamae, Tuneyoshi; Kataoka, Jun; Katsuda, Satoru; Kawahara, Hajime; Kawaharada, Madoka; Kawai, Nobuyuki; Kawasaki, Shigeo; Khangaluyan, Dmitry; Kilbourne, Caroline; Kimura, Masashi; Kinugasa, Kenzo; Kitamoto, Shunji; Kitayama, Tetsu; Kohmura, Takayoshi; Kokubun, Motohide; Kosaka, Tatsuro; Koujelev, Alex; Koyama, Katsuji; Krimm, Hans; Kubota, Aya; Kunieda, Hideyo; LaMassa, Stephanie; Laurent, Philippe; Lebrun, Francois; Leutenegger, Maurice; Limousin, Olivier; Loewenstein, Michael; Long, Knox; Lumb, David; Madejski, Grzegorz; Maeda, Yoshitomo; Makishima, Kazuo; Marchand, Genevieve; Markevitch, Maxim; Matsumoto, Hironori; Matsushita, Kyoko; McCammon, Dan; McNamara, Brian; Miller, Jon; Miller, Eric; Mineshige, Shin; Minesugi, Kenji; Mitsuishi, Ikuyuki; Miyazawa, Takuya; Mizuno, Tsunefumi; Mori, Hideyuki; Mori, Koji; Mukai, Koji; Murakami, Toshio; Murakami, Hiroshi; Mushotzky, Richard; Nagano, Housei; Nagino, Ryo; Nakagawa, Takao; Nakajima, Hiroshi; Nakamori, Takeshi; Nakazawa, Kazuhiro; Namba, Yoshiharu; Natsukari, Chikara; Nishioka, Yusuke; Nobukawa, Masayoshi; Nomachi, Masaharu; Dell, Steve O'; Odaka, Hirokazu; Ogawa, Hiroyuki; Ogawa, Mina; Ogi, Keiji; Ohashi, Takaya; Ohno, Masanori; Ohta, Masayuki; Okajima, Takashi; Okamoto, Atsushi; Okazaki, Tsuyoshi; Ota, Naomi; Ozaki, Masanobu; Paerels, Frits; Paltani, Stephane; Parmar, Arvind; Petre, Robert; Pohl, Martin; Porter, F Scott; Ramsey, Brian; Reis, Rubens; Reynolds, Christopher; Russell, Helen; Safi-Harb, Samar; Sakai, Shin-ichiro; Sameshima, Hiroaki; Sanders, Jeremy; Sato, Goro; Sato, Rie; Sato, Yoichi; Sato, Kosuke; Sawada, Makoto; Serlemitsos, Peter; Seta, Hiromi; Shibano, Yasuko; Shida, Maki; Shimada, Takanobu; Shinozaki, Keisuke; Shirron, Peter; Simionescu, Aurora; Simmons, Cynthia; Smith, Randall; Sneiderman, Gary; Soong, Yang; Stawarz, Lukasz; Sugawara, Yasuharu; Sugita, Hiroyuki; Sugita, Satoshi; Szymkowiak, Andrew; Tajima, Hiroyasu; Takahashi, Hiromitsu; Takeda, Shin-ichiro; Takei, Yoh; Tamagawa, Toru; Tamura, Takayuki; Tamura, Keisuke; Tanaka, Takaaki; Tanaka, Yasuo; Tashiro, Makoto; Tawara, Yuzuru; Terada, Yukikatsu; Terashima, Yuichi; Tombesi, Francesco; Tomida, Hiroshi; Tsuboi, Yoko; Tsujimoto, Masahiro; Tsunemi, Hiroshi; Tsuru, Takeshi; Uchida, Hiroyuki; Uchiyama, Yasunobu; Uchiyama, Hideki; Ueda, Yoshihiro; Ueno, Shiro; Uno, Shinichiro; Urry, Meg; Ursino, Eugenio; de Vries, Cor; Wada, Atsushi; Watanabe, Shin; Werner, Norbert; White, Nicholas; Yamada, Takahiro; Yamada, Shinya; Yamaguchi, Hiroya; Yamasaki, Noriko; Yamauchi, Shigeo; Yamauchi, Makoto; Yatsu, Yoichi; Yonetoku, Daisuke; Yoshida, Atsumasa; Yuasa, Takayuki

    2012-01-01

    The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit o...

  1. ASTRO-F : Infrared Imaging Surveyor (IRIS) Mission

    Science.gov (United States)

    Onaka, T.

    The ASTRO-F (also known as Infrared Imaging Surveyor: IRIS) is the second infrared satellite mission of the Institute of Space and Astronautical Science, Japan to be launched early 2004 with the M-V rocket and is planned as a second generation infrared sky survey mission. It has a 67-cm aperture telescope and is cooled by 170-liter liquid helium and Stirling-cycle coolers. Two scientific instruments share the focal plane. The infrared camera (IRC) covers 2 to 26 μm range with large two-dimensional arrays in the imaging and low-resolution spectroscopic modes and will perform deep sky surveys of selected areas of the sky with a wide field of view (10' × 10') at unprecedented sensitivity. The far-infrared Surveyor (FIS), consisting of an imaging scanner and a Fourier transform spectrometer, covers 50 to 200 μm range and makes a whole sky survey in four far-infrared bands, which is higher by more than 10 in sensitivity (20 110 mJy), better by several in the spatial resolution (30'' 50''), and longer in the spectral coverage (200 μm) than IRAS. A brief description and the current status of the ASTRO-F mission are presented.

  2. Non-hormonal systemic therapy in men with hormone-refractory prostate cancer and metastases: a systematic review from the Cancer Care Ontario Program in Evidence-based Care's Genitourinary Cancer Disease Site Group

    Directory of Open Access Journals (Sweden)

    Hotte Sébastien

    2006-05-01

    Full Text Available Abstract Background Prostate cancer that has recurred after local therapy or disseminated distantly is usually treated with androgen deprivation therapy; however, most men will eventually experience disease progression within 12 to 20 months. New data emerging from randomized controlled trials (RCTs of chemotherapy provided the impetus for a systematic review addressing the following question: which non-hormonal systemic therapies are most beneficial for the treatment of men with hormone-refractory prostate cancer (HRPC and clinical evidence of metastases? Methods A systematic review was performed to identify RCTs or meta-analyses examining first-line non-hormonal systemic (cytotoxic and non-cytotoxic therapy in patients with HRPC and metastases that reported at least one of the following endpoints: overall survival, disease control, palliative response, quality of life, and toxicity. Excluded were RCTs of second-line hormonal therapies, bisphosphonates or radiopharmaceuticals, or randomized fewer than 50 patients per trial arm. MEDLINE, EMBASE, the Cochrane Library, and the conference proceedings of the American Society of Clinical Oncology were searched for relevant trials. Citations were screened for eligibility by four reviewers and discrepancies were handled by consensus. Results Of the 80 RCTs identified, 27 met the eligibility criteria. Two recent, large trials reported improved overall survival with docetaxel-based chemotherapy compared to mitoxantrone-prednisone. Improved progression-free survival and rates of palliative and objective response were also observed. Compared with mitoxantrone, docetaxel treatment was associated with more frequent mild toxicities, similar rates of serious toxicities, and better quality of life. More frequent serious toxicities were observed when docetaxel was combined with estramustine. Three trials reported improved time-to-disease progression, palliative response, and/or quality of life with mitoxatrone

  3. 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.    

  4. 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.

  5. Original research in pathology: judgment, or evidence-based medicine?

    Science.gov (United States)

    Crawford, James M

    2007-02-01

    Pathology is both a medical specialty and an investigative scientific discipline, concerned with understanding the essential nature of human disease. Ultimately, pathology is accountable as well, as measured by the accuracy of our diagnoses and the resultant patient care outcomes. As such, we must consider the evidence base underlying our practices. Within the realm of Laboratory Medicine, extensive attention has been given to testing accuracy and precision. Critical examination of the evidence base supporting the clinical use of specific laboratory tests or technologies is a separate endeavor, to which specific attention must be given. In the case of anatomic pathology and more specifically surgical pathology, the expertise required to render a diagnosis is derived foremost from experience, both personal and literature-based. In the first instance, knowledge of the linkage between one's own diagnoses and individual patient outcomes is required, to validate the role of one's own interpretations in the clinical course of patients. Experience comes from seeing this linkage first hand, from which hopefully comes wisdom and, ultimately, good clinical judgment. In the second instance, reading the literature and learning from experts is required. Only a minority of the relevant literature is published in pathology journals to which one may subscribe. A substantial portion of major papers relevant to the practice of anatomic pathology are published in collateral clinical specialty journals devoted to specific disease areas or organs. Active effort is therefore required to seek out the literature beyond the domain of pathology journals. In examining the published literature, the essential question then becomes: Does the practice of anatomic pathology fulfill the tenets of 'evidence-based medicine' (EBM)? If the pinnacle of EBM is 'systematic review of randomized clinical trials, with or without meta-analysis', then anatomic pathology falls far short. Our published

  6. Evidence-Based Medicine in the Education of Psychiatrists

    Science.gov (United States)

    Srihari, Vinod

    2008-01-01

    Objective: Evidence-based medicine has an important place in the teaching and practice of psychiatry. Attempts to teach evidence-based medicine skills can be weakened by conceptual confusions feeding a false polarization between traditional clinical skills and evidence-based medicine. Methods: The author develops a broader conception of clinical…

  7. E-Learning and Evidence Based Practice in Schools

    Science.gov (United States)

    Quong, Terrence

    2016-01-01

    JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…

  8. The ABCs of Evidence-Based Practice for Teachers

    Science.gov (United States)

    Kretlow, Allison G.; Blatz, Sharon L.

    2011-01-01

    It is critical teachers adhere to federal policies regarding evidence-based practices. Quickly identifying and effectively using evidence-based programs and practices is particularly important for special educators, because students in special education often already have academic or behavioral deficits. Using evidence-based practices with…

  9. Efectividad de las intervenciones de seguridad vial basadas en la evidencia: una revisión de la literatura Evidence-based effectiveness of road safety interventions: a literature review

    Directory of Open Access Journals (Sweden)

    Ana M. Novoa

    2009-12-01

    evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths. Methodology: 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. Results: 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. Conclusion: 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.

  10. Revisión del tratamiento con corticoides en el dolor de espalda según la medicina basada en la evidencia Evidence-based review of steroid therapy for back pain

    Directory of Open Access Journals (Sweden)

    F. Neira

    2009-09-01

    or blocks", "medial nerve blocks" and "low back pain". The search was performed in the Trip Database, SUMSearch, National Guidelines Clearinghouse, Cochrane and centers drawing up clinical practice guidelines. Clinical practice guidelines with levels of evidence, systematic reviews, meta-analyses and cross references among publications reviewed in Spanish or English from 1979 to 2009 were accepted. Results: Five clinical practice guidelines and nine systematic reviews were selected. Analysis of these articles indicated that intradiscal injections cannot be recommended in the treatment of chronic low back pain. The evidence on lumbar, cervical and thoracic medial branch injection in the treatment of lumbar, cervical and dorsal back pain is moderate for short- and long-term improvement. The evidence for sacroiliac joint injection is limited. Cervical interlaminar epidural injection provides significant and prolonged relief in chronic intractable cervical pain. There is level II-2 evidence for lumbar interlaminar epidural steroid injection, without fluoroscopy, in providing short-term relief and level II evidence for long-term relief. Transforaminal epidural steroid injection is effective in postlaminectomy syndrome (level IV evidence. There is moderate evidence for short- and long-term improvement in cervical radicular pain. Transforaminal epidural injection provides significant relief in chronic low back pain and radicular lumbar pain with level II-1 evidence for short-term improvement and level II-2 evidence for long-term improvement, with strong level 1C recommendation. Caudal epidural steroid injection was effective in producing short-term improvement (level II evidence as well as long-term relief (level III evidence. Pain relief was achieved in postlaminectomy low back pain and spinal canal stenosis (level IV evidence. Conclusions: There are differences in the effectiveness, level of evidence and grade of recommendation for steroid use, associated or not with

  11. Evidence-based nursing practice: are we there yet?

    Science.gov (United States)

    Ervin, Naomi E

    2002-01-01

    The volume of evidence for nursing practice has increased as a result of research and scientific discoveries. Yet we are still struggling with the dilemma of how to get evidence into nursing practice. Estimates are that it takes 20 years before innovations are fully put into use. Research is one type of knowledge to be used in practice. Nursing and patient care would benefit from moving more toward knowledge based on research and evidence. This article reviews barriers to and facilitators of using evidence in nursing practice and discusses a model for promoting the systematic use of evidence in practice. The author also offers suggestions for increasing the evidence base of nursing practice. Using evidence in nursing practice is important for all nurses, but requires more that the attention of the individual nurse.

  12. The oil crisis, risk and evidence-based practice.

    Science.gov (United States)

    Traynor, Michael

    2002-09-01

    Evidence-based practice has risen to prominence over the last 20 years. Different professions have taken it up in different ways and for different purposes. It has been seen as holding both threats and advantages to professionalising endeavours and professional identity. It has engendered controversy but some criticisms of it have been unconvincing. It is possible to account for its rise as a response to tightening financial constraints on state spending in the west, as a sign of a culture increasingly concerned with risk, distrust of professionals and experts, as well as a way for professionals themselves to maintain control over their activity in the face of growing managerialism. This paper reviews the literature of some of the movement's proponents as well as criticism from various professional groups. It concludes that more useful than either arguing for or against it, is to understand the policy background and sociological reasons for its emergence and spread.

  13. The professional portfolio: an evidence-based assessment method.

    Science.gov (United States)

    Byrne, Michelle; Schroeter, Kathryn; Carter, Shannon; Mower, Julie

    2009-12-01

    Competency assessment is critical for a myriad of disciplines, including medicine, law, education, and nursing. Many nurse managers and educators are responsible for nursing competency assessment, and assessment results are often used for annual reviews, promotions, and satisfying accrediting agencies' requirements. Credentialing bodies continually seek methods to measure and document the continuing competence of licensees or certificants. Many methods and frameworks for continued competency assessment exist. The portfolio process is one method to validate personal and professional accomplishments in an interactive, multidimensional manner. This article illustrates how portfolios can be used to assess competence. One specialty nursing certification board's process of creating an evidence-based portfolio for recertification or reactivation of a credential is used as an example. The theoretical background, development process, implementation, and future implications may serve as a template for other organizations in developing their own portfolio models.

  14. 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.

  15. Surgery for gastric cancer: An evidence-based perspective

    Directory of Open Access Journals (Sweden)

    D'souza Melroy

    2009-01-01

    Full Text Available Despite a decreasing incidence, stomach cancer is the second leading cause of cancer mortality worldwide. Surgical resection offers the only chance for cure in this aggressive cancer. The surgical management of gastric cancer has witnessed numerous debates in the past decades. These include the extent of lymphadenectomy, extent of surgery, role of laparoscopic gastrectomy, and the impact of high volume of centers, on the outcome of surgery. This review attempts to address these controversies with an evidence-based perspective. A literature search in MEDLINE (www.pubmed.org has been performed with the relevant key words and corresponding MeSH terms. The search has been limited to English publications on human subjects. A manual search of the bibliographies has also been carried out, to identify the relevant publications for possible inclusion.

  16. [Computer work and De Quervain's tenosynovitis: an evidence based approach].

    Science.gov (United States)

    Gigante, M R; Martinotti, I; Cirla, P E

    2012-01-01

    The debate around the role of the work at personal computer as cause of De Quervain's Tenosynovitis was developed partially, without considering multidisciplinary available data. A systematic review of the literature, using an evidence-based approach, was performed. In disorders associated with the use of VDU, we must distinguish those at the upper limbs and among them those related to an overload. Experimental studies on the occurrence of De Quervain's Tenosynovitis are quite limited, as well as clinically are quite difficult to prove the professional etiology, considering the interference due to other activities of daily living or to the biological susceptibility (i.e. anatomical variability, sex, age, exercise). At present there is no evidence of any connection between De Quervain syndrome and time of use of the personal computer or keyboard, limited evidence of correlation is found with time using a mouse. No data are available regarding the use exclusively or predominantly for personal laptops or mobile "smart phone".

  17. [Evidence-based therapy of polycystic ovarian syndrome].

    Science.gov (United States)

    Gődény, Sándor; Csenteri, Orsolya Karola

    2015-11-01

    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.

  18. Preparing students to practice evidence-based dentistry: a mixed methods conceptual framework for curriculum enhancement.

    Science.gov (United States)

    Palcanis, Kent G; Geiger, Brian F; O'Neal, Marcia R; Ivankova, Nataliya V; Evans, Retta R; Kennedy, Lasonja B; Carera, Karen W

    2012-12-01

    This article describes a mixed methods conceptual framework for evidence-based dentistry to enhance the curriculum at the University of Alabama at Birmingham School of Dentistry. A focus of recent curriculum reform has been to prepare students to integrate evidence-based dentistry into clinical practice. The authors developed a framework consisting of four conceptual phases to introduce curriculum innovation: 1) exploration of the phenomenon; 2) development of two new instruments; 3) data collection, analysis, outcomes, and evaluation; and 4) application to curricular reform. Eight sequential procedural steps (literature review; focus group discussions; development of themes; survey design; internal review; data collection, analysis, and evaluation; development of recommendations with external review; and implementation of recommendations for curricular enhancement) guided the curricular enhancement. Faculty members supported the concept of teaching evidence-based dentistry to facilitate major curriculum reform, and course directors incorporated evidence-based teaching to prepare scientist-practitioners who meet dental performance standards. The new curriculum implemented following completion of the study is in its third year. Much of its structure is based on evidence-based teaching methodologies, and approximately one-third of the content consists of small groups researching clinical problems with applied science and discussing the findings. The framework described in this article proved useful to guide revision of predoctoral clinical education at one dental school and may be useful in other settings.

  19. Teaching strategies to support evidence-based practice.

    Science.gov (United States)

    Winters, Charlene A; Echeverri, Rebecca

    2012-06-01

    Evidence-based practice is an expected core competency of all health care clinicians regardless of discipline. Use of evidence-based practice means integrating the best research with clinical expertise and patient values to achieve optimal health outcomes. Evidence-based practice requires nurses to access and appraise evidence rapidly before integrating it into clinical practice. Role modeling and integrating the skills necessary to develop evidence-based practice into clinical and nonclinical courses is an important part in developing positive attitudes toward evidence-based practice, an essential first step to using evidence to guide practice decisions. The step-by-step approach to evidence-based practice proposed by Melnyk and colleagues provides an excellent organizing framework for teaching strategies specifically designed to facilitate nurses' knowledge and skill development in evidence-based practice.

  20. Why be an evidence-based dentistry champion?

    Science.gov (United States)

    Clarkson, Jan E; Bonetti, Debbie

    2009-09-01

    Evidence-based dentistry champions are committed to improving the quality, effectiveness, and appropriateness of dental care through the application of evidence-based principles and tools. They share knowledge and skills to promote evidence-based dentistry (EBD) in practice, guiding colleagues, patients and policy makers in the application of critical thinking skills and evidence-based decision-making. Being an evidence-based champion requires furthering an understanding of the full process and the challenges of evidence based dentistry, including the development of an evidence base, evidence synthesis and summary, the creation of best practice guidelines, as well as evidence implementation. Efforts to improve the quality, effectiveness, and appropriateness of dental care need to occur at, and be coordinated across, multiple levels of dentistry, including the patient, clinician, team, organization, and policy.

  1. Evidence Based Practice Outside the Box (Editorial

    Directory of Open Access Journals (Sweden)

    Lindsay Glynn

    2008-09-01

    Full Text Available I love food. I love cooking, baking, testing, and eating. I read about food preparation, food facts, and food service. Over the years I’ve developed my fair share of knowledge about cooking and I’m a decent cook, but I’m no chef. I guess I’m what you’d call a “foodie”. However, I have the good fortune to have a friend who is a chef and owns one of the best, and certainly the most innovative, restaurants in town. During this summer I hosted a cooking class in my home for my family with my chef friend as instructor. The Tex-Mex barbecue theme was a big hit (you can contact me for recipes, if you like, but much more fascinating was the explanation of the science behind the cooking. It turns out that there is a term for this: molecular gastronomy. Another term, and hence the genesis of my “Eureka!” moment of the summer, is evidence based cooking. Good cooking is not just following a recipe (not all of which are evidence based but at its best is the culmination of heaps of tested information regarding why and how chemical and environmental factors work together to result in a gastronomical delight. For example, will brining or marinating a pork chop make it moister? And, if brining, what temperature should the water be, how long should it soak, and how much salt is needed? Why does pounding meat increase its tenderness? What will keep guacamole from browning better – the pit or lime juice? What does baking soda do in a chocolate cake? Eggs or no eggs in fresh pasta? Like most librarians, I tend not to take information at face value. I want to know where information comes from and whether or not it is valid, based on specific factors. I’ve come to notice that evidence based, or evidence informed, practice is everywhere and has a tremendous impact on our lives. Why do you rotate the tires on your car? Evidence shows that the front tires wear more quickly (think about all those 3-pointturns, the braking, etc and therefore

  2. [Searching for evidence-based data].

    Science.gov (United States)

    Dufour, J-C; Mancini, J; Fieschi, M

    2009-08-01

    The foundation of evidence-based medicine is critical analysis and synthesis of the best data available concerning a given health problem. These factual data are accessible because of the availability on the Internet of web tools specialized in research for scientific publications. A bibliographic database is a collection of bibliographic references describing the documents indexed. Such a reference includes at least the title, summary (or abstract), a set of keywords, and the type of publication. To conduct a strategically effective search, it is necessary to formulate the question - clinical, diagnostic, prognostic, or related to treatment or prevention - in a form understandable by the research engine. Moreover, it is necessary to choose the specific database or databases, which may have particular specificity, and to analyze the results rapidly to refine the strategy. The search for information is facilitated by the knowledge of the standardized terms commonly used to describe the desired information. These come from a specific thesaurus devoted to document indexing. The most frequently used is MeSH (Medical Subject Heading). The principal bibliographic database whose references include a set of describers from the MeSH thesaurus is Medical Literature Analysis and Retrieval System Online (Medline), which has in turn become a subpart of a still more vast bibliography called PubMed, which indexes an additional 1.4 million references. Numerous other databases are maintained by national or international entities. These include the Cochrane Library, Embase, and the PASCAL and FRANCIS databases.

  3. Evidence Based Cataloguing: Moving Beyond the Rules

    Directory of Open Access Journals (Sweden)

    Kathy Carter

    2010-12-01

    Full Text Available Cataloguing is sometimes regarded as a rule-bound, production-based activity that offers little scope for professional judgement and decision-making. In reality, cataloguing involves challenging decisions that can have significant service and financial impacts. The current environment for cataloguing is a maelstrom of changing demands and competing visions for the future. With information-seekers turning en masse to Google and their behaviour receiving greater attention, library vendors are offering “discovery layer” products to replace traditional OPACs, and cataloguers are examining and debating a transformed version of their descriptive cataloguing rules (Resource Description and Access or RDA. In his “Perceptions of the future of cataloging: Is the sky really falling?” (2009, Ivey provides a good summary of this environment. At the same time, myriad new metadata formats and schema are being developed and applied for digital collections in libraries and other institutions. In today’s libraries, cataloguing is no longer limited to management of traditional AACR and MARC-based metadata for traditional library collections. And like their parent institutions, libraries cannot ignore growing pressures to demonstrate accountability and tangible value provided by their services. More than ever, research and an evidence based approach can help guide cataloguing decision-making.

  4. Evidence-Based Interactive Management of Change

    Directory of Open Access Journals (Sweden)

    Albert Fleischmann

    2011-06-01

    Full Text Available Evidence-based interactive management of change means hands-on experience of modified work processes, given evidence of change. For this kind of pro-active organizational development support we use an organisational process memory and a communication-based representation technique for role-specific and task-oriented process execution. Both are effective means for organizations becoming agile through interactively modelling the business at the process level and re-constructing or re-arranging process representations according to various needs. The tool allows experiencing role-specific workflows, as the communication-based refinement of work models allows for executable process specifications. When presenting the interactive processes to individuals involved in the business processes, changes can be explored interactively in a context-sensitive way before re-implementing business processes and information systems. The tool is based on a service-oriented architecture and a flexible representation scheme comprising the exchange of message between actors, business objects and actors (roles. The interactive execution of workflows does not only enable the individual reorganization of work but also changes at the level of the entire organization due to the represented interactions.

  5. [Prevention of atopic eczema. Evidence based guidelines].

    Science.gov (United States)

    Schäfer, T

    2005-03-01

    With an estimated prevalence of 12% for preschool children and 3% for adults, atopic eczema is a serious public health problem. This disease severely jeopardizes quality of life and is associated with considerable costs. Since there is still no causal therapy, primary and secondary prevention are especially important. Here the evidence basis for recommendations on prevention of atopic eczema is discussed on the basis of the first evidence-based consensus guideline (S3) on allergy prevention. This recommends that babies should be breastfed exclusively for at least 4 months and exposure to passive smoking be avoided even during pregnancy; restriction of the maternal diet during pregnancy has no influence, though during breastfeeding it can lower the incidence of eczema among babies at risk. Thereby this measure should be balanced with potential consequences of malnutrition. There seems to be a positive correlation between keeping small rodents (rabbits, guinea pigs), and possibly cats, and the occurrence of atopic eczema, while keeping dogs has no effect or even a protective effect. Avoidance of an unfavorable indoor climate is probably also helpful in preventing eczema. There is no evidence to support deviating from the current recommendations of the standing committee for vaccination.

  6. Subjective evidence based ethnography: method and applications.

    Science.gov (United States)

    Lahlou, Saadi; Le Bellu, Sophie; Boesen-Mariani, Sabine

    2015-06-01

    Subjective Evidence Based Ethnography (SEBE) is a method designed to access subjective experience. It uses First Person Perspective (FPP) digital recordings as a basis for analytic Replay Interviews (RIW) with the participants. This triggers their memory and enables a detailed step by step understanding of activity: goals, subgoals, determinants of actions, decision-making processes, etc. This paper describes the technique and two applications. First, the analysis of professional practices for know-how transferring purposes in industry is illustrated with the analysis of nuclear power-plant operators' gestures. This shows how SEBE enables modelling activity, describing good and bad practices, risky situations, and expert tacit knowledge. Second, the analysis of full days lived by Polish mothers taking care of their children is described, with a specific focus on how they manage their eating and drinking. This research has been done on a sub-sample of a large scale intervention designed to increase plain water drinking vs sweet beverages. It illustrates the interest of SEBE as an exploratory technique in complement to other more classic approaches such as questionnaires and behavioural diaries. It provides the detailed "how" of the effects that are measured at aggregate level by other techniques.

  7. Peer-review Platform for Astronomy Education Activities

    CERN Document Server

    Russo, Pedro; Gomez, Edward; Strubbe, Linda

    2015-01-01

    Hundreds of thousands of astronomy education activities exist, but their discoverability and quality is highly variable. The web platform for astronomy education activities, astroEDU, presented in this paper tries to solve these issues. Using the familiar peer-review workflow of scientific publications, astroEDU is improving standards of quality, visibility and accessibility, while providing credibility to these astronomy education activities. astroEDU targets activity guides, tutorials and other educational activities in the area of astronomy education, prepared by teachers, educators and other education specialists. Each of the astroEDU activities is peer-reviewed by an educator as well as an astronomer to ensure a high standard in terms of scientific content and educational value. All reviewed materials are then stored in a free open online database, enabling broad distribution in a range of different formats. In this way astroEDU is not another web repository for educational resources but a mechanism for ...

  8. Evidence-based evaluation of treatment strategy for multiple sclerosis

    Directory of Open Access Journals (Sweden)

    LI Meng-qiu

    2012-04-01

    Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

  9. The ASTRO-H X-ray Observatory

    Science.gov (United States)

    Takahashi, Tadayuki; Mitsuda, K.; Kelley, R. L.; ASTRO-H Team

    2013-04-01

    The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS), to be launched in 2015. ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-12 keV with high spectral resolution of 7 eV (FWHM), enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes. The high spectral resolution brought by the micro-calorimeter array will open up a full range of plasma diagnostics and kinematic studies of X-ray emitting gas for thousands of targets, both Galactic and extragalactic. The ASTRO-H mission objectives are: to determine the evolution of yet-unknown obscured supermassive black holes (SMBHs) in Active Galactic Nuclei (AGN); to trace the growth history of the largest structures in the Universe; to trace the chemical evolution of the universe; to probe feedback from the growth of supermassive black holes onto their galaxy and cluster environments; to provide insights into the behavior of material in extreme gravitational fields; to determine the spin of black holes and the equation of state of neutron stars; to trace particle acceleration structures in clusters of galaxies and SNRs; and to investigate the detailed physics of astrophysical jets.

  10. Evidence-Based Treatment of Maisonneuve Fractures

    NARCIS (Netherlands)

    S.A. Stufkens; M.P.J. van den Bekerom; J.N. Doornberg; C.N. van Dijk; P. Kloen

    2011-01-01

    The objective of the current study was to review the published clinical evidence available for the treatment of Maisonneuve fractures. Medline via PubMed, Orthopaedic Trauma Association (OTA) annual meetings' abstracts archives Web site, Embase, the Cochrane Database of Systematic Reviews, and the C

  11. Evidence-based treatment for mental disorders in children and adolescents.

    Science.gov (United States)

    Fabiano, Gregory A; Pelham, William E

    2002-04-01

    In the past decade, increased emphasis has been placed on identifying treatments for childhood disorders that are supported by empirical evidence of their effectiveness. This process was spearheaded by an American Psychological Association division 12 task force that identified evidence-based treatments--mostly for disorders of adulthood. Because of the publication of the task force results, other studies have been published that contribute to the knowledge base of evidence-based treatment, and these studies are briefly reviewed. Across evidence-based treatments, common features of effective treatments, such as parent involvement, use of a treatment manual, and the emphasis on generalization of treatment effects to natural settings, are also identified and reviewed.Introduction

  12. 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.

  13. Postmodern Astro-Theology, Cometary Panspermia, and the Polonnaruwa Meteorite: Derham, Wesley, Whitehead, Griffin and Cobb

    Science.gov (United States)

    Walker, Theodore, Jr.

    2013-03-01

    Here is a postmodern astro-theological response to factual evidence supporting cometary panspermia, including evidence of cyanobacteria fossils in meteorites (Hoover 2011) and diatom frustules in the Polonnaruwa meteorite (Wickramasinghe and others 2013). Distinct from William Derham's modern astro-theology, and in accordance with John Wesley's avoidance of factual demonstrations/proofs and Wesley's appreciation of factual exemplifications, postmodern astro-theology appreciates cometary panspermia. Cometary panspermia is a specific-factually correct example of panspermia in general. Generic panspermia is essential to panentheism. Cometary panspermia enriches evolutionary biology.

  14. Evidence-based toxicology: a comprehensive framework for causation.

    Science.gov (United States)

    Guzelian, Philip S; Victoroff, Michael S; Halmes, N Christine; James, Robert C; Guzelian, Christopher P

    2005-04-01

    -based opinions, expressed by experts (or consensus groups of experts) relying on their education, training, experience, wisdom, prestige, intuition, skill and improvisation. In response, evidence-based medicine (EBM) was developed, to make a conscientious, explicit and judicious use of current best evidence in deciding about the care of individual patients. Now globally embraced, EBM employs a structured, 'transparent' protocol for carrying out a deliberate, objective, unbiased and systematic review of the evidence about a formally framed question. Not only in medicine, but now in dentistry, engineering and other fields that have adapted the methods of EBM, it is the quality of the evidence and the rigor of the analysis through evidence-based logic (EBL), rather than the professional standing of the reviewer, that leads to evidence-based conclusions about what is known. Recent studies have disclosed that toxicologists (individually or in expert groups), not unlike their medical counterparts prior to EBM, show distressing variations in their biases with regard to data selection, data interpretation and data evaluation when performing reviews for causation analyses. Moreover, toxicologists often fail to acknowledge explicitly (particularly in regulatory and policy-making arenas) when shortcomings in the evidence necessitate reliance upon authority-based opinions, rather than evidence-based conclusions (Guzelian PS, Guzelian CP. Authority-based explanation. Science 2004; 303: 1468-69). Accordingly, for answering questions about general and specific causation, we have constructed a framework for evidence-based toxicology (EBT), derived from the accepted principles of EBM and expressed succinctly as three stages, comprising 12 total steps. These are: 1) collecting and evaluating the relevant data (Source, Exposure, Dose, Diagnosis); 2) collecting and evaluating the relevant knowledge (Frame the question, Assemble the relevant (delimited) literature, Assess and critique the literature

  15. The Antarctic Submillimeter Telescope and Remote Observatory (AST/RO)

    CERN Document Server

    Stark, A A; Balm, S P; Bania, T M; Bolatto, A D; Chamberlin, R A; Engargiola, G; Huang, M; Ingalls, J G; Jacobs, K; Jackson, J M; Kooi, J W; Lane, A P; Lo, K Y; Marks, R D; Martin, C L; Mumma, D; Ojha, R P; Schieder, R; Staguhn, J G; Stutzki, J; Walker, C K; Wilson, R W; Wright, G A; Zhang, X; Zimmermann, P; Zimmermann, R E; Stark, Antony A.; Bally, John; Balm, Simon P.; Bolatto, Alberto D.; Chamberlin, Richard A.; Engargiola, Gregory; Huang, Maohai; Ingalls, James G.; Jacobs, Karl; Jackson, James M.; Kooi, Jacob W.; Lane, Adair P.; Marks, Rodney D.; Martin, Christopher L.; Mumma, Dennis; Ojha, Roopesh; Schieder, Rudolf; Staguhn, Johannes; Stutzki, Juergen; Walker, Christopher K.; Wilson, Robert W.; Wright, Gregory A.; Zhang, Xiaolei; Zimmermann, Peter; Zimmermann, Ruediger

    2000-01-01

    AST/RO, a 1.7 m diameter telescope for astronomy and aeronomy studies at wavelengths between 200 and 2000 microns, was installed at the South Pole during the 1994-1995 Austral summer. The telescope operates continuously through the Austral winter, and is being used primarily for spectroscopic studies of neutral atomic carbon and carbon monoxide in the interstellar medium of the Milky Way and the Magellanic Clouds. The South Pole environment is unique among observatory sites for unusually low wind speeds, low absolute humidity, and the consistent clarity of the submillimeter sky. Four heterodyne receivers and three acousto-optical spectrometers are installed. Telescope pointing, focus, and calibration methods as well as the unique working environment and logistical requirements of the South Pole are described.

  16. What Can a Historian Do with AstroGen?

    Science.gov (United States)

    Tenn, Joseph S.

    2015-01-01

    "Astrogen", the Astronomy Genealogy Project, is in the development stage. Patterned after the Mathematics Genealogy Project at http://genealogy.math.ndsu.nodak.edu, it will eventually include most of the world's astronomers, past and present, and provide information about their years of life, highest degrees, universities, and thesis titles. There will also be links to online theses, home pages, and obituaries when these are available. Although a few details remain to be worked out before it becomes public, it is possible to make some use of what has already been compiled. I will give an example, comparing graduates of Harvard University, the University of California at Berkeley, and the University of Chicago from different decades, with information about their professional careers and publication records. The author welcomes queries about AstroGen and is seeking more participants.

  17. 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.

  18. 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.

  19. The Cadmium Zinc Telluride Imager on AstroSat

    CERN Document Server

    Bhalerao, V; Vibhute, A; Pawar, P; Rao, A R; Hingar, M K; Khanna, Rakesh; Kutty, A P K; Malkar, J P; Patil, M H; Arora, Y K; Sinha, S; Priya, P; Samuel, Essy; Sreekumar, S; Vinod, P; Mithun, N P S; Vadawale, S V; Vagshette, N; Navalgund, K H; Sarma, K S; Pandiyan, R; Seetha, S; Subbarao, K

    2016-01-01

    The Cadmium Zinc Telluride Imager (CZTI) is a high energy, wide-field imaging instrument on AstroSat. CZT's namesake Cadmium Zinc Telluride detectors cover an energy range from 20 keV to > 200 keV, with 11% energy resolution at 60 keV. The coded aperture mask attains an angular resolution of 17' over a 4.6 deg x 4.6 deg (FWHM) field of view. CZTI functions as an open detector above 100 keV, continuously sensitive to GRBs and other transients in about 30% of the sky. The pixellated detectors are sensitive to polarisation above ~100 keV, with exciting possibilities for polarisation studies of transients and bright persistent sources. In this paper, we provide details of the complete CZTI instrument, detectors, coded aperture mask, mechanical and electronic configuration, as well as data and products.

  20. Charged Particle Monitor on the AstroSat mission

    CERN Document Server

    Rao, A R; Bhargava, Yash; Khanna, Rakesh; Hingar, M K; Kutty, A P K; Malkar, J P; Basak, Rupal; Sreekumar, S; Samuel, Essy; Priya, P; Vinod, P; Bhattacharya, D; Bhalerao, V; Vadawale, S V; Mithun, N P S; Pandiyan, R; Subbarao, K; Seetha, S; Sarma, K Suryanarayana

    2016-01-01

    Charged Particle Monitor (CPM) on-board the AstroSat satellite is an instrument designed to detect the flux of charged particles at the satellite location. A Cesium Iodide Thallium (CsI(Tl)) crystal is used with a Kapton window to detect protons with energies greater than 1 MeV. The ground calibration of CPM was done using gamma-rays from radioactive sources and protons from particle accelerators. Based on the ground calibration results, energy deposition above 1 MeV are accepted and particle counts are recorded. It is found that CPM counts are steady and the signal for the onset and exit of South Atlantic Anomaly (SAA) region are generated in a very reliable and stable manner.

  1. Do You Always Need a Textbook to Teach Astro 101?

    CERN Document Server

    Rudolph, Alexander L

    2013-01-01

    The increasing use of interactive learning strategies in Astro 101 classrooms has led some instructors to consider the usefulness of a textbook in such classes. These strategies provide students a learning modality very different from the traditional lecture supplemented by reading a textbook and homework, and raises the question of whether the learning that takes place during such interactive activities is enough by itself to teach students what we wish them to know about astronomy. To address this question, assessment data is presented from an interactive class, which was first taught with a required textbook, and then with the textbook being optional. Comparison of test scores before and after this change shows no statistical difference in student achievement whether a textbook is required or not. In addition, comparison of test scores of students who purchased the textbook to those who did not, after the textbook became optional, also show no statistical difference between the two groups. The Light and Sp...

  2. Teaching evidence based medicine in family medicine

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2012-05-01

    Full Text Available The concept of evidence based medicine (EBM as the integrationof clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980’s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP in a short time is not easy. Five useful steps are described –represented by the acronym “5A+E”: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search “on the spot’’ is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GP’s office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. Conclusion. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GP’s everyday work is becoming a part of everyday practice.

  3. 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

  4. Integration of Evidence Base into a Probabilistic Risk Assessment

    Science.gov (United States)

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

    2011-01-01

    INTRODUCTION: A probabilistic decision support model such as the Integrated Medical Model (IMM) utilizes an immense amount of input data that necessitates a systematic, integrated approach for data collection, and management. As a result of this approach, IMM is able to forecasts medical events, resource utilization and crew health during space flight. METHODS: Inflight data is the most desirable input for the Integrated Medical Model. Non-attributable inflight data is collected from the Lifetime Surveillance for Astronaut Health study as well as the engineers, flight surgeons, and astronauts themselves. When inflight data is unavailable cohort studies, other models and Bayesian analyses are used, in addition to subject matters experts input on occasion. To determine the quality of evidence of a medical condition, the data source is categorized and assigned a level of evidence from 1-5; the highest level is one. The collected data reside and are managed in a relational SQL database with a web-based interface for data entry and review. The database is also capable of interfacing with outside applications which expands capabilities within the database itself. Via the public interface, customers can access a formatted Clinical Findings Form (CLiFF) that outlines the model input and evidence base for each medical condition. Changes to the database are tracked using a documented Configuration Management process. DISSCUSSION: This strategic approach provides a comprehensive data management plan for IMM. The IMM Database s structure and architecture has proven to support additional usages. As seen by the resources utilization across medical conditions analysis. In addition, the IMM Database s web-based interface provides a user-friendly format for customers to browse and download the clinical information for medical conditions. It is this type of functionality that will provide Exploratory Medicine Capabilities the evidence base for their medical condition list

  5. Evidence-based therapy for sleep disorders in neurodegenerative diseases

    Directory of Open Access Journals (Sweden)

    LIU Ling

    2013-08-01

    Full Text Available Objective To evaluate the effectiveness of the treatments for sleep disorders in neurodegenerative diseases so as to provide the best therapeutic regimens for the evidence-based treatment. Methods Search PubMed, MEDLINE, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases with "sleep disorder or sleep disturbance", "neurodegenerative diseases", "Parkinson's disease or PD", "Alzheimer's disease or AD", "multiple system atrophy or MSA" as retrieval words. The quality of the articles were evaluated with Jadad Scale. Results A total of 35 articles, including 2 systematic reviews, 5 randomized controlled trials, 13 clinical controlled trials, 13 case series and 2 epidemiological investigation studies were included for evaluation, 13 of which were high grade and 22 were low grade articles. Clinical evidences showed that: 1 advice on sleep hygiene, careful use of dopaminergic drugs and hypnotic sedative agents should be considered for PD. Bright light therapy (BLT may improve circadian rhythm sleep disorders and clonazepam may be effective for rapid eye movement sleep behavior disorder (RBD. However, to date, very few controlled studies are available to make a recommendation for the management of sleep disorders in PD; 2 treatments for sleep disorders in AD include drug therapy (e.g. melatonin, acetylcholinesterase inhibitors, antipsychotic drugs, antidepressants and non-drug therapy (e.g. BLT, behavior therapy, but very limited evidence shows the effectiveness of these treatments; 3 the first line treatment for sleep-related breathing disorder in MSA is nasal continuous positive airway pressure (nCPAP, and clonazepam is effective for RBD in MSA; 4 there is rare evidence related to the treatment of sleep disorders in dementia with Lewy body (DLB and amyotrophic lateral sclerosis (ALS. Conclusion Evidence-based medicine can provide the best clinical evidence on sleep disorders' treatment in neurodegenerative

  6. Surgical treatment of hepatocellular carcinoma:Evidence-based outcomes

    Institute of Scientific and Technical Information of China (English)

    Shintaro Yamazaki; Tadatoshi Takayama

    2008-01-01

    Surgeons may be severely criticized from the perspective of evidence-based medicine because the majority of surgical publications appear not to be convincing.In the top nine surgical journals in 1996,half of the 175publications refer to pilot studies lacking a control group,18% to animal experiments,and only 5% to randomized controlled trials (RCT).There are five levels of clinical evidence:level 1 (randomized controlled trial),level 2 (prospective concurrent cohort study),level 3 (retrospective historical cohort study),level 4(pre-post study),and level 5 (case report).Recently,a Japanese evidence-based guideline for the surgical treatment of hepatocellular carcinoma (HCC) was made by a committee (Chairman,Professor Makuuchi and five members).We searched the literature using the Medline Dialog System with four keywords:HCC,surgery,English papers,in the last 20 years.A total of 915 publications were identified systematically reviewed.At the first selection (in which surgery-dominant papers were Selected),478 papers survived.In the second selection (clearly concluded papers),181 papers survived.In the final selection (clinically significant papers),100 papers survived.The evidence level of the 100 surviving papers is shown here:level-1 papers (13%),level-2 papers (11%),level-3 papers (52%),and level-4 papers (24%);therefore,there were 24% prospective papers and 76%retrospective papers.Here,we present a part of the guideline on the five main surgical issues:indication to operation,operative procedure,peri-operative care,prognostic factor,and post-operative adjuvant therapy.

  7. 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.

  8. LEADING CHANGES IN ASSESSMENT USING AN EVIDENCE BASED APPROACH

    Directory of Open Access Journals (Sweden)

    J. O. Macaulay

    2015-08-01

    Full Text Available Introduction and objectivesIt is has been widely accepted that assessment of learning is a critical component of education and that assessment drives/guides student learning through shaping study habits and student approaches to learning. However, although most academics would agree that assessment is a critical aspect of their roles as teachers it is often an aspect of teaching that is regarded more as an additional task rather than an integral component of the teaching/learning continuum. An additional impediment to high quality assessment is the non-evidence based-approach to the decision making process. The overall aim of this project was to improve the quality of assessment in Biochemistry and Molecular Biology undergraduate education by promoting high quality assessment.Materials and methodsTo do this we developed and trialled an audit tool for mapping assessment practices. The audit tool was designed to gather data on current assessment practices and identify areas of good practice in which assessment aligned with the learning objectives and areas in need of improvement. This evidence base will then be used to drive change in assessment.Results and conclusionsUsing the assessment mapping tool we have mapped the assessment regime in a Biochemistry and Molecular Biology major at Monash University. Criteria used included: assessment type, format, timing, assessors, provision of feedback, level of learning (Bloom’s, approaches taken to planning assessment. We have mapped assessment of content and the systematic development of higher order learning and skills progression throughout the program of study. The data has enabled us to examine the assessment at unit (course level as well as the vertical development across the major. This information is now being used to inform a review of the units and the major.

  9. Treatment of neuromyelitis optica: an evidence based review

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2012-01-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS, and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

  10. CONVENTIONAL THERAPY OF PSORIATIC ARTHRITIS: EVIDENCE-BASED REVIEW

    Directory of Open Access Journals (Sweden)

    E.R. Soriano

    2011-09-01

    Full Text Available Psoriatic arthritis is a heterogeneous condition, the pattern of which is determined by any combination of pathology affecting peripheral joints, the enthesis and the spine. There is a paucity of evidence for most of the conventional agents used to treat psoriatic arthritis, with many of them being used on the basis of experience in rheumatoid arthritis. Herein, we summarise the evidence compiled relating to effectiveness of treatment for various manifestation of PsA. For those patients with progressive forms of arthritis who may benefit from intervention of newer biological therapies, the continued use of conventional therapy needs ever increasing scrutiny. Key words: Psoriatic arthritis, psoriasis, therapy

  11. Evidence-based review of clinical studies on pulpotomy.

    Science.gov (United States)

    2009-08-01

    Although pulpotomy procedures have a long history of clinical application, comparatively few dental clinical trials have evaluated this treatment approach. In this section, we provide an analysis of recent clinical studies evaluating pulpotomy procedures in dental patients.

  12. Plantar fasciitis: evidence-based review of diagnosis and therapy.

    Science.gov (United States)

    Cole, Charles; Seto, Craig; Gazewood, John

    2005-12-01

    Plantar fasciitis causes heel pain in active as well as sedentary adults of all ages. The condition is more likely to occur in persons who are obese or in those who are on their feet most of the day. A diagnosis of plantar fasciitis is based on the patient's history and physical findings. The accuracy of radiologic studies in diagnosing plantar heel pain is unknown. Most interventions used to manage plantar fasciitis have not been studied adequately; however, shoe inserts, stretching exercises, steroid injection, and custom-made night splints may be beneficial. Extracorporeal shock wave therapy may effectively treat runners with chronic heel pain but is ineffective in other patients. Limited evidence suggests that casting or surgery may be beneficial when conservative measures fail.

  13. Cardiovascular Considerations in Antidepressant Therapy: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Habibeh Yekehtaz

    2015-10-01

    Full Text Available There is a definite correlation between cardiovascular diseases and depressive disorders. Nevertheless, many aspects of this association have yet to be fully elucidated. Up to half of coronary artery disease patients are liable to suffer from some depressive symptoms, with approximately 20% receiving a diagnosis of major depressive disorders. Pharmacotherapy is a key factor in the management of major depression, not least in patients with chronic diseases who are likely to fail to show proper compliance and response to non-pharmacological interventions. Antidepressants are not deemed completely safe. Indeed, numerous side effects have been reported with the administration of antidepressants, among which cardiovascular adverse events are of paramount importance owing to their disabling and life-threatening nature. We aimed to re-examine some of the salient issues in antidepressant therapy vis-à-vis cardiovascular considerations, which should be taken into account when prescribing such medications.

  14. Cardiovascular Effects of Saffron: An Evidence-Based Review

    OpenAIRE

    Shahin Akhondzadeh; Maryam Kamalipour

    2011-01-01

    Herbal medicine can be a valuable source of assistance for traditional medicine. There are a number of herbs that can be used in conjunction with modern medicine. Herbs can also be taken to aid recovery from serious diseases. Although one should never aim to treat diseases such as cardiovascular disease solely with herbal medicine, the value of herbs used in tandem with modern medicine cannot be ignored. Saffron has been reported to help lower cholesterol and keep cholesterol levels healthy. ...

  15. Strawberry as a functional food: an evidence-based review.

    Science.gov (United States)

    Basu, Arpita; Nguyen, Angel; Betts, Nancy M; Lyons, Timothy J

    2014-01-01

    Emerging research provides substantial evidence to classify strawberries as a functional food with several preventive and therapeutic health benefits. Strawberries, a rich source of phytochemicals (ellagic acid, anthocyanins, quercetin, and catechin) and vitamins (ascorbic acid and folic acid), have been highly ranked among dietary sources of polyphenols and antioxidant capacity. It should however be noted that these bioactive factors can be significantly affected by differences in strawberry cultivars, agricultural practices, storage, and processing methods: freezing versus dry heat has been associated with maximum retention of strawberry bioactives in several studies. Nutritional epidemiology shows inverse association between strawberry consumption and incidence of hypertension or serum C-reactive protein; controlled feeding studies have identified the ability of strawberries to attenuate high-fat diet induced postprandial oxidative stress and inflammation, or postprandial hyperglycemia, or hyperlipidemia in subjects with cardiovascular risk factors. Mechanistic studies have elucidated specific biochemical pathways that might confer these protective effects of strawberries: upregulation of endothelial nitric oxide synthase (eNOS) activity, downregulation of NF-kB activity and subsequent inflammation, or inhibitions of carbohydrate digestive enzymes. These health effects may be attributed to the synergistic effects of nutrients and phytochemicals in strawberries. Further studies are needed to define the optimal dose and duration of strawberry intake in affecting levels of biomarkers or pathways related to chronic diseases.

  16. Computational AstroStatistics Fast and Efficient Tools for Analysing Huge Astronomical Data Sources

    CERN Document Server

    Nichol, R C; Connolly, A J; Davies, S; Genovese, C; Hopkins, A M; Miller, C J; Moore, A W; Pelleg, D; Richards, G T; Schneider, J; Szapudi, I; Wasserman, L H

    2001-01-01

    I present here a review of past and present multi-disciplinary research of the Pittsburgh Computational AstroStatistics (PiCA) group. This group is dedicated to developing fast and efficient statistical algorithms for analysing huge astronomical data sources. I begin with a short review of multi-resolutional kd-trees which are the building blocks for many of our algorithms. For example, quick range queries and fast n-point correlation functions. I will present new results from the use of Mixture Models (Connolly et al. 2000) in density estimation of multi-color data from the Sloan Digital Sky Survey (SDSS). Specifically, the selection of quasars and the automated identification of X-ray sources. I will also present a brief overview of the False Discovery Rate (FDR) procedure (Miller et al. 2001a) and show how it has been used in the detection of ``Baryon Wiggles'' in the local galaxy power spectrum and source identification in radio data. Finally, I will look forward to new research on an automated Bayes Netw...

  17. Evidence-based analysis of physical therapy in Parkinson's disease with recommendations for practice and research.

    NARCIS (Netherlands)

    Keus, S.H.; Bloem, B.R.; Hendriks, E.J.M.; Bredero-Cohen, A.B.; Munneke, M.

    2007-01-01

    Physical therapy is often prescribed in Parkinson's disease. To facilitate the uniformity and efficacy of this intervention, we analyzed current evidence and developed practice recommendations. We carried out an evidence-based literature review. The results were supplemented with clinical expertise

  18. The Delphi Method: An Approach for Facilitating Evidence Based Practice in Athletic Training

    Science.gov (United States)

    Sandrey, Michelle A.; Bulger, Sean M.

    2008-01-01

    Objective: The growing importance of evidence based practice in athletic training is necessitating academics and clinicians to be able to make judgments about the quality or lack of the body of research evidence and peer-reviewed standards pertaining to clinical questions. To assist in the judgment process, consensus methods, namely brainstorming,…

  19. Is Mathematical Representation of Problems an Evidence-Based Strategy for Students with Mathematics Difficulties?

    Science.gov (United States)

    Jitendra, Asha K.; Nelson, Gena; Pulles, Sandra M.; Kiss, Allyson J.; Houseworth, James

    2016-01-01

    The purpose of the present review was to evaluate the quality of the research and evidence base for representation of problems as a strategy to enhance the mathematical performance of students with learning disabilities and those at risk for mathematics difficulties. The authors evaluated 25 experimental and quasiexperimental studies according to…

  20. Transporting Evidence-Based Therapy for Adolescent Depression to the School Setting

    Science.gov (United States)

    Crisp, Heather L.; Gudmundsen, Gretchen R.; Shirk, Stephen R.

    2006-01-01

    This paper describes the Adolescent Mood Project (Project AMP), a study transporting an evidence-based, cognitive-behavioral treatment (CBT) for adolescent depression from the university lab setting to a school-based setting. Extant research on the psychosocial treatment of adolescent depression is reviewed and rationale for transporting evidence…

  1. Evidence-Based Practices for Teachers: A Synthesis of Trustworthy Online Sources

    Science.gov (United States)

    Ecker, Andrew J.

    2016-01-01

    The purpose of this study was to identify evidence-based practices (EBPs) for teachers of students with disabilities. A review of 13 trustworthy websites yielded 61 EBPs relevant, as determined by this author, to teachers of students with disabilities. The EBPs were organized into six categories: schoolwide framework, literacy instruction, math…

  2. Evidence based educational policy and practice: the case of applying the educational effectiveness knowledge base

    NARCIS (Netherlands)

    Scheerens, J.

    2014-01-01

    Evidence based educational policy and practice means, first of all, that new programs use relevant scientific knowledge for design purposes, or for critical review of initial program ideas (ex ante evaluation). Secondly, before programs are implemented on a large scale it is considered desirable to

  3. Initial steps towards an evidence-based classification system for golfers with a physical impairment

    NARCIS (Netherlands)

    Stoter, Inge K; Hettinga, Florentina J; Altmann, Viola; Eisma, Wim; Arendzen, Hans; Bennett, Tony; van der Woude, Lucas H; Dekker, Rienk

    2015-01-01

    PURPOSE: The present narrative review aims to make a first step towards an evidence-based classification system in handigolf following the International Paralympic Committee (IPC). It intends to create a conceptual framework of classification for handigolf and an agenda for future research. METHOD:

  4. Initial steps towards an evidence-based classification system for golfers with a physical impairment

    NARCIS (Netherlands)

    Stoter, Inge K.; Hettinga, Florentina J.; Altmann, Viola; Eisma, Wim; Arendzen, Hans; Bennett, Tony; van der Woude, Lucas H.; Dekker, Rienk

    2017-01-01

    Purpose: The present narrative review aims to make a first step towards an evidence-based classification system in handigolf following the International Paralympic Committee (IPC). It intends to create a conceptual framework of classification for handigolf and an agenda for future research. Method:

  5. Open access of evidence-based publications: the case of the orthopedic and musculoskeletal literature.

    Science.gov (United States)

    Yammine, Kaissar

    2015-11-01

    The open access model, where researchers can publish their work and make it freely available to the whole medical community, is gaining ground over the traditional type of publication. However, fees are to be paid by either the authors or their institutions. The purpose of this paper is to assess the proportion and type of open access evidence-based articles in the form of systematic reviews and meta-analyses in the field of musculoskeletal disorders and orthopedic surgery. PubMed database was searched and the results showed a maximal number of hits for low back pain and total hip arthroplasty. We demonstrated that despite a 10-fold increase in the number of evidence-based publications in the past 10 years, the rate of free systematic reviews in the general biomedical literature did not change for the last two decades. In addition, the average percentage of free open access systematic reviews and meta-analyses for the commonest painful musculoskeletal conditions and orthopedic procedures was 20% and 18%, respectively. Those results were significantly lower than those of the systematic reviews and meta-analyses in the remaining biomedical research. Such findings could indicate a divergence between the efforts engaged at promoting evidence-based principles and those at disseminating evidence-based findings in the field of musculoskeletal disease and trauma. The high processing fee is thought to be a major limitation when considering open access model for publication.

  6. 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.

  7. 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.

  8. Testing ASTRO-H Measurements of Bulk and Turbulent Gas Motions in Galaxy Clusters

    CERN Document Server

    Ota, Naomi; Lau, Erwin T

    2015-01-01

    Gas motions in galaxy clusters play important roles in determining the properties of the intracluster medium (ICM) and constraining cosmological parameters using X-ray and Sunyaev-Zel'dovich effect observations of galaxy clusters. The upcoming ASTRO-H mission, equipped with high-resolution X-ray spectrometer, will make the first direct measurements of gas motions in galaxy clusters through measurements of Doppler shifting and broadening of emission lines. However, the physical interpretation of the data will be challenging due to the complex thermal and velocity structures of the ICM. In this work, we investigate how well we can measure bulk and turbulent gas motions in the ICM with ASTRO-H, by analyzing mock ASTRO-H simulations of galaxy clusters extracted from cosmological hydrodynamic simulations. We assess how photon counts, spectral fitting methods, multiphase ICM structure, deprojections, and region selection affect the measurements of gas motions. We show that while ASTRO-H is capable of recovering the...

  9. Integrating evidence-based perfusion into practices: the International Consortium for Evidence-Based Perfusion.

    Science.gov (United States)

    Likosky, Donald S

    2006-12-01

    There is surmounting pressure for clinicians domestically and abroad not only to practice evidence-based perfusion, but also to supplement practice with documentation thereof. In this editorial, I shall describe an international initiative aimed at embracing this dictum from patients, regulatory bodies, and payers. "Research is the only hope that the future will be different than the past"- Daniel Mintz, MD "Practical men who believe themselves to be quite exempt from any intellectual influences are usually the slaves of some defunct economist.... It is ideas not vested interests which are dangerous for good or evil."-John Maynard Keynes.

  10. How to understand and conduct evidence-based medicine

    Science.gov (United States)

    2016-01-01

    Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM.

  11. Evidence Based Education Request Desk. EBE #890

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

    The National Center for Education Statistics (NCES) produced a study reviewing the K-12 funding formulas of all 50 states. In a section of the report, NCES examined whether states had designated funding for dual enrollment programs. They found that: "Sixty-four percent of institutions with dual enrollment programs reported that parents and…

  12. 循证医学主题综述知识系统UpToDate研究分析%The Study and Analysis of the UpToDate Knowledge System:an Evidence-based, Topic-reviewed Medical Knowledge System

    Institute of Scientific and Technical Information of China (English)

    苏大明; 张玉燕; 张华敏; 李宗友; 尚文玲; 侯酉娟; 郎朗; 郝峰

    2013-01-01

    利用信息技术和数据库技术提供的知识管理服务是医学知识服务的重要模式,构建专业的医学知识服务系统、搭建知识服务平台,是有效实施医学知识服务的重要手段。循证医学专题综述知识系统,已经成为国外提供医学知识服务的重要形式之一,出现了诸如UpToDate、DynaMed、BMJ Clinical Evidence、MD Consult等一批高质量的医学知识系统。以UpToDate知识系统为例,从知识系统的框架结构、系统功能、系统特色和评价研究等方面详细介绍了国外循证医学主题综述知识系统的发展现状,为国内医学知识服务平台和知识系统的开发提供参考和借鉴。%The services of knowledge management with information technology and database technology are the important modes of medical knowledge services. The constructions of professional medical knowledge service system and knowledge service platform are the important methods to carry out knowledge service effetely. The evidence-based, topic-reviewed medical knowledge system is one of the most important ways to provide medical knowledge service abroad. There are some high quality medical knowledge systems, such as UpToDate, DynaMed, BMJ Clinical Evidence and MD Consult. This article will introduce the progress of the evidence-based, topic-reviewed medical knowledge system out of China, and discuss the system framework, functions, system features and evaluation studies of knowledge system with the example of UpToDate Knowledge System, so as to provide a demonstration for the construction of domestic medical knowledge service platform and knowledge systems.

  13. An evidence-based conceptual framework of healthy cooking.

    Science.gov (United States)

    Raber, Margaret; Chandra, Joya; Upadhyaya, Mudita; Schick, Vanessa; Strong, Larkin L; Durand, Casey; Sharma, Shreela

    2016-12-01

    Eating out of the home has been positively associated with body weight, obesity, and poor diet quality. While cooking at home has declined steadily over the last several decades, the benefits of home cooking have gained attention in recent years and many healthy cooking projects have emerged around the United States. The purpose of this study was to develop an evidence-based conceptual framework of healthy cooking behavior in relation to chronic disease prevention. A systematic review of the literature was undertaken using broad search terms. Studies analyzing the impact of cooking behaviors across a range of disciplines were included. Experts in the field reviewed the resulting constructs in a small focus group. The model was developed from the extant literature on the subject with 59 studies informing 5 individual constructs (frequency, techniques and methods, minimal usage, flavoring, and ingredient additions/replacements), further defined by a series of individual behaviors. Face validity of these constructs was supported by the focus group. A validated conceptual model is a significant step toward better understanding the relationship between cooking, disease and disease prevention and may serve as a base for future assessment tools and curricula.

  14. Towards an evidence-based taxonomy of nonpharmacologic treatments for ADHD.

    Science.gov (United States)

    Faraone, Stephen V; Antshel, Kevin M

    2014-10-01

    We have created an evidence-based guide for clinicians to the relative utility of nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD). This article uses the term evidence-based in the sense applied by the Oxford Center for Evidenced-Based Medicine to help readers understand the degree to which nonpharmacologic treatments are supported by the scientific literature. This article also reviews the magnitude of the treatment effect expressed as the standardized mean difference effect size (also known as Cohen D). It then describes a meta-algorithm to describe how to integrate pharmacologic and nonpharmacologic treatments for ADHD.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice.

    Science.gov (United States)

    Ross, Jacqueline

    2010-04-01

    Information literacy, the recognition of information required, and the development of skills for locating, evaluating, and effectively using relevant evidence is needed for evidence-based practice (EBP). The purpose of this study was to examine perianesthesia nurses' perception of searching skills and access to evidence sources. The design was a descriptive, exploratory survey. The sample consisted of ASPAN members (n = 64) and nonmembers (n = 64). The Information Literacy for Evidence-Based Nursing Practice instrument was used. Findings were that ASPAN members read more journal articles, were more proficient with computers, and used Cumulative Index to Nursing and Allied Health Literature (CINAHL) more frequently than nonmembers. The three top barriers to use of research were: lack of understanding of organization or structure of electronic databases, lack of skills to critique and/or synthesize the literature, and difficulty in accessing research materials. In conclusion, education is needed for critiquing literature and understanding electronic databases and research articles to promote EBP in perianesthesia areas.

  17. The growth of a culture of evidence-based obstetrics in South Africa: a qualitative case study

    Directory of Open Access Journals (Sweden)

    Lewin Simon

    2011-03-01

    Full Text Available Abstract Background While the past two decades have seen a shift towards evidence-based obstetrics and midwifery, the process through which a culture of evidence-based practice develops and is sustained within particular fields of clinical practice has not been well documented, particularly in LMICs (low- and middle-income countries. Forming part of a broader qualitative study of evidence-based policy making, this paper describes the development of a culture of evidence-based practice amongst maternal health policy makers and senior academic obstetricians in South Africa Methods A qualitative case-study approach was used. This included a literature review, a policy document review, a timeline of key events and the collection and analysis of 15 interviews with policy makers and academic clinicians involved in these policy processes and sampled using a purposive approach. The data was analysed thematically. Results The concept of evidence-based medicine became embedded in South African academic obstetrics at a very early stage in relation to the development of the concept internationally. The diffusion of this concept into local academic obstetrics was facilitated by contact and exchange between local academic obstetricians, opinion leaders in international research and structures promoting evidence-based practice. Furthermore the growing acceptance of the concept was stimulated locally through the use of existing professional networks and meetings to share ideas and the contribution of local researchers to building the evidence base for obstetrics both locally and internationally. As a testimony to the extent of the diffusion of evidence-based medicine, South Africa has strongly evidence-based policies for maternal health. Conclusion This case study shows that the combined efforts of local and international researchers can create a culture of evidence-based medicine within one country. It also shows that doing so required time and perseverance

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    A Mooventhan

    2014-01-01

    Full Text Available 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.

  20. Research to support evidence-based practice in COPD community nursing.

    Science.gov (United States)

    Kirkpatrick, Pamela; Wilson, Ethel; Wimpenny, Peter

    2012-10-01

    Evidence-based practice (EBP) is a requirement of nurses through the generation of evidence to implementing it, in a bid to to improve clinical practice. However, EBP is difficult to achieve. This paper highlights an approach to generating evidence for enhancing community nursing services for patients with chronic obstructive pulmonary disease (COPD) through a collaborative partnership. A district nurse and two nursing lecturers formed a partnership to devise a systematic review protocol and perform a systematic review to enhance COPD practice. This paper illustrates the Joanna Briggs Institute (JBI) systematic review process, the review outcomes and the practitioner learning. Collaborative partnerships between academics, researchers and clinicians are a potentially useful model to facilitate enhanced outcomes in evidence-based practice and evidence application.

  1. Evidence-based approaches to dissemination and diffusion of physical activity interventions.

    Science.gov (United States)

    Owen, Neville; Glanz, Karen; Sallis, James F; Kelder, Steven H

    2006-10-01

    With the increasing availability of effective, evidence-based physical activity interventions, widespread diffusion is needed. We examine conceptual foundations for research on dissemination and diffusion of physical activity interventions; describe two school-based program examples; review examples of dissemination and diffusion research on other health behaviors; and examine policies that may accelerate the diffusion process. Lack of dissemination and diffusion evaluation research and policy advocacy is one of the factors limiting the impact of evidence-based physical activity interventions on public health. There is the need to collaborate with policy experts from other fields to improve the interdisciplinary science base for dissemination and diffusion. The promise of widespread adoption of evidence-based physical activity interventions to improve public health is sufficient to justify devotion of substantial resources to the relevant research on dissemination and diffusion.

  2. An evidence-based unified definition of lifelong and acquired premature ejaculation

    DEFF Research Database (Denmark)

    Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D

    2014-01-01

    INTRODUCTION: The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data...... at that time to develop a definition for acquired PE. AIM: The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. METHODS: In April 2013, the ISSM convened...... a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. RESULTS: The committee unanimously agreed that men with lifelong and acquired PE...

  3. Evidence-Based Practice in Rehabilitation Counseling: Perceptions and Practices

    Science.gov (United States)

    Bezyak, Jill L.; Kubota, Coleen; Rosenthal, David

    2010-01-01

    This study describes certified rehabilitation counselors' attitudes (n=163) about evidence based practice, knowledge and skills related to obtaining and evaluating evidence, use of literature in practice, availability of information, and perceived barriers to evidence-based practice. Responses related to knowledge and skills were mixed with strong…

  4. An innovative clinical practicum to teach evidence-based practice.

    Science.gov (United States)

    Brancato, Vera C

    2006-01-01

    A clinical practicum was successfully implemented for RN to BSN students to apply evidence-based practice to actual clinical problems affecting nursing practice. The author describes how this practicum was implemented and the requisite resources and support systems. This senior-level capstone course enabled students to understand and value a lifelong learning approach to evidence-based practice.

  5. The Evidence-Based Manifesto for School Librarians

    Science.gov (United States)

    Todd, Ross

    2008-01-01

    School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…

  6. 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.

  7. Management issues for women with epilepsy--focus on pregnancy (an evidence-based review): III. Vitamin K, folic acid, blood levels, and breast-feeding: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society.

    Science.gov (United States)

    Harden, Cynthia L; Pennell, Page B; Koppel, Barbara S; Hovinga, Collin A; Gidal, Barry; Meador, Kimford J; Hopp, Jennifer; Ting, Tricia Y; Hauser, W A; Thurman, David; Kaplan, Peter W; Robinson, Julian N; French, Jacqueline A; Wiebe, Samuel; Wilner, Andrew N; Vazquez, Blanca; Holmes, Lewis; Krumholz, Allan; Finnell, Richard; Shafer, Patricia O; Le Guen, Claire L

    2009-05-01

    A committee assembled by the American Academy of Neurology (AAN) reassessed the evidence related to the care of women with epilepsy (WWE) during pregnancy, including preconceptional folic acid and prenatal vitamin K use and the clinical implications of placental and breast-milk transfer of antiepileptic drugs (AEDs). The committee evaluated the available evidence based on a structured literature review and classification of relevant articles. Preconceptional folic acid supplementation is possibly effective in preventing major congenital malformations in the newborns of WWE taking AEDs. There is inadequate evidence to determine if the newborns of WWE taking AEDs have a substantially increased risk of hemorrhagic complications. Primidone and levetiracetam probably transfer into breast milk in clinically important amounts. Valproate, phenobarbital, phenytoin, and carbamazepine probably are not transferred into breast milk in clinically important amounts. Pregnancy probably causes an increase in the clearance and a decrease in the concentrations of lamotrigine, phenytoin, and, to a lesser extent carbamazepine, and possibly decreases the level of levetiracetam and the active oxcarbazepine metabolite, the monohydroxy derivative (MHD). Supplementing WWE with at least 0.4 mg of folic acid before pregnancy may be considered. Monitoring of lamotrigine, carbamazepine, and phenytoin levels during pregnancy should be considered, and monitoring of levetiracetam and oxcarbazepine (as MHD) levels may be considered. A paucity of evidence limited the strength of many recommendations.

  8. The Stocker AstroScience Center at Florida International University

    Science.gov (United States)

    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.

  9. The Astro-H Soft X-ray Spectrometer (SXS)

    Science.gov (United States)

    Porter, F. Scott; Fujimoto, Ryuichi; Kelley, Richard L.; Kilbourne, Caroline A.; Mitsuda, Kazuhiasa; Ohashi, Takaya; Astro-H/SXS Collaboration

    2009-12-01

    The Soft-X-ray Spectrometer (SXS) is a high spectral resolution, cryogenic x-ray spectrometer that will fly on the Japan/U.S. Astro-H observatory in 2014. The SXS is composed of a 36 pixel, imaging, x-ray calorimeter array that will operate at 0.05 K utilizing a 2-stage adiabatic demagnetization refrigerator and a redundant pre-cooler design using both a 40 liter liquid helium tank and a 1.7 K Joule-Thomson (JT) cryocooler. Additional redundant Stirling cycle coolers provide pre-cooling for the (JT) and cool the outer thermal shields for the JT and the helium tank. The detector system, while similar to that flown on Suzaku, is composed of larger 0.81×0.81mm pixels, but has significantly better performance, currently predicted to be better than 4 eV FWHM at 6 keV with 95% quantum efficiency. This instrument is the result of a close collaboration between many institutions in the U.S. and Japan over the last 25 years. Here we will present an overview of the SXS instrument, the SXS cooling system, and recent laboratory improvements to the detector system.

  10. Evidence-based management for preeclampsia.

    Science.gov (United States)

    von Dadelszen, Peter; Menzies, Jennifer; Gilgoff, Sarah; Xie, Fang; Douglas, M Joanne; Sawchuck, Diane; Magee, Laura A

    2007-05-01

    This review reflects both the variable presentation and the systemic nature of preeclampsia. Recommendations for the comprehensive evaluation and management of organ dysfunction associated with pre-eclampsia are included. The main points in the review are that: (1) Preeclampsia is a systemic disorder that may affect many organ systems. (2) For preeclampsia remote from term (management improves perinatal outcomes, but requires obsessive surveillance to mitigate maternal risks and is a "package." (3) Initial assessment and ongoing surveillance of women with preeclampsia should include assessment of all vulnerable maternal organs as well as of the fetus. (4) Initiate antihypertensive drug treatment immediately if sBP >160 mmHg or dBP more than 110 mmHg, or if sBP 140-159 mmHg and/or dBP 85-109 mmHg (prepregnancy renal disease or diabetes). (5) The treatment of nonsevere pregnancy hypertension should include a treatment goal of dBP 80-105 mmHg (depending on practitioner preference), with one of the following agents, Methyldopa, Labetalol, Nifedipine, or, with special indications (renal or cardiac diseases), diuretics. (6) Drugs to avoid: angiotensin-converting enzyme inhibitors; angiotensin II receptor antagonists; and atenolol. (7) For the acute management of severe hypertension, initially reduce dBP by 10 mmHg and maintain the blood pressure at or below that level with either Nifedipine or Labetalol. (8) For both prophylaxis against and treatment of eclampsia, MgSO4 (4 g IV stat, then 1 g/hr). (9) For recurrent seizures, MgSO4 (2g IV stat, then increase to 1.5 g/hr). (10) Total fluid intake should not exceed 80 ml/hr; tolerate urine outputs as low as 10 ml/hr. (11) Early-onset and/or severe preeclampsia predict later cardiovascular morbidity and mortality; it would seem prudent to offer such women screening and lipid lowering interventions.

  11. Is counter-terrorism policy evidence-based? What works, what harms, and what is unknown.

    Science.gov (United States)

    Lum, Cynthia; Kennedy, Leslie W; Sherley, Alison

    2008-02-01

    Is counter-terrorism policy evidence-based? What works, what harms, and what is unknown. One of the central concerns surrounding counter-terrorism interventions today, given the attention and money spent on them, is whether such interventions are effective. To explore this issue, we conducted a general review of terrorism literature as well as a Campbell systematic review on counter-terrorism strategies. In this article, we summarize some of our findings from these works. Overall, we found an almost complete absence of evaluation research on counter-terrorism strategies and conclude that counter-terrorism policy is not evidence-based. The findings of this review emphasise the need for government leaders, policy makers, researchers, and funding agencies to include and insist on evaluations of the effectiveness of these programs in their agendas.

  12. Evidence-based practice recommendations for memory rehabilitation.

    Science.gov (United States)

    Piras, F; Borella, E; Incoccia, C; Carlesimo, G A

    2011-03-01

    Memory impairment is a common consequence of neurological injury or disease, causing significant disability in everyday life, and is therefore a critical target for rehabilitation intervention. Here we report a review of the available evidence on the efficacy of restitution-oriented therapies and compensatory approaches for memory rehabilitation. A total of 110 studies was systematically classified and analyzed in order to generate evidence-based clinical recommendations for treatment providers. Different key aspects, such as types of brain damage, treatments characteristics and outcome measurements guided the evaluation of the literature as to appraise the potential interaction between patients characteristics, interventions and outcomes. The general conclusion is that memory re-training programs and compensatory approaches are probably effective in ameliorating memory disorders in patients with focal brain lesions, with some evidences of changes in memory functioning extending beyond the trained skills. Externally directed assistive devices and specific learning strategies are effective (with a level D and B of evidence, respectively) in retaining information relevant for daily needs also in patients with degenerative diseases. Some methodological concerns, such as the heterogeneity of subjects, interventions and outcomes studied, may limit the generalization of the present recommendations.

  13. Qigong in Cancer Care: Theory, Evidence-Base, and Practice

    Directory of Open Access Journals (Sweden)

    Penelope Klein

    2017-01-01

    Full Text Available Background: The purpose of this discussion is to explore the theory, evidence base, and practice of Qigong for individuals with cancer. Questions addressed are: What is qigong? How does it work? What evidence exists supporting its practice in integrative oncology? What barriers to wide-spread programming access exist? Methods: Sources for this discussion include a review of scholarly texts, the Internet, PubMed, field observations, and expert opinion. Results: Qigong is a gentle, mind/body exercise integral within Chinese medicine. Theoretical foundations include Chinese medicine energy theory, psychoneuroimmunology, the relaxation response, the meditation effect, and epigenetics. Research supports positive effects on quality of life (QOL, fatigue, immune function and cortisol levels, and cognition for individuals with cancer. There is indirect, scientific evidence suggesting that qigong practice may positively influence cancer prevention and survival. No one Qigong exercise regimen has been established as superior. Effective protocols do have common elements: slow mindful exercise, easy to learn, breath regulation, meditation, emphasis on relaxation, and energy cultivation including mental intent and self-massage. Conclusions: Regular practice of Qigong exercise therapy has the potential to improve cancer-related QOL and is indirectly linked to cancer prevention and survival. Wide-spread access to quality Qigong in cancer care programming may be challenged by the availability of existing programming and work force capacity.

  14. Evidence-based approach to cutaneous hyperandrogenism in women.

    Science.gov (United States)

    Schmidt, Timothy H; Shinkai, Kanade

    2015-10-01

    Hirsutism, acne, and androgenetic alopecia are classically considered signs of cutaneous hyperandrogenism (CHA). These common skin findings have significant impacts on the quality of patients' lives and pose the diagnostic challenge of excluding underlying disorders. Many with CHA have normal serum androgen levels. Hirsutism is more strongly associated with hyperandrogenism than are acne or androgenetic alopecia. Variable association of CHA with hyperandrogenemia results from the complexity of the underlying pathophysiology, including factors local to the pilosebaceous unit. CHA often occurs in the setting of polycystic ovary syndrome, the most common disorder of hyperandrogenism, but can also present in uncommon conditions, including nonclassic adrenal hyperplasia and androgen-producing tumors. A thorough history and full skin examination are important to guide appropriate diagnostic evaluation. Oral contraceptive pills with or without antiandrogens can provide therapeutic benefit for hirsutism and acne. Medical options for androgenetic alopecia remain limited. Multidisciplinary approaches may be needed given endocrine, metabolic, reproductive, and psychiatric disorders associated with CHA. More high-quality studies into the mechanisms of CHA and the benefits of antiandrogenic therapies are needed. We provide an evidence-based review of key diagnostic and therapeutic considerations in the treatment of women with CHA.

  15. Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety.

    Science.gov (United States)

    Higa-McMillan, Charmaine K; Francis, Sarah E; Rith-Najarian, Leslie; Chorpita, Bruce F

    2016-01-01

    Anxiety disorders are the most common mental health disorder among children and adolescents. We examined 111 treatment outcome studies testing 204 treatment conditions for child and adolescent anxiety published between 1967 and mid-2013. Studies were selected for inclusion in this review using the PracticeWise Evidence-Based Services database. Using guidelines identified by this journal (Southam-Gerow & Prinstein, 2014), studies were included if they were conducted with children and/or adolescents (ages 1-19) with anxiety and/or avoidance problems. In addition to reviewing the strength of the evidence, the review also examined indicators of effectiveness, common practices across treatment families, and mediators and moderators of treatment outcome. Six treatments reached well-established status for child and adolescent anxiety, 8 were identified as probably efficacious, 2 were identified as possibly efficacious, 6 treatments were deemed experimental, and 8 treatments of questionable efficacy emerged. Findings from this review suggest substantial support for cognitive-behavioral therapy (CBT) as an effective and appropriate first-line treatment for youth with anxiety disorders. Several other treatment approaches emerged as probably efficacious that are not primarily CBT based, suggesting that there are alternative evidence-based treatments that practitioners can turn to for children and adolescents who do not respond well to CBT. The review concludes with a discussion of treatments that improve functioning in addition to reducing symptoms, common practices derived from evidence-based treatments, mediators and moderators of treatment outcomes, recommendations for best practice, and suggestions for future research.

  16. Evidence-based treatments for cluster headache

    Directory of Open Access Journals (Sweden)

    Gooriah R

    2015-11-01

    Full Text Available Rubesh Gooriah, Alina Buture, Fayyaz Ahmed Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK Abstract: Cluster headache (CH, one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition. Keywords: cluster headache, pathogenesis, vasoactive intestinal peptide, suprachiasmatic nucleus

  17. Evidence-based toxicology: strait is the gate, but the road is worth taking.

    Science.gov (United States)

    Silbergeld, Ellen; Scherer, Roberta W

    2013-01-01

    The concept of evidence-based toxicology (EBT) was proposed in 2006, but progress since that time has been impeded by differing definitions and goals. This paper describes the parallels and discontinuities between the approach and methods of evidence-based medicine and health care and those proposed for toxicology. The critical element of an evidence-based approach for either discipline is the adoption of unbiased, transparent methodologies during the collection, appraisal, and pooling of evidence. This approach, implemented during the conduct of a systematic review, allows evaluation of the breadth and quality of available evidence. At present, systematic reviews are rarely done in toxicology by regulatory agencies, international organizations, or academic scientists. Adopting an EBT approach will necessitate significant changes in practice as well as attention to distinctive characteristics of toxicological studies, notably their emphasis on identifying harms and their reliance on experimental animal studies. An evidence-based approach does not obviate the role of judgment and values in decision making; its goal is to ensure provision of all available information in a transparent and unbiased manner.

  18. An evidence-based approach to treating otitis media.

    Science.gov (United States)

    Rosenfeld, R M

    1996-12-01

    More than 20 years ago, a shrewd clinician remarked, "There is little evidence that those antimicrobial agents which hypothetically or in vitro are more effective ... are superior in the treatment of otitis when compared to penicillin alone." Several hundred clinical trials later, the advantages of broad spectrum drugs remain unproved, and questions remains as to whether antibiotics are required for most episodes of AOM. Further, antibiotics have been demoted to the status of optional therapy for OME. This situation is unlikely to change as new studies with new antibiotics proliferate. What is clear, however, is that accelerated patterns of bacterial resistance mandate an evidence-based approach to managing otitis media. Bacteria have an uncanny ability to learn new mechanisms of antibiotic resistance. A large part of bacterial "education" has undoubtedly been fueled by antibiotic prescriptions from well-intentioned physicians, with unrealistic expectations of drug efficacy. A judicious approach to antibiotic treatment of otitis media can result only from knowing the spontaneous course of the disorder and incremental effect of antibiotics on clinical outcomes. In this article, a series of unifying concepts are developed to help practicing clinicians with an evidence-based approach to managing otitis media. Critical review of the published evidence suggests that the most favorable outcomes from medical treatment will occur if practitioners: appreciate the favorable natural history of untreated otitis media realize that OME may take months to resolve following a single AOM episode modify risk factors to improve the odds of spontaneous resolution use pneumatic otoscopy and confirmatory tympanometry to diagnose OME recognize the limited impact of antibiotic therapy on treatment and prevention balance the benefits of antibiotics against the risk of accelerated bacterial resistance avoid repetitive, prolonged, or prophylactic antibiotic treatment of chronic OME avoid

  19. Evidence-based Comprehensive Approach to Forearm Arterial Laceration

    Directory of Open Access Journals (Sweden)

    Janice N. Thai

    2015-12-01

    Full Text Available Introduction: Penetrating injury to the forearm may cause an isolated radial or ulnar artery injury, or a complex injury involving other structures including veins, tendons and nerves. The management of forearm laceration with arterial injury involves both operative and nonoperative strategies. An evolution in management has emerged especially at urban trauma centers, where the multidisciplinary resource of trauma and hand subspecialties may invoke controversy pertaining to the optimal management of such injuries. The objective of this review was to provide an evidence-based, systematic, operative and nonoperative approach to the management of isolated and complex forearm lacerations. A comprehensive search of MedLine, Cochrane Library, Embase and the National Guideline Clearinghouse did not yield evidence-based management guidelines for forearm arterial laceration injury. No professional or societal consensus guidelines or best practice guidelines exist to our knowledge. Discussion: The optimal methods for achieving hemostasis are by a combination approach utilizing direct digital pressure, temporary tourniquet pressure, compressive dressings followed by wound closure. While surgical hemostasis may provide an expedited route for control of hemorrhage, this aggressive approach is often not needed (with a few exceptions to achieve hemostasis for most forearm lacerations. Conservative methods mentioned above will attain the same result. Further, routine emergent or urgent operative exploration of forearm laceration injuries are not warranted and not cost-beneficial. It has been widely accepted with ample evidence in the literature that neither injury to forearm artery, nerve or tendon requires immediate surgical repair. Attention should be directed instead to control of bleeding, and perform a complete physical examination of the hand to document the presence or absence of other associated injuries. Critical ischemia will require expeditious

  20. 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)

  1. Organizational change tactics: the evidence base in the literature.

    Science.gov (United States)

    Packard, Thomas; Shih, Amber

    2014-01-01

    Planned organizational change processes can be used to address the many challenges facing human service organizations (HSOs) and improve organizational outcomes. There is massive literature on organizational change, ranging from popular management books to academic research on specific aspects of change. Regarding HSOs, there is a growing literature, including increasing attention to implementation science and evidence-based practices. However, research which offers generalizable, evidence-based guidelines for implementing change is not common. The purpose of the authors was to assess the evidence base in this organizational change literature to lay the groundwork for more systematic knowledge development in this important field.

  2. NCLEX-RN success: evidence-based strategies.

    Science.gov (United States)

    Thomas, Marie H; Baker, Susan Scott

    2011-01-01

    Evidence-based nursing requires that students think reflectively and use clinical inquiry to develop clinical reasoning and decision-making skills. Likewise, nursing students need a strategy to be successful in passing the NCLEX-RN. The authors identify strategies based on nursing research to facilitate student success. While learning the evidence-based nursing process, the student must begin to think like a nurse while answering clinical practice questions. Using the skills taught for evidence-based nursing can be a powerful tool to approach the NCLEX-RN and succeed.

  3. Factors influencing the development of evidence-based practice among nurses: a self-report survey

    Directory of Open Access Journals (Sweden)

    Dalheim Anne

    2012-10-01

    Full Text Available Abstract Background Health authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers. Aims The present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital. Methods Cross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP. The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation. Results Nurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse’s age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence. Conclusion Skills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice.

  4. Implementing evidence-based practices in an emergency department

    DEFF Research Database (Denmark)

    Kirk, Jeanette W.; Nilsen, Per

    2016-01-01

    and screening routines provided a flow stop. Four associated contradictions were identified: insufficient time to implement guidelines; guilty conscience due to perceived nonadherence to evidence-based practices; newcomers having different priorities; and conflicting views of what constituted being...

  5. Stroboscopy for benign laryngeal pathology in evidence based health care

    OpenAIRE

    Printza, A; Triaridis, S; Themelis, C; Constantinidis, J

    2012-01-01

    Background and Aims: Voice disorders are common. The aim of this study is to evaluate the diagnostic value of stroboscopy for voice disorders related with benign pathology and apply results in evidence based health care.

  6. Knowledge translation and interprofessional collaboration: Where the rubber of evidence-based care hits the road of teamwork.

    Science.gov (United States)

    Zwarenstein, Merrick; Reeves, Scott

    2006-01-01

    Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in interprofessional relations. Interprofessional education and collaboration interventions aim to improve interprofessional relations, which may in turn facilitate the work of knowledge translation and thus evidence-based practice. We summarize systematic review work on the effects of interventions for interprofessional education and collaboration. The current evidence base contains mainly descriptive studies of these interventions. Knowledge is limited regarding the impact on care and outcomes and the extent to which the interventions increase the practice of evidence-based care. Rigorous multimethod research studies are needed to develop and strengthen the current evidence base in this field. We describe a Health Canada-funded randomized trial in which quantitative and qualitative data will be gathered in 20 general internal medicine units located at 5 Toronto, Ontario, teaching hospitals. The project examines the impact of interprofessional education and collaboration interventions on interprofessional relationships, health care processes (including evidence-based practice), and patient outcomes. Routes are suggested by which interprofessional education and collaboration interventions might affect knowledge translation and evidence-based practice.

  7. 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.

  8. 循证医学课程对医学生核心能力影响的系统评价%Effectiveness of Evidence-based Medicine Curriculum for Improving Global Essential Competencies of Undergraduate Medical Students:A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    郑会贤; 陈进; 李幼平; 陈燕玲

    2009-01-01

    Objective To assess the effectiveness of evidence-based medicine for improving core competencies of undergraduate medical students.Methods MEDLINE,ERIC,Academic Source Premier,Campbell Library databases and three Chinese Databases(CBM,CNKI,VIP) were searched from January 1992 to May 2009.We also used Google to searching related literature.The design is a systematic review of randomized,non-randomized,and before-after studies.Two reviewers did study selection,quality assessment,and data abstraction independently.Di erent opinions were resolved by consensus.We used an adaptation of the quality measure from Gemma Flores-Mateo et al to assess the quality of selected studies.And descriptive analysis was conducted.Results A total of 17 studies met the selection criteria,2 of them were of high quality,the others were of moderate quality.Studies involved Competencies of Scienti c Foundation of Medicine,Clinical Skills,and Management of Information.Conclusion Competencies of Scientific Foundation of Medicine,Clinical Skills,and Management of Information are improved by evidence-based medicine teaching.No study on professional values,attitudes,behavior and ethics,population health and health systems,management of information,critical thinking and research is available.It is impossible to assess the four domains above.%目的 系统评价循证医学课程对医学生核心能力的影响.方法 计算机检索CBM、CNKI、VIP、MEDLINE、ERIC、Academic Source Premier、Carnpbell Library,同时使用Google学术搜索有关循证医学教育的随机对照、非随机对照(与对照组比较或课程前后比较)研究,检索时间限定为1992年1月至2009年5月.两名研究者独立筛选文献,提取数据并交叉核对,而后采用Gemma Flores-Mateo等人改编的质量评价表评价文献质量,对纳入研究进行描述性分析.结果 共纳入17篇文献,其中高质量文献2篇,中等质量15篇.内容包括医学科学基础知识、临床技能、信息管

  9. The Astro-H high temperature superconductor lead assemblies

    Science.gov (United States)

    Canavan, E. R.; James, B. L.; Hait, T. P.; Oliver, A.; Sullivan, D. F.

    2014-11-01

    The Soft X-ray Spectrometer (SXS) instrument, one of several instruments on JAXA's Astro-H mission, will observe diffuse X-ray sources with unparalleled spectral resolution using a microcalorimeter array operating at 50 mK. The array is cooled with a multi-stage Adiabatic Demagnetization Refrigerator mounted on a 40 l helium tank. The tank is at the center of a typical 'shell in shell' cryostat, with the innermost shield cooled by a JT cryocooler, and successive outer shields cooled by stirling-cycle cryocoolers. To achieve a multi-year liquid helium lifetime and to avoid exceeding the limited capacity of the JT cooler, very strict requirements are placed on every source of heat leak into these surfaces from the higher temperature shields. However, each ADR stage draws a maximum of 2 A, and the Wiedemann-Franz Law precludes even an optimized set of normal-metal leads capable of such high current from achieving the required low thermal conductance. Instead, a set of lead assemblies have been developed based on narrow high temperature superconductor (HTS) tapes derived from commercially available coated conductors. Although the HTS tapes are flexible and have high tensile strength, they are extremely sensitive to damage through a number of mechanisms. A robust set of assemblies have been developed that provide mechanical support to the tapes, provide appropriate interfaces at either end, and yet still meet the challenging thermal requirements. An Engineering Model (EM) set of HTS lead assemblies have survived environmental testing, both as individual units and as part of the EM cryostat, and have performed without problem in recent operation of the EM instrument. The Flight Model (FM) HTS lead assemblies are currently nearing completion.

  10. Japanese infrared survey mission IRIS (ASTRO-F)

    Science.gov (United States)

    Murakami, Hiroshi

    1998-08-01

    The IR Imaging Survey (IRIS) is the second IR astronomy mission of the Institute of Space and Astronomical Science (ISAS). The IRIS is a 70 cm cooled telescope dedicated for IR sky survey. This project has been approved as ISAS's 21st science mission 'ASTRO-F', and prototype model development has been ongoing since 1997. The IRIS will be launched with ISAS's launch vehicle M-V, into a sun-synchronous polar orbit with an altitude of 750 km. The IRIS telescope has a 70 cm aperture and is cooled to 6K using Stirling-cycle coolers and liquid helium. The primary and secondary mirrors are light-weight mirrors make of silicon carbide. Two focal- plane instruments are installed. One is the far-IR surveyor (FIS) which will survey the entire sky in the wavelength range from 50 to 200 micron with angular resolutions of 30- 50 arcsec. The other focal-plane instrument is the IR camera (IRC). It employs large-format detector arrays and will take deep images of selected sky regions in the near and mid IR range. The field of view of the IRC is 10 arcmin and the spatial resolution is approximately 2 arcsec. The IRIS has much higher sensitivity than that of the IRAS survey. The detection limits are 1-100 micro Jy in the near-MID IR and 10-100 mJy in the far IR. With the IRIS survey, great progress is expected in the research on evolution of galaxies, formation of stars and planets, dark matter and brown dwarfs. The IRIS is now scheduled to be launched in early 2003.

  11. Putting the practice into evidence-based dentistry.

    Science.gov (United States)

    Coulter, Ian D

    2007-01-01

    Whenever a new field emerges in health care, a period is experienced in which the field tries to define itself. This is the position evidence-based dental practice finds itself in at the moment. In this paper, it is argued that, for dentistry to enter into the brave new world of evidence-based practice, it will require some rethinking of the research enterprise in the profession.

  12. How to Reach Evidence-Based Usability Evaluation Methods.

    Science.gov (United States)

    Marcilly, Romaric; Peute, Linda

    2017-01-01

    This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing evidence. Reciprocally, it presents how evidence-based usability knowledge will help improve usability practice. Finally, it underlines that evaluation and evidence participate in a virtuous circle that will help improve scientific knowledge and evaluation practice.

  13. An evidence-based algorithm for the treatment of neuropathic pain

    DEFF Research Database (Denmark)

    Finnerup, Nanna Brix; Otto, Marit; Jensen, Troels Staehelin;

    2007-01-01

    OBJECTIVE: The purpose of this article is to discuss an evidence-based algorithm that can be implemented by the primary care physician in his/her daily clinical practice for the treatment of patients with neuropathic pain conditions. METHOD: A treatment algorithm for neuropathic pain was formulated...... on the basis of a review of 105 high-quality, randomized, placebo-controlled clinical trials. The number needed to treat (NNT) and number needed to harm (NNH) were used to compare the safety and effectiveness of current treatments for neuropathic pain syndromes. Most of the clinical trials reviewed...... with different experimental designs and outcomes. CONCLUSION: Patients presenting with neuropathic pain are becoming a more frequent occurrence for the primary care physician as the population ages. Evidence-based treatment options allow for the most efficient and effective pharmacotherapy regimen...

  14. ASTRO-H White Paper - Stars -- Accretion, Shocks, Charge Exchanges and Magnetic Phenomena

    CERN Document Server

    Tsuboi, Y; Audard, M; Hamaguchi, K; Leutenegger, M A; Maeda, Y; Mori, K; H,; Murakami,; Sugawara, Y; Tsujimoto, M

    2014-01-01

    X-ray emission from stars has origins as diverse as the stars themselves: accretion shocks, shocks generated in wind-wind collisions, or release of magnetic energy. Although the scenarios responsible for X-ray emission are thought to be known, the physical mechanisms operating are in many cases not yet fully understood. Full testing of many of these mechanisms requires high energy resolution, large effective area, and coverage of broad energy bands. The loss of the X-ray calorimeter spectrometer on board ASTRO-E2 was a huge blow to the field; it would have provided a large sample of high resolution spectra of stars with high signal-to-noise ratio. Now, with the advent of the ASTRO-H Soft X-ray Spectrometer and Hard X-ray Imager, we will be able to examine some of the hot topics in stellar astrophysics and solve outstanding mysteries.

  15. A discourse on the contributions of evidence-based medicine to wound care.

    Science.gov (United States)

    Al-Benna, Sammy

    2010-06-01

    Although a healthcare system crippled by lack of resources cannot perform effectively, spending more money in an ineffective system may not lead to better outcomes. To ensure systemwide resource maximization, evidence-based medicine and guidelines that consider treatment cost-effectiveness and recommend treatment for persons with the most to gain are required. To demonstrate that increasing use of evidence-based medicine can improve wound care, the effect of informed treatment decisions on improving patient care was reviewed. A Medline and OvidSP literature search was conducted of English-language literature using the MESH terms evidence-based practice and wounds and injuries. The adoption of evidence-based medicine by individual healthcare professionals can help ensure the limited resources available are used efficiently, enhancing confidence that additional funds will translate into more people receiving better wound care and having better health. Wound care professionals are encouraged to participate in conducting well-designed and controlled clinical studies of wound dressings and to resist the routine use of new, usually more expensive, dressings in the absence of good quality clinical evidence for their benefit over existing products.

  16. Generating Executable Knowledge for Evidence-Based Medicine Using Natural Language and Semantic Processing

    OpenAIRE

    Borlawsky, Tara; Friedman, Carol; Lussier, Yves A.

    2006-01-01

    With an increase in the prevalence of patients having multiple medical conditions, along with the increasing number of medical information sources, an intelligent approach is required to integrate the answers to physicians' patient-related questions into clinical practice in the shortest, most specific way possible. Cochrane Scientific Reviews are currently considered to be the “gold standard” for evidence-based medicine (EBM), because of their well-defined systematic approach to assessing th...

  17. EFFECTIVE BLENDED LEARNING PRACTICES: Evidence-based Perspectives in ICT-facilitated Education

    OpenAIRE

    2009-01-01

    EFFECTIVE BLENDED LEARNING PRACTICES:Evidence-based Perspectives in ICT-facilitated EducationEdited by Elizabeth Stacey and Philippa Gerbic, Information ScienceReference; 1 edition (March 30, 2009), ISBN-10: 1605662968, 358 pp.Reviewed by Yasin OZARSLANFaculty of Education,Eskisehir Osmangazi University,Eskisehir-TURKEYBlended learning refers to the integration of faceto-face and online learning activities with the goal of maximizing the value of students' experiences in both settings. This b...

  18. Current knowledge on evidence-based shockwave treatments for shoulder pathology.

    Science.gov (United States)

    Moya, Daniel; Ramón, Silvia; Guiloff, Leonardo; Gerdesmeyer, Ludger

    2015-12-01

    Shoulder pain is one of the most common musculoskeletal pathologies. Treatment by ESWT (extracorporeal shockwave therapy) has emerged as an alternative when conservative treatment fails in rotator cuff calcific tendinopathy, prior to invasive procedures. The clinical efficacy of ESWT in non-calcific tendinopathy remains controversial. The good results in the treatment of rotator cuff calcifications, have led to indications of ESWT being expanded to other shoulder pathologies. We review the current state of indications and evidence based practice.

  19. Evidence Base of Clinical Studies on Tai Chi: A Bibliometric Analysis

    OpenAIRE

    Guo-Yan Yang; Li-Qiong Wang; Jun Ren; Yan Zhang; Meng-Ling Li; Yu-Ting Zhu; Jing Luo; Yan-Jun Cheng; Wen-Yuan Li; Peter M. Wayne; Jian-Ping Liu

    2015-01-01

    BACKGROUND: The safety and health benefits of Tai Chi mind-body exercise has been documented in a large number of clinical studies focused on specific diseases and health conditions. The objective of this systematic review is to more comprehensively summarize the evidence base of clinical studies of Tai Chi for healthcare. METHODS AND FINDINGS: We searched for all types of clinical studies on Tai chi in PubMed, the Cochrane Library and four major Chinese electronic databases from their incept...

  20. Community Education and Evidence-based Knowledge Use

    Directory of Open Access Journals (Sweden)

    N mohaghegh

    2015-09-01

    Full Text Available Introduction: Utilizing as well as transferring knowledge can be provided via motivating teachers, educating researchers, better utilizing of evidence and creating communication between members of the scientific communities based on the needs of the community and community education. Therefore, the present study mainly aimed at evaluating the process of knowledge production and use of evidence in the research centres of Tehran and Iran University of Medical Sciences. Moreover, this study intended to investigate its application in improving the health system and community education of students.   Methods: In this descriptive cross-sectional study, the study population finally consisted of 68 research centres affiliated to Tehran and Iran University of Medical Sciences. In order to glean the study data, a questionnaire was utilized by Nejat et al. in two fields of “knowledge production” and “promote using of evidence”, and the study data were analyzed using SPSS (version 18.   Results: The production and use of knowledge status in Tehran and Iran medical universities in regard with “knowledge and evidence production” used in decision-making was reported in a favourable condition. Moreover, an unfavourable condition was revealed regarding “promoting use of evidence” which needs proper intervention.   Conclusion: The study finding revealed that at the beginning of the formulation of each research, identifying the specific audience of the study results causes the produced evidence and knowledge to be applicable. This leads to conducting research in accordance with the needs of community. As a result, status of medical universities in Iran necessitates to be reviewed. Ameliorating production status and promoting evidence-based knowledge can lead to a significant qualitative development in community education.