WorldWideScience

Sample records for astro evidence-based review

  1. Evidence-based review of three-dimensional conformal radiotherapy for localized prostate cancer: An ASTRO outcomes initiative

    International Nuclear Information System (INIS)

    Purpose: To perform a systematic review of the evidence to determine the efficacy and effectiveness of three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer; provide a clear presentation of the key clinical outcome questions related to the use of 3D-CRT in the treatment of localized prostate cancer that may be answered by a formal literature review; and provide concise information on whether 3D-CRT improves the clinical outcomes in the treatment of localized prostate cancer compared with conventional RT. Methods and Materials: We performed a systematic review of the literature through a structured process developed by the American Society for Therapeutic Radiology and Oncology's Outcomes Committee that involved the creation of a multidisciplinary task force, development of clinical outcome questions, a formal literature review and data abstraction, data review, and outside peer review. Results: Seven key clinical questions were identified. The results and task force conclusions of the literature review for each question are reported. Conclusion: The technological goals of reducing morbidity with 3D-CRT have been achieved. Randomized trials and follow-up of completed trials remain necessary to address these clinical outcomes specifically with regard to patient subsets and the use of hormonal therapy

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

    International Nuclear Information System (INIS)

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

  3. 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.

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

    OpenAIRE

    Preeti Devnani; Racheal Fernandes

    2015-01-01

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

  5. AMNIOTIC FLUID EMBOLISM: AN EVIDENCE-BASED REVIEW

    OpenAIRE

    Conde-Agudelo, Agustin; Romero, Roberto

    2009-01-01

    We conducted an evidence-based review of information bout amniotic fluid embolism (AFE). The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. The case fatality rate and perinatal mortality associated with AFE are 13–30% and 9–44%, respectively. Risk factors associated with an increased risk of AFE include advanced maternal age, placental abnormalities, operative deliveries, eclampsia, polyhydramnios, cervical lacerations, and uterine ru...

  6. An evidence-based review of dental matrix systems.

    Science.gov (United States)

    Owens, Barry M; Phebus, Jeffrey G

    2016-01-01

    The restoration of proximal surface cavities, originating from Class II carious lesions, to "normal" anatomical specifications is a fundamental objective for the dental practitioner. Cognitive interpretation of tooth morphology attained from evidence-based resources, together with the necessary psychomotor skills for correct design and completion, are considered essential strategies for restoration success. Also, the visualization of the original tooth structure, if present, should substantially benefit the dentist in the creation of a clinically satisfactory restoration. The purpose of this evidence-based review is to define the cause and effect of decisions based on optimum treatment standards of care for the patient. The concepts of form and function, as related to the oral environment, and the consequences of unsatisfactory dental restorative care will be scrutinized. This article will identify and explain the different challenges and solutions for restoration of dental proximal lesions and provide an overview of past, present, and future procedures. PMID:27599285

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

    Directory of Open Access Journals (Sweden)

    Preeti Devnani

    2015-01-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Synthesizing Quantitative Evidence for Evidence-based Nursing: Systematic Review.

    Science.gov (United States)

    Oh, Eui Geum

    2016-06-01

    As evidence-based practice has become an important issue in healthcare settings, the educational needs for knowledge and skills for the generation and utilization of healthcare evidence are increasing. Systematic review (SR), a way of evidence generation, is a synthesis of primary scientific evidence, which summarizes the best evidence on a specific clinical question using a transparent, a priori protocol driven approach. SR methodology requires a critical appraisal of primary studies, data extraction in a reliable and repeatable way, and examination for validity of the results. SRs are considered hierarchically as the highest form of evidence as they are a systematic search, identification, and summarization of the available evidence to answer a focused clinical question with particular attention to the methodological quality of studies or the credibility of opinion and text. The purpose of this paper is to introduce an overview of the fundamental knowledge, principals and processes in SR. The focus of this paper is on SR especially for the synthesis of quantitative data from primary research studies that examines the effectiveness of healthcare interventions. To activate evidence-based nursing care in various healthcare settings, the best and available scientific evidence are essential components. This paper will include some examples to promote understandings. PMID:27349664

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

    Directory of Open Access Journals (Sweden)

    Talapatra Kaustav

    2006-01-01

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

  12. IAU astroEDU: an open-access platform for peer-reviewed astronomy education activities

    Science.gov (United States)

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

    2015-08-01

    astroEDU is an open access platform for peer-reviewed astronomy education activities. It addresses key problems in educational repositories such as variability in quality, not maintained or updated regularly, limited content review, and more. This is achieved through a peer-review process similar to what scholarly articles are based on. Activities submitted are peer-reviewed by an educator and a professional astronomer which gives the credibility to the activities. astroEDU activities are open-access in order to make the activities accessible to educators around the world while letting them discover, review, distribute and remix the activities. The activity submission process allows authors to learn how to apply enquiry-based learning into the activity, identify the process skills required, how to develop core goals and objectives, and how to evaluate the activity to determine the outcome. astroEDU is endorsed by the International Astronomical Union meaning each activity is given an official stamp by the international organisation for professional astronomers.

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

    Directory of Open Access Journals (Sweden)

    Meredith Harrell

    2014-01-01

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

  14. Developing a Comprehensive Search Strategy for Evidence Based Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Sekhar Thadiparthi

    2008-03-01

    % MEDLINE, 18% PsycINFO, 8% EMBASE, 2% Sociological Abstracts.Conclusions ‐ Development of a comprehensive review of the literature requires searching multiple databases and methods of manual searching in order to locate all relevant citations. Understanding the project needs, recognizing the limitations and strengths of specific electronic databases, and being aware of other methods for developing and refining a search are vital in planning an effective and comprehensive search strategy. Reporting standards for literature searches as part of the broader push for procedurally transparent and reproducible systematic reviews is not only advisable, but good evidence based practice.

  15. Evidence-based care in Iran: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Morteza Ghojazadeh

    2014-08-01

    Conclusion: Weak knowledge, weak attitude, and time shortage .are among the most significant barriers of evidence-based care in Iran. These problems require more accurate planning and more favorable policies on the part of medical science authorities.

  16. Astro-WISE and Grid

    NARCIS (Netherlands)

    Begeman, Kor; Belikov, Andrey N.; Dijkstra, Fokke; Meyer-Zhao, Zheng; Valentijn, Edwin A.; Vriend, Willem-Jan

    2013-01-01

    The paper reviews the Astro-WISE infrastructure and demonstrates that the Astro-WISE Information System provides a Grid itself. We describe the integration of Astro-WISE with an external Grid infrastructure (BiGGrid). The integration is performed on all infrastructural layers (data storage, metadata

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

    Science.gov (United States)

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

    2012-01-01

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

  18. 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

  19. Outcome of non-invasive treatment modalities on back pain: an evidence-based review

    OpenAIRE

    van Tulder, Maurits W.; Koes, Bart; Malmivaara, Antti

    2005-01-01

    At present, there is an increasing international trend towards evidence-based health care. The field of low back pain (LBP) research in primary care is an excellent example of evidence-based health care because there is a huge body of evidence from randomized trials. These trials have been summarized in a large number of systematic reviews. This paper summarizes the best available evidence from systematic reviews conducted within the framework of the Cochrane Back Review Group on non-invasive...

  20. [Evidence-Based Review of Laryngeal Cancer Surgery].

    Science.gov (United States)

    Wiegand, S

    2016-04-01

    Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number of organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery and transoral robotic surgery, have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the U.S.. Improving the evidence base in laryngeal cancer surgery by successful establishment of surgical trials should be the future goal. PMID:27128401

  1. An evidence-based systematic review of spearmint by the natural standard research collaboration.

    Science.gov (United States)

    Ulbricht, Catherine; Costa, Dawn; M Grimes Serrano, Jill; Guilford, Jacquelyn; Isaac, Richard; Seamon, Erica; Varghese, Minney

    2010-06-01

    An evidence-based systematic review of spearmint (Mentha spicata, Mentha viridis) including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing. PMID:22435615

  2. 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.

  3. 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.

  4. 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

    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

  5. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2012-04-01

    Skype is a popular and free software application that allows PCs and mobile devices to be used for video communication over the Internet. We reviewed the literature to determine whether the clinical use of Skype is supported by evidence. One small (n = 7) controlled clinical trial had assessed the effect of nursing communication using Skype on elderly patients with dementia and their carers. However, we were unable to identify any large, well-designed studies which had formally evaluated the safety, clinical effectiveness, security and privacy of Skype for the routine delivery of patient care. While there were many case reports and small studies, no firm evidence either in favour of, or against the use of Skype for clinical telehealth was found. The risks and benefits of using Skype for clinical purposes are not known. PMID:22362829

  9. Comprehensive evidence-based review on European antitussives.

    Science.gov (United States)

    Morice, Alyn; Kardos, Peter

    2016-01-01

    Acute cough caused by viral respiratory tract infections is probably the most common illness to afflict mankind. Despite the widespread but ineffective prescribing of antibiotics, there is no specific therapy. Home remedies and over-the-counter medicines are the mainstay for treatment of this short-lived but debilitating condition where cough is a major troublesome symptom. Across Europe, there are large variations in the recommendations made by healthcare professionals for the treatment of acute cough. This has arisen through custom and practice based on the evidence of historical studies performed to standards well short of what would be considered legitimate today. Acute cough is particularly difficult to study in a controlled setting because of the high rate of spontaneous remission and a large placebo effect. Here we detail the validated modern methodology used to assess the efficacy of antitussives and review the drugs commonly used in Europe against these standards. PMID:27547407

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Strawberry as a health promoter: an evidence based review.

    Science.gov (United States)

    Giampieri, Francesca; Forbes-Hernandez, Tamara Y; Gasparrini, Massimiliano; Alvarez-Suarez, José M; Afrin, Sadia; Bompadre, Stefano; Quiles, Josè L; Mezzetti, Bruno; Battino, Maurizio

    2015-05-01

    Since a high intake of fruits and vegetables is inversely related to the incidence of several degenerative diseases, the importance of a balanced diet in relation to human health has received increased consumer attention worldwide. Strawberries (Fragaria X ananassa, Duch.) are a rich source of a wide variety of nutritive compounds such as sugars, vitamins, and minerals, as well as non-nutritive, bioactive compounds such as flavonoids, anthocyanins and phenolic acids. All of these compounds exert a synergistic and cumulative effect on human health promotion and in disease prevention. Strawberry phenolics are indeed able (i) to detoxify free radicals blocking their production, (ii) to modulate the expression of genes involved in metabolism, cell survival and proliferation and antioxidant defense, and (iii) to protect and repair DNA damage. The overall objective of the present review is to update and discuss the key findings, from recent in vivo studies, on the effects of strawberries on human health. Particular attention will be paid to the molecular mechanisms proposed to explain the health effects of polyphenols against the most common diseases related to oxidative stress driven pathologies, such as cancer, cardiovascular diseases, type II diabetes, obesity and neurodegenerative diseases, and inflammation. PMID:25803191

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Evidence based approach to unani contraceptives: a review

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Seybolt LM

    2012-06-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    Knight, Carolyn

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Morteza Ghojazadeh

    2015-03-01

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

  20. Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

    OpenAIRE

    van Tulder, Maurits W.; Koes, Bart; Seitsalo, Seppo; Malmivaara, Antti

    2005-01-01

    Within the framework of evidence-based medicine high-quality randomised trials and systematic reviews are considered a necessary prerequisite for progress in orthopaedics. This paper summarises the currently available evidence on surgical and other invasive procedures for low back pain. Results of systematic reviews conducted within the framework of the Cochrane Back Review Group were used. Data were gathered from the latest Cochrane Database of Systematic Reviews 2005, Issue 2. The Cochrane ...

  1. Implementation of evidence-based practice in nursing using action research: a review

    NARCIS (Netherlands)

    Munten, Guus; Bogaard, Joop van den; Cox, Karen; Garretsen, Henk; Bongers, Inge

    2010-01-01

    As is often reported in the literature exploring the research-practice gap, applying the principles of evidence-based practice is easier said than done. Action research is a methodology with an explicit intent of linking the worlds of research and practice. This review attempts to answer the questio

  2. Astro-Particle Physics

    OpenAIRE

    Raffelt, G. G.

    1997-01-01

    Recent developments of those areas of astro-particle physics are discussed that were represented at the HEP97 conference. In particular, the current status of direct and indirect dark-matter searches and of TeV neutrino and gamma-ray astronomy will be reviewed.

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

    Science.gov (United States)

    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.

  4. A burden on business? Reviewing the evidence base on regulation and small-business performance

    OpenAIRE

    Kitching, John

    2006-01-01

    The evidence base regarding the impact of regulation on small-business performance is reviewed. The substantive findings of various studies and their methodological approaches are critiqued. Many studies suffer from inadequate conceptualisation of ‘regulation’ and methodological shortcomings, and fail to investigate the causal mechanisms through which regulation contributes to business-performance outcomes. In some cases, they positively encourage superficial and misleading results. More soph...

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

    OpenAIRE

    Farzaneh Agha-hosseini; Mahdieh-Sadat Moosavi

    2013-01-01

    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 ...

  6. Proof of concept: Developing a peer reviewed, evidence-based, interactive e-learning programme.

    Science.gov (United States)

    Sinclair, Peter; Schoch, Monica; Black, Kirsten; Woods, Matthew

    2011-06-01

    Knowledge and skill acquisition related to vascular access are traditionally individual institutional educational initiatives. Australia currently has no national evidence based education programme for renal nurses. A survey of Australian and New Zealand Nephrology Educators' conducted in 2009, identified the need for more effective and consistent delivery of clinical education for nurses using innovative, web-based approaches supporting the tenets of e-learning methodologies. This paper discusses the development, implementation and proposed evaluation of a peer reviewed Australasian e-learning programme on buttonhole cannulation. It will further highlight the benefits of inter-organisational partnerships and how these partnerships can facilitate positive change in teaching and learning practices. This project has unique characteristics that collectively provide value, distinction and innovation to nurses, patients and renal departments. As the e-learning programme was founded on a platform of evidence-based practice it is therefore easily transferable to an international context. PMID:21561547

  7. Improving the evidence base for transfusion medicine: the work of the UK systematic review initiative.

    Science.gov (United States)

    Brunskill, S J; Hyde, C J; Stanworth, S J; Dorée, C J; Roberts, D J; Murphy, M F

    2009-04-01

    Clarifying the existing evidence base is crucial to improve the effectiveness of transfusion practice. The UK Systematic Review Initiative has been pursuing this objective primarily through writing systematic reviews on important topics in transfusion medicine. Here, we describe our progress for the past 5 years. We are the only research group that identifies transfusion medicine randomized controlled trials (RCTs) for the Cochrane Central Register of Controlled Trials, and to date, we have contributed 3002 RCT citations. The article considers future challenges including the need for wider involvement from the transfusion medicine community in the process of maintaining and updating systematic reviews and the identification and prioritization of topics for further clinical research including clinical trials. Collaboration between international and local research groups is important if these challenges are to be met. PMID:19320853

  8. Outcome of non-invasive treatment modalities on back pain: an evidence-based review.

    Science.gov (United States)

    van Tulder, Maurits W; Koes, Bart; Malmivaara, Antti

    2006-01-01

    At present, there is an increasing international trend towards evidence-based health care. The field of low back pain (LBP) research in primary care is an excellent example of evidence-based health care because there is a huge body of evidence from randomized trials. These trials have been summarized in a large number of systematic reviews. This paper summarizes the best available evidence from systematic reviews conducted within the framework of the Cochrane Back Review Group on non-invasive treatments for non-specific LBP. Data were gathered from the latest Cochrane Database of Systematic Reviews 2005, Issue 2. The Cochrane reviews were updated with additional trials, if available. Traditional NSAIDs, muscle relaxants, and advice to stay active are effective for short-term pain relief in acute LBP. Advice to stay active is also effective for long-term improvement of function in acute LBP. In chronic LBP, various interventions are effective for short-term pain relief, i.e. antidepressants, COX2 inhibitors, back schools, progressive relaxation, cognitive-respondent treatment, exercise therapy, and intensive multidisciplinary treatment. Several treatments are also effective for short-term improvement of function in chronic LBP, namely COX2 inhibitors, back schools, progressive relaxation, exercise therapy, and multidisciplinary treatment. There is no evidence that any of these interventions provides long-term effects on pain and function. Also, many trials showed methodological weaknesses, effects are compared to placebo, no treatment or waiting list controls, and effect sizes are small. Future trials should meet current quality standards and have adequate sample size. PMID:16320031

  9. 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.

  10. Devil's Claw (Harpagophytum procumbens DC): an evidence-based systematic review by the Natural Standard Research Collaboration.

    Science.gov (United States)

    Brendler, Thomas; Gruenwald, Joerg; Ulbricht, Catherine; Basch, Ethan

    2006-01-01

    An evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interaction, adverse effects, toxicology, and dosing. PMID:17135164

  11. 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.

  12. 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

  13. Ethical practice of evidence-based medicine: A review for plastic surgeons

    Directory of Open Access Journals (Sweden)

    Rajeev B Ahuja

    2013-01-01

    Full Text Available Last decade has witnessed a spurt in articles focused on the topic of evidence-based medicine (EBM and medical ethics. These articles are not only educative, but draw attention to the changing scenario of medical practice. Surgeons seem a bit less attentive to practice of EBM, more so in the developing world. The theme is now percolating in our realm for demonstrable incorporation of EBM in our practice, which is allegorical of a good physician and is also likely to become demanding legally. In practicing EBM, several conflicts may arise with the ethical vows of medicine. However, majority of these conflicting issues have germinated from a capitalistic approach to medical practice, where the fear of extraneous compulsions dictating prescriptions and procedures in the garb of ′evidence-based practice′ conflicts ethical behaviour. This review shall appraise the reader with important definitions of medical ethics, EBM and how to incorporate best evidence into ones practice. While, EBM brings objectivity to treatment to derive measurable outcomes it should not become regimented or metamorphose as a pseudonym for defensive medicine to escalate treatment costs. EBM also has several limitations one of which is to place the onus on the practicing physician to search for the best evidence and the other is the resource constraint of practice in the developing world. How a plastic surgery practice could be made to conform to evidence based (EB procedures is proposed as insufficient surgical skills can pose a serious threat to not only the practice of EB procedures, but to ethical responsibilities as well. In conclusion, it is necessary to incorporate ethical temperance into EB procedures to withstand societal, peer and legal pressures of current times.

  14. 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.

  15. 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

  16. Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review.

    Science.gov (United States)

    van Tulder, Maurits W; Koes, Bart; Seitsalo, Seppo; Malmivaara, Antti

    2006-01-01

    Within the framework of evidence-based medicine high-quality randomised trials and systematic reviews are considered a necessary prerequisite for progress in orthopaedics. This paper summarises the currently available evidence on surgical and other invasive procedures for low back pain. Results of systematic reviews conducted within the framework of the Cochrane Back Review Group were used. Data were gathered from the latest Cochrane Database of Systematic Reviews 2005, Issue 2. The Cochrane reviews were updated using the evidence summary on surgery and other invasive procedures from the COST B13 European Guidelines for the Management of Acute and Chronic Non-Specific Low Back Pain. Facet joint, epidural, trigger point and sclerosant injections have not clearly been shown to be effective and can consequently not be recommended. There is no scientific evidence on the effectiveness of spinal stenosis surgery. Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc prolapses that fail to resolve with the conservative management. Cognitive intervention Combined with exercises is recommended for chronic low back pain, and fusion surgery may be considered only in carefully selected patients after active rehabilitation programmes during 2 years time have failed. Demanding surgical fusion techniques are not better than the traditional posterolateral fusion without internal fixation. PMID:16320030

  17. 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

  18. Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review 1

    Science.gov (United States)

    Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

    2016-01-01

    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. PMID:27598378

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

    Science.gov (United States)

    Martinez, Angel Johann Solorzano

    2016-09-01

    Workplace violence in health care settings is an occupational issue concerning nurses and other health care professionals. Patient aggression against nurses is often the most common form of violence in clinical settings, occurring in emergency departments, inpatient psychiatric settings, and nursing homes. Physical and verbal assaults are the major forms of workplace violence encountered by nurses. Current research has identified staff, environmental, and patient risk factors as the major precursors of workplace violence initiated by patients. Nurses often experience significant physical and psychological negative consequences after an episode of workplace violence. A review of the evidence was conducted to identify current evidence-based interventions that can help nurses minimize the incidence of workplace violence. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 31-36.]. PMID:27576226

  20. 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.

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

    International Nuclear Information System (INIS)

    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

  2. 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.

  3. 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

  4. 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…

  5. Review of Online Evidence-based Practice Point-of-Care Information Summary Providers: Response by the Publisher of DynaMed

    OpenAIRE

    Alper, Brian S.

    2010-01-01

    In response to Banzi's et al review of online evidence-based practice point-of-care resources published in the Journal of Medical Internet Research, the publisher of DynaMed clarifies his evidence-based methodology.

  6. Attenuating the Systemic Inflammatory Response to Adult Cardiopulmonary Bypass: A Critical Review of the Evidence Base.

    Science.gov (United States)

    Landis, R Clive; Brown, Jeremiah R; Fitzgerald, David; Likosky, Donald S; Shore-Lesserson, Linda; Baker, Robert A; Hammon, John W

    2014-09-01

    A wide range of pharmacological, surgical, and mechanical pump approaches have been studied to attenuate the systemic inflammatory response to cardiopulmonary bypass, yet no systematically based review exists to cover the scope of anti-inflammatory interventions deployed. We therefore conducted an evidence-based review to capture "self-identified" anti-inflammatory interventions among adult cardiopulmonary bypass procedures. To be included, trials had to measure at least one inflammatory mediator and one clinical outcome, specified in the "Outcomes 2010" consensus statement. Ninety-eight papers satisfied inclusion criteria and formed the basis of the review. The review identified 33 different interventions and approaches to attenuate the systemic inflammatory response. However, only a minority of papers (35 of 98 [35.7%]) demonstrated any clinical improvement to one or more of the predefined outcome measures (most frequently myocardial protection or length of intensive care unit stay). No single intervention was supported by strong level A evidence (multiple randomized controlled trials [RCTs] or meta-analysis) for clinical benefit. Interventions at level A evidence included off-pump surgery, minimized circuits, biocompatible circuit coatings, leukocyte filtration, complement C5 inhibition, preoperative aspirin, and corticosteroid prophylaxis. Interventions at level B evidence (single RCT) for minimizing inflammation included nitric oxide donors, C1 esterase inhibition, neutrophil elastase inhibition, propofol, propionyl-L-carnitine, and intensive insulin therapy. A secondary analysis revealed that suppression of at least one inflammatory marker was necessary but not sufficient to confer clinical benefit. The most effective interventions were those that targeted multiple inflammatory pathways. These observations are consistent with a "multiple hit" hypothesis, whereby clinically effective suppression of the systemic inflammatory response requires hitting multiple

  7. 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

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

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    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.

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

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    Misa Mi

    2012-09-01

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

  10. 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.

  11. 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.

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

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    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.

  13. 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

  14. An evidence-based review of natalizumab therapy in the management of Crohn’s disease

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    Raja GR Edula

    2009-11-01

    Full Text Available Raja GR Edula, Michael F PiccoMayo Clinic, Jacksonville, Florida, USAAbstract: Treatment options for Crohn’s disease have evolved beyond the early goals of induction and remission and are now more focused on preventing complications by altering the natural history of the disease. The advent of biologic therapies has revolutionized the management of Crohn’s disease. Specifically, antibodies to tumor necrosis factor alpha induce rapid mucosal healing. This translates into improved patient outcomes. However, many patients will fail these and other therapies. Natalizumab is a new biologic agent that has been approved for the treatment of moderately to severely active Crohn’s disease in patients who have failed or are intolerant to immunosuppressants and/or tumor necrosis factor inhibitors. It is a selective adhesion molecule inhibitor to alpha-4 integrin resulting in inhibition of the migration of inflammatory cells across the endothelium. This unique mechanism of action has been shown to be effective in the treatment of Crohn’s disease, making it an important option for otherwise refractory patients. Its use has been limited to these refractory patients because of concerns about the development of complications, especially progressive multifocal leukoencephalopathy. In this review, evidence-based data on the indications, efficacy and safety of natalizumab will be presented and its role in the management of patients with Crohn’s disease will be defined.Keywords: Crohn’s disease, natalizumab, alpha-4 integrin

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

    Directory of Open Access Journals (Sweden)

    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

  16. Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review.

    Science.gov (United States)

    Youngster, Ilan; Arcavi, Lidia; Schechmaster, Renata; Akayzen, Yulia; Popliski, Hen; Shimonov, Janna; Beig, Svetlana; Berkovitch, Matitiahu

    2010-09-01

    , phenazopyridine, primaquine, rasburicase and tolonium chloride (toluidine blue). Regarding all other medications, our review found no evidence to contravene their use in normal therapeutic doses to G6PD-deficient patients. There is a need for evidence-based global consensus regarding medication use in G6PD-deficient patients. PMID:20701405

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  19. Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review

    Science.gov (United States)

    Wong, Connie; Odom, Samuel L.; Hume, Kara A.; Cox, Ann W.; Fettig, Angel; Kucharczyk, Suzanne; Brock, Matthew E.; Plavnick, Joshua B.; Fleury, Veronica P.; Schultz, Tia R.

    2015-01-01

    The purpose of this study was to identify evidenced-based, focused intervention practices for children and youth with autism spectrum disorder. This study was an extension and elaboration of a previous evidence-based practice review reported by Odom et al. ("Prev Sch Fail" 54:275-282, 2010b, doi:10.?1080/?1045988100378550?6). In the…

  20. 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.

  1. 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. PMID:25360229

  2. 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.

  3. 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

  4. What Are the Barriers to Residents' Practicing Evidence-Based Medicine? A Systematic Review.

    NARCIS (Netherlands)

    N. van Dijk; L. Hooft; M. Wieringa-de Waard

    2010-01-01

    Purpose Insufficient time and lack of skills are important barriers to the practice of evidence-based medicine (EBM). Residents could have additional barriers because their practice can be strongly influenced by the educational system and clinical supervisors. The purpose of this study, therefore, w

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

    Directory of Open Access Journals (Sweden)

    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

  6. 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.

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

    OpenAIRE

    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 rese...

  8. Evidence based postoperative physiotherapy management of adolescent idiopathic scoliosis - a literature review

    OpenAIRE

    Ahola, Janette

    2015-01-01

    The purpose of this thesis was to gather evidence-based and up-to-date studies about Adolescent Idiopathic Scoliosis (AIS) and its’ post-operative physiotherapy management. The thesis was made for Satakunta Central Hospital (Satakunnan keskussairaala). The need for such topic came from the physiotherapists working at the paediatric outpatient clinic. They wanted to have concrete updated information of post-operative physiotherapy management for scoliosis surgery patients. The theoretical ...

  9. [The development of evidence-based psychotherapy for use in alcoholism. A review].

    Science.gov (United States)

    Loeber, S; Mann, K

    2006-05-01

    Past decades have seen enormous advances in the development and validation of evidence-based approaches to psychotherapy for alcoholism. While psychoanalytic and early behavioral techniques were the original basis of psychotherapy in this field, evidence-based approaches are now built up on the principles of motivational interviewing and cognitive-behavior therapy. Different techniques have been developed to modify preceding and persisting conditions favoring problem behavior, e.g., training in coping/social skills and the community reinforcement approach. According to the results of the project MATCH, one of the largest treatment trials, "cognitive-behavioral intervention" combines motivational enhancement therapy, the 12-step approach, and cognitive-behavior therapy, with the aim of providing new and even more efficacious psychotherapy for alcohol dependent patients. These very promising developments are beset with huge problems, however, insofar as few of the new evidence-based treatment approaches are accepted as standard treatment in Germany, in addition to which only a fraction of all alcohol-dependent persons in the country find their way into the care system, for various reasons. Early diagnosis and facilitation of access to the various treatment options available could be a future task for general practitioners and also for company / industrial medical schemes. PMID:16374642

  10. 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

  11. Evidence base and components of Brief Admission as an intervention for patients with borderline personality disorder: a review of the literature

    NARCIS (Netherlands)

    Helleman, M.; Goossens, P.J.J.; Kaasenbrood, A.; Achterberg, T. van

    2014-01-01

    PURPOSE: To review the available evidence-based literature on the components of brief inpatient psychiatric hospital admission as an intervention for patients with borderline personality disorder. DESIGN AND METHOD: Systematic literature search, narrative literature review. Content analysis. FINDING

  12. Formulating the Evidence Based Practice Question: A Review of the Frameworks

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    Karen Sue Davies

    2011-06-01

    Full Text Available IntroductionQuestions are the driving force behind evidence based practice (EBP (Eldredge, 2000. If there were no questions, EBP would be unnecessary. Evidence based practice questions focus on practical real-world problems and issues. The more urgent the question, the greater the need to place it in an EBP context.One of the most challenging aspects of EBP is to actually identify the answerable question. This ability to identify the question is fundamental to then locating relevant information to answer the question. An unstructured collection of keywords can retrieve irrelevant literature, which wastes time and effort eliminating inappropriate information. Successfully retrieving relevant information begins with a clearly defined, well-structured question. A standardized format or framework for asking questionshelps focus on the key elements. Question generation also enables a period of reflection. Is this the information I am really looking for? Why I am looking for this information? Is there another option to pursue first?This paper introduces the first published framework, PICO (Richardson, Wilson, Nishikawa and Hayward, 1995 and some of its later variations including ECLIPSE (Wildridge and Bell, 2002 and SPICE (Booth, 2004. Sample library and information science (LIS questions are provided to illustrate the use of these frameworks to answer questions in disciplines other than medicine.Booth (2006 published a broad overview of developing answerable research questions which also considered whether variations to the original PICO framework were justifiable and worthwhile. This paper will expand on that work.

  13. Evidence-Based Parenting Interventions to Promote Secure Attachment: Findings From a Systematic Review and Meta-Analysis.

    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

  14. Where are the systematic reviews in transfusion medicine? A study of the transfusion evidence base.

    Science.gov (United States)

    Dorée, Carolyn; Stanworth, Simon; Brunskill, Susan J; Hopewell, Sally; Hyde, Chris J; Murphy, Mike F

    2010-10-01

    Transfusion medicine has become a large and complex specialty. Although there are now systematic reviews covering many aspects of transfusion, these span a large number of clinical areas and are published across more than a hundred different medical journals, making it difficult for transfusion medicine practitioners and researchers to keep abreast of the current high-level evidence. In response to this problem, NHS Blood and Transplant's Systematic Review Initiative (SRI) has produced a comprehensive overview of systematic reviews in transfusion medicine. A systematic search (to December 2009) and screening procedure were followed by the appraisal of systematic reviews according to predefined inclusion criteria. The 340 eligible systematic reviews were mapped to 10 transfusion intervention groups and 14 topic groups within clinical medicine. Trends in the systematic review literature were examined and gaps in the literature described. The spread of systematic reviews across clinical areas was found to be very uneven, with some areas underreviewed and others with multiple systematic reviews on the same topic, making the identification of the best evidence for current transfusion practice a continuing challenge. References and links to all systematic reviews included in this overview can be freely accessed via the SRI's new online database, the Transfusion Evidence Library (www.transfusionguidelines.org). PMID:20851331

  15. 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…

  16. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

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

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  17. Methods of Evidence-Based Anatomy: a guide to conducting systematic reviews and meta-analysis of anatomical studies.

    Science.gov (United States)

    Henry, Brandon Michael; Tomaszewski, Krzysztof A; Walocha, Jerzy A

    2016-05-01

    Evidence-Based Anatomy (EBA) is the concept of applying evidence-based principles and research methods to the anatomical sciences. While narrative reviews are common in the anatomical sciences, true systematic reviews (SR) and meta-analysis (MA) are only beginning to grow in popularity. In order to enhance the quality of future EBA studies, and ensure the clinical reliability of their results, a uniform methodology is needed. In this paper, we present a step-by-step methodological guide for performing SRs and MAs of anatomical studies. We address the EBA-specific challenges in each step of the SR and MA process, and discuss methods and strategies to overcome these difficulties. Furthermore, we discuss in detail the statistical methods used in MA of anatomical data, including multi-categorical and single-categorical pooled prevalence estimates, as well as pooled means of one group. Lastly, we discuss the major limitations of EBA, including the lack of a proper quality assessment tool for anatomical studies. The methods described in this paper present a uniform road map for future EBA studies. PMID:26844627

  18. 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.

  19. Outcomes for implementation science: an enhanced systematic review of instruments using evidence-based rating criteria

    OpenAIRE

    Lewis, Cara C.; Fischer, Sarah; Weiner, Bryan J.; Stanick, Cameo; Kim, Mimi; Martinez, Ruben G.

    2015-01-01

    Background High-quality measurement is critical to advancing knowledge in any field. New fields, such as implementation science, are often beset with measurement gaps and poor quality instruments, a weakness that can be more easily addressed in light of systematic review findings. Although several reviews of quantitative instruments used in implementation science have been published, no studies have focused on instruments that measure implementation outcomes. Proctor and colleagues establishe...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. The use of lasers in Becker's naevus: An evidence-based review.

    Science.gov (United States)

    Momen, Sophie; Mallipeddi, Raj; Al-Niaimi, Firas

    2016-08-01

    Becker's naevus is a hamartoma that often appears during puberty. Clinically this presents with a pigmented and often hairy patch most often on the shoulders. Treatment has always been challenging and lasers are often used with mixed results. This article reviews the evidence of all the laser treatments used in Becker's naevus and analyses the findings from the published studies and trials. PMID:26735085

  4. 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…

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

    OpenAIRE

    Reiber, Karin

    2011-01-01

    [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 ...

  6. Complementary and Alternative Medicine and Cardiovascular Disease: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Matthew J. Rabito

    2013-01-01

    Full Text Available Complementary and alternative medicine (CAM plays a significant role in many aspects of healthcare worldwide, including cardiovascular disease (CVD. This review describes some of the challenges of CAM in terms of scientific research. Biologically-based therapies, mind-body therapies, manipulative and body-based therapies, whole medical systems, and energy medicine are reviewed in detail with regard to cardiovascular risk factors and mediation or modulation of cardiovascular disease pathogenesis. CAM use among patients with CVD is prevalent and in many instances provides positive and significant effects, with biologically-based and mind-body therapies being the most commonly used treatment modalities. More rigorous research to determine the precise physiologic effects and long-term benefits on cardiovascular morbidity and mortality with CAM usage, as well as more open lines of communication between patients and physicians regarding CAM use, is essential when determining optimal treatment plans.

  7. Developing primary care review criteria from evidence-based guidelines: coronary heart disease as a model.

    OpenAIRE

    Hutchinson, Allen; McIntosh, Aileen; Anderson, Jeff; Gilbert, Claire; Field, Rosemary

    2003-01-01

    BACKGROUND: National Health Service (NHS) initiatives such as Clinical Governance, National Service Frameworks and the National Institute of Clinical Excellence (NICE) clinical guidelines programme create demand for tools to enable performance review by healthcare professionals. Ideally such tools should enable clinical teams to assess quality of care and highlight areas of good practice or where improvement is needed. They should also be able to be used to demonstrate progress towards goals ...

  8. 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

  9. Evidence-based veterinary dermatology: a systematic review of interventions for Malassezia dermatitis in dogs.

    Science.gov (United States)

    Negre, Amélie; Bensignor, Emmanuel; Guillot, Jacques

    2009-02-01

    The aim of this systematic review was to evaluate the efficacy of antifungal treatments for Malassezia dermatitis in dogs and, when possible, to propose recommendation for or against their use. Electronic searches were carried out using PubMed MEDLINE(R), CABDirect and CONSULTANT database. The volumes of Advances in Veterinary Dermatology, the proceedings of ESVD/ECVD and AAVD/ACVD congresses were hand-searched for studies relevant to this review. All articles and book chapters discussing treatment of Malassezia dermatitis were scanned for additional citations. Lastly, a request was sent to the Vetderm Listserv to share recent clinical trials. The analysis evaluated study design, methodology quality, subject enrolment quality, type of interventions and outcome measures. The searches identified 35 articles, and 14 trials that fulfilled the following selection criteria: (i) in vivo clinical trials, (ii) dogs showing clinical lesions of Malassezia dermatitis and (iii) enrolment of at least five dogs. Among these, only eight studies fulfilled the following additional criterion: (iv) prospective in vivo clinical trials reporting clinical and mycological outcome measures. A total number of 14 different treatment protocols included four blinded, randomized and controlled trials (quality of evidence grade A), four controlled studies lacking blinding and/or randomization (grade B), five open uncontrolled trials (grade C) and one descriptive study (grade D). This systematic review allowed us to recommend, with good evidence, the use of only one topical treatment of Malassezia dermatitis (2% miconazole nitrate +2% chlorhexidine, twice a week for 3 weeks) and with fair evidence the use of two systemic treatments with azole derivatives (ketoconazole, 10 mg kg(-1) day(-1) and itraconazole, 5 mg kg(-1) day(-1) for 3 weeks). PMID:19152584

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

    OpenAIRE

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

    2015-01-01

    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 do...

  11. Nilotinib for the treatment of chronic myeloid leukemia: An evidence-based review

    Directory of Open Access Journals (Sweden)

    Elias Jabbour

    2009-10-01

    Full Text Available Elias Jabbour, Jorge Cortes, Hagop KantarjianDepartment of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USAIntroduction: Chronic myelogenous leukemia (CML is a progressive and often fatal hematopoietic neoplasm. The Bcr-Abl tyrosine kinase inhibitor imatinib mesylate represented a major therapeutic advance over conventional CML therapy, with more than 90% of patients obtaining complete hematologic response, and 70%–80% of patients achieving a complete cytogenetic response. Despite the high efficacy of imatinib, a minority of patients in chronic phase CML and more patients in advanced phases are resistant to imatinib, or develop resistance during treatment. This is attributed, in 40% to 50% of cases, to the development of mutations in the Bcr-Abl tyrosine kinase domain that impair imatinib binding. Attempts to circumvent resistance led to the discovery of nilotinib (Tasigna, a novel, potent and selective oral Bcr-Abl kinase inhibitor.Aims: To review the evidence for the use of nilotinib in the management of CML.Evidence review: Preclinical and clinical investigations demonstrate that nilotinib effectively overcomes imatinib resistance, and has further improved the treatment of CML.Place in therapy: Nilotinib is currently indicated for patients with CML in chronic and accelerated phases following imatinib failure. Randomized studies are ongoing to assess the efficacy of nilotinib in patients with newly diagnosed CML.Keywords: CML, tyrosine kinase inhibitors, nilotinib, imatinib-resistance, imatinibintolerance.

  12. Preventing trachoma through environmental sanitation: a review of the evidence base.

    Science.gov (United States)

    Prüss, A; Mariotti, S P

    2000-01-01

    A review of the available evidence for the associations between environmental sanitation and transmission of trachoma was undertaken with a view to identifying preventive interventions. The WHO Global Alliance for the Elimination of Trachoma by the Year 2020 (GET2020) has adopted the "SAFE" strategy, consisting of four components: Surgery, Antibiotic treatment, promotion of Facial cleanliness and initiation of Environmental changes. This review of 19 studies selected from the 39 conducted in different parts of the world shows that there is clear evidence to support the recommendation of facial cleanliness and environmental improvements (i.e. the F and E components of the SAFE strategy) to prevent trachoma. Person-to-person contact and flies appear to constitute the major transmission pathways. Improvement of personal and community hygiene has great potential for a sustainable reduction in trachoma transmission. Controlled clinical trials are needed to estimate the relative contribution of various elements to the risk of transmission of trachoma and the effectiveness of different interventions. These could show the relative attributable risks and effectiveness of interventions to achieve improvement of personal hygiene and fly control by environmental improvements, alone or in combination, and with or without antibiotic treatment. PMID:10743299

  13. Stereotactic Body Radiosurgery for Spinal Metastatic Disease: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    William A. Hall

    2011-01-01

    Full Text Available Spinal metastasis is a problem that afflicts many cancer patients. Traditionally, conventional fractionated radiation therapy and/or surgery have been the most common approaches for managing such patients. Through technical advances in radiotherapy, high dose radiation with extremely steep drop off can now be delivered to a limited target volume along the spine under image-guidance with very high precision. This procedure, known as stereotactic body radiosurgery, provides a technique to rapidly treat selected spinal metastasis patients with single- or limited-fraction treatments that have similar to superior efficacies compared with more established approaches. This review describes current treatment systems in use to deliver stereotactic body radiosurgery as well as results of some of the larger case series from a number of institutions that report outcomes of patients treated for spinal metastatic disease. These series include nearly 1400 patients and report a cumulative local control rate of 90% with myelopathy risk that is significantly less than 1%. Based on this comprehensive review of the literature, we believe that stereotactic body radiosurgery is an established treatment modality for patients with spinal metastatic disease that is both safe and highly effective.

  14. 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.

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

    Science.gov (United States)

    Budhrani-Shani, Pinky; Berry, Donna L; 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

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. 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

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

    Science.gov (United States)

    Williams, Peter G

    2014-09-01

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

  7. 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

  8. 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.

  9. 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 injury type, injury timing, neurosensory disturbances and intra-operative findings. Best functional nerve recovery occurred after direct apposition and suturing if nerve ending gaps were nerve grafting (sural/greater auricular nerve). Timing of microneurosurgical repair after injury remains debated. Most authors recommend surgery when neurosensory deficit shows no improvement 90 days post-diagnosis. Nerve transection diagnosed intra-operatively should be repaired in situ; minor nerve injury repair can be delayed. No consensus exists regarding optimal methods and timing for IAN/LN repair. We suggest a schematic guideline for treating IAN/LN injury, based on the most current evidence. We acknowledge that additional RCTs are required to provide definitive confirmation of optimal treatment approaches. PMID:26059454

  10. 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.

  11. Environmental risk factors for inflammatory bowel diseases: Evidence based literature review

    Science.gov (United States)

    Abegunde, Ayokunle T; Muhammad, Bashir H; Bhatti, Owais; Ali, Tauseef

    2016-01-01

    AIM: Advances in genetics and immunology have contributed to the current understanding of the pathogenesis of inflammatory bowel diseases (IBD). METHODS: The current opinion on the pathogenesis of IBD suggests that genetically susceptible individuals develop intolerance to dysregulated gut microflora (dysbiosis) and chronic inflammation develops as a result of environmental insults. Environmental exposures are innumerable with varying effects during the life course of individuals with IBD. Studying the relationship between environmental factors and IBD may provide the missing link to increasing our understanding of the etiology and increased incidence of IBD in recent years with implications for prevention, diagnosis, and treatment. Environmental factors are heterogeneous and genetic predisposition, immune dysregulation, or dysbiosis do not lead to the development of IBD in isolation. RESULTS: Current challenges in the study of environmental factors and IBD are how to effectively translate promising results from experimental studies to humans in order to develop models that incorporate the complex interactions between the environment, genetics, immunology, and gut microbiota, and limited high quality interventional studies assessing the effect of modifying environmental factors on the natural history and patient outcomes in IBD. CONCLUSION: This article critically reviews the current evidence on environmental risk factors for IBD and proposes directions for future research. PMID:27468219

  12. 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. PMID:22818190

  13. 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

  14. Testosterone and prostate cancer: an evidence-based review of pathogenesis and oncologic risk.

    Science.gov (United States)

    Michaud, Jason E; Billups, Kevin L; Partin, Alan W

    2015-12-01

    Testosterone plays a central role in male development and health. Likewise, androgen deficiency, or hypogonadism, is associated with a variety of symptoms including decreased energy, diminished libido and erectile dysfunction, among others. Male androgen levels steadily decline with age, and, in a subset of symptomatic older men, can result in late-onset hypogonadism (LOH). Over the last decade, increased awareness of hypogonadism among patients and providers has led to a significant rise in the use of testosterone replacement therapy (TRT) for hypogonadism, and especially in LOH. Accompanying the rise in TRT are concerns of potential adverse effects, including cardiovascular risks and the promotion of prostate cancer. The 'androgen hypothesis' asserts that prostate cancer development and progression is driven by androgens, and thus TRT has the theoretical potential to drive prostate cancer development and progression. In this review, we examine existing data surrounding testosterone and prostate cancer. There is significant evidence that androgens promote prostate cancer in experimental systems. However, there is no clear evidence that elevations in endogenous testosterone levels promote the development of prostate cancer in humans. As a result of experimental and historical data on the progression of prostate cancer following TRT, there has been widespread belief that TRT will promote disease progression in prostate cancer patients. Despite these fears, there are a growing number of studies demonstrating no increase in prostate cancer incidence among men on TRT. Furthermore, in studies involving a small number of patients, there has been no discernable increase in disease progression in prostate cancer patients on TRT. While data from large, prospective, randomized, controlled trials are absent, TRT in select prostate cancer patients is likely safe. In the end, the use of TRT in prostate cancer patients is still considered experimental and should only be offered

  15. 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

  16. Intentional burn injury: an evidence-based, clinical and forensic review.

    Science.gov (United States)

    Greenbaum, Adam R; Donne, Jeremy; Wilson, Diana; Dunn, Kenneth W

    2004-11-01

    Burn injury can be inflicted intentionally either by one person to another whenever one has the ability to physically control the other, or it can be self-inflicted. There is scant evidential basis for much that is written about and practiced in the evaluation and care of patients that have sustained intentional burn injuries. Yet this is an area in which medical personnel must necessarily be trained in both the therapeutic and forensic aspects of a complex problem. Failure to appreciate the complexity of medical and forensic interactions may have far reaching effects. A missed diagnosis can result in inappropriate medical care, on-going abuse and future fatality. Inept management can result on the one hand, in blame levelled inappropriately placing incomparable strain on family units and innocent parties, and on the other, allow abusers to continue unchecked. This is the first review on the subject in which lawyers and doctors collaborate to produce a holistic approach to this subject. In it we describe the legal considerations that medical staff must appreciate when approaching patients who may have suffered intentional burns. We analyse the various scenarios in which intentional burning can be found and challenge the clinical dogma with much of the management of paediatric inflicted burns has become imbued. We suggest a rational and balanced approach to all intentional burn injuries-especially when children are involved. In the light of current case law in which dogmatic medical evidence has been implicated in wrongful convictions for child abuse in the UK, it is imperative that medical professionals gather evidence carefully and completely and apply it with logic and impartiality. This paper will aid clinicians who may not be experienced in dealing with burn injuries, but find themselves in the position of seeing a burn acutely, to avoid common mistakes. PMID:15475134

  17. 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

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

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    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

  19. The academic, economic and societal impacts of Open Access: an evidence-based review.

    Science.gov (United States)

    Tennant, Jonathan P; Waldner, François; Jacques, Damien C; Masuzzo, Paola; Collister, Lauren B; Hartgerink, Chris H J

    2016-01-01

    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 research communities if

  20. Lenalidomide in multiple myeloma: an evidence-based review of its role in therapy

    Directory of Open Access Journals (Sweden)

    Paul Richardson

    2009-11-01

    Full Text Available Paul Richardson, Constantine Mitsiades, Jacob Laubach, Robert Schlossman, Irene Ghobrial, Teru Hideshima, Nikhil Munshi, Kenneth AndersonJerome Lipper Multiple Myeloma Center, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USAIntroduction: Multiple myeloma (MM is a relatively common and incurable hematological malignancy. Currently, there is no single standard therapy, with choice of treatment dependent on individual patient factors. Lenalidomide is an immunomodulatory drug with potent antitumor, antiangiogenic, immunomodulatory, and proapoptotic activity in MM.Aims: To evaluate the evidence for the use of lenalidomide in its current indication in relapsed or refractory MM, and additionally its investigational use for the treatment of newly diagnosed MM.Evidence review: In patients with relapsed and refractory MM, adding lenalidomide to high-dose dexamethasone significantly improves response rates and time-to-progression, relative to high-dose dexamethasone alone. This translates into a significant extension of overall survival (with a median extension of 9.1 months in a pivotal phase III study. Outcome is independent of patient age, number of previous therapies, type of previous therapy (including thalidomide or autologous stem cell transplantation, renal impairment, and β2-microglobulin level. Evidence suggests that combining lenalidomide with low-dose dexamethasone improves outcomes in patients with newly diagnosed disease and is superior to lenalidomide combined with highdose dexamethasone. Myelosuppression is the predominant toxicity observed, although some studies have shown high incidences of venous thromboembolism in the absence of prophylactic antithrombotic anticoagulation therapy. There is currently only limited evidence regarding the health economics of lenalidomide.Role in therapy: The encouraging results obtained with lenalidomide alone and in combination with dexamethasone

  1. The academic, economic and societal impacts of Open Access: an evidence-based review

    Science.gov (United States)

    Tennant, Jonathan P.; Waldner, François; Jacques, Damien C.; Masuzzo, Paola; Collister, Lauren B.; Hartgerink, Chris. H. J.

    2016-01-01

    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 research communities if

  2. Analysis of the efficacy of the peppermint oil (Mentha piperita L. on irritable bowel syndrome: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Joana Costa Gomes

    2013-04-01

    Full Text Available Objective: To evaluate the efficacy of peppermint oil (Mentha piperita L. on individuals diagnosed with irritable bowel syndrome (IBS regarding symptom improvement and quality of life enhancement. Methods: Literature search was conducted according to evidence based on methodology review at Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier and Medline, as well as using the MeSH index terms “Irritable bowel syndrome” and “peppermint oil”. We selected practice guidelines, systematic reviews, meta-analysis and randomized controlled trials that evaluated peppermint oil (PO efficacy in improving symptoms and/or quality of life when compared to placebo or other approved therapy for IBS. Results and Discussion: A total of eight articles were selected including five practice guidelines and three systematic reviews/ meta-analysis. Existing evidence suggests that there are enough data to support the use of peppermint oil in IBS for overall symptomatic relief, especially when abdominal pain is the dominant symptom, when compared to placebo (with an odds ratio of 2.7; CI 95%, 1.6 to 4.8 and NNT of 3. There is also evidence regarding overall quality of life improvement when using PO compared to placebo (p<0.001. Conclusion: So far, evidence suggests that PO should be considered for IBS patients, especially in the presence of abdominal pain (Strength of recommendation B. However, more high methodological quality studies that evaluate long-term efficacy and security of PO are needed.

  3. Approved and investigational uses of modafinil : an evidence-based review.

    Science.gov (United States)

    Kumar, Raminder

    2008-01-01

    Modafinil is a wake-promoting agent that is pharmacologically different from other stimulants. It has been investigated in healthy volunteers, and in individuals with clinical disorders associated with excessive sleepiness, fatigue, impaired cognition and other symptoms. This review examines the use of modafinil in clinical practice based on the results of randomized, double-blind, placebo-controlled clinical trials available in the English language in the MEDLINE database. In sleep-deprived individuals, modafinil improves mood, fatigue, sleepiness and cognition to a similar extent as caffeine but has a longer duration of action. Evidence for improved cognition in non-sleep-deprived healthy volunteers is controversial.Modafinil improves excessive sleepiness and illness severity in all three disorders for which it has been approved by the US FDA, i.e. narcolepsy, shift-work sleep disorder and obstructive sleep apnoea with residual excessive sleepiness despite optimal use of continuous positive airway pressure (CPAP). However, its effects on safety on the job and on morbidities associated with these disorders have not been ascertained. Continued use of CPAP in obstructive sleep apnoea is essential. Modafinil does not benefit cataplexy.In very small, short-term trials, modafinil improved excessive sleepiness in patients with myotonic dystrophy. It was efficacious in fairly large studies of attention deficit hyperactivity disorder (ADHD) in children and adolescents, and was as efficacious as methylphenidate in a small trial, but has not been approved by the FDA, in part because of its serious dermatological toxicity. In a trial of 21 non-concurrent subjects, with 2-week treatment periods, modafinil was as effective as dexamfetamine in adult ADHD. Modafinil was helpful for depressive symptoms in bipolar disorder in a trial that excluded patients with stimulant-induced mania. A single dose of modafinil may hasten recovery from general anaesthesia after day surgery. A

  4. Calorimeters in Astro and Particle physics

    OpenAIRE

    Pretzl, Klaus

    2005-01-01

    In this article an attempt is made to review some of the original works leading to new developments of calorimeters which are so widely and successfully used in astro and particle physics experiments. This report is far from being complete and the author apologizes for omissions and misquotations.

  5. 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.

  6. How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P

    Directory of Open Access Journals (Sweden)

    Wilson Philip

    2012-11-01

    Full Text Available Abstract Background Interventions to promote positive parenting are often reported to offer good outcomes for children but they can consume substantial resources and they require rigorous appraisal. Methods Evaluations of the Triple P parenting program were subjected to systematic review and meta-analysis with analysis of biases. PsychInfo, Embase and Ovid Medline were used as data sources. We selected published articles reporting any child-based outcome in which any variant of Triple P was evaluated in relation to a comparison condition. Unpublished data, papers in languages other than English and some book chapters were not examined. Studies reporting Eyberg Child Behavior Inventory or Child Behavior Checklist scores as outcomes were used in the meta-analysis. Results A total of 33 eligible studies was identified, most involving media-recruited families. Thirty-one of these 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. Most papers only reported maternal assessments of child behavior. Twenty-three papers were incorporated in the meta-analysis. No studies involved children younger than two-years old and comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. For maternally-reported outcomes the summary effect size was 0.61 (95%CI 0.42, 0.79. Paternally-reported outcomes following Triple P intervention were smaller and did not differ significantly from the control condition (effect size 0.42 (95%CI -0.02, 0.87. The two studies involving an active control group showed no between-group differences. There was limited evidence of publication bias, but there was substantial selective reporting bias, and preferential reporting of positive results in article abstracts. Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel. No trials were registered and only two papers contained conflict of interest

  7. 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. PMID:26148335

  8. 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

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

    Directory of Open Access Journals (Sweden)

    Andrew F. Long

    2011-01-01

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

  10. Follow-up for cervical cancer: a Program in Evidence-Based Care systematic review and clinical practice guideline update

    Science.gov (United States)

    Elit, L.; Kennedy, E.B.; Fyles, A.; Metser, U.

    2016-01-01

    Background In 2009, the Program in Evidence-based Care (pebc) of Cancer Care Ontario published a guideline on the follow-up of cervical cancer. In 2014, the pebc undertook an update of the systematic review and clinical practice guideline for women in this target population. Methods The literature from 2007 to August 2014 was searched using medline and embase [extended to 2000 for studies of human papillomavirus (hpv) dna testing]. Outcomes of interest were measures of survival, diagnostic accuracy, and quality of life. A working group evaluated the need for changes to the earlier guidelines and incorporated comments and feedback from internal and external reviewers. Results One systematic review and six individual studies were included. The working group concluded that the new evidence did not warrant changes to the 2009 recommendations, although hpv dna testing was added as a potentially more sensitive method of detecting recurrence in patients treated with radiotherapy. Comments from internal and external reviewers were incorporated. Recommendations Summary Follow-up care after primary treatment should be conducted and coordinated by a physician experienced in the surveillance of cancer patients. A reasonable follow-up strategy involves visits every 3–4 months within the first 2 years, and every 6–12 months during years 3–5. Visits should include a patient history and complete physical examination, with elicitation of relevant symptoms. Vaginal vault cytology examination should not be performed more frequently than annually. Combined positron-emission tomography and computed tomography, other imaging, and biomarker evaluation are not advocated; hpv dna testing could be useful as a method of detection of recurrence after radiotherapy. General recommendations for follow-up after 5 years are also provided. PMID:27122975

  11. 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

  12. Evidence based pediatrics.

    OpenAIRE

    Elizabeta ZISOVSKA

    2015-01-01

    It is very difficult to define the entire phrase “Evidence based pediatrics”, covering all components of this overused sentence. The definition comes out of the common sentence and it means integration of the individual clinical expertize together with the best external clinically available evidence of the systematic reviews which are of interest and benefit of the individual patient.Development of clinically appropriate structured question follows PICO model, i.e. containing f...

  13. Review for librarians of evidence-based practice in nursing and the allied health professions in the United States

    Science.gov (United States)

    Kronenfeld, Michael; Stephenson, Priscilla L.; Nail-Chiwetalu, Barbara; Tweed, Elizabeth M.; Sauers, Eric L.; McLeod, Tamara C. Valovich; Guo, Ruiling; Trahan, Henry; Alpi, Kristine M.; Hill, Beth; Sherwill-Navarro, Pamela; Allen, Margaret (Peg); Stephenson, Priscilla L.; Hartman, Linda M.; Burnham, Judy; Fell, Dennis; Kronenfeld, Michael; Pavlick, Raymond; MacNaughton, Ellen W.; Nail-Chiwetalu, Barbara

    2007-01-01

    Objective: This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources. Included Professions: Professions are athletic training, audiology, health education and promotion, nursing, occupational therapy, physical therapy, physician assisting, respiratory care, and speech-language pathology. Approach: Each section provides a description of a profession, highlighting changes that increase the importance of clinicians' access to and use of the profession's knowledgebase, and a review of each profession's efforts to support EBP. The paper concludes with a discussion of the librarian's role in providing EBP support to the profession. Conclusions: EBP is in varying stages of growth among these fields. The evolution of EBP is evidenced by developments in preservice training, growth of the literature and resources, and increased research funding. Obstacles to EBP include competing job tasks, the need for additional training, and prevalent attitudes and behaviors toward research among practitioners. Librarians' skills in searching, organizing, and evaluating information can contribute to furthering the development of EBP in a given profession. PMID:17971887

  14. 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.

  15. A systematic review of how studies describe educational interventions for evidence-based practice: stage 1 of the development of a reporting guideline

    OpenAIRE

    Phillips, Anna C; Lewis, Lucy K; McEvoy, Maureen P; Galipeau, James; Glasziou, Paul; Hammick, Marilyn; Moher, David; Tilson, Julie K; Williams, Marie T

    2014-01-01

    Background The aim of this systematic review was to identify which information is included when reporting educational interventions used to facilitate foundational skills and knowledge of evidence-based practice (EBP) training for health professionals. This systematic review comprised the first stage in the three stage development process for a reporting guideline for educational interventions for EBP. Methods The review question was ‘What information has been reported when describing educati...

  16. Instructional methods used by health sciences librarians to teach evidence-based practice (EBP): a systematic review*†‡

    Science.gov (United States)

    Swanberg, Stephanie M.; Dennison, Carolyn Ching; Farrell, Alison; Machel, Viola; Marton, Christine; O'Brien, Kelly K.; Pannabecker, Virginia; Thuna, Mindy; Holyoke, Assako Nitta

    2016-01-01

    Background Librarians often teach evidence-based practice (EBP) within health sciences curricula. It is not known what teaching methods are most effective. Methods A systematic review of the literature was conducted searching CINAHL, EMBASE, ERIC, LISTA, PubMed, Scopus, and others. Searches were completed through December 2014. No limits were applied. Hand searching of Medical Library Association annual meeting abstracts from 2009–2014 was also completed. Studies must be about EBP instruction by a librarian within undergraduate or graduate health sciences curricula and include skills assessment. Studies with no assessment, letters and comments, and veterinary education studies were excluded. Data extraction and critical appraisal were performed to determine the risk of bias of each study. Results Twenty-seven studies were included for analysis. Studies occurred in the United States (20), Canada (3), the United Kingdom (1), and Italy (1), with 22 in medicine and 5 in allied health. Teaching methods included lecture (20), small group or one-on-one instruction (16), computer lab practice (15), and online learning (6). Assessments were quizzes or tests, pretests and posttests, peer-review, search strategy evaluations, clinical scenario assignments, or a hybrid. Due to large variability across studies, meta-analysis was not conducted. Discussion Findings were weakly significant for positive change in search performance for most studies. Only one study compared teaching methods, and no one teaching method proved more effective. Future studies could conduct multisite interventions using randomized or quasi-randomized controlled trial study design and standardized assessment tools to measure outcomes. PMID:27366120

  17. 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.

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

    NARCIS (Netherlands)

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

    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

  19. 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

  20. 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.

  1. An evidence-based review on the likely economic and environmental impact of genetically modified cereals and oilseeds for UK agriculture

    OpenAIRE

    Areal, Francisco; Dunwell, Jim; Jones, Philip; Park, Julian; McFarlane, Ian; Srinivasan, Chittur; Tranter, Richard

    2015-01-01

    An evidence-based review of the potential impact that the introduction of genetically-modified (GM) cereal and oilseed crops could have for the UK was carried out. The inter-disciplinary research project addressed the key research questions using scenarios for the uptake, or not, of GM technologies. This was followed by an extensive literature review, stakeholder consultation and financial modelling. The world area of canola, oilseed rape (OSR) low in both erucic acid in the oil and glucosino...

  2. 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.

  3. 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…

  4. 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

  5. Review for librarians of evidence-based practice in nursing and the allied health professions in the United States

    OpenAIRE

    Tweed, Elizabeth M.; Sauers, Eric L.; McLeod, Tamara C. Valovich; Guo, Ruiling; Trahan, Henry; Alpi, Kristine M.; Hill, Beth; Sherwill-Navarro, Pamela; Allen, Margaret (Peg); Stephenson, Priscilla L.; Hartman, Linda M.; Burnham, Judy; Fell, Dennis; Kronenfeld, Michael; Pavlick, Raymond

    2007-01-01

    Objective: This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources.

  6. Evidence-based nursing interventions and guidelines for prone positioning of adult, ventilated patients: A systematic review

    Directory of Open Access Journals (Sweden)

    Anna Nolte

    2008-02-01

    Full Text Available Although the prone positioning of a critically ill patient poses a challenge to nursing interventions, it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to those patients lying prone as to those lying supine. The purpose of this study was firstly to conduct a systematic review of the literature as exploration and description of the evidence in support of the beneficial nursing interventions during prone positioning of ventilated patients, and secondly to develop evidence-based nursing guidelines for the nursing process. This exploratory, descriptive and retrospective systematic review includes data from 45 clinical trials, with a total population of 2 148 patients. Data was extracted onto data abstraction forms, assessed for methodological quality and finally summarised in evidence tables. All statistical calculations for the meta-analysis were performed by the RevMan 4.2.8 program. Prone positioning showed significant (p < 0.0001 increases in the partial pressure of oxygen in arterial blood (PaO2 weighted mean difference (WMD = 11.43 and the partial pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO2/FiO2 ratio (WMD = 21.58, 95% CI = 11.36; 31.8. The effects of complications, oxygenation and haemodynamic outcomes compared with the different prone-positioning protocols produced inconclusive results. Nursing guidelines for prone positioning were developed based on the best available evidence. The lack of related articles on nursing care of prone positioning was a drawback. Based on these results, recommendations are made towards further study on the nursing care of prone-positioned patients. Opsomming Hoewel maaglêposisionering van die pasiënt, wat in ‘n kritieke toestand is, ‘n uitdaging aan verpleegsorg bied, is dit steeds die verantwoordelikheid van die verpleegkundige om dieselfde basiese en kritieke sorg aan pasiënte te lewer in die maaglêposisie as aan pasi

  7. Can UGT1A1 genotyping reduce morbidity and mortality in patients with metastatic colorectal cancer treated with irinotecan? An evidence-based review

    OpenAIRE

    Palomaki, Glenn E; Bradley, Linda A.; Douglas, Michael P.; Kolor, Katherine; Dotson, W. David

    2009-01-01

    This evidence-based review addresses the question of whether testing for UGT1A1 mutations in patients with metastatic colorectal cancer treated with irinotecan leads to improvement in outcomes (e.g., irinotecan toxicity, response to treatment, morbidity, and mortality), when compared with no testing. No studies were identified that addressed this question directly. The quality of evidence on the analytic validity of current UGT1A1 genetic testing methods is adequate (scale: convincing, adequa...

  8. 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.

  9. Health risks for ataxia-telangiectasia mutated heterozygotes: a systematic review, meta-analysis and evidence-based guideline.

    Science.gov (United States)

    van Os, N J H; Roeleveld, N; Weemaes, C M R; Jongmans, M C J; Janssens, G O; Taylor, A M R; Hoogerbrugge, N; Willemsen, M A A P

    2016-08-01

    Ataxia-telangiectasia (AT) is an autosomal recessive neurodegenerative disorder with immunodeficiency and an increased risk of developing cancer, caused by mutations in the ataxia-telangiectasia mutated (ATM) gene. Logically, blood relatives may also carry a pathogenic ATM mutation. Female carriers of such a mutation have an increased risk of breast cancer. Other health risks for carriers are suspected but have never been studied systematically. Consequently, evidence-based guidelines for carriers are not available yet. We systematically analyzed all literature and found that ATM mutation carriers have a reduced life expectancy because of mortality from cancer and ischemic heart diseases (RR 1.7, 95% CI 1.2-2.4) and an increased risk of developing cancer (RR 1.5, 95% CI 0.9-2.4), in particular breast cancer (RRwomen 3.0, 95% CI 2.1-4.5), and cancers of the digestive tract. Associations between ATM heterozygosity and other health risks have been suggested, but clear evidence is lacking. Based on these results, we propose that all female carriers of 40-50 years of age and female ATM c.7271T>G mutation carriers from 25 years of age onwards be offered intensified surveillance programs for breast cancer. Furthermore, all carriers should be made aware of lifestyle factors that contribute to the development of cardiovascular diseases and diabetes. PMID:26662178

  10. Evidence-Based Interventions for Immigrant Students Experiencing Behavioral and Academic Problems: A Systematic Review of the Literature

    Science.gov (United States)

    Bal, Aydin; Perzigian, Aaron B. T.

    2013-01-01

    The purpose of the present research review is to identify effective, high quality school-based interventions for immigrant students with disabilities or academic and behavioral problems. A systematic review of the literature was conducted to synthesize international research studies. Initial and criteria-based selection processes yielded six…

  11. 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…

  12. 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

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

    OpenAIRE

    Williams, Peter G.

    2014-01-01

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

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

    OpenAIRE

    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...

  15. 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.

  16. 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.

  17. 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 answering questions in health care, and can be implemented to minimise biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all...... parameters required by a risk model may not be always feasible. This paper describes novel approaches for determining question suitability and for prioritising questions for systematic review in this area. Risk assessment questions that aim to estimate a parameter are likely to be suitable for systematic...

  18. Evidence-Based Accommodation Decision Making at the Postsecondary Level: Review of the Evidence for Foreign Language Learning

    Science.gov (United States)

    Sparks, Richard L.

    2008-01-01

    This article reviews empirical evidence related to college students classified as learning disabled (LD) and foreign language (FL) learning by examining whether there are differences between: (a) students classified and not classified as LD enrolled in FL courses; (b) LD students with and without IQ-achievement discrepancies and FL aptitude,…

  19. Evidence-Based versus Junk-Based Evaluation Research: Some Lessons from 35 Years of the Evaluation Review

    Science.gov (United States)

    Berk, Richard

    2011-01-01

    Along with the late Howard Freeman, Richard Berk was a founding editor of "Evaluation Review" (then "Evaluation Quarterly") in 1977. He resigned as editor of this journal at the end of 2010. In this article, he reflects on his experiences. (Contains 3 notes.)

  20. Evidence-based nursing interventions and guidelines for prone positioning of adult, ventilated patients: A systematic review

    OpenAIRE

    Anna Nolte; Elsabe Nel; Suegnet Nortje

    2008-01-01

    Although the prone positioning of a critically ill patient poses a challenge to nursing interventions, it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to those patients lying prone as to those lying supine. The purpose of this study was firstly to conduct a systematic review of the literature as exploration and description of the evidence in support of the beneficial nursing interventions during prone positioning of ventilated patients, an...

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

    OpenAIRE

    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...

  2. 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.

  3. 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...

  4. 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...... and electronic patient records for diabetes patients, this paper reports research in progress regarding the prospects and pitfalls of evidence-based development....

  5. 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.

  6. 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

  7. 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].

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

    Science.gov (United States)

    Mandernach, Molly W; Beyth, Rebecca J; Rajasekhar, Anita

    2015-01-01

    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. PMID:26345156

  9. 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.

  10. 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. PMID:24611725

  11. Azilsartan medoxomil in the management of hypertension: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Angeloni E

    2016-04-01

    Full Text Available Emiliano Angeloni Cardiovascular Pathophysiology and Imaging, Sapienza Università di Roma, Rome, Italy Background: Azilsartan (AZI is a relatively new angiotensin receptor blocker available for the treatment of any stage of hypertension, which was eventually given in combination with chlorthalidone (CLT. Objective: To review pharmacology and clinical role of AZI monotherapy and AZI/CLT or AZI/amlodipine combination therapies for hypertension management. Methods: PubMed, Embase, and Cochrane Library were searched using search terms “azilsartan”, “chlorthalidone,” “pharmacology,” “pharmacokinetics,” “pharmacodynamics,” “pharmacoeconomics,” and “cost-effectiveness.” To obtain other relevant information, US Food and Drug Association as well as manufacturer prescribing information were also reviewed. Results: Randomized controlled trials demonstrated AZI to be superior to other sartans, such as valsartan, olmesartan, and candesartan, in terms of 24-hour ambulatory blood pressure monitoring (ABPM reduction with respect. That beneficial effect of azilsartan was also associated with similar safety profiles. When compared to other antihypertensive drugs, azilsartan was found to be superior to any angiotensin-converting enzyme inhibitor, including ramipril, in terms of ABPM results, and noninferior to amlodipine in terms of sleep-BP control. The association of AZI and CLT was then found to be superior to other sartans + thiazide combination therapies in terms of both BP lowering and goal achievement. The combination of AZI and amlodipine has also been tested in clinical trials, but compared only with placebo, demonstrating its superiority in terms of efficacy and similarity in terms of safety. Conclusion: Azilsartan is a safe and effective treatment option for every stage of hypertension, both alone or in fixed-dose combination tablets with chlorthalidone or amlodipine. Beneficial effects of AZI were also noted in patients

  12. Vilazodone for the treatment of major depressive disorder: an evidence-based review of its place in therapy

    Directory of Open Access Journals (Sweden)

    Hellerstein DJ

    2015-04-01

    Full Text Available David J Hellerstein,1,2 Joseph Flaxer11Department of Psychiatry, Columbia University, 2New York State Psychiatric Institute, New York, NY, USAIntroduction: It has clearly been demonstrated that depressive disorders constitute a major worldwide public health problem, with massive economic and quality-of-life consequences. Existing pharmacological treatments have limited efficacy, with only about a third of patients achieving remission on any one medication. Delayed onset of action and variable tolerability contribute to this limited efficacy. Vilazodone, introduced in the US in 2011, has been described as the first member of the serotonin partial agonist-reuptake inhibitor (SPARI class of medications, combining serotonin-reuptake inhibition with 5-HT1A partial agonism. This agent could potentially have benefits for subgroups of depressed patients, including depressed patients with comorbid anxiety and patients with anxiety disorders, and might have fewer sexual side effects than selective serotonin-reuptake inhibitors (SSRIs.Aims: We reviewed existing clinical trials that assess the benefits of vilazodone for treatment of major depression.Evidence review: In clinical trials, including two Phase III studies and two Phase IV studies, vilazodone has been shown to have efficacy greater than placebo on the Montgomery–Åsberg Depression Rating Scale, comparable efficacy to citalopram, and continued benefit after 52 weeks of treatment. The safety profile for vilazodone is comparable to other SSRI medications, and tolerability also appears generally comparable to other SSRI medications.Place in therapy: Vilazodone, which has been described as the first-of-class SPARI medication, may potentially have benefits for subgroups of patients, particularly those depressed individuals with coexisting anxiety symptoms or anxiety disorders. However, convincing evidence for these benefits has as yet not been published.Keywords: vilazodone, antidepressant

  13. Azilsartan medoxomil in the management of hypertension: an evidence-based review of its place in therapy

    Science.gov (United States)

    Angeloni, Emiliano

    2016-01-01

    Background Azilsartan (AZI) is a relatively new angiotensin receptor blocker available for the treatment of any stage of hypertension, which was eventually given in combination with chlorthalidone (CLT). Objective To review pharmacology and clinical role of AZI monotherapy and AZI/CLT or AZI/amlodipine combination therapies for hypertension management. Methods PubMed, Embase, and Cochrane Library were searched using search terms “ azilsartan”, “chlorthalidone,” “pharmacology,” “pharmacokinetics,” “pharmacodynamics,” “pharmacoeconomics,” and “cost-effectiveness.” To obtain other relevant information, US Food and Drug Association as well as manufacturer prescribing information were also reviewed. Results Randomized controlled trials demonstrated AZI to be superior to other sartans, such as valsartan, olmesartan, and candesartan, in terms of 24-hour ambulatory blood pressure monitoring (ABPM) reduction with respect. That beneficial effect of azilsartan was also associated with similar safety profiles. When compared to other antihypertensive drugs, azilsartan was found to be superior to any angiotensin-converting enzyme inhibitor, including ramipril, in terms of ABPM results, and noninferior to amlodipine in terms of sleep-BP control. The association of AZI and CLT was then found to be superior to other sartans + thiazide combination therapies in terms of both BP lowering and goal achievement. The combination of AZI and amlodipine has also been tested in clinical trials, but compared only with placebo, demonstrating its superiority in terms of efficacy and similarity in terms of safety. Conclusion Azilsartan is a safe and effective treatment option for every stage of hypertension, both alone or in fixed-dose combination tablets with chlorthalidone or amlodipine. Beneficial effects of AZI were also noted in patients with any degree of renal impairment. In addition, safety profiles of AZI were similar to that of the placebo. PMID:27103882

  14. 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

  15. 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. PMID:26724823

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Profile of everolimus in the treatment of tuberous sclerosis complex: an evidence-based review of its place in therapy

    Science.gov (United States)

    Capal, Jamie K; Franz, David Neal

    2016-01-01

    Tuberous sclerosis complex (TSC) is a relatively rare genetic disorder, affecting one in 6,000 births. Mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, which have been previously used to prevent solid organ transplant rejection, augment anticancer treatment regimens, and prevent neovascularization of artificial cardiac stents, are now approved for treating TSC-related manifestations, such as subependymal giant cell astrocytomas and renal angiomyolipomas. The use of everolimus in treating subependymal giant cell astrocytomas is supported by long-term Phase II and III clinical trials. Seizures are a common feature in TSC, occurring in up to 96% of patients. While mTOR inhibitors currently do not have regulatory approval in treating this manifestation, small clinical studies have demonstrated beneficial outcomes with everolimus. Further evidence from a forthcoming Phase III clinical study may provide additional support for the use of everolimus for this indication. Also, there are no approved treatments for TSC-associated neuropsychiatric disorders, which include intellectual disability, behavioral difficulties, and autism spectrum disorder, but preclinical data and small studies have suggested that some neuropsychiatric symptoms may be improved through mTOR inhibition therapy. More evidence is needed, particularly regarding safety in young infants. This review focuses on the current evidence supporting the use of everolimus in neurologic and neuropsychiatric manifestations of TSC, and the place of everolimus in therapy. PMID:27601910

  18. An evidence-based review of edoxaban and its role in stroke prevention in patients with nonvalvular atrial fibrillation.

    Science.gov (United States)

    Acharya, Tushar; Deedwania, Prakash

    2015-01-01

    Atrial fibrillation is the most common arrhythmia in the elderly. It is responsible for significant morbidity and mortality from cardioembolic complications like stroke. As a result, atrial fibrillation patients are risk-stratified using the CHADS2 or CHA2DS2-VASc scoring systems. Those at intermediate-to-high risk have traditionally been treated with therapeutic anticoagulation with warfarin for stroke prevention. Although effective, warfarin use is fraught with multiple concerns, such as a narrow therapeutic window, drug-drug and drug-food interactions, and excessive bleeding. Novel oral anticoagulant agents have recently become available as viable alternatives for warfarin therapy. Direct thrombin inhibitor dabigatran and factor Xa inhibitors like rivaroxaban and apixaban have already been approved by the US Food and Drug Administration (FDA) for stroke prevention in patients with nonvalvular atrial fibrillation. Edoxaban is the latest oral direct factor Xa inhibitor studied in the largest novel oral anticoagulant trial so far: ENGAGE AF-TIMI 48. Treatment with a 30 mg or 60 mg daily dose of edoxaban was found to be noninferior to dose-adjusted warfarin in reducing the rate of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, with a lower incidence of bleeding complications and cardiovascular deaths. Edoxaban was recently reviewed by an FDA advisory committee and recommended as a stroke-prophylaxis agent. Once approved, it promises to provide another useful alternative to warfarin therapy. PMID:26019695

  19. An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation.

    Science.gov (United States)

    Deedwania, Prakash; Huang, Grace W

    2012-01-01

    Atrial fibrillation (AF) is a common cardiac arrhythmia, especially in the elderly population. It is associated with cardioembolic complications, particularly strokes, resulting in severe functional deficit or death. AF patients are first stratified into low, intermediate, and high risk for thromboembolic events using the CHADS(2) and CHA(2)DS(2)-VASc score systems. Depending on their risks, patients are treated with either therapeutic anticoagulation with warfarin or acetylsalicylic acid for stroke prevention. Although warfarin is the recommended therapy, it is underutilized clinically due to concern for narrow therapeutic window, drug-to-drug and drug-to-food interactions, and hemorrhagic complications. Newer anticoagulant agents such as dabigatran (a direct thrombin inhibitor) and rivaroxaban (a direct factor Xa inhibitor) have already been approved by US Food and Drug Administration for stroke prevention in patients with nonvalvular atrial fibrillation. Apixaban is the newest oral direct factor Xa inhibitor and it has been extensively studied in the AVERROES and ARISTOTLE trials. Apixaban demonstrated reduced incidence of primary outcome of stroke and bleeding events when compared with warfarin. Apixaban is currently being reviewed by the Food and Drug Administration as a stroke prophylactic agent. In addition, there are several other indirect factor Xa inhibitors and vitamin K antagonists under study presently. Results from these studies will provide us with information about possible alternatives to warfarin. PMID:22826692

  20. 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

  1. 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

    2016-04-01

    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. PMID:26091353

  2. An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation.

    Science.gov (United States)

    Deedwania, Prakash; Huang, Grace W

    2012-01-01

    Atrial fibrillation (AF) is a common cardiac arrhythmia, especially in the elderly population. It is associated with cardioembolic complications, particularly strokes, resulting in severe functional deficit or death. AF patients are first stratified into low, intermediate, and high risk for thromboembolic events using the CHADS(2) and CHA(2)DS(2)-VASc score systems. Depending on their risks, patients are treated with either therapeutic anticoagulation with warfarin or acetylsalicylic acid for stroke prevention. Although warfarin is the recommended therapy, it is underutilized clinically due to concern for narrow therapeutic window, drug-to-drug and drug-to-food interactions, and hemorrhagic complications. Newer anticoagulant agents such as dabigatran (a direct thrombin inhibitor) and rivaroxaban (a direct factor Xa inhibitor) have already been approved by US Food and Drug Administration for stroke prevention in patients with nonvalvular atrial fibrillation. Apixaban is the newest oral direct factor Xa inhibitor and it has been extensively studied in the AVERROES and ARISTOTLE trials. Apixaban demonstrated reduced incidence of primary outcome of stroke and bleeding events when compared with warfarin. Apixaban is currently being reviewed by the Food and Drug Administration as a stroke prophylactic agent. In addition, there are several other indirect factor Xa inhibitors and vitamin K antagonists under study presently. Results from these studies will provide us with information about possible alternatives to warfarin.

  3. An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Deedwania P

    2012-07-01

    Full Text Available Prakash Deedwania,1 Grace W Huang21Chief Cardiology Division, VACCHCS/UCSF, 2Division of Cardiology, UCSF Program, Fresno, CA, USAAbstract: Atrial fibrillation (AF is a common cardiac arrhythmia, especially in the elderly population. It is associated with cardioembolic complications, particularly strokes, resulting in severe functional deficit or death. AF patients are first stratified into low, intermediate, and high risk for thromboembolic events using the CHADS2 and CHA2DS2-VASc score systems. Depending on their risks, patients are treated with either therapeutic anticoagulation with warfarin or acetylsalicylic acid for stroke prevention. Although warfarin is the recommended therapy, it is underutilized clinically due to concern for narrow therapeutic window, drug-to-drug and drug-to-food interactions, and hemorrhagic complications. Newer anticoagulant agents such as dabigatran (a direct thrombin inhibitor and rivaroxaban (a direct factor Xa inhibitor have already been approved by US Food and Drug Administration for stroke prevention in patients with nonvalvular atrial fibrillation. Apixaban is the newest oral direct factor Xa inhibitor and it has been extensively studied in the AVERROES and ARISTOTLE trials. Apixaban demonstrated reduced incidence of primary outcome of stroke and bleeding events when compared with warfarin. Apixaban is currently being reviewed by the Food and Drug Administration as a stroke prophylactic agent. In addition, there are several other indirect factor Xa inhibitors and vitamin K antagonists under study presently. Results from these studies will provide us with information about possible alternatives to warfarin.Keywords: atrial fibrillation, stroke prevention, apixaban

  4. 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. PMID:27099226

  5. Profile of everolimus in the treatment of tuberous sclerosis complex: an evidence-based review of its place in therapy.

    Science.gov (United States)

    Capal, Jamie K; Franz, David Neal

    2016-01-01

    Tuberous sclerosis complex (TSC) is a relatively rare genetic disorder, affecting one in 6,000 births. Mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, which have been previously used to prevent solid organ transplant rejection, augment anticancer treatment regimens, and prevent neovascularization of artificial cardiac stents, are now approved for treating TSC-related manifestations, such as subependymal giant cell astrocytomas and renal angiomyolipomas. The use of everolimus in treating subependymal giant cell astrocytomas is supported by long-term Phase II and III clinical trials. Seizures are a common feature in TSC, occurring in up to 96% of patients. While mTOR inhibitors currently do not have regulatory approval in treating this manifestation, small clinical studies have demonstrated beneficial outcomes with everolimus. Further evidence from a forthcoming Phase III clinical study may provide additional support for the use of everolimus for this indication. Also, there are no approved treatments for TSC-associated neuropsychiatric disorders, which include intellectual disability, behavioral difficulties, and autism spectrum disorder, but preclinical data and small studies have suggested that some neuropsychiatric symptoms may be improved through mTOR inhibition therapy. More evidence is needed, particularly regarding safety in young infants. This review focuses on the current evidence supporting the use of everolimus in neurologic and neuropsychiatric manifestations of TSC, and the place of everolimus in therapy. PMID:27601910

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

    Directory of Open Access Journals (Sweden)

    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

  7. 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

  8. An evidence-based review of edoxaban and its role in stroke prevention in patients with nonvalvular atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Acharya T

    2015-04-01

    Full Text Available Tushar Acharya, Prakash Deedwania Division of Cardiology, Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA Abstract: Atrial fibrillation is the most common arrhythmia in the elderly. It is responsible for significant morbidity and mortality from cardioembolic complications like stroke. As a result, atrial fibrillation patients are risk-stratified using the CHADS2 or CHA2DS2-VASc scoring systems. Those at intermediate-to-high risk have traditionally been treated with therapeutic anticoagulation with warfarin for stroke prevention. Although effective, warfarin use is fraught with multiple concerns, such as a narrow therapeutic window, drug–drug and drug–food interactions, and excessive bleeding. Novel oral anticoagulant agents have recently become available as viable alternatives for warfarin therapy. Direct thrombin inhibitor dabigatran and factor Xa inhibitors like rivaroxaban and apixaban have already been approved by the US Food and Drug Administration (FDA for stroke prevention in patients with nonvalvular atrial fibrillation. Edoxaban is the latest oral direct factor Xa inhibitor studied in the largest novel oral anticoagulant trial so far: ENGAGE AF-TIMI 48. Treatment with a 30 mg or 60 mg daily dose of edoxaban was found to be noninferior to dose-adjusted warfarin in reducing the rate of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, with a lower incidence of bleeding complications and cardiovascular deaths. Edoxaban was recently reviewed by an FDA advisory committee and recommended as a stroke-prophylaxis agent. Once approved, it promises to provide another useful alternative to warfarin therapy. Keywords: atrial fibrillation, stroke prevention, novel oral anticoagulants, factor Xa inhibitors, edoxaban

  9. 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

  10. 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

  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. Evidence based practice

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2011-01-01

    Evidence-based practice (EBP) is an influential interdisciplinary movement that originated in medicine as evidence-based medicine (EBM) about 1992. EBP is of considerable interest to library and information science (LIS) because it focuses on a thorough documentation of the basis for the decision...... is that practitioners lose their autonomy, that the understanding of theory and of underlying mechanisms is weakened, and that the concept of evidence is too narrow in the empiricist tradition. In this article, it is suggested that we should speak of “research-based practice” rather than EBP, because this term is open...... to more fruitful epistemologies and provides a broader understanding of evidence.The focus on scientific argumentation in EBP is an important contribution from EBP to LIS, which is long overdue, but parts of the underlying epistemological assumptions should be replaced: EBP is too narrow, too formalist...

  13. Engendering the Evidence Base: A Critical Review of the Conceptual and Empirical Foundations of Gender-Responsive Interventions for Girls’ Delinquency

    Directory of Open Access Journals (Sweden)

    Patricia K. Kerig

    2013-08-01

    Full Text Available A dramatic rise in arrest rates for girls over the past decade has led to an increasing interest in understanding gender differences in the risk factors that are associated with delinquency. Moreover, the call has been made for the implementation of gender-specific or gender-responsive interventions in order to effectively divert girls from an antisocial course. However, questions have been raised about three key assumptions underlying the gender-responsive approach to girls involved in the juvenile justice system: is there unequivocal evidence for gender-specificity in the risk factors that contribute to girls’ delinquency; is there clear evidence that existing non-gender-responsive evidence-based interventions for delinquency are less effective for girls than boys; and is there well-grounded evidence that interventions specifically tailored for girls are differentially effective? This article reviews the available research regarding each of these questions and proposes an agenda for future research into the development of effective interventions for juvenile justice-involved girls.

  14. 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.

  15. 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.

  16. The Role of 18F-FDG-PET and PET/CT in Patients with Colorectal Liver Metastases Undergoing Selective Internal Radiation Therapy with Yttrium-90: A First Evidence-Based Review

    OpenAIRE

    Salvatore Annunziata; Giorgio Treglia; Carmelo Caldarella; Federica Galiandro

    2014-01-01

    Purpose. To provide a first evidence-based review of the literature on the role of fluorine-18-fluorodeoxyglucose positron emission tomography and positron emission tomography/computed tomography (FDG-PET and PET/CT) in patients with colorectal liver metastases (CRLM) undergoing selective internal radiation therapy (SIRT) with yttrium-90 (90Y) microspheres. Methods. A comprehensive computer literature search was conducted to find relevant published articles on whole-body FDG-PET or PET/CT in ...

  17. 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

  18. 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…

  19. 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…

  20. 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.

  1. 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…

  2. 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].

  3. 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.

  4. 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.

  5. Evidence-based Nursing Practice: To Infinity and Beyond.

    Science.gov (United States)

    Pape, Tess M.

    2003-01-01

    Provides an historical background for evidence-based practice and methods for assimilating research into practice. Information searching, systematic reviews, and other decision-making models are discussed using specific questions for establishing policy guidelines. Stresses the need for evidence-based practice implementing the best-known practices…

  6. Evidence-Based Assessment of Anxiety Disorders in Adults

    Science.gov (United States)

    Antony, Martin M.; Rowa, Karen

    2005-01-01

    This article discusses issues related to the development and dissemination of evidence-based assessment strategies for anxiety disorders and associated problems. It begins with a review of the criteria that should be considered when determining whether particular assessment procedures are evidence-based. These include such factors as reliability,…

  7. Evidence-based Assessment of Cognitive Functioning in Pediatric Psychology

    OpenAIRE

    Campbell, Jonathan M.; Brown, Ronald T.; Cavanagh, Sarah E.; Vess, Sarah F.; Segall, Mathew J.

    2008-01-01

    Objective To review the evidence base for measures of cognitive functioning frequently used within the field of pediatric psychology. Methods From a list of 47 measures identified by the Society of Pediatric Psychology (Division 54) Evidence-Based Assessment Task Force Workgroup, 27 measures were included in the review. Measures were organized, reviewed, and evaluated according to general domains of functioning (e.g., attention/executive functioning, memory). Results Twenty-two of 27 measures...

  8. VLBI2010: The Astro-Geo Connection

    Science.gov (United States)

    Porcas, Richard

    2010-01-01

    VLBI2010 holds out promise for greatly increased precision in measuring geodetic and Earth rotation parameters. As a by-product there will be a wealth of interesting new astronomical data. At the same time, astronomical knowledge may be needed to disentangle the astronomical and geodetic contributions to the measured delays and phases. This presentation explores this astro-geo link.

  9. 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

  10. 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...

  11. Radio-astro-tools and spectral cube

    Science.gov (United States)

    Ginsburg, Adam

    2016-03-01

    SpectralCube is a toolkit for efficiently handling and performing simple analysis of spectral data cubes. It was designed for use with ALMA and JVLA data, but is readily and easily applicable to other data cubes including optical and infrared IFUs. This 5-minute "lightning talk" gives a brief overview and update of spectral_cube & the radio-astro-tools packages.

  12. Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache.

    Science.gov (United States)

    Holtkamp, Matthew D; Grimes, Jamie; Ling, Geoffrey

    2016-06-01

    Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force. Mild TBI or concussion is now well recognized to be a risk of military service as well as participation in athletic sports such as football. Posttraumatic headache (PTH) is the most common symptom after mTBI in US service members. PTH most commonly presents with migraine-like headache features. The following is an overview of the epidemiology, pathophysiology, clinical course, prognosis, complications, and treatment of mTBI and associated comorbidities with a focus on PTH. There is a particular emphasis on emerging evidence-based clinical practice. One important medical consequence of the recognition that mTBI is a highly prevalent among military service members is that the Department of Defense (DoD) is dedicating significant financial and intellectual resources to better understanding and developing treatments for TBI. The identification of the importance of TBI among the US military population has had the added benefit of increasing awareness of this condition among civilian populations, particularly those engaged in both professional and youth sports. The NIH and NSF are also supporting important TBI research. President Obama's Brain Initiative is also providing additional impetus for these efforts. Unfortunately, the understanding of the acute and chronic effects of mTBI on the brain remains limited. Gratefully, there is hope that through innovative research, there will be advances in elucidating the underlying pathophysiology, which will lead to clinical and prognostic indicators, ultimately resulting in new treatment options for this very complicated set of disorders. PMID:27084376

  13. 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.

  14. 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.

  15. 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. PMID:17616326

  16. 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.

  17. 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...

  18. 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...

  19. 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...

  20. 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,…

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. Defending Evidence Based Practice (Editorial

    Directory of Open Access Journals (Sweden)

    Lindsay Glynn

    2007-07-01

    contributing to the existing literature by publishing original research. One of the strengths of the EBLIP journal is the Evidence Summaries section. Not only are these critical appraisals of previously published research, but the critical appraisals themselves are peer reviewed. The knowledge base, therefore, is being populated with original research as well as rigorously evaluated research. Am I still feeling defensive? Perhaps a little. I am sure that the time and effort that I have invested in EBLIP cannot help but create some bias. On the other hand, I have seen that evidence based practice is making an impact on how numerous individuals and institutions approach decision making. I am reading, seeing and hearing about research being designed, performed and evaluated within a new framework. EBP is standard practice in the health professions and is swiftly gaining solid ground in the social sciences, education and in government. Our profession prides itself on being on the cutting edge of information access and management: if information professionals choose not to adopt the model, which has been proven time and time again to be effective, they risk being placed outside cutting edge, innovative practice. Is that where we want to be?

  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. [Evidence-based and promising interventions to prevent infectious diseases among youth as a result of poor hand hygiene in schools: a literature review].

    Science.gov (United States)

    Malherbe, Hélène; Nugier, Angélique; Clément, Juliette; Lamboy, Béatrice

    2013-01-01

    Infectious diseases remain a major cause of death among young people throughout the world. This paper reviews the current knowledge of empirically validated and promising interventions aimed at preventing infectious diseases among children caused by poor hand hygiene in schools. The study used a standard protocol to identify and review the literature and to classify the selected interventions. Approximately ten interventions were found to have a beneficial effect by promoting hand washing and hand hygiene in schools. The study also found that most of the interventions were implemented at elementary school. However, some interventions were also implemented at kindergarten or in child care centers, while others were aimed at university students. Most of the interventions were implemented by teachers, peers and/or external professionals. The study found that hand hygiene is effective regardless of the type of cleaning product used (i.e. antibacterial or plain soap, alcohol-based or alcohol-free hand sanitizer). This study aims to contribute to the understanding of empirically validated and promising interventions and to promote reflection on professional practice in France. PMID:23782636

  9. 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

  10. 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.

  11. 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...... opportunities for play, nature exploration and sensory stimulation. As it is increasingly expected that designers base their decisions on research evidence, there is a need to develop approaches to facilitate this, which also applies to playground design. The design of PlayLab Cph was based on relevant evidence......, best practice, and the theories of Affordances and Behaviour Settings. A post-occupancy evaluation was carried out through a questionnaire survey and observation studies, which revealed that a majority of the potential evidence-based affordances were actualised, and that the application of the theories...

  12. 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

  13. Belatacept for the prophylaxis of organ rejection in kidney transplant patients: an evidence-based review of its place in therapy

    Science.gov (United States)

    Hardinger, Karen L; Sunderland, Daniel; Wiederrich, Jennifer A

    2016-01-01

    Background Belatacept is a novel immunosuppressive therapy designed to improve clinical outcomes associated with kidney transplant recipients while minimizing use of calcineurin inhibitors (CNIs). Methods We searched for clinical trials related to administration of belatacept to kidney transplant patients compared to various immunosuppression regimens, as well as for studies that utilized data from belatacept trials to validate new surrogate measures. The purpose of this review is to consolidate the published evidence of belatacept’s effectiveness and safety in renal transplant recipients to better elucidate its place in clinical practice. Results Analysis of the results from the Belatacept Evaluation of Nephroprotection and Effi-cacy as First-Line Immunosuppressive Trial (BENEFIT) study, a de novo trial that compared cyclosporine (CsA)-based therapy to belatacept-based therapy in standard criteria donors, found a significant difference in mean estimated glomerular filtration rate (eGFR) of 13–15 mL/min/1.73 m2 and 23–27 mL/min/1.73 m2 at 1 year and 7 years, respectively. The BENEFIT-EXT study was similarly designed with the exception that it included extended criteria donors. Renal function improved significantly for the more intensive belatacept group in all years of the BENEFIT-EXT study; however, it was not significant in the less intensive group until 5 years after transplant. Belatacept regimens resulted in lower blood pressure, cholesterol levels, and incidence of new-onset diabetes after transplant compared to CsA-based regimens. Results from conversion of CNIs to belatacept therapy, dual therapy of belatacept with sirolimus, and belatacept with corticosteroid avoidance therapy are also included in this article. Conclusion The evidence reviewed in this article suggests that belatacept is an effective alternative in kidney transplant recipients. Compared to CNI-based therapy, belatacept-based therapy results in superior renal function and similar rates

  14. 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

  15. 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

  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. 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.

  19. 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

  20. 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

  1. IPS guidestar selection for stellar mode (ASTRO)

    Science.gov (United States)

    Mullins, Larry; Wooten, Lewis

    1988-01-01

    This report describes how guide stars are selected for the Optical Sensor Package (OSP) for the Instrument Pointing System (IPS) when it is operating in the stellar mode on the ASTRO missions. It also describes how the objective loads are written and how the various roll angles are related; i.e., the celestial roll or position angle, the objective load roll angles, and the IPS gimbal angles. There is a brief description of how the IPS operates and its various modes of operation; i.e., IDOP, IDIN, and OSPCAL.

  2. Evidence-based medicine – an appropriate tool for evidence-based health policy? A case study from Norway

    OpenAIRE

    Malterud, Kirsti; Bjelland, Anne Karen; Elvbakken, Kari Tove

    2016-01-01

    Abstract Background Evidence-based policy (EBP), a concept modelled on the principles of evidence-based medicine (EBM), is widely used in different areas of policymaking. Systematic reviews (SRs) with meta-analyses gradually became the methods of choice for synthesizing research evidence about interventions and judgements about quality of evidence and strength of recommendations. Critics have argued that the relation between research evi...

  3. COPD exacerbations: an evidence-based review

    OpenAIRE

    Robbins RA

    2012-01-01

    COPD exacerbations are a major source of COPD morbidity, mortality and cost. Exacerbations tend to become more frequent as COPD progresses with the cause assumed to be infectious in about 80% of patients. The mainstay of management is inhaled bronchodilators with judicious use of oxygen, antibiotics, corticosteroids and assisted ventilation. Recent studies have examined strategies to prevent exacerbations of COPD including use of macrolide antibiotics and self-management education.

  4. 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

  5. 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...

  6. 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.

  7. Evidence Base Update for Autism Spectrum Disorder.

    Science.gov (United States)

    Smith, Tristram; Iadarola, Suzannah

    2015-01-01

    This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in this journal (Rogers & Vismara, 2008 ). We identified psychological or behavioral interventions that had been manualized and evaluated in either (a) experimental or quasi-experimental group studies or (b) systematic reviews of single-subject studies. We extracted data from all studies that met these criteria and were published after the previous review. Interventions were categorized across two dimensions. First, primary theoretical principles included applied behavior analysis (ABA), developmental social-pragmatic (DSP), or both. Second, practice elements included scope (comprehensive or focused), modality (individual intervention with the child, parent training, or classrooms), and intervention targets (e.g., spoken language or alternative and augmentative communication). We classified two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA + DSP), 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training), and 5 as possibly efficacious (individual, comprehensive ABA + DSP; comprehensive ABA classrooms; focused ABA for spoken communication; focused ABA parent training; and teacher-implemented, focused DSP). The evidence base for ASD interventions has grown substantially since 2008. An increasing number of interventions have some empirical support; others are emerging as potentially efficacious. Priorities for future research include improving outcome measures, developing interventions for understudied ASD symptoms (e.g., repetitive behaviors), pinpointing mechanisms of action in interventions, and adapting interventions for implementation with fidelity by community providers. PMID:26430947

  8. 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.

    OpenAIRE

    Heather Ganshorn

    2010-01-01

    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 – Subjec...

  9. Reducing Emergency Department Crowding: Evidence Based Strategies.

    Science.gov (United States)

    Khalifa, Mohamed; Zabani, Ibrahim

    2016-01-01

    Emergency department (ED) crowding has become a major barrier to receiving timely care. King Faisal Specialist Hospital & Research Center, Saudi Arabia worked on identifying evidence based strategies for reducing the ED crowding by improving the intake. In addition to a review of literature, qualitative survey methods were used to identify strategies, which were classified into 10 suggested procedures categorized into three types of changes. Physical improvements include using physician cubicles, creating a team triage area and an internal waiting area for less acute patients instead of occupying beds. Technology improvements; include using informatics to update the electronic emergency record with information, using palmar scanning to instantly identify patients and using radio communication devices. Process improvements; include a scribe program to decrease clerical documentation tasks, switching between low flow and high flow processes, placing a physician in triage and using patient segmentation methods. PMID:27350468

  10. Evidence-based integrative dermatology

    Directory of Open Access Journals (Sweden)

    Saravu R Narahari

    2013-01-01

    Full Text Available American recognition for medical pluralism arrived in 1991. The National Center for Complementary and Alternative Medicine was established under the National Institutes of Health in 1998. Following this, patients and researchers began exploring use of integrative medicine. Terence Ryan with Gerry Bodeker in Europe, Brian Berman in America, and the Indian council of Medical Research advocated traditional medicine and integrative medicine. The Institute of Applied Dermatology (IAD, Kerala has developed integrated allopathic (biomedical and ayurvedic therapies to treat Lymphatic Filariasis, Lichen planus, and Vitiligo. Studies conducted at the IAD have created a framework for evidence-based and integrative dermatology (ID. This paper gives an overview of advances in ID with an example of Lichen Planus, which was examined jointly by dermatologists and Ayurveda doctors. The clinical presentation in these patients was listed in a vikruthi table of comparable biomedical terms. A vikruthi table was used for drug selection in ayurvedic dermatology. A total of 19 patients were treated with ayurvedic prescriptions to normalize the vatha-kapha for 3 months. All patients responded and no side effects were recorded. In spite of advancing knowledge on ID, several challenges remain for its use on difficult to treat chronic skin diseases. The formation of new integrative groups and financial support are essential for the growth of ID in India.

  11. 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.

  12. A Third-Generation Evidence Base for Human Spaceflight Risks

    Science.gov (United States)

    Kundrot, Craig E.; Lumpkins, Sarah; Steil, Jennifer; Pellis, Neal; Charles, John

    2014-01-01

    NASA's Human Research Program seeks to understand and mitigate risks to crew health and performance in exploration missions center dot HRP's evidence base consists of an Evidence Report for each HRP risk center dot Three generations of Evidence Reports 1) Review articles + Good content - Limited authorship, infrequent updates 2) Wikipedia articles + Viewed often, very open to contributions - Summary of reviews, very few contributions 3) HRP-controlled wiki articles + Incremental additions to review articles with editorial control

  13. 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.

  14. 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.

  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. ASTROS - A sub-arcsec CCD star tracker

    Science.gov (United States)

    Stanton, R. H.; Alexander, J. W.; Dennison, E. W.; Glavich, T. A.; Salomon, P. M.

    1984-01-01

    The design and application of ASTROS (Advanced Star and Target Reference Optical Sensor) are described, with emphasis on performance test results acquired with a prototype system. The ASTROS tracker provides extremely precise measurements of star image coordinates as inputs to the Image Motion Compensation (IMC) system used to stabilize the science instrument focal planes. Performance levels achieved are dramatic improvements over the levels achieved with image dissector designs with comparable fields of view.

  17. 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.

  18. AstroML: Machine learning and data mining in astronomy

    Science.gov (United States)

    VanderPlas, Jacob; Fouesneau, Morgan; Taylor, Julia

    2014-07-01

    Written in Python, AstroML is a library of statistical and machine learning routines for analyzing astronomical data in python, loaders for several open astronomical datasets, and a large suite of examples of analyzing and visualizing astronomical datasets. An optional companion library, astroML_addons, is available; it requires a C compiler and contains faster and more efficient implementations of certain algorithms in compiled code.

  19. 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.

  20. 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…

  1. 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…

  2. 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....

  3. 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.

  4. 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.

  5. Evidence-based clinical practice

    DEFF Research Database (Denmark)

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

    2016-01-01

    Using the best quality of clinical research evidence is essential for choosing the right treatment for patients. How to identify the best research evidence is, however, difficult. In this narrative review we summarise these threats and describe how to minimise them. Pertinent literature was consi...... research are carefully considered and minimised, research results will be more valid and this will benefit patients and heath care systems....

  6. Evidence-Based ACL Reconstruction.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 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-analyses focused 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. PMID:25692162

  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. Making Evidence-based Practice Educational.

    Science.gov (United States)

    Elliott, John

    2001-01-01

    Examines David Hargreaves' ideas about the nature of evidence-based practice and the future direction for educational research. States that one major theme is that current discourse about evidence-based teaching is uninformed by an articulate educational theory, therefore excluding thoughtful consideration of implications of such a theory for…

  10. Evidence-Based Practice and School Nursing

    Science.gov (United States)

    Adams, Susan; McCarthy, Ann Marie

    2005-01-01

    School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by…

  11. Evidence-Based Clearinghouses in Social Work

    Science.gov (United States)

    Soydan, Haluk; Mullen, Edward J.; Alexandra, Laine; Rehnman, Jenny; Li, You-Ping

    2010-01-01

    Objectives: The purpose of this article is to describe several evidence-based clearinghouses focused on social work and related intervention outcomes, placing them in the context of how such clearinghouses can contribute to research dissemination to foster effective, evidence-based practice. Method: The study employed an analysis of data provided…

  12. 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-

  13. Implementing Evidence-Based Social Work Practice

    Science.gov (United States)

    Mullen, Edward J.; Bledsoe, Sarah E.; Bellamy, Jennifer L.

    2008-01-01

    Recently, social work has been influenced by new forms of practice that hold promise for bringing practice and research together to strengthen the scientific knowledge base supporting social work intervention. The most recent new practice framework is evidence-based practice. However, although evidence-based practice has many qualities that might…

  14. 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

  15. 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...

  16. AMICA, an astro-mapper for AMS

    Science.gov (United States)

    Monfardini, Alessandro; Trampus, Paolo; Battiston, Roberto; Gargiulo, Corrado

    2006-07-01

    The alpha magnetic spectrograph (AMS) is a composite particle detector to be accommodated on the International Space Station (ISS). 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 degrees of freedom. In this paper, we describe in detail the AMICA sub-system, the accommodation/integration issues and the in-flight alignment procedure adopting identified galactic (Pulsars) and extra-galactic (AGNs) sources.

  17. 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...

  18. 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.

  19. 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

  20. [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. PMID:17886755

  1. Sicily statement on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Hopayian Kevork

    2005-01-01

    Full Text Available Abstract Background A variety of definitions of evidence-based practice (EBP exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC". Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.

  2. 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.

  3. 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

  4. De Bijziendheid van evidence based practice

    NARCIS (Netherlands)

    Steyaert, Jan; Biggelaar, Tineke van den; Peels, Johan

    2010-01-01

    Evidence based practice is tegenwoordig "hot"in de sociale sector maar is dat terecht? Is er veel heil van te verwachten en draagt dit bij aan beroepsinnovatie? Kritische beschouwing over een trendy fenomeen.

  5. Evidence Based Practice: Science? Or Art? (Editorial)

    OpenAIRE

    Denise Koufogiannakis

    2011-01-01

    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...

  6. AstroBetter: A Blog and Wiki for Professional Astronomers

    Science.gov (United States)

    Rigby, Jane

    2011-01-01

    AstroBetter.com is a multi-contributor blog and wiki website designed for information sharing among professional astronomers. The goal of the site is to increase the productivity of astronomers by creating a centralized location for tips and tools of our multifaceted trade. Our content includes topics related to data reduction and analysis, general computing, writing papers and proposals, giving talks, teaching, career planning, productivity, organization, and diversity and equity in science and education. While we have several contributors, the site is intended to be community driven and we encourage everyone to publish to the wiki, submit guest posts, suggest post ideas, and to comment on blog entries. One of our primary goals is to consolidate and reduce the transient nature of the astronomy community's collective knowledge base by having an active wiki. Currently, the most common way to share astro-centric tools and tips that are not appropriate for a published paper, is to put them on an individual's website. However, the average astronomer's website will have at least four different addresses over the course of their career and only the site owner can edit the content. As a result, information on personal websites goes stale very quickly and deal links to such sites abound. It is our hope that community maintained wikis, such as the one hosted on AstroBetter, will gradually replace the personal website. In this poster we introduce the contributors to AstroBetter, show statistics about our current readership, give excerpts of some of our most popular posts and wiki entries, and show how anyone can add or edit content on the wiki. The goal of this poster is to spread the work about AstroBetter and increase our community of readers and wiki editors, because together, we can AstroBetter.

  7. AstroGrid: the UK's Virtual Observatory Initiative

    Science.gov (United States)

    Mann, Robert G.; Astrogrid Consortium; Lawrence, Andy; Davenhall, Clive; Mann, Bob; McMahon, Richard; Irwin, Mike; Walton, Nic; Rixon, Guy; Watson, Mike; Osborne, Julian; Page, Clive; Allan, Peter; Giaretta, David; Perry, Chris; Pike, Dave; Sherman, John; Murtagh, Fionn; Harra, Louise; Bentley, Bob; Mason, Keith; Garrington, Simon

    AstroGrid is the UK's Virtual Observatory (VO) initiative. It brings together the principal astronomical data centres in the UK, and has been funded to the tune of ˜pounds 5M over the next three years, via PPARC, as part of the UK e--science programme. Its twin goals are the provision of the infrastructure and tools for the federation and exploitation of large astronomical (X-ray to radio), solar and space plasma physics datasets, and the delivery of federations of current datasets for its user communities to exploit using those tools. Whilst AstroGrid's work will be centred on existing and future (e.g. VISTA) UK datasets, it will seek solutions to generic VO problems and will contribute to the developing international virtual observatory framework: AstroGrid is a member of the EU-funded Astrophysical Virtual Observatory project, has close links to a second EU Grid initiative, the European Grid of Solar Observations (EGSO), and will seek an active role in the development of the common standards on which the international virtual observatory will rely. In this paper we shall primarily describe the concrete plans for AstroGrid's one-year Phase A study, which will centre on: (i) the definition of detailed science requirements through community consultation; (ii) the undertaking of a ``functionality market survey" to test the utility of existing technologies for the VO; and (iii) a pilot programme of database federations, each addressing different aspects of the general database federation problem. Further information on AstroGrid can be found at AstroGrid .

  8. Undergraduate Information Literacy Instruction Is Not Enough to Prepare Junior Doctors for Evidence Based Practice. A Review of: Cullen, R., Clark, M., & Esson, R. (2011. Evidence-based information-seeking skills of junior doctors entering the workforce: An evaluation of the impact of information literacy training during pre-clinical years. Health Information & Libraries Journal, 28(2, 119-129. doi:10.1111/j.1471-1842.2011.00933.x

    Directory of Open Access Journals (Sweden)

    Carol D. Howe

    2012-06-01

    systematic reviews as well as using “explode” and “focus”, which tied for the lowest rating. The observed searches on average were rated lower than the self-assessments on all but one parameter. None of the average scores for either the self-rating or the observer-rating approached “highly skilled”. Conclusion – The authors concluded that the information literacy instruction the participants received as undergraduates did not prepare them adequately for evidence-based practice. Even though most participants said they remembered their undergraduate information literacy instruction, neither the average scores for the self-rating nor the observer-rating approached “highly skilled”. From that they could surmise that the attainment of information literacy should be a career-long learning process, beginning with undergraduate instruction and extending throughout one’s clinical practice.The authors also found that the level of instruction cohorts received as undergraduates did not seem to correspond to their current ability. Cohort 1, who received no information literacy instruction as undergraduates, scored higher on average than cohorts 3 and 4 on the self-assessment and higher than cohorts 3, 4, and 5 on the observer assessment. Cohort 1 also used more evidence based sources than did cohort 4, who received the most training on evidence-based medicine. Cohorts 1 and 2 reported the most postgraduate information literacy instruction, leading the authors to postulate that the further along one is in his medical career, the more important evidence based practice, and thus information literacy instruction, becomes. Even with additional instruction, however, the participants did not seem prepared for evidence-based practice. The authors concluded that information literacy instruction during postgraduate training and clinical practice—possibly giving the doctor’s specialty consideration when designing instruction—might be more important than undergraduate

  9. Acquisition and track algorithms for the Astros star tracker

    Science.gov (United States)

    Shalom, E.; Alexander, J. W.; Stanton, R. H.

    1985-01-01

    The Astros star tracker has been designed for an employment with the Space Shuttle. An achievement of the performance levels needed has required critical trade-offs between the hardware design and the control algorithms. This paper provides a description of the development of the acquisition and track algorithms. Attention is given to an Astros system overview, a system firmware description, cluster evaluation, guide star selection, exposure time determination, video data input, update interval timing, exposure time sequencing full frame video A/D conversion, analog threshold for acquisition, minimum threshold determination, and the theoretical basis for the track algorithm.

  10. The Astro-E/XRS Blocking Filter Calibration

    Science.gov (United States)

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

    1999-01-01

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

  11. 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.

  12. Astro Concepts: Learning Underlying Physics Principles in Conceptual Astronomy

    Science.gov (United States)

    Mazzolini, Margaret; Halls, Bronwyn

    2000-08-01

    Astro Concepts is a project within Swinburne University of Technology in Melbourne developing browser-based software modules on Optical Telescopes, Nebulae and Binary Stars. The modules are designed to enhance students' understanding of basic physics concepts, which underlie introductory-level conceptual astronomy courses. When complete, the Astro Concepts modules will be available for use in university courses in introductory astronomy, introductory physics teaching, secondary teaching and online astronomy education. The strategy outlined here is to obtain a reasonable level of understanding of the necessary physics concepts by presenting them embedded in relevant and interesting astronomy contexts, and by the use of an engaging educational approach requiring active learning by the student.

  13. Evaluation of Evidence-based Nursing Pain Management Practice.

    Science.gov (United States)

    Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

    2015-08-01

    It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

  14. 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

  15. ASTRO-F/FIS observing simulation including detector characteristics

    Science.gov (United States)

    Jeong, Woong-Seob; Pak, Soojong; Lee, Hyung Mok; Nakagawa, Takao; Kim, Minjin; Oh, Sang Hoon; Kaneda, Hidehiro; Makiuti, Sin'itirou; Shirahata, Mai; Matsuura, Shuji; Patrashin, Mikhail A.; Pearson, Chris; Shibai, Hiroshi

    2004-01-01

    We have examined the effects of transients, glitches caused by cosmic ray hits, and the crosstalk of the far-infrared detector arrays on-board ASTRO-F on its survey mode data. We used simple model fits to laboratory measurements for the transients and glitch profiles. We also tested several correction methods, based on these models, to recover the original signal.

  16. The role of ASTRO and the radiation oncologist in preparedness

    International Nuclear Information System (INIS)

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

  17. 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.

  18. AstroML: Python-powered Machine Learning for Astronomy

    Science.gov (United States)

    Vander Plas, Jake; Connolly, A. J.; Ivezic, Z.

    2014-01-01

    As astronomical data sets grow in size and complexity, automated machine learning and data mining methods are becoming an increasingly fundamental component of research in the field. The astroML project (http://astroML.org) provides a common repository for practical examples of the data mining and machine learning tools used and developed by astronomical researchers, written in Python. The astroML module contains a host of general-purpose data analysis and machine learning routines, loaders for openly-available astronomical datasets, and fast implementations of specific computational methods often used in astronomy and astrophysics. The associated website features hundreds of examples of these routines being used for analysis of real astronomical datasets, while the associated textbook provides a curriculum resource for graduate-level courses focusing on practical statistics, machine learning, and data mining approaches within Astronomical research. This poster will highlight several of the more powerful and unique examples of analysis performed with astroML, all of which can be reproduced in their entirety on any computer with the proper packages installed.

  19. Astro-H: science goals, development status, and European contribution

    Science.gov (United States)

    Sanchez-Fernandez, C.

    2015-07-01

    The joint JAXA/NASA ASTRO-H mission is the sixth X-ray mission initiated by the Institute of Space and Astronautical Science (ISAS). 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 a 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). ASTRO-H is expected to provide breakthrough results in the studies of the large-scale structure of the Universe and its evolution, the behaviour of matter in the strong gravitational field regime, providing time-resolved spectra from material approaching the event horizon of a black hole, the physical conditions in sites of cosmic-ray acceleration, and the distribution of dark matter in galaxy clusters at different redshifts. ASTRO-H will be launched into low-Earth orbit from the Tanegashima Space Center, Japan, by a JAXA H-IIA rocket.

  20. 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.

  1. 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...

  2. 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.

  3. AstroGrid-D: Grid technology for astronomical science

    Science.gov (United States)

    Enke, Harry; Steinmetz, Matthias; Adorf, Hans-Martin; Beck-Ratzka, Alexander; Breitling, Frank; Brüsemeister, Thomas; Carlson, Arthur; Ensslin, Torsten; Högqvist, Mikael; Nickelt, Iliya; Radke, Thomas; Reinefeld, Alexander; Reiser, Angelika; Scholl, Tobias; Spurzem, Rainer; Steinacker, Jürgen; Voges, Wolfgang; Wambsganß, Joachim; White, Steve

    2011-02-01

    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 (Section 2.1), and advanced applications for specific scientific purposes (Section 2.2), such as a connection to robotic telescopes (Section 2.2.3). We can show from these examples how grid execution improves e.g. the scientific workflow. Chapter 3 explains the software tools and services that we adapted or newly developed. Section 3.1 is focused on the administrative aspects of the infrastructure, to manage users and monitor activity. Section 3.2 characterises the central components of our architecture: The AstroGrid-D information service to collect and store metadata, a file management system, the data management system, and a job manager for automatic submission of compute tasks. We summarise the successfully established infrastructure in chapter 4, concluding with our future plans to establish AstroGrid-D as a platform of modern e-Astronomy.

  4. ASTRO's 2007 Core Physics Curriculum for Radiation Oncology Residents

    International Nuclear Information System (INIS)

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

  5. 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.     

  6. Evidence-Based Assessment of Obsessive–Compulsive Disorder

    Science.gov (United States)

    Rapp, Amy M.; Bergman, R. Lindsay; Piacentini, John; McGuire, Joseph F.

    2016-01-01

    Obsessive–compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793

  7. 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.

  8. Evidence-Based Assessment of Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Rapp, Amy M; Bergman, R Lindsay; Piacentini, John; McGuire, Joseph F

    2016-01-01

    Obsessive-compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%-2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793

  9. Enhancing learning and teaching through technology: a guide to evidence-based practice for academic developers

    OpenAIRE

    Kirkwood, Adrian; Price, Linda

    2011-01-01

    This is a guide to help academic-developers support academics in developing scholarly and evidence-based approaches to learning and teaching with technology. This has guide been peer reviewed by the Higher Education Academy.

  10. Enhancing learning and teaching through technology: a guide to evidence-based practice for policy makers

    OpenAIRE

    Kirkwood, Adrian; Price, Linda

    2011-01-01

    This is a guide to help Policy-makers support academics in developing scholarly and evidence-based approaches to learning and teaching with technology. This has guide been peer reviewed by the Higher Education Academy.

  11. 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…

  12. 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…

  13. 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,…

  14. 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…

  15. Evaluation of Evidence-Based Nursing Pain Management Practice

    Science.gov (United States)

    Song, Wenjia; Eaton, Linda H.; Gordon, Debra B.; Hoyle, Christine; Doorenbos, Ardith Z.

    2014-01-01

    Background It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. Aims This study aimed to (a) modify and test an evaluation tool for nursing cancer pain documentation, and (b) describe the frequency and quality of nursing pain documentation in one oncology unit via electronic medical system. Design and Setting A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Methods Medical records were examined for 37 adults hospitalized during April and May of 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. Results The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. Conclusions The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

  16. 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.

  17. [Looking for evidence-based medical informatics].

    Science.gov (United States)

    Coiera, Enrico

    2016-03-01

    e-Health is experiencing a difficult time. On the one side, the forecast is for a bright digital health future created by precision medicine and smart devices. On the other hand, most large scale e-health projects struggle to make a difference and are often controversial. Both futures fail because they are not evidence-based. Medical informatics should follow the example of evidence-based medicine, i.e. conduct rigorous research that gives us evidence to solve real world problems, synthesise that evidence and then apply it strictly. We already have the tools for creating a different universe. What we need is evidence, will, a culture of learning, and hard work. PMID:27030221

  18. 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...

  19. 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...

  20. 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.

  1. 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...

  2. 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.

  3. Introduction to astroML: Machine Learning for Astrophysics

    CERN Document Server

    VanderPlas, Jacob T; Ivezic, Zeljko; Gray, Alex

    2014-01-01

    Astronomy and astrophysics are witnessing dramatic increases in data volume as detectors, telescopes and computers become ever more powerful. During the last decade, sky surveys across the electromagnetic spectrum have collected hundreds of terabytes of astronomical data for hundreds of millions of sources. Over the next decade, the data volume will enter the petabyte domain, and provide accurate measurements for billions of sources. Astronomy and physics students are not traditionally trained to handle such voluminous and complex data sets. In this paper we describe astroML; an initiative, based on Python and scikit-learn, to develop a compendium of machine learning tools designed to address the statistical needs of the next generation of students and astronomical surveys. We introduce astroML and present a number of example applications that are enabled by this package.

  4. The ASTRO-H X-ray astronomy satellite

    Science.gov (United States)

    Takahashi, Tadayuki; Mitsuda, Kazuhisa; 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 D.; Boyce, Kevin; Brenneman, Laura; Brown, Gregory; Cackett, Ed; Canavan, Edgar; Chernyakova, Maria; Chiao, Meng; Coppi, Paolo; Costantini, Elisa; de Plaa, Jelle; den Herder, Jan-Willem; DiPirro, Michael; Done, Chris; Dotani, Tadayasu; Doty, John; Ebisawa, Ken; 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, Katsuhiro; Hayashi, Takayuki; 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; Itoh, 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; Khangaluyan, Dmitry; Kilbourne, Caroline; Kimball, Mark; Kimura, Masashi; Kitamoto, Shunji; Kitayama, Tetsu; Kohmura, Takayoshi; Kokubun, Motohide; Konami, Saori; Kosaka, Tatsuro; Koujelev, Alexander; Koyama, Katsuji; Krimm, Hans; Kubota, Aya; Kunieda, Hideyo; LaMassa, Stephanie; Laurent, Philippe; Lebrun, François; 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; O'Dell, Steve; Odaka, Hirokazu; Ogawa, Hiroyuki; Ogawa, Mina; Ogi, Keiji; Ohashi, Takaya; Ohno, Masanori; Ohta, Masayuki; Okajima, Takashi; Okazaki, Tsuyoshi; Ota, Naomi; Ozaki, Masanobu; Paerels, Frits; Paltani, Stéphane; Parmar, Arvind; Petre, Robert; Pinto, Ciro; Pohl, Martin; Pontius, James; Porter, F. S.; Pottschmidt, Katja; Ramsey, Brian; Reis, Rubens; Reynolds, Christopher; Ricci, Claudio; Russell, Helena; Safi-Harb, Samar; Saito, Shinya; Sakai, Shin-ichiro; Sameshima, Hiroaki; Sato, Kosuke; Sato, Rie; Sato, Goro; Sawada, Makoto; Serlemitsos, Peter; Seta, Hiromi; Shibano, Yasuko; Shida, Maki; Shimada, Takanobu; Shirron, Peter; Simionescu, Aurora; Simmons, Cynthia; Smith, Randall; Sneiderman, Gary; Soong, Yang; Stawarz, Lukasz; Sugawara, Yasuharu; Sugita, Satoshi; Szymkowiak, Andrew; Tajima, Hiroyasu; Takahashi, Hiroaki; Takahashi, Hiromitsu; Takeda, Shin-ichiro; Takei, Yoh; Tamagawa, Toru; Tamura, Keisuke; Tamura, Takayuki; Tanaka, Takaaki; Tanaka, Yasuyuki; 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, Hideki; Uchiyama, Yasunobu; 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, Shinya; Yamada, Takahiro; 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

    2014-07-01

    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 ΔE cosmic-ray acceleration, and the distribution of dark matter in galaxy clusters at different redshifts.

  5. [Evidence-based medicine: an epistemological approach].

    Science.gov (United States)

    Henao, Daniel Eduardo; Jaimes, Fabián Alberto

    2009-03-01

    Evidence-based medicine gathers physician's experience and the best scientific evidence to make medical decisions. This proposal has been widely promulgated by medical opinion leaders. Despite a large literature supporting this practice, a formal discussion has not been established regarding its epistemological consequences in daily medical work. The main proposal of evidence-based medicine consists of choosing the best medical decision according to the best available results from scientific studies. Herein, the goal was to highlight inappropriate application of the scientific method used by physics to clinical science. The inaccuracy resides in describing health and disease in strictly numeric equivalents that can be homogenized on a continuous scale. Finally, the authors consider each diseased human being as a complex system, unique and particular, and that this being is defined by an historical background as well as current actual context. Therefore, evidence-based medicine possesses certain limitations that must be recognized in order to to provide better health care to patients. PMID:19753837

  6. ASTRO's core physics curriculum for radiation oncology residents

    International Nuclear Information System (INIS)

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

  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. The evidence base for professional and self-care prevention

    DEFF Research Database (Denmark)

    Twetman, Svante

    2015-01-01

    BACKGROUND: The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures. METHODS: A mapping of systematic reviews (SR) of literature was carried out in Pub....... Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low. CONCLUSIONS: There are knowledge gaps in many domains of cariology...

  9. 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. PMID:27542426

  10. AstroStat-A VO tool for statistical analysis

    Science.gov (United States)

    Kembhavi, A. K.; Mahabal, A. A.; Kale, T.; Jagade, S.; Vibhute, A.; Garg, P.; Vaghmare, K.; Navelkar, S.; Agrawal, T.; Chattopadhyay, A.; Nandrekar, D.; Shaikh, M.

    2015-06-01

    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 analyses are 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 them.

  11. Submillimeter Astronomy from the South Pole (AST/RO)

    Science.gov (United States)

    Stark, Antony A.

    2013-01-01

    The Antarctic Submillimeter Telescope and Remote Observatory (AST/RO), a 1.7 m diameter offset Gregorian telescope for astronomy and aeronomy studies at wavelengths between 200 and 2000 μm, saw first light in 1995 and operated until 2005. It was the first radio telescope to operate continuously throughout the winter on the Antarctic Plateau. It served as a site testing instrument and prototype for later instruments, as well as executing a wide variety of scientific programs that resulted in six doctoral theses and more than one hundred scientific publications. 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. Especially significant are the exceptionally low values of sky noise found at this site, a result of the small water vapor content of the atmosphere. Multiple submillimeter-wave and Terahertz detector systems were in operation on AST/RO, including heterodyne and bolometric arrays. AST/RO's legacy includes comprehensive submillimeter-wave site testing of the South Pole, spectroscopic studies of 492 GHz and 809 GHz neutral atomic carbon and 460 GHz and 806 GHz carbon monoxide in the Milky Way and Magellanic Clouds, and the first detection of the 1.46 THz [N II] line from a ground-based observatory.

  12. 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...

  13. 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 ...

  14. 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.

  15. Paving the way for evidence-based medicine in Pakistan.

    Science.gov (United States)

    Zaidi, Zareen; Hashim, Jawad; Iqbal, Mobeen; Quadri, K Mujtaba

    2007-11-01

    Evidence-based Medicine (EBM) is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimal clinical care to patients. EBM has become popular due to: the need for valid information about diagnosis, prognosis, therapy and prevention during patient care; traditional sources such as textbooks and expert opinion being frequently out-of-date; and knowledge of current best evidence declining with time from graduation from medical college. EBM has become feasible for practicing clinicians due to: new strategies for appraising studies; availability of systematic reviews (summaries) of current best evidence; and information technology (computers with Internet access). In a resource-limited country such as Pakistan, an evidence-based approach can be cost-effective by reducing clinical practices that have no proven benefit. Commonly perceived obstacles to EBM include limited access to computers, the Internet and online resources. Reliable resources of EBM are available (such as The Cochrane Database of Systematic Reviews http://www.cochrane.org) although many of these require paid subscriptions. Another difficulty is the issue of applicability of data from other countries to patients in our setting with different socio-economic factors. Other barriers to EBM in developing countries include: inexperience in small-group learning, limited time to attend workshops, and the lack of role models for practicing EBM. We have also tried to address the common fallacies related to EBM in the hope of greater use of these skills by busy clinicians as well as academic researchers. PMID:18062522

  16. 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

  17. 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.

  18. 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

  19. Magnitude calibration of a fixed head star tracker using Astro-1 flight data

    Science.gov (United States)

    Rakoczy, John M.; West, Mark E.

    1992-01-01

    The Astro-1 UV astronomy mission was hampered by the failures of the automatic star acquisition procedure. The acquisition procedure depended on the Instrument Pointing Subsystem's Fixed Head Star Trackers (FHST) to acquire, track and identify guidestars of known visual magnitude. During the Astro-1 mission it was suspected that the star magnitudes measured by the FHST were much lower than predicted. A postflight investigation of the Astro-1 flight data confirmed and quantified this suspicion. Star magnitude calibration curves computed from the flight data depict the variance from the preflight calibration curves. These results are helping engineers to plan improvements to the acquisition procedure for the upcoming Astro-2 mission.

  20. Peer-review Platform for Astronomy Education Activities

    OpenAIRE

    Russo, Pedro; Gomez, Edward; Heenatigala, Thilina; 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 o...

  1. An evidence-based guideline of using music for elderly with dementia to reduce agitated behaviors

    OpenAIRE

    陳健禧; Chan, Kin-hei, Anthony

    2013-01-01

    Agitated behaviours in dementia elderly predispose to negative outcomes. Music intervention is an evidence-based intervention that could help to ease the situation. The integrative and systematic review studies provide evidence that music intervention is effective in reducing agitated behaviours in dementia elderly. The assessment of the implementation potential, the feasibility and transferability demonstrate the music intervention can be implemented in local setting. An evidence-based guide...

  2. 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.

  3. 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. PMID:14509997

  4. 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.

  5. [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. PMID:26645442

  6. Disseminating evidence-based care into practice.

    Science.gov (United States)

    Coleman, Eric A; Rosenbek, Susan A; Roman, Sarah P

    2013-08-01

    The Centers for Medicare and Medicaid Services (CMS) has launched the Partnership for Patients initiative, promising a 20% reduction in readmissions nationally across all payers by December 31, 2013. To address this ambitious goal, CMS has awarded grants to Hospital Engagement Networks, Pioneer Accountable Care Organizations, and the Community-based Care Transitions Program, as well as instituted new penalties for excessive readmission that began in October 2012. National efforts aimed at realizing this goal are predicated, in part, on our effectiveness in disseminating evidence-based care models into practice to improve outcomes and reduce costs. The Care Transitions Intervention (CTI) has been developed, tested, and disseminated to over 750 health care organizations in 40 states nationwide. Four factors promote wide-scale CTI dissemination. The first factor focuses on model fidelity whereby adopters are given insight into which elements of the intervention can be adapted and customized. The second factor concerns the selection of Transitions Coaches and reinforcement of their role through training and participation in a national peer learning network. The third factor relates to model execution with attention to integrating the intervention into existing workflows and fostering relationships with community stakeholders. The fourth factor involves cultivating the support to sustain or expand the intervention through continually making the business case in a changing health care landscape. The lessons learned through the dissemination and implementation of the CTI may be generalizable to the spread of a variety of evidence-based care models.

  7. 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.

  8. 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.

  9. 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 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

  10. Achievements and Limitations of Evidence-Based Medicine.

    Science.gov (United States)

    Sheridan, Desmond J; Julian, Desmond G

    2016-07-12

    Evidence-based medicine (EBM) has a long history, but was revived in the early 1990s by a campaign mounted by a movement that took its name. The EBM movement focused attention on the need for greater objectivity in medical decision-making and led to the Cochrane Collaboration, which provides reviews of evidence on the basis of comparative research. Important limitations of EBM's effect on medicine have also emerged. Failure to acknowledge the limitations of clinical trials and systematic reviews has limited their applicability to individual patients' circumstances. An almost exclusive focus on drugs and devices has left vast areas of health care in an evidence vacuum. An overdependence on commissions for its research may have limited its independence in selecting what it investigates. EBM needs to widen its scope beyond drugs and devices to address many areas that often lack evidence at present, notably, health policy, management, and reforms. PMID:27386775

  11. 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

  12. An evidence-based view on hyperbilirubinaemia

    NARCIS (Netherlands)

    Dijk, Peter H.; Hulzebos, Christian V.

    2012-01-01

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

  13. 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.

  14. EVIDENCE-BASED USE OF EPLERENONE

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevski

    2014-07-01

    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.

  15. 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.

  16. Oncology Nursing Is Evidence-Based Care.

    Science.gov (United States)

    Kennedy Sheldon, Lisa; Brown, Carlton G

    2016-06-01

    This issue of the Clinical Journal of Oncology Nursing (CJON) will be the final time that you will see the Evidence-Based Practice (EBP) feature column. Why? Because we have seen oncology nursing evolve in the past 20 years and EBP is everywhere! We use it in our clinics and hospital units, incorporate it into decisions about symptom management, and use evidence to develop survivorship guidelines. We discuss EBP in journal clubs and use applications on mobile devices to find the best interventions for our patients. We have oncology nurses sitting on committees to develop guidelines based on the best evidence and expert opinion. We have come a long way and it is our belief that EBP is included in almost every article in CJON and, therefore, a need no longer exists for an individual column about EBP. 
. PMID:27206287

  17. 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.

  18. Theory- and evidence-based Intervention

    DEFF Research Database (Denmark)

    Nissen, Poul

    2011-01-01

    In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence-based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning which includes recognition...... of the influence of community, school, peers, famely and the functional and structural domains of personality at the behavioural, psenomenological, intra-psychic and biophysical level in a dialectical process. One important aspect of the theoretical basis for presentation of this model is that the child......'s personality must be understood in terms of the historical development. This assessment and intervention model focusses equally on strength and virtues as well as obstacles against development within the individual and its relations. Finally, guidelines for how to measure outcome are provided....

  19. Building a Comprehensive Online Homework System for Astro 101 within Sapling Learning

    Science.gov (United States)

    Urban, Andrea

    2014-01-01

    What does an effective homework system for Astro 101 look like? We discuss the method of creating a library of questions for Astro 101 as well as the philosophy behind the types of homework questions (and feedback) that are written within the Sapling Learning homework system. We also discuss which topics may require deeper investigations and how they can be addressed using interactive simulations.

  20. 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.

  1. 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].

  2. Depression in young people: description, assessment and evidence-based treatment

    OpenAIRE

    Carr, Alan

    2008-01-01

    OBJECTIVE: The literature on depression in children and adolescents was reviewed to provide an update for clinicians. REVIEW PROCESS: Literature of particular relevance to evidence-based practice was selected for critical review. Meta-analyses and controlled trials were prioritized for review along with key assessment instruments. OUTCOMES: An up-to-date overview of clinical features, epidemiology, prognosis, aetiology, assessment and intervention was provided. CONCLUSIONS: Depression in chil...

  3. Toward Evidence-Based Transport of Evidence-Based Treatments: MST as an Example

    Science.gov (United States)

    Schoenwald, Sonja K.

    2008-01-01

    This article describes the journey toward evidence-based transport and implementation in usual care settings of Multisystemic Therapy (MST) for youth with drug abuse and behavioral problems (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998). Research and experience informing the design of the MST transport strategy, progress in…

  4. 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…

  5. 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.

  6. 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

  7. 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.    

  8. 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.

  9. 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…

  10. Evidence-based medicine in general practice specialty training

    NARCIS (Netherlands)

    S.E. Zwolsman

    2012-01-01

    Aio’s huisartsgeneeskunde hebben adequate kennis ten aanzien van evidence-based medicine (geneeskunde op basis van bewijs). In de huisartspraktijk is evidence-based gedrag vaak niet direct zichtbaar, maar artsen kunnen wel aangeven op welk aspect van evidence-based medicine de voorgeschreven behande

  11. 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

  12. 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.

  13. 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.

  14. ASTRO-H Soft X-Ray Telescope (SXT)

    Science.gov (United States)

    Soong, Yang; Serlemitsos Peter J.; Okajima, Takashi; Hahne, Devin

    2011-01-01

    ASTRO-H is an astrophysics satellite dedicated for X-ray spectroscopic study non-dispersively and to carry out survey complementally, which will be borne out of US-Japanese collaborative effort. Among the onboard instruments there are four conically approximated Wolter-I X-ray mirrors, among which two of them are soft X-ray mirrors\\ of which the energy range is from a few hundred eV to 15 keY, currently being fabricated in the X-ray Optics Lab at Goddard Space Flight Center. The focal point instruments will be a calorimeter (SXS) and a CCD camera (SXI), respectively. The reflectors of the mirror are made of heat-formed aluminum substrate of the thickness gauged of 152 micron, 229 micron, and 305 micron of the alloy 5052 H-19, followed by epoxy replication on gold-sputtered smooth Pyrex cylindrical mandrels to acquire the X-ray reflective surface. The epoxy layer is 10 micron nominal and surface gold layer of 0.2 micron. Improvements on angular response over the Astro-El/Suzaku mirrors come from error reduction on the figure, the roundness, and the grazing angle/radius mismatching of the reflecting surface, and tighter specs and mechanical strength on supporting structure to reduce the reflector positioning and the assembly errors. In this paper, we report the results of calibration of the engineering model of SXT (EM), and project the quality of the flight mirrors.

  15. 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...

  16. 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.

  17. Decision support for health care: the PROforma evidence base

    Directory of Open Access Journals (Sweden)

    John Fox

    2006-03-01

    Full Text Available Cancer Research UK has developed PROforma, a formal language for modelling clinical processes, along with associated tools for creating decision support, care planning, clinical workflow management and other applications. The PROforma method has been evaluated in a variety of settings: in primary health care (prescribing, referral of suspected cancer patients, genetic risk assessment and in specialist care of patients with breast cancer, leukaemia, HIV infection and other conditions. About nine years of experience have been gained with PROforma technologies. Seven trials of decision support applications have been published or are in preparation. Each of these has shown significant positive effects on a variety of measures of quality and/or outcomes of care. This paper reviews the evidence base for the clinical effectiveness of these PROforma applications, and previews the CREDO project _a multi-centre trial of a complex PROforma application for supporting integrated breast cancer care across primary and secondary care settings.

  18. 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.

  19. [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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  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. Teaching Evidence-Based Medicine More Effectively

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2010-10-01

    Full Text Available Evidence-based Medicine (EBM is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT were 170 members of the medical faculty who were divided into two groups of 86 (intervention and 84 (control. Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI was defined and computed. Results: The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P

  6. 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.

  7. Evidence-based treatment for acute spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Zhouming Deng; Jiajia Su; Lin Cai; Ansong Ping; Wei Jin; Renxiong Wei; Yan Zhan

    2011-01-01

    OBJECTIVE: To formulate an evidence-based treatment for one patient with acute spinal cord injury and summarize evidence for evaluating acute spinal cord injury treatment. METHODS: Studies related to the treatment for acute spinal cord injury were identified via a search of National Guideline Clearinghouse (NGC, 2000-11), the Cochrane Library (Issue 1, 2011), TRIP Database (2000-11), and PubMed (1966-2011). Treatment strategies were formulated according to three basic principles: best evidence, doctor's professional experience, and wishes of the patient. RESULTS: A total of 34 articles were selected, including 1 NGC guideline, 22 systematic reviews, and 11 randomized controlled trials. Based on our review, we arrived at the following recommendations: no clinical evidence exists definitively to recommend the use of any of neuroprotective pharmaceuticals; surgery should be undertaken early; mechanical compression devices and low-molecular weight heparin should be employed to prevent thrombosis; respiratory muscle training is beneficial for pulmonary function and quality of life; and functional electrical stimulation and acupuncture can promote functional recovery. The patient accordingly underwent surgery 6 hours after trauma without receiving any neuroprotective pharmaceuticals; low-molecular weight heparin and intermittent pneumatic compression were applied to prevent thrombosis. He also underwent respiratory muscle training daily for 8 weeks and received functional electrical stimulation for 15 minutes and acupuncture for 30 minutes every day. After follow-up for 3 months, the above therapeutic regimen was confirmed efficacious for acute spinal cord injury.CONCLUSION: Evidence-based medicine provides an individualized treatment protocol for acute spinal cord injury, which can significantly improve the therapeutic effect and prognosis.

  8. 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 ...

  9. 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

  10. 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 PMID:11914169

  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. 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.

  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. 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.

  15. 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.

  16. 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.

  17. Bringing Science into Schools through Astronomy. Project ASTRO, Tucson

    CERN Document Server

    Barban, C; Barban, Caroline; Dole, Herve

    2005-01-01

    We report our experience in bringing science into US and French classrooms. We participated in the US scientific educational program Project ASTRO. It is based on a partnership between a school teacher and an astronomer. They together design and realize simple and interesting scientific activities for the children to learn and enjoy science. We present four hands-on activities we realized in a 4th-grade class (10 yr-old kids) in Tucson (USA) in 2002-2003. Among the covered topics were: the Solar System, the Sun (helioseismology) and the Galaxies. We also present a similar experience done in two classrooms in 2005, in Chatenay-Malabry (France) in partnership with an amateur astronomy association (Aphelie). This is a pleasant and rewarding activity, extremely well appreciated by the children and the school teachers. It furthermore promotes already at a young age the excitement of science, and provides concrete examples of the scientific methodology.

  18. 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...

  19. ASTRO-F/FIS observing simulation including detector effects

    Science.gov (United States)

    Jeong, W.; Pak, S.; Lee, H.; Nakagawa, T.; Kim, M.; Oh, S.; Kaneda, H.; Matsuura, S.; Patrashin, M.; Shibai, H.

    Based on the present hardware specifications and configurations of the ASTRO-F/FIS (Far-Infrared Surveyor), we are developing a software that simulates the observations with this instrument. Various kinds of detector effects affect the quality of the signal obtained from the detector. In order to correct the signal exactly, we need to analyze the characteristics of the detector and simulate various detector effects. In this presentation, we will show the simulated data sets based on the experimental data measured in the laboratory. Using the simulator, we will discuss the effects of cosmic-ray hitting, transient, crosstalk and non-uniformity of detectors, and propose an appropriate methods for the data reduction.

  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. 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.

  2. 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

  3. Do You Need a Textbook to Teach Astro 101?

    Science.gov (United States)

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

    2011-01-01

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

  4. 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.

  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. 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.

  7. 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.

  8. Portuguese version of the evidence-based practice questionnaire

    OpenAIRE

    Pereira, Rui Pedro Gomes; Guerra, Ana; Peixoto, Maria José; Martins, Teresa; Barbieri, Maria do Céu; Carneiro, António Vaz

    2014-01-01

    1. Objectives: Evidence-based practice is defined as the process by which nurses make clinical decisions using the best available scientific evidence, according with their clinical experience and patient preferences in the context of available resources. The Evidence-Based Practice Questionnaire (EBPQ) developed by Upton & Upton (2006) was designed to collect information and opinions on the use of evidence-based practices by health professionals and is validating its important so that it can ...

  9. 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.

  10. 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. ...

  11. 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.

  12. Evidence-based surgical treatment of carotid stenosis. Literature review.

    Science.gov (United States)

    Andaluz, N; Zuccarello, M

    2004-03-01

    Carotid stenosis is an important cause of transient ischemic attacks and stroke. The cause of carotid stenosis is most often atherosclerosis, which accounts for 10% to 20% of brain infarction cases. Despite the introduction of tissue-plasminogen activator and other promising experimental therapies for select patients with acute ischemic stroke prevention remains the best approach to reduce its impact. Stroke-prone patients can be identified and targeted for specific interventions. At this juncture, treatment of carotid stenosis is a well-established therapeutic target and a pillar of stroke prevention. Two main strategies exist for the treatment of carotid stenosis. The 1st is stabilization or halting the progression of the carotid plaque formation with medications and modifications of risk factors (e.g., hypertension, diabetes, smoking, obesity, high cholesterol). The 2nd approach is the elimination or reduction of carotid stenosis by carotid endarterectomy or angioplasty and stenting. Carotid endarterectomy is the mainstay of therapy for symptomatic, severe carotid stenosis. Although its role for asymptomatic patients appears more limited, it is distinct for severe stenosis. Carotid angioplasty and stenting are techniques in maturation with the attractiveness of being less invasive that face the challenge of at least replicating the results of surgery. In this article, we will discuss the surgical management of symptomatic and asymptomatic carotid stenosis based on the evidence provided by the literature. PMID:15257259

  13. Emergency contraception review: evidence-based recommendations for clinicians

    OpenAIRE

    Cleland, Kelly; Raymond, Elizabeth G.; Westley, Elizabeth; Trussell, James

    2014-01-01

    Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile and availability. The most effective emergency contraceptive is the copper IUD, followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, while ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Althoug...

  14. 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.

  15. 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:

  16. Fetal Implications of Diagnostic Radiation Exposure During Pregnancy: Evidence-based Recommendations.

    Science.gov (United States)

    Rimawi, Bassam H; Green, Victoria; Lindsay, Michael

    2016-06-01

    The purpose of this article is to review the fetal and long-term implications of diagnostic radiation exposure during pregnancy. Evidence-based recommendations for radiologic imaging modalities utilizing exposure of diagnostic radiation during pregnancy, including conventional screen-film mammography, digital mammography, tomosynthesis, and contrast-enhanced mammography are described. PMID:26982251

  17. 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…

  18. 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.

  19. The German evidence-based guidelines for Hodgkin's lymphoma. Aspects for radiation oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Eich, H.T.; Kriz, J. [Muenster Univ. (Germany). Dept. of Radiation Oncology; Schmidberger, H. [Mainz Univ. (Germany). Dept. of Radiation Oncology; Boell, B.; Klimm, B.; Engert, A. [Koeln Univ. (Germany). First Dept. of Internal Medicine; Rancea, M. [Koeln Univ. (Germany). Cochrane Haematological Malignancies Group; Mueller, R.P. [Koeln Univ. (Germany). Dept. of Radiation Oncology

    2013-06-15

    This report reviews aspects of the German evidence-based guidelines for Hodgkin's lymphoma relevant to radiation oncologists. Stage-adapted treatment is discussed with the focus on radiotherapy. Up-to-date literature citations provide an overview of current recommendations. (orig.)

  20. 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

  1. Clinical and Research Perspectives on Nonspeech Oral Motor Treatments and Evidence-Based Practice

    Science.gov (United States)

    Muttiah, Nimisha; Georges, Katie; Brackenbury, Tim

    2011-01-01

    Purpose: Evidence-based practice (EBP) involves the incorporation of research evidence, clinical expertise, and client values in clinical decision making. One case in which these factors conflict is the use of nonspeech oral motor treatments (NSOMTs) for children with developmental speech sound disorders. Critical reviews of the research evidence…

  2. 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,…

  3. Motivation and Engagement of Boys: Evidence-Based Teaching Practices. Appendices

    Science.gov (United States)

    Munns, Geoff; Arthur, Leonie; Downes, Toni; Gregson, Robyn; Power, Anne; Sawyer, Wayne; Singh, Michael; Thistleton-Martin, Judith; Steele, Frances

    2012-01-01

    The first appendix in this report is the complete version of the literature review from the research project "Motivation and Engagement of Boys: Evidence-based Teaching Practices." This project was carried out by the University of Western Sydney on behalf of the Australian Government Department of Education, Science and Training (DEST) between…

  4. 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

  5. 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…

  6. 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.

  7. 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. PMID:17312899

  8. 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.

  9. “Evidence of me” in evidence based medicine?

    OpenAIRE

    Lockwood, Susan

    2004-01-01

    Evidence based medicine provides independent, validated advice about treatment options, but does it take sufficient account of individual patients' values to provide them with an optimal health outcome?

  10. Evidence-based practice: developing mentors to support students.

    Science.gov (United States)

    Barry, Debbie; Houghton, Trish; Warburton, Tyler

    2016-08-17

    This article, the ninth in a series of 11, provides guidance for new and established mentors and practice teachers on evidence-based practice, the seventh domain of the Nursing and Midwifery Council's Standards to Support Learning and Assessment in Practice (SSLAP). Evidence-based practice is an important aspect of contemporary healthcare and is central to student preparation programmes for nursing, midwifery and specialist community public health nursing (SCPHN). The article describes evidence-based practice, discussing the importance and implementation of an evidence-based approach in the context of role development for mentors and practice teachers in the preparation of nursing, midwifery and SCPHN students. PMID:27533414

  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. 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.

  14. 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.

  15. 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...

  16. Evidence-based practice for pain identification in cognitively impaired nursing home residents.

    Science.gov (United States)

    Sacoco, Christina; Ishikawa, Sally

    2014-09-01

    Pain identification of cognitively impaired elderly is very challenging. This project aimed to identify best practices for pain assessment in nursing home residents with cognitive impairment and to establish a standardized pain assessment guide to optimize nursing practice and resident outcomes. The Iowa Model of Evidence-Based Practice to Promote Quality of Care guided the project's process. Phase I of the project analyzed data gained from chart reviews on current practices of pain assessment, and Phase II used the results of Phase I to develop, implement, and evaluate an evidence-based practice standard for nursing assessment of pain for cognitively impaired residents. PMID:25155534

  17. 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. PMID:27413657

  18. 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.

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

    Science.gov (United States)

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

    2016-01-01

    This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, and limited to, the absence of evidence for a Serious Adverse Effect, the criteria for which are rigorously defined. This review adopts an evidence-based approach, based on an aggregation of experience from human trials, taking care not to confuse speculation on potential hazards or lack of data to refute such speculation with evidence for risk. Safety data from animal tests for tissue damage are reviewed with systematic consideration of translation to humans. Arbitrary safety considerations are avoided. Computational models are used to relate dose to brain exposure in humans and animals. We review relevant dose-response curves and dose metrics (e.g. current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to theoretically vulnerable populations including children and the elderly, subjects with mood disorders, epilepsy, stroke, implants, and home users. Evidence from relevant animal models indicates that brain injury by Direct Current Stimulation (DCS) occurs at predicted brain current densities (6.3-13 A/m(2)) that are over an order of magnitude above those produced by conventional tDCS. To date, the use of conventional tDCS protocols in human trials (≤40 min, ≤4 milliamperes, ≤7.2 Coulombs) has not produced any reports of a Serious Adverse Effect or irreversible injury across over 33,200 sessions and 1000 subjects with repeated sessions. This includes a wide variety of subjects, including persons from potentially vulnerable populations. PMID:27372845

  20. The Sky is the Limit: Benefits from Partnering with the Project ASTRO National Network!

    Science.gov (United States)

    Walker, Constance E.; Zevin, D.; van der Veen, W.; Fraknoi, A.; Wilson, R.; Gurton, S.; White, V.; Clemens, C.; Harvey, J.

    2006-12-01

    As a partner for EPO programs, the Project ASTRO National Network offers access to hundreds of trained educators and astronomer-educator partnerships across the country. This makes the Network extremely suitable for dissemination and/or testing of new science education products, in particular those that benefit from support by scientists and/or (through Family ASTRO) those that target families/communities. For example, the Network is currently being leveraged (through NASA funding) to create and disseminate nationally new hands-on classroom activities on solar physics. Project ASTRO is a national program that partners professional and amateur astronomers with local educators at regional sites around the country. Developed by the Astronomical Society of the Pacific, Project ASTRO provides training for astronomer-educator partnerships in hands-on, inquiry-based science activities while emphasizing the importance of student preconceptions as a starting point for learning. During an intensive two-day training workshop, a partnership is forged that blends the teacher's knowledge of instructional methods and classroom management with the astronomer's knowledge of and passion for science and astronomy. Nationwide, over 500 active astronomer-educator partnerships bring the excitement of astronomy to over 20,000 students annually. All Project ASTRO sites follow the same model for partnership training and support and meet annually to discuss common strategies and share new ideas. Many sites also target families/communities through the Family ASTRO sister program. Each site (there are 15 total in the Network) is managed by a Lead Institution supported by a Local Coalition of scientific and educational organizations who help with recruiting of new participants, programming, and fund-raising. This poster will detail why the Project ASTRO National Network is an ideal partner for EPO programs. For more information on various ways your organization can partner with the Project

  1. 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.

  2. 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.

  3. Soft X-ray transmission of optical blocking filters for the X-ray CCD cameras onboard Astro-E 2

    Energy Technology Data Exchange (ETDEWEB)

    Kitamoto, Shunji E-mail: kitamoto@rikkyo.ac.jp; Kohmura, Takayoshi; Yamamoto, Norimasa; Saito, Harue; Takano, Haruko; Suga, Kazuharu; Ozawa, Eiji; Suzuki, Kazuma; Kato, Risa; Tachibana, Yusuke; Tsuji, Yusuke; Koganei, Ken; Hayashida, Kiyoshi; Katayama, Haruyoshi; Enoguchi, Hideyuki; Nakashima, Yusuke; Shiroshouji, Takayuki

    2003-06-11

    We measured soft X-ray transmission of Optical Blocking Filters for Charge Coupled Device cameras, which will be launched as focal plane detectors of X-ray telescopes onboard the Japanese fifth X-ray astronomical satellite, Astro-E 2. The filters were made from polyimide coated with Al. The X-ray absorption fine structures at the K edges of C, N, O and Al were measured. The depth of the absorption edge of O was deep, compared to the other elements of polyimide. This is the evidence of the oxidation of Al.

  4. Astro-E2衛星ベーキングにおけるアウトガス量の測定

    OpenAIRE

    Anabuki, Naohisa; 穴吹 直久

    2005-01-01

    Performance of various instruments on-board a satellite could be degraded by the outgas from the satellite on orbit. In order to prevent such degradation, satellite baking in a vacuum chamber is often employed. It is essential to measure the outgassing rate accurately during the baking to evaluate the reduction of the outgas on orbit. The satellite baking of Astro-E2 was carried out for about 10 days in the spring of 2004. A TQCM was used to measure the outgassing rate, which is described in ...

  5. Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

    OpenAIRE

    Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Eickhoff, Axel; Schulze, Johannes

    2015-01-01

    Herbal traditional Chinese medicine (TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providing effective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pu...

  6. Personalizing Research: Special Educators' Awareness of Evidence-Based Practice

    Science.gov (United States)

    Guckert, Mary; Mastropieri, Margo A.; Scruggs, Thomas E.

    2016-01-01

    Although evidence-based practices are considered critical to student success, a research-to-practice gap exists. This qualitative study examined practicing special education teachers' perceptions of their use of evidence-based practices. Special education teachers were interviewed and their classroom practices examined. Major themes emerged and…

  7. Evidence-based gene predictions in plant genomes

    Science.gov (United States)

    Automated evidence-based gene building is a rapid and cost-effective way to provide reliable gene annotations on newly sequenced genomes. One of the limitations of evidence-based gene builders, however, is their requirement for gene expression evidence—known proteins, full-length cDNAs, or expressed...

  8. 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…

  9. Evidence-Based Practice Guidelines and School Nursing

    Science.gov (United States)

    Adams, Susan; McCarthy, Ann Marie

    2007-01-01

    The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

  10. 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.

  11. 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.

  12. Evidence-based intervention in physical activity

    DEFF Research Database (Denmark)

    Heath, Gregory W; Parra, Diana C; Sarmiento, Olga L;

    2012-01-01

    Promotion of physical activity is a priority for health agencies. We searched for reviews of physical activity interventions, published between 2000 and 2011, and identified effective, promising, or emerging interventions from around the world. The informational approaches of community......-wide and mass media campaigns, and short physical activity messages targeting key community sites are recommended. Behavioural and social approaches are effective, introducing social support for physical activity within communities and worksites, and school-based strategies that encompass physical education......, classroom activities, after-school sports, and active transport. Recommended environmental and policy approaches include creation and improvement of access to places for physical activity with informational outreach activities, community-scale and street-scale urban design and land use, active transport...

  13. 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.

  14. Implementation of evidence-based practice: A naturopath perspective.

    Science.gov (United States)

    Ooi, Soo Liang; Rae, John; Pak, Sok Cheon

    2016-02-01

    Evidence-based practice (EBP), an approach to clinical practice that places emphasis on the use of best available research evidence for decision-making, has been adopted broadly in clinical practice. As a patient-focused approach, EBP promotes the spirit of inquiry. It can also facilitate consistency of care across professional boundaries, and clarify the directions of research. However, over-emphasis on systematic reviews and randomised control trials as the "gold standard" for evidence is a major limitation of EBP as it is being practised today. There are also objections to EBP based on epistemological grounds. Complementary and alternative medicine (CAM) therapies often fare unfavourably under the scrutiny of EBP due to the lack of research and inherent differences in healing ideology. Naturopathy is a unique form of CAM, based on both traditional and scientific knowledge. We argue that there is no conflict between naturopathy and EBP. EBP can be adopted as a useful approach to assimilate scientific evidence in naturopathic practices. However, naturopaths need to reconcile tensions between traditional and scientific knowledge in their choice of treatment remedies, while adhering to the naturopathic principles of healing, to benefit the patients. They must also maintain their emphasis on clinical expertise, and also patient preferences and values, in clinical decision-making. PMID:26850801

  15. 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. PMID:26138647

  16. 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.

  17. Updated Evidence-Based Treatment Algorithm in Pulmonary Arterial Hypertension

    Science.gov (United States)

    Barst, Robyn J.; Gibbs, J. Simon; Ghofrani, Hossein A.; Hoeper, Marius M.; McLaughlin, Vallerie V.; Rubin, Lewis J.; Sitbon, Olivier; Tapson, Victor; Galiè, Nazzareno

    2009-01-01

    Uncontrolled and controlled clinical trials with different compounds and procedures are reviewed to define the risk-benefit profiles for therapeutic options in pulmonary arterial hypertension (PAH). A grading system for the level of evidence of treatments based on the controlled clinical trials performed with each compound is used to propose an evidence-based treatment algorithm. The algorithm includes drugs approved by regulatory agencies for the treatment of PAH and/or drugs available for other indications. The different treatments have been evaluated mainly in idiopathic PAH, heritable PAH, and in PAH associated with the scleroderma spectrum of diseases or with anorexigen use. Extrapolation of these recommendations to other PAH subgroups should be done with caution. Oral anticoagulation is proposed for most patients; diuretic treatment and supplemental oxygen are indicated in cases of fluid retention and hypoxemia, respectively. High doses of calcium channel blockers are indicated only in the minority of patients who respond to acute vasoreactivity testing. Nonresponders to acute vasoreactivity testing, or responders who remain in World Health Organization (WHO) functional class III, should be considered candidates for treatment with either an oral phosphodiesterase-5 inhibitor or an oral endothelin-receptor antagonist. Continuous intravenous administration of epoprostenol remains the treatment of choice in WHO functional class IV patients. Combination therapy is recommended for patients treated with PAH monotherapy who remain in New York Heart Association functional class III. Atrial septostomy and lung transplantation are indicated for refractory patients or where medical treatment is unavailable. PMID:19555861

  18. Drugs and blood transfusions: dogma- or evidence-based practice?

    Science.gov (United States)

    Murdock, J; Watson, D; Dorée, C J; Blest, A; Roberts, M M; Brunskill, S J

    2009-02-01

    There is a lack of consensus on the safety of the coadministration of drugs and red blood cells (RBCs). A systematic review was undertaken to establish the evidence base for this question and assess how the evidence may be translated into present clinical day practice. Comprehensive searches of MEDLINE, EMBASE, CINAHL, the Cochrane Library and hand searching of transfusion journals, guidelines and websites identified 12 relevant papers: 11 in-vitro experiments and 1 case report. Data on incidences of haemolysis and agglutination following coadministration were extracted and analysed. Overall findings suggest that iron chelators (two papers), antimicrobials (three papers) and lower doses of opioids (three papers) are safe to coadminister with RBCs. Haemolysis was observed with higher doses of opioids (three papers). Transposition of these findings to clinical practice is limited because of the lack of clinical applicability of in-vitro experiments and diversity in how, and what, clinical outcome measures were used. Further evidence from true clinical settings would be required to inform clinical practice on the efficacy and safety of the coadministration of drugs and RBCs. PMID:19302450

  19. Respiratory clinical guidelines inform ward-based nurses’ clinical skills and knowledge required for evidence-based care

    OpenAIRE

    Alisha M. Johnson; SMITH, Sheree M.S.

    2016-01-01

    Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. ­Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge ­identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory pati...

  20. Introducing evidence based medicine to the journal club, using a structured pre and post test: a cohort study

    OpenAIRE

    Mahoney Martin C; Cramer J Steven

    2001-01-01

    Abstract Background Journal Club at a University-based residency program was restructured to introduce, reinforce and evaluate residents understanding of the concepts of Evidence Based Medicine. Methods Over the course of a year structured pre and post-tests were developed for use during each Journal Club. Questions were derived from the articles being reviewed. Performance with the key concepts of Evidence Based Medicine was assessed. Study subjects were 35 PGY2 and PGY3 residents in a Unive...

  1. 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.

  2. Astro 001 through an Interactive, Multimedia Science Fiction Story

    Science.gov (United States)

    Palma, Christopher; Charlton, J. C.; Tr'Ehnl, N.; Herrmann, K. A.; Narayanan, A.

    2006-12-01

    We present a preview of a new, fully on-line astronomy course for undergraduate non-science majors at Penn State, to be offered for the first time in Spring 2007, with an expected enrollment of 300-600 students. The entire course content is conveyed through an interactive story, capitalizing on the many multimedia astronomy resources publically available on the WWW. The four units of the course, basic astronomy and the nighttime sky, our solar system, stars and the Milky Way Galaxy, and extragalactic astronomy and cosmology deliver the same content as a traditional Astro 001 course. The story for our first unit involves a student abducted by aliens and taken to another planet. There the student is confronted with puzzles involving a different stellar system configuration. The final unit involves a student's quest for a career, aided by visits to alien civilizations in which they explain their varied views of life which is shaped by cosmological findings. The four units are united by a character, the Riddler, who poses riddles about various aspects of the course, and whose identity and purpose is revealed gradually as a reward for completion of various subtopics. This initial offering of the course will be entirely web-based except for traditional evening in-class exams. Our own exams and a standardized preand post-assessment will be used to benchmark our students' performance against those from our traditional course. We gratefully acknowledge funding from an STScI IDEAS award.

  3. AstroCollation: Building Knowledge Communities In Transient Astronomy

    Science.gov (United States)

    Graham, Matthew; Djorgovski, S. G.; Drake, A. J.; Donalek, C.; Mahabal, A. A.; Stalzer, M.; Williams, R. D.

    2010-01-01

    First-generation citizen science projects (such as Galaxy Zoo) have proven very successful at utilizing the efforts of volunteers (human computation) to attack specific problem areas, such as certain types of image analysis, where machines are not currently especially effective. However, there has been little or no attempt in these to capture or transfer the domain knowledge from carbon-based to silicon-based systems. AstroCollation is a next generation collaborative science venture that aims to foster a more synergistic relationship between humans and machines around transient astronomy. Data mining algorithms will be applied to transient event data to produce conceptual models describing them. These models will then be presented to citizen scientists for value judgments, deciding which of a set of models provides the best description, as well as providing contextual information to aid the classification process. Finally decisions and information are factored back into the system and consolidated to produce a consensus description of an event. The project is predicated upon semantic technologies - allowing the formal representation of conceptual relations within a particular domain - and will leverage data and infrastructure from the Catalina Real-time Transient Survey and SkyAlert system. It will address such issues as the formal treatment of uncertainty in data, how to map a multistage computational process to a simple and minimal interface or set of interfaces, and how to fold human computation into a workflow process where time criticality can be important.

  4. Soft x-ray imager (SXI) onboard ASTRO-H

    Science.gov (United States)

    Tsunemi, Hiroshi; Hayashida, Kiyoshi; Tsuru, Takeshi Go; Dotani, Tadayasu; Hiraga, Junko S.; Anabuki, Naohisa; Bamba, Aya; Hatsukade, Isamu; Kohmura, Takayoshi; Mori, Koji; Murakami, Hiroshi; Nakajima, Hiroshi; Ozaki, Masanobu; Uchida, Hiroyuki; Yamauchi, Makoto

    2010-07-01

    We are designing an X-ray CCD camera (SXI) for ASTRO-H, including many new items. We have developed the CCD, CCD-NeXT4, that is a P-channel type CCD. It has a thick depletion layer of 200μm with an imaging area of 30mm square. Since it is back-illuminated, it has a good low energy response and is robust against the impact of micro-meteorites. We will employ 4 chips to cover the area of 60mm square. A mechanical rather than peltier cooler will be employed so that we can cool the CCD to -120°C. We will also introduce an analog ASIC that is placed very close to the CCD. It performs well, having a similar noise level to that assembled by using individual parts used on SUZAKU. We also employ a modulated X-ray source (MXS), that improves the accuracy of the calibration. The SXI will have one of the largest SΩ among various satellites.

  5. The Astro-H Soft X-Ray Mirror

    Science.gov (United States)

    Robinson, David; Okajima, Takashi; Serlemitsos, Peter; Soong, Yang

    2012-01-01

    The Astro-H is led by the Japanese Space Agency (JAXA) in collaboration with many other institutions including the NASA Goddard Space Flight Center. Goddard's contributions include two soft X-ray telescopes (SXTs). The telescopes have an effective area of 562 square cm at 1 keV and 425 square cm at 6 keV with an image quality requirement of 1.7 arc-minutes half power diameter (HPD). The engineering model has demonstrated 1.1 arc-minutes HPD error. The design of the SXT is based on the successful Suzaku mission mirrors with some enhancements to improve the image quality. Two major enhancements are bonding the X-ray mirror foils to alignment bars instead of allowing the mirrors to float, and fabricating alignment bars with grooves within 5 microns of accuracy. An engineering model SXT was recently built and subjected to several tests including vibration, thermal, and X-ray performance in a beamline. Several lessons were learned during this testing that will be incorporated in the flight design. Test results and optical performance are discussed, along with a description of the design of the SXT.

  6. FLASK: Full-sky Lognormal Astro-fields Simulation Kit

    Science.gov (United States)

    Xavier, Henrique S.; Abdalla, Filipe B.; Joachimi, Benjamin

    2016-06-01

    FLASK (Full-sky Lognormal Astro-fields Simulation Kit) makes tomographic realizations on the sphere of an arbitrary number of correlated lognormal or Gaussian random fields; it can create joint simulations of clustering and lensing with sub-per-cent accuracy over relevant angular scales and redshift ranges. It is C++ code parallelized with OpenMP; FLASK generates fast full-sky simulations of cosmological large-scale structure observables such as multiple matter density tracers (galaxies, quasars, dark matter haloes), CMB temperature anisotropies and weak lensing convergence and shear fields. The mutiple fields can be generated tomographically in an arbitrary number of redshift slices and all their statistical properties (including cross-correlations) are determined by the angular power spectra supplied as input and the multivariate lognormal (or Gaussian) distribution assumed for the fields. Effects like redshift space distortions, doppler distortions, magnification biases, evolution and intrinsic aligments can be introduced in the simulations via the input power spectra which must be supplied by the user.

  7. Development and Testing of a Literature Search Protocol for Evidence Based Nursing: An Applied Student Learning Experience

    OpenAIRE

    Andy Hickner; Friese, Christopher R.; Margaret Irwin

    2011-01-01

    Objective – The study aimed to develop a search protocol and evaluate reviewers' satisfaction with an evidence-based practice (EBP) review by embedding a library science student in the process.Methods – The student was embedded in one of four review teams overseen by a professional organization for oncology nurses (ONS). A literature search protocol was developed by the student following discussion and feedback from the review team. Organization staff provided process feedback. Reviewers from...

  8. Becoming evidence based practitioners: a study of final year occupational therapy, speech and language therapy and physiotherapy students at the University of Limerick

    OpenAIRE

    Woods, Fidelma

    2013-01-01

    non-peer-reviewed Background: Health professionals are urged to use evidence-based practice to make valid decisions to optimise client outcomes and clinical efficiency (Rotter et al 2010). Education and fieldwork placement allows health professional students to develop their evidence-base practice knowledge and skills (Stube and Jedlicka 2007). The majority of evidence-base practice studies, focus on qualified healthcare professionals rather than students. Objectives: This study aims to...

  9. 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

  10. 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

  11. Strengths and limitations of evidence-based dermatology

    Directory of Open Access Journals (Sweden)

    Hywel C Williams

    2014-01-01

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

  12. Strengths and limitations of evidence-based dermatology.

    Science.gov (United States)

    Williams, Hywel C

    2014-03-01

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

  13. Interverntion, evidence-based research and everyday life

    DEFF Research Database (Denmark)

    Dreier, Ole

    2011-01-01

    Intervention is a key concept in the technology of psychology and it plays a decisive role in evidence-based research. But analyses of this concept are remarkably sparse. Based on a critical analysis of the conception of intervention in the American Psychological Association’s guidelines for...... evidence-based research and practice, I argue that, while psychological interventions are primarily meant to work in people’s everyday lives, how interventions do so is barely addressed and poorly captured. Evidence-based research, as currently conceived, is an obstacle to overcome this shortcoming...

  14. Evidence based radiation oncology: Breast cancer

    International Nuclear Information System (INIS)

    Purpose: Radiotherapy is, similar to surgery, a local treatment. In the case of breast cancer, it is generally given after conservative or after more extensive, tumour and patient adapted, surgery. The target volumes can be the breast and/or the thoracic wall and/or the regional lymph node areas. The integration and the extent of radiotherapy as part of the comprehensive treatment of the breast cancer patient, including the amount of surgery and the sequencing with the systemic treatments, has to be well discussed with all medical specialists involved in treating breast cancer on a multidisciplinary basis. Guidelines for the appropriate prescription and execution of radiotherapy are of utmost importance. However, individualisation based on the individual patients' and tumours' characteristics should always be envisaged. Materials and methods: Based on a review of the literature the level of evidence that is available for the indications for radiotherapy is summarised, as well as the main clinical questions that are unanswered today. An overview of the recent and ongoing clinical trails in breast cancer will highlight some of the current ongoing debates. Conclusions: In the case of breast cancer, radiotherapy, given after as well conservative as extensive risk-adapted surgery, significantly reduces the risk of local and regional recurrences. Especially for patients with an intermediate to high absolute risk for local recurrences, a positive influence on overall survival has been shown, notably when appropriate radiotherapy techniques are used. Most important is that the best results that we can offer to our breast cancer patients for all clinical endpoints (local and regional control; quality of life; cosmetic results; survival) can be obtained by a multidisciplinary and patient-oriented approach, involving all those involved in the treatment of breast cancer patients

  15. Insufficient Evidence: The Problems of Evidence-Based Nursing.

    Science.gov (United States)

    Rolfe, Gary

    1999-01-01

    Challenges the wisdom of basing nursing practice on the findings of statistical research and offers objections to the philosophy of evidence-based nursing. Proposes rethinking what counts as evidence, suggesting a model based on reflection after the event. (SK)

  16. Implementing evidence-based practices in an emergency department

    DEFF Research Database (Denmark)

    Wassar Kirk, Jeanette; 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...

  17. 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.

  18. 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

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

    OpenAIRE

    Christina Ouzouni; Konstantinos Nakakis

    2008-01-01

    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 litera...

  20. The place of research and Evidence Based Practice in nursing.

    OpenAIRE

    HRSTKOVÁ, Pavla

    2011-01-01

    Nursing is a permanently developing field of activity. Research plays an irreplaceable role in this field. We moreover more and more often see the term Evidence Based Practice nowadays. However a lot of general nurses do not know that this term also relates to the field of nursing, where it is called Evidence Based Nursing. Quantitative research was chosen for this thesis. The research was performed in South Bohemian and Central Bohemian regions among general nurses with bachelor degree. The ...