A Market Failure Perspective on Value Creation in PSM

DEFF Research Database (Denmark)

Berg, Christian Edelvold; Lowe, Gregory Ferrell; Lund, Anker Brink

2014-01-01

Public service media is present in most countries because public intervention of this kind compensates market-failure by providing merit goods that are not provided by commercial players to the public writ large. Nonetheless, PSM is often regarded as a negative for private media providers...

The Role of Explicit and Tacit Knowledge in Purchasing and Supply Management (PSM) Today and in Future

DEFF Research Database (Denmark)

Bals, Lydia; Kelly, Steve; Schulze, Heike

While research has shed considerable light on the organizational-level maturity of PSM organizations, the individual competencies of PSM, especially in light of current developments in the workplace such as digitization, have received relatively less attention. Firstly, this paper identifies the ...

On the bright and dark side of public service motivation : the relationship between PSM and employee wellbeing

NARCIS (Netherlands)

van Loon, Nina Mari; Vandenabeele, Wouter|info:eu-repo/dai/nl/323038816; Leisink, Peter|info:eu-repo/dai/nl/071055266

2015-01-01

This paper reveals that the relationship between public service motivation (PSM) and employee wellbeing depends on the societal impact potential (SIP) through the job and organizational type. In people-changing organizations, PSM relates to higher burnout and lower job satisfaction when SIP is high:

Study on rotational bands in odd-odd nuclei 102,l04Nb by using PSM

International Nuclear Information System (INIS)

Dong Yongsheng; Hu Wentao; Feng Youliang; Wang Jinbao; Yu Shaoying; Shen Caiwan

2012-01-01

The Projected Shell Model (PSM) is used to study the low energy scheme of the neutron-rich normal-deformed isotopes of odd-odd nuclei 102,104 Nb. The quasiparticle configuration is assigned. The theoretical calculations of the energy band of 102,104 Nb could well reproduce the experimental data. It is shown that PSM is a valid method for studying the low energy scheme of heavy nuclei. (authors)

PSM/SH2-B distributes selected mitogenic receptor signals to distinct components in the PI3-kinase and MAP kinase signaling pathways.

Science.gov (United States)

Deng, Youping; Xu, Hu; Riedel, Heimo

2007-02-15

The Pro-rich, PH, and SH2 domain containing mitogenic signaling adapter PSM/SH2-B has been implicated as a cellular partner of various mitogenic receptor tyrosine kinases and related signaling mechanisms. Here, we report in a direct comparison of three peptide hormones, that PSM participates in the assembly of distinct mitogenic signaling complexes in response to insulin or IGF-I when compared to PDGF in cultured normal fibroblasts. The complex formed in response to insulin or IGF-I involves the respective peptide hormone receptor and presumably the established components leading to MAP kinase activation. However, our data suggest an alternative link from the PDGF receptor via PSM directly to MEK1/2 and consequently also to p44/42 activation, possibly through a scaffold protein. At least two PSM domains participate, the SH2 domain anticipated to link PSM to the respective receptor and the Pro-rich region in an association with an unidentified downstream component resulting in direct MEK1/2 and p44/42 regulation. The PDGF receptor signaling complex formed in response to PDGF involves PI 3-kinase in addition to the same components and interactions as described for insulin or IGF-I. PSM associates with PI 3-kinase via p85 and in addition the PSM PH domain participates in the regulation of PI 3-kinase activity, presumably through membrane interaction. In contrast, the PSM Pro-rich region appears to participate only in the MAP kinase signal. Both pathways contribute to the mitogenic response as shown by cell proliferation, survival, and focus formation. PSM regulates p38 MAP kinase activity in a pathway unrelated to the mitogenic response.

Antimicrobial resistance trends among Escherichia coli isolates obtained from dairy cattle in the northeastern United States, 2004-2011.

Science.gov (United States)

Cummings, Kevin J; Aprea, Victor A; Altier, Craig

2014-01-01

Monitoring antimicrobial resistance trends among bacteria isolated from food animals and people is necessary to inform risk analyses and guide public policy regarding antimicrobial use. Our objectives were to describe the antimicrobial resistance status of Escherichia coli isolates from dairy cattle in the northeastern United States and to identify trends in resistance to selected antimicrobial agents over time. We collected data retrospectively for all bovine E. coli isolates that were obtained from samples submitted to Cornell University's Animal Health Diagnostic Center between January 1, 2004 and December 31, 2011. We investigated temporal trends in the prevalence of resistant E. coli for each antimicrobial agent using the Cochran-Armitage trend test. Antimicrobial susceptibility testing was performed on 3373 bovine E. coli isolates from clinical samples submitted during the study period. Overall resistance to each antimicrobial agent ranged from 2.7% (enrofloxacin) to 91.3% (oxytetracycline). There was evidence of a significantly decreasing trend in prevalence of resistance to several agents: chlortetracycline, florfenicol, neomycin, oxytetracycline, spectinomycin, and trimethoprim/sulfamethoxazole. However, a significantly increasing trend in prevalence of resistance to enrofloxacin was also evident. These results do not support the idea that current antimicrobial use practices on dairy operations are driving a general increase in the emergence and dissemination of drug-resistant E. coli in the region served by the laboratory. However, resistance to some drugs remained consistently high during the study period, and increasing resistance to enrofloxacin is a key area of concern.

Cochrane and its prospects in Bosnia and Herzegovina: Relying on Cochrane Croatia.

Science.gov (United States)

Mahmić-Kaknjo, Mersiha; Puljak, Livia; Markotić, Filipa; Fidahić, Mahir; Muhamedagić, Lejla; Zakarija-Grković, Irena

2015-01-01

In this article we describe Cochrane and its products: Cochrane systematic reviews (CSRs) and other Cochrane evidence. Cochrane is a unique, international, non-profit organisation that offers health care providers, health care consumers and other decision makers unbiased and highly reliable information on health, which is pivotal for conscientious and responsible decision making in overall healthcare. Cochrane offers the highest ranked evidence in Evidence Based Medicine (EBM)--systematic reviews. Currently, CSRs are freely available in BH, and therefore, they ought to be widely used, and understood. We will present the new Cochrane Strategy to 2020, which was the main topic of the 6th Croatian Cochrane Symposium (CroCoS), as well as explore prospects for spreading Cochrane activities to Bosnia and Herzegovina (BH), through collaboration with Cochrane Croatia. BH has no officially organized Cochrane activity, as yet. We hope that this article will raise awareness about Cochrane in BH, help promote its activities, and deepen the existing collaboration with Cochrane Croatia. There are already some changes being introduced concerning Cochrane--at least, in one half, the Federation of BH (FBH). Two documents symbolising official recognition of policy changes towards Cochrane have recently been published in the Official Gazette of FBH. Since founding a BH Cochrane Branch would be costly and difficult to achieve in a complicated environment, such as the one we have, BH could use the good will, experience, knowledge, and translated educational, training and web materials of Cochrane Croatia, particularly given the language similarities, to promote evidence based medicine in BH. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Antimicrobial resistance trends among Salmonella isolates obtained from horses in the northeastern United States (2001-2013).

Science.gov (United States)

Cummings, Kevin J; Perkins, Gillian A; Khatibzadeh, Sarah M; Warnick, Lorin D; Aprea, Victor A; Altier, Craig

2016-05-01

OBJECTIVE To describe the antimicrobial resistance patterns of Salmonella isolates obtained from horses in the northeastern United States and to identify trends in resistance to select antimicrobials over time. SAMPLE 462 Salmonella isolates from horses. PROCEDURES Retrospective data were collected for all Salmonella isolates obtained from equine specimens that were submitted to the Cornell University Animal Health Diagnostic Center between January 1, 2001, and December 31, 2013. Temporal trends in the prevalence of resistant Salmonella isolates were investigated for each of 13 antimicrobials by use of the Cochran-Armitage trend test. RESULTS The prevalence of resistant isolates varied among antimicrobials and ranged from 0% (imipenem) to 51.5% (chloramphenicol). During the observation period, the prevalence of resistant isolates decreased significantly for amoxicillin-clavulanic acid, ampicillin, cefazolin, cefoxitin, ceftiofur, chloramphenicol, and tetracycline and remained negligible for amikacin and enrofloxacin. Of the 337 isolates for which the susceptibility to all 13 antimicrobials was determined, 138 (40.9%) were pansusceptible and 192 (57.0%) were multidrug resistant (resistant to ≥ 3 antimicrobial classes). The most common serovar isolated was Salmonella Newport, and although the annual prevalence of that serovar decreased significantly over time, that decrease had only a minimal effect on the observed antimicrobial resistance trends. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that current antimicrobial use in horses is not promoting the emergence and dissemination of antimicrobial-resistant Salmonella strains in the region served by the laboratory.

Evolving Practice Trends of Aortic Root Surgery in North America.

Science.gov (United States)

Caceres, Manuel; Ma, Yicheng; Rankin, J Scott; Saha-Chaudhuri, Paramita; Gammie, James S; Suri, Rakesh M; Thourani, Vinod H; Englum, Brian R; Esmailian, Fardad; Czer, Lawrence S; Puskas, John D; Svensson, Lars G

2014-08-19

Aortic-valve sparing (AVS) techniques have emerged as alternatives to composite graft-valve replacement (CVR) for treatment of aortic root aneurysm. This study analyzed recent practice trends of aortic root surgery using the Society of Thoracic Surgeons database. From January 2000 through June 2011, 31,747, Overall patients received AVS (n=3,585/31,747; 11.3%) or CVR (n=28,162/31,747; 88.7%). A High-Risk Subgroup was defined as: age >75 years, endocarditis, aortic stenosis, dialysis, multi-valve surgery, valve reoperation, or emergency/salvage status, and high-risk patients were less likely to receive AVS (n=20,356/31,747 [64.1%]; 6% AVS; unadjusted operative mortality 10.5% AVS and 11.7% CVR). The remaining patients comprised a Low-Risk Subgroup, in which AVS was more common (n=11,388/31,747 [35.9%]; 21% AVS; unadjusted operative mortality 1.4% AVS and 3.1% CVR). Procedural changes over 3 equal time periods (P1-P2-P3) were evaluated by Cochran-Armitage trends analysis. Compared to AVS, Overall CVR patients had worse baseline risk profiles and higher unadjusted operative mortality. In High-Risk patients, AVS mortality was comparable to CVR (10.5% vs 11.7%, p=0.19), but AVS mortality was lower in the Low-Risk group (1.4% vs 3%, pAVS percentages and trend p-values were: High-Risk (6%/6%/7%, p=0.26) and Low-Risk (12%/21%/25%, pAVS increased over time in Low-Risk patients while bioprostheses increased in CVR. Favorable outcomes support the trend toward further expansion of AVS. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Russian translations for Cochrane.

Science.gov (United States)

Yudina, E V; Ziganshina, L E

2015-01-01

Cochrane collaboration has made a huge contribution to the development of evidence-based medicine; Cochrane work is the international gold standard of independent, credible and reliable high-quality information in medicine. Over the past 20 years the Cochrane Collaboration helped transforming decision-making in health and reforming it significantly, saving lives and contributing to longevity [1]. Until recently, Cochrane evidence were available only in English, which represents a significant barrier to their wider use in non-English speaking countries. To provide access to evidence, obtained from Cochrane Reviews, for health professionals and general public (from non-English-speaking countries), bypassing language barriers, Cochrane collaboration in 2014 initiated an international project of translating Plain language summaries of Cochrane Reviews into other languages [2, 3]. Russian translations of Plain language summaries were started in May 2014 by the team from Kazan Federal University (Department of Basic and Clinical Pharmacology; 2014-2015 as an Affiliated Centre in Tatarstan of the Nordic Cochrane Centre, since August 2015 as Cochrane Russia, a Russian branch of Cochrane Nordic, Head - Liliya Eugenevna Ziganshina) on a voluntary basis. To assess the quality of Russian translations of Cochrane Plain Language Summaries (PLS) and their potential impact on the Russian speaking community through user feedback with the overarching aim of furthering the translations project. We conducted the continuous online survey via Google Docs. We invited respondents through the electronic Russian language discussion forum on Essential Medicines (E-lek), links to survey on the Russian Cochrane.org website, invitations to Cochrane contributors registered in Archie from potential Russian-speaking countries. We set up the survey in Russian and English. The respondents were asked to respond to the questionnaire regarding the relevance and potential impact of the Cochrane Russian

The Cochrane collaboration

NARCIS (Netherlands)

Scholten, R. J. P. M.; Clarke, M.; Hetherington, J.

2005-01-01

The Cochrane Collaboration is an international, not-for-profit organisation that aims to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health-care interventions. Cochrane systematic reviews

Real Time Physiological Status Monitoring (RT-PSM): Accomplishments, Requirements, and Research Roadmap

Science.gov (United States)

2016-03-01

actionable information. With many lessons learned , the first implementation of real time physiological monitoring (RT-PSM) uses thermal-work strain... Bidirectional Inductive On-Body Network (BIONET) for WPSM Develop sensor links and processing nodes on-Soldier and non-RF links off-Soldier Elintrix...recent sleep watches (e.g., BASIS Peak, Intel Corp.) are attempting to parse sleep quality beyond duration and interruptions into deep and REM sleep

Pelatihan Bisol bagi Penyandang Tunarungu dan Tunawicara di SLB PSM Takeran sebagai Bekal Berwirausaha

Directory of Open Access Journals (Sweden)

Swasti Maharani

2018-06-01

Full Text Available Impairment is something that most people do not want. There is impairment due to congenital from birth and there is also impairment caused by accidents. For example is deaf and mute. People with hearing impairment have limited hearing, whereas mute sufferers have limitations in terms of oral /voice and many also experience less hearing. Deaf people and mute need skills to maintain their survival, in SLB PSM Takeran there are lessons that teach about skills, but the skills of students in SLB PSM Takeran not well distributed, the creative craft made by SLB students are still stored neatly in school. Therefore, need to given the training bisol (Bisnis Online for the deaf and mute in SLB PSM Takeran. The training was followed by 12 deaf and mute students at SLB Takeran. The training was held for two days with demo material on how to create social media account starting from e-mail creation, facebook, twitter, instagram, bukalapak, blibli.com and so on, then how to upload photos of products to be marketed, how to send goods Through shipping services. The results of the training were analyzed by qualitative approach. The results of the qualitative analysis (based on observation and interview show that all participants feel the new knowledge and skills, namely the skills of doing business online. In addition, it can provide entrepreneurial supplies for people with deaf and mute. The future plan after this training will be the establishment of a disability community in Kecamatan Takeran, where the community will develop their skills and be able to create jobs for people with disabilities. So as to create financial independence for persons with disabilities.

Regional, Seasonal, and Temporal Variations in the Prevalence of Antimicrobial-Resistant Escherichia coli Isolated from Pigs at Slaughter in Denmark (1997-2005)

DEFF Research Database (Denmark)

Abatih, E. N.; Emborg, Hanne-Dorthe; Jensen, Vibeke Frøkjær

2009-01-01

The aim of this study was to analyze and discuss regional, seasonal, and temporal trends in the occurrence of antimicrobial-resistant Escherichia coli isolated from pigs at slaughter in Denmark between 1997 and 2005. Data on antimicrobial-resistant E. coli were obtained from the Danish Integrated...... Antimicrobial Resistance Monitoring and Research Programme database. The Cochran-Armitage trend test was used to detect the presence and evaluate the significance of regional, seasonal, and annual trends in the occurrence of antimicrobial-resistant E. coli for four drugs. Associations between resistance...... of resistant E. coli as compared to the other seasons of the year. Our study provides evidence of statistically significant regional, seasonal, and temporal variations for ampicillin- and streptomycin-resistant E. coli isolated from pigs at slaughter in Denmark between 1997 and 2005....

Interaction, Co-creation and Participation in PSM Literature, Policy and Strategy: A Comparative Case Study Analysis of Flanders, the Netherlands, France and the UK

Directory of Open Access Journals (Sweden)

Anne-Sofie Vanhaeght

2015-12-01

Full Text Available The article critically evaluates whether there is a (mismatch between ideas on audience involvement in public service media (PSM theory and the translation thereof in public broadcasters’ policy and strategy documents. The literature section theoretically frames this discussion, first, discussing five objectives of PSM and audience involvement. Subsequently, it studies how the BBC (UK, France Télévisions (France, VRT (Flanders, and NPO (the Netherlands have to (policy and intend to (strategy involve their audiences. These cases have been selected with an eye on including both better-funded (BBC, FTV and smaller public broadcasters (VRT, NPO, as well as different media systems. For the analysis, the method of goal-means tree analysis is adopted, a type of qualitative document analysis that can be deployed to uncover goal-means relationships in policy and strategy texts. The main argument is that, rather than a mismatch, some of the questionable, normative assumptions made in theories concerning audience involvement and PSM are also present in the PSM policy and strategy texts.

Exploring the Context Dependency of the PSM-Performance Relationship

DEFF Research Database (Denmark)

Lynggard, Mikkel; Pedersen, Mogens Jin; Andersen, Lotte Bøgh

2016-01-01

The public service motivation (PSM) of public employees matters to their performance at work. Yet research on how context factors moderate the PSM–performance relationship is sparse. This article shows how the PSM–performance relationship may depend on two context factors: (a) the extent of work...... autonomy that a public organization provides its employees and (b) the service users’ capacity to affect the organization’s service provision. We test a set of moderation hypotheses using school data (teacher survey data with administrative data on schools and student). Using within-student between......-teachers fixed effects regression, we find a stronger PSM–performance relationship in organizational contexts involving greater regulation of employee work autonomy for users with low to moderate user capacity....

The first ever Cochrane event in Russia and Russian speaking countries - Cochrane Russia Launch - Evidence-based medicine

DEFF Research Database (Denmark)

Ziganshina, Liliya Eugenevna; Jørgensen, Karsten Juhl

2017-01-01

Kazan hosted Russia's second International Conference QiQUM 2015 on Cochrane evidence for health policy, which was entirely independent of the pharmaceutical or other health industry, bringing together 259 participants from 11 countries and 13 regions of the Russian Federation. The Conference......, Tajikistan and Russia introduced the concept of Cochrane systematic review and the Use of Cochrane evidence in WHO policy setting. Websites document conference materials and provide interface for future collaboration: http......://kpfu.ru/biology-medicine/struktura-instituta/kafedry/kfikf/konferenciya/mezhdunarodnaya-konferenciya-39dokazatelnaya.html and http://russia.cochrane.org/news/international-conference....

Testing for genetic association taking into account phenotypic information of relatives.

Science.gov (United States)

Uh, Hae-Won; Wijk, Henk Jan van der; Houwing-Duistermaat, Jeanine J

2009-12-15

We investigated efficient case-control association analysis using family data. The outcome of interest was coronary heart disease. We employed existing and new methods that take into account the correlations among related individuals to obtain the proper type I error rates. The methods considered for autosomal single-nucleotide polymorphisms were: 1) generalized estimating equations-based methods, 2) variance-modified Cochran-Armitage (MCA) trend test incorporating kinship coefficients, and 3) genotypic modified quasi-likelihood score test. Additionally, for X-linked single-nucleotide polymorphisms we proposed a two-degrees-of-freedom test. Performance of these methods was tested using Framingham Heart Study 500 k array data.

Trends in citations to books on epidemiological and statistical methods in the biomedical literature.

Science.gov (United States)

Porta, Miquel; Vandenbroucke, Jan P; Ioannidis, John P A; Sanz, Sergio; Fernandez, Esteve; Bhopal, Raj; Morabia, Alfredo; Victora, Cesar; Lopez, Tomàs

2013-01-01

There are no analyses of citations to books on epidemiological and statistical methods in the biomedical literature. Such analyses may shed light on how concepts and methods changed while biomedical research evolved. Our aim was to analyze the number and time trends of citations received from biomedical articles by books on epidemiological and statistical methods, and related disciplines. The data source was the Web of Science. The study books were published between 1957 and 2010. The first year of publication of the citing articles was 1945. We identified 125 books that received at least 25 citations. Books first published in 1980-1989 had the highest total and median number of citations per year. Nine of the 10 most cited texts focused on statistical methods. Hosmer & Lemeshow's Applied logistic regression received the highest number of citations and highest average annual rate. It was followed by books by Fleiss, Armitage, et al., Rothman, et al., and Kalbfleisch and Prentice. Fifth in citations per year was Sackett, et al., Evidence-based medicine. The rise of multivariate methods, clinical epidemiology, or nutritional epidemiology was reflected in the citation trends. Educational textbooks, practice-oriented books, books on epidemiological substantive knowledge, and on theory and health policies were much less cited. None of the 25 top-cited books had the theoretical or sociopolitical scope of works by Cochrane, McKeown, Rose, or Morris. Books were mainly cited to reference methods. Books first published in the 1980s continue to be most influential. Older books on theory and policies were rooted in societal and general medical concerns, while the most modern books are almost purely on methods.

Trends in citations to books on epidemiological and statistical methods in the biomedical literature.

Directory of Open Access Journals (Sweden)

Miquel Porta

Full Text Available BACKGROUND: There are no analyses of citations to books on epidemiological and statistical methods in the biomedical literature. Such analyses may shed light on how concepts and methods changed while biomedical research evolved. Our aim was to analyze the number and time trends of citations received from biomedical articles by books on epidemiological and statistical methods, and related disciplines. METHODS AND FINDINGS: The data source was the Web of Science. The study books were published between 1957 and 2010. The first year of publication of the citing articles was 1945. We identified 125 books that received at least 25 citations. Books first published in 1980-1989 had the highest total and median number of citations per year. Nine of the 10 most cited texts focused on statistical methods. Hosmer & Lemeshow's Applied logistic regression received the highest number of citations and highest average annual rate. It was followed by books by Fleiss, Armitage, et al., Rothman, et al., and Kalbfleisch and Prentice. Fifth in citations per year was Sackett, et al., Evidence-based medicine. The rise of multivariate methods, clinical epidemiology, or nutritional epidemiology was reflected in the citation trends. Educational textbooks, practice-oriented books, books on epidemiological substantive knowledge, and on theory and health policies were much less cited. None of the 25 top-cited books had the theoretical or sociopolitical scope of works by Cochrane, McKeown, Rose, or Morris. CONCLUSIONS: Books were mainly cited to reference methods. Books first published in the 1980s continue to be most influential. Older books on theory and policies were rooted in societal and general medical concerns, while the most modern books are almost purely on methods.

Trend and Seasonal Patterns of Injuries and Mortality Due to Motorcyclists Traffic Accidents; A Hospital-Based Study.

Science.gov (United States)

Hosseinpour, Marjan; Mohammadian-Hafshejani, Abdollah; Esmaeilpour Aghdam, Mohammad; Mohammadian, Mahdi; Maleki, Farzad

2017-01-01

To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan. This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database from 2006 to 2010. During the study period, 83648 people injured due to motorcycle traffic accidents were referred to hospitals, all of them entered in the study. Logistic regression model was used to calculate the hospital mortality odds ratio, and Cochrane-Armitage test was used for assessment of linear trend. During the study period, the hospital admission for motorcycle accident was 83,648 and 89.3% (74743) of them were men. Mean age in accidents time was 26.41±14.3 years. The injuries and death sex ratio were 8.4 and 16.9, respectively. Lowest admission rate was during autumn and highest during summer. The injury mortality odds ratio was 1.01 (CI 95% 0.73-1.39) in the Spring, 1.34 (CI95% 1.01-1.79) in summer and 1.17 (CI95% 0.83-1.63). It was also calculated to be 2.51 (CI95% 1.36-4.64) in age group 40-49, 2.39 (CI95% 1.51-5.68) in 50-59 and 4.79 (CI95% 2.49-9.22) in 60-69 years. The mortality odds ratio was 3.53 (CI95% 2.77-4.5) in rural place, 1.33 (CI95% 1.15-1.54) in men, and 2.44 (CI95% 2.09-2.85) in the road out of town and village. In addition, trend of motorcycle accidents mortality was increasing ( p accidents injuries are more common in men, summer, young age and rural roads. These high risk groups need more attention, care and higher training.

Statistical Multiplicity in Systematic Reviews of Anaesthesia Interventions: A Quantification and Comparison between Cochrane and Non-Cochrane Reviews

DEFF Research Database (Denmark)

Imberger, Georgina; Vejlby, Alexandra Hedvig Damgaard; Hansen, Sara Bohnstedt

2011-01-01

Systematic reviews with meta-analyses often contain many statistical tests. This multiplicity may increase the risk of type I error. Few attempts have been made to address the problem of statistical multiplicity in systematic reviews. Before the implications are properly considered, the size...... of systematic reviews and aimed to assess whether this quantity is different in Cochrane and non-Cochrane reviews....... of the issue deserves clarification. Because of the emphasis on bias evaluation and because of the editorial processes involved, Cochrane reviews may contain more multiplicity than their non-Cochrane counterparts. This study measured the quantity of statistical multiplicity present in a population...

Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States.

Science.gov (United States)

Rao, Pravin Kumar; Boulet, Sheree L; Mehta, Akanksha; Hotaling, James; Eisenberg, Michael L; Honig, Stanton C; Warner, Lee; Kissin, Dmitry M; Nangia, Ajay K; Ross, Lawrence S

2017-04-01

Although testosterone replacement therapy use in the United States has increased dramatically in the last decade, to our knowledge trends in testosterone replacement therapy use among reproductive-age men have not been investigated. We assessed changes in testosterone replacement therapy use and practice patterns among 18 to 45-year-old American men from 2003 to 2013 and compared them to older men. This is a retrospective, cross-sectional analysis of men 18 to 45 and 56 to 64 years old who were enrolled in the Truven Health MarketScan® Commercial Claims Databases throughout each given calendar year from 2003 to 2013, including 5,094,868 men in 2013. Trends in the yearly rates of testosterone replacement therapy use were calculated using Poisson regression. Among testosterone replacement therapy users, the Cochran-Armitage test was used to assess temporal trends in age, formulation type, semen analysis and serum testosterone level testing during the 12 months preceding the documented use of testosterone replacement therapy. Between 2003 and 2013, there was a fourfold increase in the rate of testosterone use among 18 to 45-year-old men from 29.2/10,000 person-years to 118.1/10,000 person-years (p replacement therapy users, topical gel formulations were initially most used. Injection use then doubled between 2009 and 2012 (23.5% and 46.2%, respectively) and surpassed topical gel use in 2013. In men 56 to 64 years old there was a statistically significant threefold increase in testosterone replacement therapy use (p replacement therapy use increased fourfold in men 18 to 45 years old compared to threefold in older men. This younger age group should be a focus for future studies due to effects on fertility and unknown long-term sequelae. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Increasing antimicrobial resistance in clinical isolates of Staphylococcus intermedius group bacteria and emergence of MRSP in the UK.

Science.gov (United States)

Beever, L; Bond, R; Graham, P A; Jackson, B; Lloyd, D H; Loeffler, A

2015-02-14

Frequencies of antimicrobial resistance were determined amongst 14,555 clinical Staphylococcus intermedius group (SIG) isolates from UK dogs and cats to estimate resistance trends and quantify the occurrence of meticillin-resistant Staphylococcus pseudintermedius (MRSP). Reports from two diagnostic laboratories (13,313 general submissions, 1242 referral centre only submissions) were analysed retrospectively (2003/2006-2012). MRSP were defined by phenotypic resistance to meticillin and concurrent broad β-lactam resistance; a subset was confirmed genetically (SIG-specific nuc and mecA). Trends were analysed by Cochran-Armitage test. Resistance remained below 10 per cent for cefalexin, amoxicillin-clavulanic acid and the fluoroquinolones. Increasing resistance trends were seen in both laboratories for ampicillin/amoxicillin (both PResistance to cefalexin increased over time in referral hospital isolates (Presistance to important antimicrobials was identified overtime and the emergence of MRSP from UK clinical cases was confirmed. Attention to responsible use of antibacterial therapy in small animal practice is urgently needed. British Veterinary Association.

Knowledge Translation: The Bridging Function of Cochrane Rehabilitation.

Science.gov (United States)

Negrini, Stefano; Gimigliano, Francesca; Arienti, Chiara; Kiekens, Carlotte

2017-12-12

Cochrane Rehabilitation is aimed to ensure that all rehabilitation professionals can apply Evidence Based Clinical Practice and take decisions according to the best and most appropriate evidence in this specific field, combining the best available evidence as gathered by high-quality Cochrane systematic reviews, with their own clinical expertise and the values of patients. This mission can be pursued through knowledge translation. The aim of this article is to shortly present what knowledge translation is, how and why Cochrane (previously known as Cochrane Collaboration) is trying to reorganize itself in light of knowledge translation, and the relevance that this process has for Cochrane Rehabilitation and in the end for the whole world of rehabilitation. It is well known how it is difficult to effectively apply in everyday life what we would like to do and to apply the scientific knowledge in the clinical field: this is called the know-do gap. In the field of evidence-based medicine, where Cochrane belongs, it has been proven that high-quality evidence is not consistently applied in practice. A solution to these problems is the so-called knowledge translation. In this context, Cochrane Rehabilitation is organized to provide the best possible knowledge translation in both directions (bridging function), obviously toward the world of rehabilitation (spreading reviews), but also to the Cochrane community (production of reviews significant for rehabilitation). Cochrane is now strongly pushing to improve its knowledge translation activities, and this creates a strong base for Cochrane Rehabilitation work, focused not only on spreading the evidence but also on improving its production to make it more meaningful for the world of rehabilitation. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Feasibility of a knowledge translation CME program: Courriels Cochrane.

Science.gov (United States)

Pluye, Pierre; Grad, Roland; Granikov, Vera; Theriault, Guyléne; Frémont, Pierre; Burnand, Bernard; Mercer, Jay; Marlow, Bernard; Arroll, Bruce; Luconi, Francesca; Légaré, France; Labrecque, Michel; Ladouceur, Roger; Bouthillier, France; Sridhar, Soumya Bindiganavile; Moscovici, Jonathan

2012-01-01

Systematic literature reviews provide best evidence, but are underused by clinicians. Thus, integrating Cochrane reviews into continuing medical education (CME) is challenging. We designed a pilot CME program where summaries of Cochrane reviews (Courriels Cochrane) were disseminated by e-mail. Program participants automatically received CME credit for each Courriel Cochrane they rated. The feasibility of this program is reported (delivery, participation, and participant evaluation). We recruited French-speaking physicians through the Canadian Medical Association. Program delivery and participation were documented. Participants rated the informational value of Courriels Cochrane using the Information Assessment Method (IAM), which documented their reflective learning (relevance, cognitive impact, use for a patient, expected health benefits). IAM responses were aggregated and analyzed. The program was delivered as planned. Thirty Courriels Cochrane were delivered to 985 physicians, and 127 (12.9%) completed at least one IAM questionnaire. Out of 1109 Courriels Cochrane ratings, 973 (87.7%) conta-ined 1 or more types of positive cognitive impact, while 835 (75.3%) were clinically relevant. Participants reported the use of information for a patient and expected health benefits in 595 (53.7%) and 569 (51.3%) ratings, respectively. Program delivery required partnering with 5 organizations. Participants valued Courriels Cochrane. IAM ratings documented their reflective learning. The aggregation of IAM ratings documented 3 levels of CME outcomes: participation, learning, and performance. This evaluation study demonstrates the feasibility of the Courriels Cochrane as an approach to further disseminate Cochrane systematic literature reviews to clinicians and document self-reported knowledge translation associated with Cochrane reviews. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and

Feasibility of a Knowledge Translation CME Program: "Courriels Cochrane"

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Pluye, Pierre; Grad, Roland; Granikov, Vera; Theriault, Guylene; Fremont, Pierre; Burnand, Bernard; Mercer, Jay; Marlow, Bernard; Arroll, Bruce; Luconi, Francesca; Legare, France; Labrecque, Michel; Ladouceur, Roger; Bouthillier, France; Sridhar, Soumya Bindiganavile; Moscovici, Jonathan

2012-01-01

Introduction: Systematic literature reviews provide best evidence, but are underused by clinicians. Thus, integrating Cochrane reviews into continuing medical education (CME) is challenging. We designed a pilot CME program where summaries of Cochrane reviews ("Courriels Cochrane") were disseminated by e-mail. Program participants…

A probabilistic sampling method (PSM for estimating geographic distance to health services when only the region of residence is known

Directory of Open Access Journals (Sweden)

Peek-Asa Corinne

2011-01-01

Full Text Available Abstract Background The need to estimate the distance from an individual to a service provider is common in public health research. However, estimated distances are often imprecise and, we suspect, biased due to a lack of specific residential location data. In many cases, to protect subject confidentiality, data sets contain only a ZIP Code or a county. Results This paper describes an algorithm, known as "the probabilistic sampling method" (PSM, which was used to create a distribution of estimated distances to a health facility for a person whose region of residence was known, but for which demographic details and centroids were known for smaller areas within the region. From this distribution, the median distance is the most likely distance to the facility. The algorithm, using Monte Carlo sampling methods, drew a probabilistic sample of all the smaller areas (Census blocks within each participant's reported region (ZIP Code, weighting these areas by the number of residents in the same age group as the participant. To test the PSM, we used data from a large cross-sectional study that screened women at a clinic for intimate partner violence (IPV. We had data on each woman's age and ZIP Code, but no precise residential address. We used the PSM to select a sample of census blocks, then calculated network distances from each census block's centroid to the closest IPV facility, resulting in a distribution of distances from these locations to the geocoded locations of known IPV services. We selected the median distance as the most likely distance traveled and computed confidence intervals that describe the shortest and longest distance within which any given percent of the distance estimates lie. We compared our results to those obtained using two other geocoding approaches. We show that one method overestimated the most likely distance and the other underestimated it. Neither of the alternative methods produced confidence intervals for the distance

A probabilistic sampling method (PSM) for estimating geographic distance to health services when only the region of residence is known

Science.gov (United States)

2011-01-01

Background The need to estimate the distance from an individual to a service provider is common in public health research. However, estimated distances are often imprecise and, we suspect, biased due to a lack of specific residential location data. In many cases, to protect subject confidentiality, data sets contain only a ZIP Code or a county. Results This paper describes an algorithm, known as "the probabilistic sampling method" (PSM), which was used to create a distribution of estimated distances to a health facility for a person whose region of residence was known, but for which demographic details and centroids were known for smaller areas within the region. From this distribution, the median distance is the most likely distance to the facility. The algorithm, using Monte Carlo sampling methods, drew a probabilistic sample of all the smaller areas (Census blocks) within each participant's reported region (ZIP Code), weighting these areas by the number of residents in the same age group as the participant. To test the PSM, we used data from a large cross-sectional study that screened women at a clinic for intimate partner violence (IPV). We had data on each woman's age and ZIP Code, but no precise residential address. We used the PSM to select a sample of census blocks, then calculated network distances from each census block's centroid to the closest IPV facility, resulting in a distribution of distances from these locations to the geocoded locations of known IPV services. We selected the median distance as the most likely distance traveled and computed confidence intervals that describe the shortest and longest distance within which any given percent of the distance estimates lie. We compared our results to those obtained using two other geocoding approaches. We show that one method overestimated the most likely distance and the other underestimated it. Neither of the alternative methods produced confidence intervals for the distance estimates. The algorithm

Who cares? The lost legacy of Archie Cochrane.

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Askheim, Clemet; Sandset, Tony; Engebretsen, Eivind

2017-03-01

Over the last 20 years, the evidence-based medicine (EBM) movement has sought to develop standardised approaches to patient treatment by drawing on research results from randomised controlled trials (RCTs). The Cochrane Collaboration and its eponym, Archie Cochrane, have become symbols of this development, and Cochrane's book Effectiveness and Efficiency from 1972 is often referred to as the first sketch of what was to become EBM. In this article, we claim that this construction of EBM's historical roots is based on a selective reading of Cochrane's text. Through a close reading of this text, we show that the principal aim of modern EBM, namely to warrant clinical decisions based on evidence drawn from RCTs, is not part of Cochrane's original project. He had more modest ambitions for what RCTs can accomplish, and, more importantly, he was more concerned with care and equality than are his followers in the EBM movement. We try to reconstruct some of Cochrane's lost legacy and to articulate some of the important silences in Effectiveness and Efficiency From these clues it might be possible, we argue, to remodel EBM in a broader, more pluralistic, more democratic and less authoritarian manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PENINGKATAN KETERAMPILAN MELAKUKAN PROSEDUR KEARSIPAN MENGGUNAKAN KARTU KENDALI DENGAN METODE DEMONSTRASI MELALUI MEDIA ALAT PERAGA BAGI SISWA KELAS XI-AP SMK PSM RANDUBLATUNG BLORA TAHUN AJARAN 2013/2014

Directory of Open Access Journals (Sweden)

Wahid Sri Yuliani

2013-11-01

Full Text Available Observasi awal di SMK PSM Randublatung Blora kelas XI Administrasi Perkantoran ditemukan bahwa keterampilan siswa dalam prosedur mengarsip menggunakan kartu kendali masih rendah. Hal ini dapat dilihat dari proses pengisian kartu kendali masih banyak yang salah dan tidak rangkap tiga, selain itu siswa dalam mengarsip banyak yang bertanya dengan temannya. Subjek penelitian ini adalah siswa kelas XI AP SMK PSM Randublatung Blora tahun ajaran 2 013/2014. Instrumen yang digunakan adalah tes dan non tes. Instrumen tes berupa tes evaluasi untuk mengetahui hasil belajar siswa. Instrumen non tes berupa lembar pengamatan keterampilan siswa. Hasil penelitian pada siklus I menunjukkan rata-rata tingkat keterampilan siswa sebesar 61,71% termasuk dalam kategori cukup. Untuk hasil penelitian siklus II menunjukkan rata -rata tingkat keterampilan siswa sebesar 85,79% termasuk dalam kategori sangat baik. Based on the first observation, is students grade XI AP SMK PSM Randublatung Blora founded that students; skill in archives procedure using control card is still low. It can be seen from t he mistake on the filling of control card and it is not triplicate. Besides, there are many students that ask to their friends in achieving. The subject of this research is students grade XI AP SMK PSM Randublatung Blora year 2013/2014. Test instrument is evaluation test to know the students’ studying result. Non test instrument is a sheet of skill observation and a sheet of students’ activity observation. Observation result on cycle I show that the average of student skill is 61,71% include in enough category. Meanwhile, the cycle II show that the average of student skill is 85,79% include in very good category. © 2014 UniversitasNegeri Semarang

Do Cochrane reviews provide a good model for social science?

DEFF Research Database (Denmark)

Konnerup, Merete; Kongsted, Hans Christian

2012-01-01

Formalised research synthesis to underpin evidence-based policy and practice has become increasingly important in areas of public policy. In this paper we discuss whether the Cochrane standard for systematic reviews of healthcare interventions is appropriate for social research. We examine...... the formal criteria of the Cochrane Collaboration for including particular study designs and search the Cochrane Library to provide quantitative evidence on the de facto standard of actual Cochrane reviews. By identifying the sample of Cochrane reviews that consider observational designs, we are able...... to conclude that the majority of reviews appears limited to considering randomised controlled trials only. Because recent studies have delineated conditions for observational studies in social research to produce valid evidence, we argue that an inclusive approach is essential for truly evidence-based policy...

Assessing and presenting summaries of evidence in Cochrane Reviews

NARCIS (Netherlands)

Langendam, Miranda W.; Akl, Elie A.; Dahm, Philipp; Glasziou, Paul; Guyatt, Gordon; Schünemann, Holger J.

2013-01-01

Cochrane Reviews are intended to help providers, practitioners and patients make informed decisions about health care. The goal of the Cochrane Applicability and Recommendation Methods Group (ARMG) is to develop approaches, strategies and guidance that facilitate the uptake of information from

Trends and disparities in receipt of pharmacotherapy among pregnant women in publically funded treatment programs for opioid use disorder in the United States.

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Short, Vanessa L; Hand, Dennis J; MacAfee, Lauren; Abatemarco, Diane J; Terplan, Mishka

2018-06-01

To describe differences in geographic, demographic, treatment, and substance use characteristics by pharmacotherapy receipt among pregnant women entering publically funded treatment for opioid use disorder (OUD) in the United States. 1996 to 2014 Treatment Episode Data Set-Admissions data from pregnant admissions with OUD, defined as reporting opioids as the primary substance of use leading to the treatment episode, were analyzed for this cross-sectional study. The proportion of all pregnant admissions with OUD who received pharmacotherapy was calculated by year and U.S. census region. Trends across time were assessed using the Cochrane-Armitage Trend test. Associations between demographic, substance use, and treatment characteristics and pharmacotherapy receipt were assessed using Chi-square tests and multivariable logistic regression. The proportion of pregnant admissions where opioids were the primary substance of use increased from 16.9% to 41.6% during the study period, while the proportion of pregnant admissions with OUD who received pharmacotherapy remained relatively unchanged at around 50%. Overall, pharmacotherapy recipients were generally older and white, more likely to receive treatment in an outpatient setting, be self-referred, and report heroin as the primary substance, daily substance use, and intravenous drug use, and less likely to have a co-occurring psychiatric problem compared to those who did not receive pharmacotherapy. Regional differences in pharmacotherapy utilization exist; the South consistently had the fewest pregnant admissions with OUD receiving pharmacotherapy. Although the proportion of pregnant admissions to substance use treatment centers with OUD has increased since the mid-1990s, the proportion receiving pharmacotherapy has not changed. Significant variations in pharmacotherapy utilization exist by geography and demographic, substance use and treatment characteristics. Utilization of pharmacotherapy at publically funded

The Cochrane Library : more systematic reviews on nutrition needed

NARCIS (Netherlands)

Summerbell, CD; Chinnock, P; O'Malley, C; van Binsbergen, JJ

The knowledge and relevance of nutrition as well as the demand for well-funded advices increase. The Cochrane Collaboration plays a leading role within the evidence-based medicine and practice. We advocate therefore more specialized nutritional interest within the Cochrane Collaboration. In case

Dialogues with Marilyn Cochran-Smith

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Fiorentini, Dario; Crecci, Vanessa Moreira

2015-01-01

For more than 30 years, Dr. Marilyn Cochran-Smith has developed and directed research and contributed to publications about education and "practitioner research," especially about teachers' research and learning in inquiry communities. Her primary topics are inquiry communities, teacher research, teacher education for social…

The impact of Cochrane Reviews: a mixed-methods evaluation of outputs from Cochrane Review Groups supported by the National Institute for Health Research.

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Bunn, Frances; Trivedi, Daksha; Alderson, Phil; Hamilton, Laura; Martin, Alice; Pinkney, Emma; Iliffe, Steve

2015-04-01

The last few decades have seen a growing emphasis on evidence-informed decision-making in health care. Systematic reviews, such as those produced by Cochrane, have been a key component of this movement. The National Institute for Health Research (NIHR) Systematic Review Programme currently supports 20 Cochrane Review Groups (CRGs) in the UK and it is important that this funding represents value for money. The overall aim was to identify the impacts and likely impacts on health care, patient outcomes and value for money of Cochrane Reviews published by 20 NIHR-funded CRGs during the years 2007-11. We sent questionnaires to CRGs and review authors, undertook interviews with guideline developers (GDs) and used bibliometrics and documentary review to get an overview of CRG impact and to evaluate the impact of a sample of 60 Cochrane Reviews. The evaluation was guided by a framework with four categories (knowledge production, research targeting, informing policy development and impact on practice/services). A total of 3187 new and updated reviews were published on the Cochrane Database of Systematic Reviews between 2007 and 2011, 1502 (47%) of which were produced by the 20 CRGs funded by the NIHR. We found 40 examples where reviews appeared to have influenced primary research and reviews had contributed to the creation of new knowledge and stimulated debate. Twenty-seven of the 60 reviews had 100 or more citations in Google Scholar™ (Google, CA, USA). Overall, 483 systematic reviews had been cited in 247 sets of guidance. This included 62 sets of international guidance, 175 sets of national guidance (87 from the UK) and 10 examples of local guidance. Evidence from the interviews suggested that Cochrane Reviews often play an instrumental role in informing guidance, although reviews being a poor fit with guideline scope or methods, reviews being out of date and a lack of communication between CRGs and GDs were barriers to their use. Cochrane Reviews appeared to have led

The Cochrane Collaboration: Institutional Analysis of a Knowledge Commons

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Heywood, Peter; Stephani, Anne Marie; Garner, Paul

2018-01-01

Cochrane is an international network that produces and updates new knowledge through systematic reviews for the health sector. Knowledge is a shared resource, and can be viewed as a commons. As Cochrane has been in existence for 25 years, we used Elinor Ostrom's theory of the commons and Institutional Analysis and Development Framework to appraise…

Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials

DEFF Research Database (Denmark)

Jørgensen, L; Paludan-Müller, A. S.; Laursen, David

2016-01-01

the tool is applied to both Cochrane and non-Cochrane systematic reviews. Methods: A review of published comments (searches in PubMed, The Cochrane Methodology Register and Google Scholar) and an observational study (100 Cochrane and 100 non-Cochrane reviews from 2014). Results: Our review included 68...

Causes of death in patients with childhood-onset type 1 diabetes receiving dialysis in Japan: Diabetes Epidemiology Research International (DERI) Mortality Study.

Science.gov (United States)

Onda, Yoshiko; Nishimura, Rimei; Morimoto, Aya; Sano, Hironari; Utsunomiya, Kazunori; Tajima, Naoko

2015-01-01

To investigate the causes of death and how they changed over time in patients with childhood-onset type 1 diabetes who were receiving dialysis. Of the 1384 patients who were diagnosed with type 1 diabetes atdeath trends were expressed according to the duration of dialysis. The leading causes of death were end-stage renal disease (ESRD) (36.3%), cardiovascular disease (CVD) (31.9%), and infections (20.3%). Among CVD, cerebral hemorrhage was the most frequent (38.9%) and showed a significant trend for an increase in the duration of dialysis (P=0.01, the Cochran-Armitage trend test). The mortality from ESRD concentrated within 5 years of dialysis and that from CVD increased after 10 years of dialysis, while the mortality from infections peaked during 5 to 10 years from initiation of dialysis. The leading causes of death in dialysis patients with type 1 diabetes were ESRD, CVD, and infections. As the duration of dialysis increased, however, CVD contributed more to mortality. Special attention should be paid to CVD, particularly cerebral hemorrhage, to improve the long-term prognosis of patients. Copyright © 2015 Elsevier Inc. All rights reserved.

The first ever Cochrane event in Russia and Russian speaking countries - Cochrane Russia Launch - Evidence-based medicine: Achievements and barriers (QiQUM 2015) International Conference, Kazan, December 7-8, 2015.

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Ziganshina, Liliya Eugenevna; Jørgensen, Karsten Juhl

2016-01-01

Kazan hosted Russia's second International Conference QiQUM 2015 on Cochrane evidence for health policy, which was entirely independent of the pharmaceutical or other health industry, bringing together 259 participants from 11 countries and 13 regions of the Russian Federation. The Conference was greeted and endorsed by world leaders in Evidence-based medicine, health and pharmaceutical information, policy and regulation, and the World Health Organization. Participants discussed the professional and social problems arising from biased health information, unethical pharmaceutical promotion, misleading reporting of clinical trials with consequent flaws in health care delivery and the role of Cochrane evidence for informed decisions and better health. The first in history Cochrane workshop, facilitated jointly by experts from Cochrane and the WHO, with 40 participants from Kazakhstan, Kyrgyzstan, Tajikistan and Russia introduced the concept of Cochrane systematic review and the Use of Cochrane evidence in WHO policy setting. Websites document conference materials and provide interface for future collaboration: http://kpfu.ru/biology-medicine/struktura-instituta/kafedry/kfikf/konferenciya/mezhdunarodnaya-konferenciya-39dokazatelnaya.html and http://russia.cochrane.org/news/international-conference.

Cochrane Rehabilitation Methodology Committee: an international survey of priorities for future work.

Science.gov (United States)

Levack, William M; Meyer, Thorsten; Negrini, Stefano; Malmivaara, Antti

2017-10-01

Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. We conducted an international online survey via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people's current capabilities to assist with this work. The survey findings indicated strongest interest in work on how reviewers have interpreted and applied Cochrane methods in reviews on rehabilitation topics in the past, and on gathering a collection of existing publications on review methods for undertaking systematic reviews relevant to rehabilitation. Many people are already interested in contributing to the work of the Methodology Committee and there is a large amount of expertise for this work in the extended Cochrane Rehabilitation network already.

Contemporary use trends and survival outcomes in patients undergoing radical cystectomy or bladder-preservation therapy for muscle-invasive bladder cancer.

Science.gov (United States)

Cahn, David B; Handorf, Elizabeth A; Ghiraldi, Eric M; Ristau, Benjamin T; Geynisman, Daniel M; Churilla, Thomas M; Horwitz, Eric M; Sobczak, Mark L; Chen, David Y T; Viterbo, Rosalia; Greenberg, Richard E; Kutikov, Alexander; Uzzo, Robert G; Smaldone, Marc C

2017-11-15

The current study was performed to examine temporal trends and compare overall survival (OS) in patients undergoing radical cystectomy (RC) or bladder-preservation therapy (BPT) for muscle-invasive urothelial carcinoma of the bladder. The authors reviewed the National Cancer Data Base to identify patients with AJCC stage II to III urothelial carcinoma of the bladder from 2004 through 2013. Patients receiving BPT were stratified as having received any external-beam radiotherapy (any XRT), definitive XRT (50-80 grays), and definitive XRT with chemotherapy (CRT). Treatment trends and OS outcomes for the BPT and RC cohorts were evaluated using Cochran-Armitage tests, unadjusted Kaplan-Meier curves, adjusted Cox multivariate regression, and propensity score matching, using increasingly stringent selection criteria. A total of 32,300 patients met the inclusion criteria and were treated with RC (22,680 patients) or BPT (9620 patients). Of the patients treated with BPT, 26.4% (2540 patients) and 15.5% (1489 patients), respectively, were treated with definitive XRT and CRT. Improved OS was observed for RC in all groups. After adjustments with more rigorous statistical models controlling for confounders and with more restrictive BPT cohorts, the magnitude of the OS benefit became attenuated on multivariate (any XRT: hazard ratio [HR], 2.115 [95% confidence interval [95% CI], 2.045-2.188]; definitive XRT: HR, 1.870 [95% CI, 1.773-1.972]; and CRT: HR, 1.578 [95% CI, 1.474-1.691]) and propensity score (any XRT: HR, 2.008 [95% CI, 1.871-2.154]; definitive XRT: HR, 1.606 [95% CI, 1.453-1.776]; and CRT: HR, 1.406 [95% CI, 1.235-1.601]) analyses. In the National Cancer Data Base, receipt of BPT was associated with decreased OS compared with RC in patients with stage II to III urothelial carcinoma. Increasingly stringent definitions of BPT and more rigorous statistical methods adjusting for selection biases attenuated observed survival differences. Cancer 2017;123:4337-45. © 2017

A Computational Tool for Testing Dose-related Trend Using an Age-adjusted Bootstrap-based Poly-k Test

Directory of Open Access Journals (Sweden)

Hojin Moon

2006-08-01

Full Text Available A computational tool for testing for a dose-related trend and/or a pairwise difference in the incidence of an occult tumor via an age-adjusted bootstrap-based poly-k test and the original poly-k test is presented in this paper. The poly-k test (Bailer and Portier 1988 is a survival-adjusted Cochran-Armitage test, which achieves robustness to effects of differential mortality across dose groups. The original poly-k test is asymptotically standard normal under the null hypothesis. However, the asymptotic normality is not valid if there is a deviation from the tumor onset distribution that is assumed in this test. Our age-adjusted bootstrap-based poly-k test assesses the significance of assumed asymptotic normal tests and investigates an empirical distribution of the original poly-k test statistic using an age-adjusted bootstrap method. A tumor of interest is an occult tumor for which the time to onset is not directly observable. Since most of the animal carcinogenicity studies are designed with a single terminal sacrifice, the present tool is applicable to rodent tumorigenicity assays that have a single terminal sacrifice. The present tool takes input information simply from a user screen and reports testing results back to the screen through a user-interface. The computational tool is implemented in C/C++ and is applied to analyze a real data set as an example. Our tool enables the FDA and the pharmaceutical industry to implement a statistical analysis of tumorigenicity data from animal bioassays via our age-adjusted bootstrap-based poly-k test and the original poly-k test which has been adopted by the National Toxicology Program as its standard statistical test.

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

Science.gov (United States)

Meyer, Sascha

2013-11-01

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

A prevalence-based association test for case-control studies.

Science.gov (United States)

Ryckman, Kelli K; Jiang, Lan; Li, Chun; Bartlett, Jacquelaine; Haines, Jonathan L; Williams, Scott M

2008-11-01

Genetic association is often determined in case-control studies by the differential distribution of alleles or genotypes. Recent work has demonstrated that association can also be assessed by deviations from the expected distributions of alleles or genotypes. Specifically, multiple methods motivated by the principles of Hardy-Weinberg equilibrium (HWE) have been developed. However, these methods do not take into account many of the assumptions of HWE. Therefore, we have developed a prevalence-based association test (PRAT) as an alternative method for detecting association in case-control studies. This method, also motivated by the principles of HWE, uses an estimated population allele frequency to generate expected genotype frequencies instead of using the case and control frequencies separately. Our method often has greater power, under a wide variety of genetic models, to detect association than genotypic, allelic or Cochran-Armitage trend association tests. Therefore, we propose PRAT as a powerful alternative method of testing for association.

Discussion around the Steinberg-Cochran-Guinan model

International Nuclear Information System (INIS)

Ansart, J.P.; Naulin, G.

1991-01-01

The Steinberg-Cochran-Guinan model (material dynamic comportment model) is presented. Theoretical and experimental results (especially on beryllium) give a modification of the S.C.G. model, taking into account influence of high deformation speed on elastic limit and on the strain hardening function. (A.B.). 8 refs., 2 tabs

Trends in Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization (from the Baptist Health South Florida Employee Study).

Science.gov (United States)

Ogunmoroti, Oluseye; Utuama, Ovie; Spatz, Erica S; Rouseff, Maribeth; Parris, Don; Das, Sankalp; Younus, Adnan; Guzman, Henry; Tran, Thinh; Agatston, Arthur; Feldman, Theodore; Virani, Salim S; Maziak, Wasim; Veledar, Emir; Nasir, Khurram

2016-03-01

The American Heart Association (AHA)'s 2020 goal is to improve the cardiovascular health (CVH) of people living in the United States (US) by 20% and reduce mortality from cardiovascular diseases and stroke by 20%. Given that 155 million adults are in the US workforce, and >60% have employee-based insurance, workplace studies provide an important opportunity to assess and potentially advance CVH through the use of comprehensive workplace wellness programs. Among a cohort of employees of the Baptist Health System, CVH was assessed annually during voluntary health fairs and health risk assessments (HRA) from 2011 to 2014 using the AHA's 7 CVH metrics: smoking, body mass index (BMI), physical activity, diet, blood pressure, total cholesterol, and blood glucose. Each metric was categorized as ideal, intermediate, or poor according to the AHA criteria. Cochrane-Armitage test was used to detect trends in CVH by year. Ideal CVH, defined as meeting ideal criteria for all 7 metrics, was assessed and compared across years. The overall cohort was 34,746 with 4,895 employees in 2011, 10,724 in 2012, 9,763 in 2013, and 9,364 in 2014. Mean age (SD) was between 43 (±12) and 46 years (±12). Female to male ratio was 3:1. The prevalence of study participants who met the ideal criteria for diet, physical activity, and blood pressure increased significantly from 2011 to 2014 but for BMI, total cholesterol, and blood glucose, a significant decrease was noticed. In addition, the prevalence of study participants in ideal CVH although low, increased significantly over time (0.3% to 0.6%, p health care organization. The positive findings noted for the metrics of smoking, physical activity, total cholesterol, and blood glucose should be reinforced. However, the metrics of diet, BMI, and blood pressure need more attention. Copyright © 2016 Elsevier Inc. All rights reserved.

Economics methods in Cochrane systematic reviews of health promotion and public health related interventions.

Science.gov (United States)

Shemilt, Ian; Mugford, Miranda; Drummond, Michael; Eisenstein, Eric; Mallender, Jacqueline; McDaid, David; Vale, Luke; Walker, Damian

2006-11-15

Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as well as regular dialogue between Cochrane reviewers and economists to

Economics methods in Cochrane systematic reviews of health promotion and public health related interventions

Directory of Open Access Journals (Sweden)

McDaid David

2006-11-01

Full Text Available Abstract Background Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. Methods The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Results Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. Conclusion There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as

Evidence from the Cochrane Collaboration for Traditional Chinese Medicine Therapies

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Wieland, Susan; Kimbrough, Elizabeth; Cheng, Ker; Berman, Brian M.

2009-01-01

Abstract Background The Cochrane Collaboration, an international not-for-profit organization that prepares and maintains systematic reviews of randomized trials of health care therapies, has produced reviews summarizing much of the evidence on Traditional Chinese Medicine (TCM). Our objective was to review the evidence base according to Cochrane systematic reviews. Methods In order to detect reviews focusing on TCM, we searched the titles and abstracts of all reviews in Issue 4, 2008 of the Cochrane Database of Systematic Reviews. For each review, we extracted data on the number of trials included and the total number of participants. We provided an indication of the strength of the review findings by assessing the reviewers' abstract conclusions statement. We supplemented our assessment of the abstract conclusions statements with a listing of the comparisons and outcomes showing statistically significant meta-analyses results. Results We identified 70 Cochrane systematic reviews of TCM, primarily acupuncture (n = 26) and Chinese herbal medicine (n = 42), and 1 each of moxibustion and t'ai chi. Nineteen (19) of 26 acupuncture reviews and 22/42 herbal medicine reviews concluded that there was not enough good quality trial evidence to make any conclusion about the efficacy of the evaluated treatment, while the remaining 7 acupuncture and 20 herbal medicine reviews and each of the moxibustion and t'ai chi reviews indicated a suggestion of benefit, which was qualified by a caveat about the poor quality and quantity of studies. Most reviews included many distinct interventions, controls, outcomes, and populations, and a large number of different comparisons were made, each with a distinct forest plot. Conclusions Most Cochrane systematic reviews of TCM are inconclusive, due specifically to the poor methodology and heterogeneity of the studies reviewed. Some systematic reviews provide preliminary evidence of Chinese medicine's benefits to certain patient populations

Geographic disparities in pneumonia-specific under-five mortality rates in Mainland China from 1996 to 2015: a population-based study.

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Kang, Leni; He, Chunhua; Miao, Lei; Liang, Juan; Zhu, Jun; Li, Xiaohong; Li, Qi; Wang, Yanping

2017-06-01

This study aimed to investigate the disparities in pneumonia-specific under-five mortality rates (U5MRs) among and within three geographic regions in Mainland China from 1996 to 2015. Data were obtained from the national Under-Five Child Mortality Surveillance System and grouped into 2-year periods. The Cochran-Armitage trend test and Cochran-Mantel-Haenszel test were used to assess trends and differences in the pneumonia-specific U5MRs among and within geographic regions. Relative risks (RRs) and 95% confidence intervals (95% CIs) were calculated. The pneumonia-specific U5MR decreased by 90.6%, 89.0%, and 83.5% in East, Middle, and West China, respectively, with a larger decrease in rural areas. The pneumonia-specific U5MR was highest in West China, and was 7.2 (95% CI 5.9-8.7) times higher than that in East China in 2014-2015. In 2014-2015, the RRs were 1.7 (95% CI 1.2-2.5), 1.6 (95% CI 1.1-2.1), and 3.4 (95% CI 2.8-4.0) between rural and urban areas in East, Middle, and West China, respectively. Pneumonia-specific U5MRs decreased from 1996 to 2015 across China, particularly in rural areas. However, disparities remained among and within geographic regions. Additional strategies and interventions should be introduced in West China, especially the rural areas, to further reduce the pneumonia-specific U5MR. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Intervention quality is not routinely assessed in Cochrane systematic reviews of radiation therapy interventions.

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Abdul Rahim, Mohamad R; James, Melissa L; Hickey, Brigid E

2017-10-01

The aim of this study was to maximise the benefits from clinical trials involving technological interventions such as radiation therapy. High compliance to the quality assurance protocols is crucial. We assessed whether the quality of radiation therapy intervention was evaluated in Cochrane systematic reviews. We searched 416 published Cochrane systematic reviews and identified 67 Cochrane systematic reviews that investigated radiation therapy or radiotherapy as an intervention. For each systematic review, either quality assurance or quality control for the intervention was identified by a description of such processes in the published systematic reviews. Of the 67 Cochrane systematic reviews studied, only two mentioned quality assurance or quality control. Our findings revealed that 65 of 67 (97%) Cochrane systematic reviews of radiation therapy interventions failed to consider the quality of the intervention. We suggest that advice about the evaluation of intervention quality be added to author support materials. © 2017 The Royal Australian and New Zealand College of Radiologists.

Antenatal interventions to reduce preterm birth: an overview of Cochrane Systematic Reviews.

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Piso, Brigitte; Zechmeister-Koss, Ingrid; Winkler, Roman

2014-04-23

Several factors are associated with an increased risk of preterm birth (PTB); therefore, various interventions might have the potential to influence it. Due to the large number of interventions that address PTB, the objective of this overview is to summarise evidence from Cochrane reviews regarding the effects and safety of these different interventions. We conducted a systematic literature search in the Cochrane Database of Systematic Reviews. Included reviews should be based on randomised controlled trials comparing antenatal non-pharmacological and pharmacological interventions that directly or indirectly address PTB with placebo/no treatment or routine care in pregnant women at less than 37 completed weeks of gestation without signs of threatened preterm labour. We considered PTB at less than 37 completed weeks of gestation as the primary outcome. We included 56 Cochrane systematic reviews. Three interventions increased PTB risk significantly. Twelve interventions led to a statistically significant lower incidence of PTBs. However, this reduction was mostly observed in defined at-risk subgroups of pregnant women. The remaining antenatal interventions failed to prove a significant effect on PTB PTBs). As an unintended result of this review, we identified 28 additional Cochrane reviews which intended to report on PTB < 37 weeks, but were not able to find any RCTs reporting appropriate data. The possible effects of a diverse range of interventions on PTB have been evaluated in Cochrane systematic reviews. Few interventions have been demonstrated to be effective and a small number have been found to be harmful. For around half of the interventions evaluated, the Cochrane review concluded that there was insufficient evidence to provide sound recommendations for clinical practice. No RCT evidence is available for a number of potentially relevant interventions.

Are the Cochrane group registers comprehensive? A case study of Japanese psychiatry trials

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McGuire Hugh

2002-04-01

Full Text Available Abstract Background Language bias is a form of publication bias and constitutes a serious threat to meta-analyses. The Cochrane Controlled Trials Register is one attempt to remedy this and now contains more than 300,000 citations. However we are still unsure if it provides comprehensive coverage, particularly for non-English trials. Methods We have recently established a comprehensive register of Japanese trials of psychotropic drugs through extensive personal contacts, electronic searches and handsearches. We examined two Cochrane psychiatry group registers against this Japanese database. Results The Japanese register contained 56 reports of randomized controlled trials (RCTs of antidepressants for depression but the Cochrane Depression, Anxiety and Neurosis group register contained 18, with an overlap of only nine. The Japanese register contained 61 reports of RCTs of neuroleptics for schizophrenia and the Cochrane Schizophrenia group register contained 36, with an overlap of only six. Taking account of some duplicate publications, only a quarter to a third of all relevant Japanese RCTs were retrievable from the Cochrane group registers. Conclusions Similar, or worse, yields may be expected with RCTs conducted in other East Asian countries, and in other fields of medicine. What evidence there is suggests that this situation may lead to a systematic over estimate of treatment effect.

Reporting of conflicts of interest from drug trials in Cochrane reviews: cross sectional study.

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Roseman, Michelle; Turner, Erick H; Lexchin, Joel; Coyne, James C; Bero, Lisa A; Thombs, Brett D

2012-08-16

To investigate the degree to which Cochrane reviews of drug interventions published in 2010 reported conflicts of interest from included trials and, among reviews that reported this information, where it was located in the review documents. Cross sectional study. Cochrane Database of Systematic Reviews. Systematic reviews of drug interventions published in 2010 in the Cochrane Database of Systematic Reviews, with review content classified as up to date in 2008 or later and with results from one or more randomised controlled trials. Of 151 included Cochrane reviews, 46 (30%, 95% confidence interval 24% to 38%) reported information on the funding sources of included trials, including 30 (20%, 14% to 27%) that reported information on trial funding for all included trials and 16 (11%, 7% to 17%) that reported for some, but not all, trials. Only 16 of the 151 Cochrane reviews (11%, 7% to 17%) provided any information on trial author-industry financial ties or trial author-industry employment. Information on trial funding and trial author-industry ties was reported in one to seven locations within each review, with no consistent reporting location observed. Most Cochrane reviews of drug trials published in 2010 did not provide information on trial funding sources or trial author-industry financial ties or employment. When this information was reported, location of reporting was inconsistent across reviews.

Production and citation of cochrane systematic reviews: a bibliometrics analysis.

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Shen, Jiantong; Li, Youping; Clarke, Mike; Du, Liang; Wang, Li; Zhong, Dake

2014-05-06

To evaluate the production and utilization of Cochrane systematic reviews(CSRs) and to analyze its influential factors, so as to improve the capacity of translating CSRs into practice. All CSRs and protocols were retrieved from the Cochrane Library ISSUE 2, 2011 and citation data were retrieved from SCI database. Citation analysis was used to analyze the situation of CSRs production and utilization. CSR publication had grown from an annual average of 32 to 718 documents. Only one developing country was among the ten countries with the largest amount of publications. High income countries accounted for 83% of CSR publications and 90.8% of cited counts. 34.7% of CSRs had a cited count of 0, while only 0.9% had been cited more than 50 times. Highly cited CSRs were published in England, Australia, Canada, USA and other high income countries. The countries with a Cochrane center or a Cochrane methodology group had a greater capability of CSRs production and citing than others. The CSRs addressing the topics of diseases were more than those targeted at public health issues. There was a big gap in citations of different interventions even for the same topic. The capability of CSR production and translation grew rapidly, but varied among countries and institutions, which was affected by several factors such as the capability of research, the resourcesand the applicability of the evidence. It is important to improve evidence translation through educating, training and prioritizing the problems based on real demands of end user. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Metformin for endometrial hyperplasia: a Cochrane protocol.

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Clement, Naomi S; Oliver, Thomas R W; Shiwani, Hunain; Saner, Juliane R F; Mulvaney, Caroline A; Atiomo, William

2016-08-16

Endometrial hyperplasia is a precancerous lesion of the endometrium, commonly presenting with uterine bleeding. If managed expectantly, it frequently progresses to endometrial carcinoma, rates of which are increasing dramatically worldwide. However, the established treatment for endometrial hyperplasia (progestogens) involves multiple side effects and leaves the risk of recurrence. Metformin is the most commonly used oral hypoglycaemic agent in type 2 diabetes mellitus. It has also been linked to the reversal of endometrial hyperplasia and may therefore contribute to decreasing the prevalence of endometrial carcinoma without the fertility and side effect consequences of current therapies. However, the efficacy and safety of metformin being used for this therapeutic target is unclear and, therefore, this systematic review will aim to determine this. We will search the following trials and databases with no language restrictions: Cochrane Gynaecology and Fertility Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; EBSCO Cumulative Index to Nursing and Allied Health Literature; PubMed; Google Scholar; ClinicalTrials.gov; the WHO International Trials Registry Platform portal; OpenGrey and the Latin American and Caribbean Health Sciences Literature (LILACS). We will include randomised controlled trials (RCTs) of use of metformin compared with a placebo or no treatment, conventional medical treatment (eg, progestogens) or any other active intervention. Two review authors will independently assess the trial eligibility, risk of bias and extract appropriate data points. Trial authors will be contacted for additional data. The primary review outcome is the regression of endometrial hyperplasia histology towards normal histology. Secondary outcomes include hysterectomy rate; abnormal uterine bleeding; quality of life scores and adverse reactions to treatments. Dissemination of the completed review will be through the Cochrane

Acupuncture for neurological disorders in the Cochrane reviews:Characteristics of included reviews and studies

Institute of Scientific and Technical Information of China (English)

Deren Wang; Weimin Yang; Ming Liu

2011-01-01

OBJECTIVE: To summarize Cochrane reviews of acupuncture for neurological disorders, and characteristics of included reviews and studies.DATA SOURCES: A computer-based online search of the Cochrane Library (Issue 7 of 12, July 2010) was performed with the key word "acupuncture" and systematic evaluations for acupuncture for neurological disorders were screened.STUDY SELECTION: Systematic reviews on acupuncture in the treatment of neurological disorders were included, and the characteristics of these reviews were analyzed based on methods recommended by the Cochrane collaboration.MAIN OUTCOME MEASURES: Basic characteristics, methodological quality, main reasons for excluding trials, results and conclusions of Cochrane reviews were assessed.RESULTS: A total of 18 Cochrane systematic reviews were included, including 13 completed reviews and five research protocols. The 13 completed reviews involved 111 randomized controlled trials, including 43 trials (38.7%) conducted in China, 47 trials (42.3%) using sham-acupuncture or placebo as control, 15 trials (13.5%) with relatively high quality, 91 trials (81.9%) reporting data on follow-up. Primary outcomes used in the Cochrane reviews were reported by 65 trials (58.6%), and adverse events were reported in 11 trials (9.9%). Two hundred and eighty three trials were excluded. Two reviews on headache suggested that acupuncture is a valuable non-drug treatment for patients with chronic or recurrent headache, and has better curative effects on migraine compared with preventative drug treatment. CONCLUSION: Of the Cochrane reviews on acupuncture in the treatment of neurological disorders, two reviews evaluating the efficacy of acupuncture in treating headaches drew positive conculsions, while other reviews did not obtain positive conclusions due to a small sample size or low methodological quality. The methodological quality of acupuncture trials needs further improvement.

Comparison of cardiovascular mortality in the Great East Japan and the Great Hanshin-Awaji Earthquakes　- a large-scale data analysis of death certificates.

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Takegami, Misa; Miyamoto, Yoshihiro; Yasuda, Satoshi; Nakai, Michikazu; Nishimura, Kunihiro; Ogawa, Hisao; Hirata, Ken-Ichi; Toh, Ryuji; Morino, Yoshihiro; Nakamura, Motoyuki; Takeishi, Yasuchika; Shimokawa, Hiroaki; Naito, Hiroaki

2015-01-01

Large earthquakes have been associated with cardiovascular disease (CVD) mortality. In Japan, the 1995 Great Hanshin-Awaji (H-A) Earthquake was an urban-underground-type earthquake, whereas the 2011 Great East Japan (GEJ) Earthquake was an ocean-trench type. In the present study, we examined how these different earthquake types affected CVD mortality. We examined death certificate data from 2008 to 2012 for 131 municipalities in Iwate, Miyagi, and Fukushima prefectures (n=320,348) and from 1992 to 1996 for 220 municipalities in Hyogo, Osaka, and Kyoto prefectures (n=592,670). A Poisson regression model showed significant increases in the monthly numbers of acute myocardial infarction (AMI)-related deaths (incident rate ratio [IRR] GEJ=1.34, P=0.001; IRR of H-A=1.57, Pdeaths (IRR of GEJ=1.42, Pdeaths remained significant only for H-A (IRR=1.13, P=0.029). When analyzing the standardized mortality ratio (SMR) after the earthquakes using the Cochran-Armitage trend test, seismic intensity was significantly associated with AMI mortality for 2 weeks after both the GEJ (P for trend=0.089) and H-A earthquakes (P for trend=0.005). Following the GEJ and H-A earthquakes, there was a sharp increase in CVD mortality. The effect of the disaster was sustained for months after the H-A earthquake, but was diminished after the GEJ Earthquake.

Usefulness of Cochrane Skin Group reviews for clinical practice.

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Davila-Seijo, P; Batalla, A; Garcia-Doval, I

2013-10-01

Systematic reviews are one of the most important sources of information for evidence-based medicine. However, there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice. The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making. We performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August, 2012. We retrieved 55 reviews, which were analyzed and graded independently by 2 investigators into 3 categories: 0 (insufficient evidence to support or reject the use of an intervention), 1 (insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions), and 2 (sufficient evidence to support or reject the use of an intervention). Our analysis showed that 25.5% (14/55) of the studies did not provide sufficient evidence to support or reject the use of the interventions studied, 45.5% (25/25) provided sufficient but not strong evidence to support recommendations or suggestions, and 29.1% (16/55) provided strong evidence to support or reject the use of 1 or more of the interventions studied. Most of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice. Clinicians should read these reviews and reconsider their current practice. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

Decline in sperm count and motility in young adult men from 2003 to 2013: observations from a U.S. sperm bank.

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Centola, G M; Blanchard, A; Demick, J; Li, S; Eisenberg, M L

2016-03-01

Controversy exists regarding stability of semen quality over time with papers reporting decrease, increase or stable parameters in heterogeneous populations. The current study examined semen parameters of young adult men from 2003 to 2013 at an urban U.S. sperm bank. Semen parameters were analyzed before and after cryopreservation for a total of 9425 specimens from 489 individuals. Demographic information was obtained from a social and medical history questionnaire. Following 2-3 days abstinence, the specimens were collected at the laboratory and assessed by uniform technicians and techniques. The data were analyzed using generalized linear regression after adjustment for age, days of abstinence, for repeated samples, as well as by the Cochran-Armitage trend test. The within variability was accounted for by the repeated measures model. All p values were two-sided with p sperm concentration (-3.55, 95% CI -4.87, -2.23; p count (-10.75, 95% CI -15.95, -5.54; p count (-9.43, 95% CI -13.14, -5.73; p Average) (p(trend) = 0.02). BMI (p(trend) = 0.73), educational attainment (p(trend) = 0.2), race/ethnicity (p(trend) = 0.53), and lifestyle habits (weekly exercise, p(trend) = 0.21; smoking, p(trend) = 0.99; marital status, p(trend) = 0.85) remained constant. Uniform technicians and techniques over the study period make measurement bias unlikely. This report demonstrates a decline in semen quality among young adult men in the Boston area who were attending or completed a college education during the past 10 years, and requires further study. © 2016 American Society of Andrology and European Academy of Andrology.

Human Calmodulin-Like Protein CALML3: A Novel Marker for Normal Oral Squamous Mucosa That Is Downregulated in Malignant Transformation

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Michael D. Brooks

2013-01-01

Full Text Available Oral cancer is often diagnosed only at advanced stages due to a lack of reliable disease markers. The purpose of this study was to determine if the epithelial-specific human calmodulin-like protein (CALML3 could be used as marker for the various phases of oral tumor progression. Immunohistochemical analysis using an affinity-purified CALML3 antibody was performed on biopsy-confirmed oral tissue samples representing these phases. A total of 90 tissue specimens were derived from 52 patients. Each specimen was analyzed in the superficial and basal mucosal cell layers for overall staining and staining of cellular subcompartments. CALML3 was strongly expressed in benign oral mucosal cells with downregulation of expression as squamous cells progress to invasive carcinoma. Based on the Cochran-Armitage test for trend, expression in the nucleus and at the cytoplasmic membrane significantly decreased with increasing disease severity. Chi-square test showed that benign tissue specimens had significantly more expression compared to dysplasia/CIS and invasive specimens. Dysplasia/CIS tissue had significantly more expression than invasive tissue. We conclude that CALML3 is expressed in benign oral mucosal cells with a statistically significant trend in downregulation as tumorigenesis occurs. CALML3 may thus be a sensitive new marker for oral cancer screening.

Should Cochrane reviews be performed during the development of new concepts?

DEFF Research Database (Denmark)

Humaidan, P; Kol, S; Engmann, L

2012-01-01

of explicit, reproducible criteria in the selection of studies for review. Thus, Cochrane reviews, undoubtedly provide many useful clinical guidelines. In this opinion paper, however, it is questioned at what level of clinical development of a new strategy a Cochrane review should be conducted in order...... development. We question the current policy of meta-analysis and recommend that in the future, the meta-analysts should await the results of a sufficient number of well-performed studies with an established new regime before an analysis is performed in order to avoid too early and possibly biased conclusions....

Nonsteroidal Antiinflammatory Drugs for Axial Spondyloarthritis: A Cochrane Review

NARCIS (Netherlands)

Kroon, Féline P. B.; van der Burg, Lennart R. A.; Ramiro, Sofia; Landewé, Robert B. M.; Buchbinder, Rachelle; Falzon, Louise; van der Heijde, Désirée

2016-01-01

To determine the benefits and harms of nonsteroidal antiinflammatory drugs (NSAID) in axial spondyloarthritis (axSpA). Systematic review using Cochrane Collaboration methodology. randomized controlled trials (RCT) and quasi-RCT (to June 2014), investigating NSAID versus any control for axSpA, and

Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review.

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Esposito, Marco; Grusovin, Maria Gabriella; Loli, Vasiliki; Coulthard, Paul; Worthington, Helen V

2010-01-01

Marco Esposito is the first author of two of the included studies; however, he was not involved in the quality assessment of these trials. This review is based on a Cochrane systematic review entitled 'Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications' published in The Cochrane Library (see http://www.cochrane.org for more information). Cochrane systematic reviews are regularly updated to include new research, and in response to comments and criticisms from readers. If you wish to comment on this review, please send your comments to the Cochrane website or to Marco Esposito. The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane Review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by the Cochrane Collaboration. To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic/placebo administration and, if antibiotics are of benefit, to find which type, dosage and duration is the most effective. The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched up to 2 June 2010 for randomised controlled clinical trials (RCTs) with a follow-up of at least 3 months comparing the administration of various prophylactic antibiotic regimens versus no antibiotics to patients undergoing dental implant placement. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Meta-analyses were

Impact of concurrent chemotherapy with radiation therapy for elderly patients with newly diagnosed glioblastoma: a review of the National Cancer Data Base.

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Huang, Jiayi; Samson, Pamela; Perkins, Stephanie M; Ansstas, George; Chheda, Milan G; DeWees, Todd A; Tsien, Christina I; Robinson, Clifford G; Campian, Jian L

2017-02-01

To investigate the utilization and overall survival (OS) impact of concurrent chemotherapy in combination with radiation therapy (RT) for elderly glioblastoma (GBM) patients. Elderly patients (age >70) with supratentorial and nonmetastatic GBM who received RT of 20-75 Gy with concurrent single-agent chemotherapy (ChemoRT) or without (RT alone) during 2004-2012 were identified from the National Cancer Data Base (NCDB). The Cochran-Armitage test was used for trend analysis. Hazard ratios (HR) and 95% confidence intervals (CIs) were determined using Cox proportional hazards. Propensity score analysis was performed to reduce selection bias in treatment allocation. A total of 5252 patients were identified (RT alone: n = 1389; ChemoRT: n = 3863). There was increasing utilization of chemotherapy during this period (45-80%, P 80 (25-68%, P benefit was demonstrated with 1202 pairs of propensity-matched patients (HR 0.79, 95% CI 0.73-0.86, P chemotherapy has been administered with RT for the majority of elderly GBM patients. Addition of chemotherapy to RT for elderly GBM patients is associated with significantly improve OS in routine clinical practice.

Factors Associated with Persistence with Teriparatide Therapy: Results from the DANCE Observational Study

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Deborah T. Gold

2011-01-01

Full Text Available Purpose. Determine patient-reported reasons for discontinuation with teriparatide. Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months, and follow-up questionnaire 2 (QF2, 12 months. Discontinuation reported at QF1 and QF2 was defined as “early” and “late,” respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation. Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were “concerns about treatment outweighing the benefits” (n=53 and “difficulty paying” (n=47. Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.

Adjuvant chemotherapy for stage III colon cancer in the oldest old: results beyond clinical guidelines.

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Abraham, Anasooya; Habermann, Elizabeth B; Rothenberger, David A; Kwaan, Mary; Weinberg, Armin D; Parsons, Helen M; Gupta, Pankaj; Al-Refaie, Waddah B

2013-01-15

Randomized trials demonstrating the benefits of chemotherapy in patients with American Joint Committee on Cancer stage III colon cancer underrepresent persons aged ≥ 75 years. The generalizability of these studies to a growing elderly population remains unknown. Using the California Cancer Registry for 1994 through 2008, the authors conducted a population-based study of postcolectomy patients aged 50 years to 94 years with stage III (N1M0) colon adenocarcinoma. A 2-sided chi-square test and Cochran-Armitage test for trend were used to compare patient and tumor characteristics associated with receipt of chemotherapy across age groups. Multivariate regression was used to assess the association between older age and receipt of chemotherapy. Kaplan-Meier methods and Cox proportional hazards modeling were used to evaluate the association between chemotherapy and mortality, with propensity score adjustment. Approximately 44% (12,382 patients) of the study cohort was aged ≥ 75 years. Persons aged ≥ 75 years were found to be less likely to have received adjuvant chemotherapy than those aged colon cancer in the elderly. Copyright © 2012 American Cancer Society.

Assessing bias in osteoarthritis trials included in Cochrane reviews

DEFF Research Database (Denmark)

Hansen, Julie Bolvig; Juhl, Carsten Bogh; Boutron, Isabelle

2014-01-01

the first appearing forest plot for overall pain in the Cochrane review. Treatment effect sizes will be expressed as standardised mean differences (SMDs), where the difference in mean values available from the forest plots is divided by the pooled SD. To empirically assess the risk of bias in treatment...

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Cochrane review: virtual reality for stroke rehabilitation.

Science.gov (United States)

Laver, K; George, S; Thomas, S; Deutsch, J E; Crotty, M

2012-09-01

Virtual reality and interactive video gaming are innovative therapy approaches in the field of stroke rehabilitation. The primary objective of this review was to determine the effectiveness of virtual reality on motor function after stroke. The impact on secondary outcomes including activities of daily living was also assessed. Randomised and quasi-randomised controlled trials that compared virtual reality with an alternative or no intervention were included in the review. The authors searched the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, electronic databases, trial registers, reference lists, Dissertation Abstracts, conference proceedings and contacted key researchers and virtual reality manufacturers. Search results were independently examined by two review authors to identify studies meeting the inclusion criteria. Nineteen studies with a total of 565 participants were included in the review. Variation in intervention approaches and outcome data collected limited the extent to which studies could be compared. Virtual reality was found to be significantly more effective than conventional therapy in improving upper limb function (standardised mean difference, SMD) 0.53, 95% confidence intervals [CI] 0.25 to 0.81)) based on seven studies, and activities of daily living (ADL) function (SMD 0.81, 95% CI 0.39 to 1.22) based on three studies. No statistically significant effects were found for grip strength (based on two studies) or gait speed (based on three studies). Virtual reality appears to be a promising approach however, further studies are required to confirm these findings.

Updated method guidelines for cochrane musculoskeletal group systematic reviews and metaanalyses

DEFF Research Database (Denmark)

Ghogomu, Elizabeth A T; Maxwell, Lara J; Buchbinder, Rachelle

2014-01-01

The Cochrane Musculoskeletal Group (CMSG), one of 53 groups of the not-for-profit, international Cochrane Collaboration, prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. It is important that authors conducting CMSG reviews and the readers of our...... reviews be aware of and use updated, state-of-the-art systematic review methodology. One hundred sixty reviews have been published. Previous method guidelines for systematic reviews of interventions in the musculoskeletal field published in 2006 have been substantially updated to incorporate...... using network metaanalysis. Method guidelines specific to musculoskeletal disorders are provided by CMSG editors for various aspects of undertaking a systematic review. These method guidelines will help improve the quality of reporting and ensure high standards of conduct as well as consistency across...

Agreement between Cochrane Neonatal reviews and clinical practice guidelines for newborns in Denmark a cross sectional study

DEFF Research Database (Denmark)

Brok, Jesper; Greisen, Gorm; Madsen, Lars P

2007-01-01

for disagreement were numerous; usage of evidence with higher bias risks than randomised trials in guidelines development was the most frequent one. Cochrane reviews were rarely (10%) used during guideline development. Nine guideline topics (5%) revealed diversity among the departments' recommendations....... CONCLUSIONS: There is good agreement between Cochrane reviews and neonatal guidelines in Denmark. The disagreements are few. Cochrane reviews were rarely used for guideline development. Guideline heterogeneity among neonatal departments seems moderate....

Twelve-year prevalence of common neonatal congenital malformations in Zhejiang Province, China.

Science.gov (United States)

Sun, Ge; Xu, Zhe-Ming; Liang, Jian-Feng; Li, Lin; Tang, Da-Xing

2011-11-01

One of the challenges that pediatricians face when examining birth defects is to understand the trends in its occurrence and provide clues to etiology. This study was undertaken to retrospectively assess the prevalence of 10 common neonatal congenital malformations by reviewing a database of all deliveries from 28 weeks up until 7 days of birth from January 1998 to December 2009 in Zhejiang Province, China. Ten common neonatal congenital malformations were selected for analysis. The incidence and the Cochran-Armitage Trend were assessed via SAS9.2. A P value ≤0.05 was considered statistically significant. Of 83 888 perinatals, 374 (4.46‰) suffered from congenital heart diseases (CHD), 77 (0.92‰) from congenital hydrocephalus, 32 (0.38‰) from intestinal atresia/stenosis, 36 (0.43‰) from anorectal malformations, 149 (1.78‰) from kidney malformations, 139 (3.31‰) from hypospadias (male), 178 (2.12‰) from orofacial clefts (OFC), 188 (2.24‰) from polydactyly, 62 (0.74‰) from syndactyly, and 269 (3.21‰) from accessory auricle anomaly. Their trend of prevalence varied as follows: CHD, P=0.0026; hydrocephalus, P=0.0042; intestinal atresia/stenosis, P=0.0103; anorectal malformations, P=0.4332; kidney malformations, Pmalformations (Pmalformations (P=0.4332), polydactyly (P=0.0867) and syndactyly (P=0.1941). The incidences of CHD, intestinal atresia/stenosis, kidney malformations, hypospadias, OFC, and accessory auricle anomaly have increased in the last 12 years, but the incidences of anorectal malformations, polydactyly and syndactyly remain stable. The incidence of hydrocephalus shows a downward trend.

Visualization of evidence-based medicine domain knowledge: production and citation of Cochrane systematic reviews.

Science.gov (United States)

Shen, Jiantong; Li, Youping; Clarke, Mike; Du, Liang; Wang, Li; Zhong, Dake

2013-02-01

To evaluate the production and utilization of Cochrane systematic reviews (CSRs) and to analyze its influential factors, so as to improve the capacity of translating CSRs into practice. All CSRs and protocols were retrieved from the Cochrane Library (Issue 2, 2011) and citation data were retrieved from SCI database. Citation analysis was used to analyze the situation of CSRs production and utilization. CSR publication had grown from an annual average of 32 to 718 documents. Only one developing country was among the ten countries with the largest amount of publications. High-income countries accounted for 83% of CSR publications and 90.8% of cited counts. A total 34.7% of CSRs had a cited count of 0, whereas only 0.9% had been cited more than 50 times. Highly cited CSRs were published in England, Australia, Canada, USA and other high-income countries. The countries with a Cochrane center or a Cochrane methodology group had a greater capability of CSRs production and citing than others. The CSRs addressing the topics of diseases were more than those targeted at public health issues. There was a big gap in citations of different interventions even on the same topic. The capability of CSR production and utilization grew rapidly, but varied among countries and institutions, which was affected by several factors such as the capability of research, resources and the applicability of evidence. It is important to improve evidence translation through educating, training and prioritizing the problems based on real demands of end users. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Predictors of trimodality therapy and trends in therapy for malignant pleural mesothelioma.

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Nelson, David B; Rice, David C; Niu, Jiangong; Atay, Scott M; Vaporciyan, Ara A; Antonoff, Mara B; Hofstetter, Wayne L; Walsh, Garrett L; Swisher, Stephen G; Roth, Jack A; Tsao, Anne S; Gomez, Daniel R; Giordano, Sharon H; Mehran, Reza J; Sepesi, Boris

2018-05-01

Malignant pleural mesothelioma is an aggressive and rare malignancy that frequently recurs despite aggressive therapy. We evaluated the frequency of treatment with surgery, radiation or chemotherapy, changes in therapy and survival over time and factors associated with the receipt of trimodality therapy. The National Cancer Database (NCDB) was used to query patients with histologically proven malignant pleural mesothelioma (2004-14). Treatment over time was evaluated using the Armitage trend test. Factors associated with the receipt of trimodality therapy were analysed using logistic regression. Among 20 561 patients, only 4028 (20%) underwent cancer-directed surgery; 533 (2.6%) of whom received trimodality therapy. From 2004 to 2014, the use of surgery with chemotherapy increased 87% (P 26 miles for treatment were more likely to undergo trimodality therapy. Additional factors associated with the receipt of trimodality therapy include age less than 70, Charlson comorbidity score of 0 and presence of private insurance. Many malignant pleural mesothelioma patients are not treated with trimodality therapy, with significant variation in treatment patterns. Referrals to high-volume and specialized centres may help offer more therapeutic options and trial or registry enrolment.

Agreement between reported use of interventions for liver diseases and research evidence in Cochrane systematic reviews

DEFF Research Database (Denmark)

Kürstein, Pia; Gluud, Lise L; Willemann, Marlene

2005-01-01

This study evaluates the agreement between reported use of interventions for patients with liver diseases and research evidence in Cochrane systematic reviews.......This study evaluates the agreement between reported use of interventions for patients with liver diseases and research evidence in Cochrane systematic reviews....

Parenting Training for Intellectually Disabled Parents: A Cochrane Systematic Review

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Coren, Esther; Thomae, Manuela; Hutchfield, Jemeela

2011-01-01

Objectives: This article presents a Cochrane/Campbell systematic review of the evidence on the effect of parent training to support the parenting of parents with intellectual disabilities. Method: Randomized controlled trials (RCTs) comparing parent training interventions for parents with intellectual disability with usual care or with a control…

Agreement between Cochrane Neonatal Group reviews and clinical guidelines for newborns at a Copenhagen University Hospital - a cross-sectional study

DEFF Research Database (Denmark)

Brok, Jesper; Greisen, Gorm; Jacobsen, Robert Thorkild

2007-01-01

To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development.......To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development....

A Review of Cochrane Systematic Reviews of Interventions Relevant to Orthoptic Practice.

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Rowe, Fiona J; Elliott, Sue; Gordon, Iris; Shah, Anupa

2017-09-01

To present an overview of the range of systematic reviews on intervention trials pertinent to orthoptic practice, produced by the Cochrane Eyes and Vision group (CEV). We searched the 2016 Cochrane Library database (31.03.2016) to identify completed reviews and protocols of direct relevance to orthoptic practice. These reviews are currently completed and published, available on www.thecochranelibrary.com (free to UK health employees) or via the CEV website (http://eyes.cochrane.org/) . We found 27 completed CEV reviews across the topics of strabismus, amblyopia, refractive errors, and low vision. Seven completed CEV protocols addressed topics of strabismus, amblyopia, refractive errors, low vision, and screening. We found 3 completed Cochrane Stroke reviews addressing visual field loss, eye movement impairment, and age-related vision loss. The systematic review process presents an important opportunity for any clinician to contribute to the establishment of reliable, evidence-based orthoptic practice. Each review has an abstract and plain language summary that many non-clinicians find useful, followed by a full copy of the review (background, objectives, methods, results, discussion) with a conclusion section that is divided into implications for practice and implications for research. The current reviews provide patients/parents/carers with information about various different conditions and treatment options, but also provide clinicians with a summary of the available evidence on interventions, to use as a guide for both clinical practice and future research planning. The reviews identified in this overview highlight the evidence available for effective interventions for strabismus, amblyopia, refractive errors, and low vision or stroke rehabilitation as well as the gaps in the evidence base. Thus, a demand exists for future robust, randomized, controlled trials of such interventions of importance in orthoptic practice.

Cluster Randomised Trials in Cochrane Reviews: Evaluation of Methodological and Reporting Practice.

Directory of Open Access Journals (Sweden)

Marty Richardson

Full Text Available Systematic reviews can include cluster-randomised controlled trials (C-RCTs, which require different analysis compared with standard individual-randomised controlled trials. However, it is not known whether review authors follow the methodological and reporting guidance when including these trials. The aim of this study was to assess the methodological and reporting practice of Cochrane reviews that included C-RCTs against criteria developed from existing guidance.Criteria were developed, based on methodological literature and personal experience supervising review production and quality. Criteria were grouped into four themes: identifying, reporting, assessing risk of bias, and analysing C-RCTs. The Cochrane Database of Systematic Reviews was searched (2nd December 2013, and the 50 most recent reviews that included C-RCTs were retrieved. Each review was then assessed using the criteria.The 50 reviews we identified were published by 26 Cochrane Review Groups between June 2013 and November 2013. For identifying C-RCTs, only 56% identified that C-RCTs were eligible for inclusion in the review in the eligibility criteria. For reporting C-RCTs, only eight (24% of the 33 reviews reported the method of cluster adjustment for their included C-RCTs. For assessing risk of bias, only one review assessed all five C-RCT-specific risk-of-bias criteria. For analysing C-RCTs, of the 27 reviews that presented unadjusted data, only nine (33% provided a warning that confidence intervals may be artificially narrow. Of the 34 reviews that reported data from unadjusted C-RCTs, only 13 (38% excluded the unadjusted results from the meta-analyses.The methodological and reporting practices in Cochrane reviews incorporating C-RCTs could be greatly improved, particularly with regard to analyses. Criteria developed as part of the current study could be used by review authors or editors to identify errors and improve the quality of published systematic reviews incorporating

Clinical recommendations of Cochrane reviews in pediatric gastroenterology: systematic analysis.

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Goda, Yvonne; Sauer, Harald; Schöndorf, Dominik; Hennes, Pia; Gortner, Ludwig; Gräber, Stefan; Meyer, Sascha

2015-01-01

Systematic and up-to-date Cochrane reviews in pediatrics in general and in pediatric gastroenterology in particular are important tools in disseminating the best available evidence to the medical community, thus providing the physician at the bedside with invaluable information and recommendations with regard to specific clinical questions. A systematic literature review was conducted, including all Cochrane reviews published by the Cochrane Review Group in the field of pediatric gastroenterology between 1993 and 2012, with regard to the percentage of reviews that concluded that a certain intervention provided a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence was inconclusive. In total, 86 reviews in the field of pediatric gastroenterology were included. The majority of reviews assessed pharmacological interventions (46/86); other important fields included prevention (15/86) and nutrition (9/86). A total of 33/86 reviews issued definite recommendations (positive, 19/86; negative, 14/86). The remaining 53/86 reviews were either inconclusive (24/86) or only of limited conclusiveness (29/86). The percentage of inconclusive reviews increased from 9% (1998-2002) to 19% (2003-2007; P < 0.05) to finally 24% (2008-2012) (P < 0.05). The three most common reasons for the need for further research were heterogeneity of studies (26/86), small number of patients (18/86), and insufficient data (16/86). Further high-quality research is necessary to increase the proportion of reviews with clear recommendations. Funding and research agencies are key to selecting the most appropriate research programs. © 2014 Japan Pediatric Society.

Producing Cochrane systematic reviews-a qualitative study of current approaches and opportunities for innovation and improvement.

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Turner, Tari; Green, Sally; Tovey, David; McDonald, Steve; Soares-Weiser, Karla; Pestridge, Charlotte; Elliott, Julian

2017-08-01

Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review production and emerging opportunities to improve the efficiency and sustainability of these processes. To inform discussions about how to best achieve this, we conducted 26 interviews and an online survey with 106 respondents. Respondents highlighted the importance and challenge of creating reliable, timely systematic reviews. They described the challenges and opportunities presented by current production models, and they shared what they are doing to improve review production. They particularly highlighted significant challenges with increasing complexity of review methods; difficulty keeping authors on board and on track; and the length of time required to complete the process. Strong themes emerged about the roles of authors and Review Groups, the central actors in the review production process. The results suggest that improvements to Cochrane's systematic review production models could come from improving clarity of roles and expectations, ensuring continuity and consistency of input, enabling active management of the review process, centralising some review production steps; breaking reviews into smaller "chunks", and improving approaches to building capacity of and sharing information between authors and Review Groups. Respondents noted the important role new technologies have to play in enabling these improvements. The findings of this study will inform the development of new Cochrane Review production models and may provide valuable data for other systematic review producers as they consider how best to produce rigorous, reliable, up-to-date reviews.

No Contribution of GAD-65 and IA-2 Autoantibodies around Time of Diagnosis to the Increasing Incidence of Juvenile Type 1 Diabetes: A 9-Year Nationwide Danish Study

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Steffen U. Thorsen

2016-01-01

Full Text Available Aims. A new perspective on autoantibodies as pivotal players in the pathogenesis of type 1 diabetes (T1D has recently emerged. Our key objective was to examine whether increased levels of autoantibodies against the β-cell autoantigens glutamic acid decarboxylase (isoform 65 (GADA and insulinoma associated antigen-2A (IA-2A mirrored the 3.4% annual increase in incidence of T1D. Methods. From the Danish Childhood Diabetes Register, we randomly selected 500 patients and 500 siblings for GADA and IA-2A analysis (1997 through 2005. Blood samples were taken within three months after onset. A robust log-normal regression model was used. Nine hundred children and adolescents had complete records and were included in the analysis. Cochran-Armitage test for trend was used to evaluate changes in prevalence of autoantibody positivity by period. Results. No significant changes in levels of GADA and IA-2A were found over our 9-year study period. No trends in autoantibody positivity—in either patients or siblings—were found. Levels of GADA and IA-2A were significantly associated with HLA risk groups and GADA with age. Conclusion. The prevalence of positivity and the levels of GADA and IA-2A have not changed between 1997 and 2005 in newly diagnosed patients with T1D and their siblings without T1D.

What do Cochrane systematic reviews say about probiotics as preventive interventions?

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Braga, Vinícius Lopes; Rocha, Luana Pompeu Dos Santos; Bernardo, Daniel Damasceno; Cruz, Carolina de Oliveira; Riera, Rachel

2017-01-01

Probiotics have been used for a range of clinical situations and their use is strongly encouraged by the media worldwide. This study identified and summarized all Cochrane systematic reviews about the preventive effects of probiotics in clinical practice. Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp). We included all Cochrane reviews on any probiotics when they were used as preventive interventions and compared with no intervention, placebo or any other pharmacological or non-pharmacological intervention. 17 Cochrane systematic reviews fulfilled our inclusion criteria and were summarized in this report. None of the reviews included in the present study provided high-quality evidence for any outcome. The benefits from use of probiotics included decreased incidence of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea; decreased incidence of upper respiratory tract infections and duration of episodes; decreased need for antibiotics and absences from school due to colds; and decreased incidence of ventilator-associated pneumonia. Probiotics seem to decrease the incidence of gestational diabetes mellitus, birthweight, risk of vaginal infection and incidence of eczema. Despite the marketing and the benefits associated with probiotics, there is little scientific evidence supporting the use of probiotics. None of the reviews provided any high-quality evidence for prevention of illnesses through use of probiotics. More trials are needed to gain better knowledge of probiotics and to confirm when their use is beneficial and cost-effective.

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

Science.gov (United States)

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

2015-08-01

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

Early-Onset Acute Recurrent and Chronic Pancreatitis Is Associated with PRSS1 or CTRC Gene Mutations.

Science.gov (United States)

Giefer, Matthew J; Lowe, Mark E; Werlin, Steven L; Zimmerman, Bridget; Wilschanski, Michael; Troendle, David; Schwarzenberg, Sarah Jane; Pohl, John F; Palermo, Joseph; Ooi, Chee Y; Morinville, Veronique D; Lin, Tom K; Husain, Sohail Z; Himes, Ryan; Heyman, Melvin B; Gonska, Tanja; Gariepy, Cheryl E; Freedman, Steven D; Fishman, Douglas S; Bellin, Melena D; Barth, Bradley; Abu-El-Haija, Maisam; Uc, Aliye

2017-07-01

To assess whether the age of onset was associated with unique features or disease course in pediatric acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). Demographic and clinical information on children with ARP or CP was collected at INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE) centers. The Cochran-Armitage trend test and Jonckheere-Terpstra test were used to examine for differences between pediatric age groups (pancreatitis, 111 (32%) were 6-11 years of age, and 102 (30%) were ≥12 years of age. Early-onset disease was associated with mutations in cationic trypsinogen (PRSS1) (P pancreatitis (P = .02), family history of CP (P chronic renal failure (P = .02). Later-onset disease was more commonly present with hypertriglyceridemia (P = .04), ulcerative colitis (P = .02), autoimmune diseases (P pancreatitis is associated strongly with PRSS1 or CTRC mutations and family history of pancreatitis. Children with later-onset disease are more likely to have nongenetic risk factors. Future studies are needed to investigate whether the disease course, response to therapy, or clinical outcomes differ relative to the timing of disease onset. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of Global Horizontal Irradiance in Version 3 of the National Solar Radiation Database.

Energy Technology Data Exchange (ETDEWEB)

Hansen, Clifford; Martin, Curtis E.; Guay, Nathan Gene

2015-09-01

We report an analysis that compares global horizontal irradiance (GHI) estimates from version 3 of the National Solar Radiation Database (NSRDB v3) with surface measurements of GHI at a wide variety of locations over the period spanning from 2005 to 2012. The NSRDB v3 estimate of GHI are derived from the Physical Solar Model (PSM) which employs physics-based models to estimate GHI from measurements of reflected visible and infrared irradiance collected by Geostationary Operational Environment Satellites (GOES) and several other data sources. Because the ground measurements themselves are uncertain our analysis does not establish the absolute accuracy for PSM GHI. However by examining the comparison for trends and for consistency across a large number of sites, we may establish a level of confidence in PSM GHI and identify conditions which indicate opportunities to improve PSM. We focus our evaluation on annual and monthly insolation because these quantities directly relate to prediction of energy production from solar power systems. We find that generally, PSM GHI exhibits a bias towards overestimating insolation, on the order of 5% when all sky conditions are considered, and somewhat less (-3%) when only clear sky conditions are considered. The biases persist across multiple years and are evident at many locations. In our opinion the bias originates with PSM and we view as less credible that the bias stems from calibration drift or soiling of ground instruments. We observe that PSM GHI may significantly underestimate monthly insolation in locations subject to broad snow cover. We found examples of days where PSM GHI apparently misidentified snow cover as clouds, resulting in significant underestimates of GHI during these days and hence leading to substantial understatement of monthly insolation. Analysis of PSM GHI in adjacent pixels shows that the level of agreement between PSM GHI and ground data can vary substantially over distances on the order of 2 km. We

What do Cochrane systematic reviews say about probiotics as preventive interventions?

Directory of Open Access Journals (Sweden)

Vinícius Lopes Braga

Full Text Available ABSTRACT BACKGROUND: Probiotics have been used for a range of clinical situations and their use is strongly encouraged by the media worldwide. This study identified and summarized all Cochrane systematic reviews about the preventive effects of probiotics in clinical practice. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM, Universidade Federal de São Paulo (Unifesp. METHODS: We included all Cochrane reviews on any probiotics when they were used as preventive interventions and compared with no intervention, placebo or any other pharmacological or non-pharmacological intervention. RESULTS: 17 Cochrane systematic reviews fulfilled our inclusion criteria and were summarized in this report. None of the reviews included in the present study provided high-quality evidence for any outcome. The benefits from use of probiotics included decreased incidence of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea; decreased incidence of upper respiratory tract infections and duration of episodes; decreased need for antibiotics and absences from school due to colds; and decreased incidence of ventilator-associated pneumonia. Probiotics seem to decrease the incidence of gestational diabetes mellitus, birthweight, risk of vaginal infection and incidence of eczema. CONCLUSION: Despite the marketing and the benefits associated with probiotics, there is little scientific evidence supporting the use of probiotics. None of the reviews provided any high-quality evidence for prevention of illnesses through use of probiotics. More trials are needed to gain better knowledge of probiotics and to confirm when their use is beneficial and cost-effective.

Potential and Limitations of Cochrane Reviews in Pediatric Cardiology: A Systematic Analysis.

Science.gov (United States)

Poryo, Martin; Khosrawikatoli, Sara; Abdul-Khaliq, Hashim; Meyer, Sascha

2017-04-01

Evidence-based medicine has contributed substantially to the quality of medical care in pediatric and adult cardiology. However, our impression from the bedside is that a substantial number of Cochrane reviews generate inconclusive data that are of limited clinical benefit. We performed a systematic synopsis of Cochrane reviews published between 2001 and 2015 in the field of pediatric cardiology. Main outcome parameters were the number and percentage of conclusive, partly conclusive, and inconclusive reviews as well as their recommendations and their development over three a priori defined intervals. In total, 69 reviews were analyzed. Most of them examined preterm and term neonates (36.2%), whereas 33.3% included also non-pediatric patients. Leading topics were pharmacological issues (71.0%) followed by interventional (10.1%) and operative procedures (2.9%). The majority of reviews were inconclusive (42.9%), while 36.2% were conclusive and 21.7% partly conclusive. Although the number of published reviews increased during the three a priori defined time intervals, reviews with "no specific recommendations" remained stable while "recommendations in favor of an intervention" clearly increased. Main reasons for missing recommendations were insufficient data (n = 41) as well as an insufficient number of trials (n = 22) or poor study quality (n = 19). There is still need for high-quality research, which will likely yield a greater number of Cochrane reviews with conclusive results.

Uit de Cochrane Library: effectieve maatregelen beschikbaar voor valpreventie bij ouderen

NARCIS (Netherlands)

Hamerlynck, J. V. T. H.; Middeldorp, S.; Scholten, R. J. P. M.

2006-01-01

Approximately 30% of people over 65 years of age and living in the community fall each year; the percentage is higher in institutions. A fifth of the incidents require medical attention. A Cochrane systematic review of 62 studies, encompassing 21,668 elderly people, showed that several interventions

Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis.

Science.gov (United States)

Yin, Shande; Chuai, Yunhai; Wang, Aiming; Zhang, Lanmei

2015-06-01

To assess the conclusiveness of Cochrane reviews in the field of gynaecological cancer. The Cochrane Library was searched for reviews regarding gynaecological cancer published between 1 January 2000 and 1 November 2014. Data were extracted from each paper and the conclusiveness of each review was assessed. The study included 66 reviews, 41 (62.1%) of which were conclusive. Of these, 58 included randomized controlled trials (RCTs), 37 (63.8%) of which were conclusive. Conclusive reviews of RCTs included significantly more patients than inconclusive reviews, but there was no difference in the number of included studies. Of the eight reviews of nonrandomized studies, four (50.0%) were conclusive. The majority of reviews recognized the need for additional studies. In the field of gynaecological cancer, reviews are more likely to be conclusive when they include RCTs, as well as large numbers of patients. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Cochrane Acute Respiratory Infections Group's Stakeholder Engagement Project identified systematic review priority areas.

Science.gov (United States)

Scott, Anna Mae; Clark, Justin; Dooley, Liz; Jones, Ann; Jones, Mark; Del Mar, Chris

2018-05-22

Cochrane Acute Respiratory Infections (ARI) Group conducts systematic reviews of the evidence for treatment and prevention of ARIs. We report the results of a prioritisation project, aiming to identify highest priority systematic review topics. The project consisted of 2 Phases. Phase 1 analysed the gap between existing RCTs and Cochrane Systematic Reviews (reported previously). Phase 2 (reported here) consisted of a two-round survey. In round 1, respondents prioritised 68 topics and suggested up to 10 additional topics; in Round 2, respondents prioritised top 25 topics from Round 1. Respondents included clinicians, researchers, systematic reviewers, allied health, patients, and carers, from 33 different countries. In Round 1, 154 respondents identified 20 priority topics, most commonly selecting topics in non-specific ARIs, influenza, and common cold. 50 respondents also collectively suggested 134 additional topics. In Round 2, 78 respondents prioritised top 25 topics, most commonly in the areas of non-specific ARIs, pneumonia and influenza. We generated a list of priority systematic review topics, to guide the Cochrane ARI Group's systematic review work for the next 24 months. Stakeholder involvement enhanced the transparency of the process, and will increase the usability and relevance of the Group's work to stakeholders. Copyright © 2018 Elsevier Inc. All rights reserved.

Impact assessment of a maternal health project in a megacity, Nigeria: toward a future with more demand for maternal health services.

Science.gov (United States)

Matsuoka, Sadatoshi; Koga, Sumiko; Suzui, Emiko; Tsukada, Yoshiko; Ohashi, Kazutomo; Johnson, Taiwo

2017-10-01

To improve the quantity and quality of maternal health services in Lagos State, Nigeria having a maternal mortality ratio of 555 per 100 000 live births, a four-year project was implemented since February 2010. The major activity of the project was training for both the service supply and demand sides. This study aimed to examine the impact of the project on coverages and quality of the services in target areas, and guide statewide policies. The Cochran-Armitage test for trend was applied to understand trends in the service coverages during 2009-2013. The same test was performed to analyse trends in the proportions of perineal conditions (i.e. intact or tear) and to evaluate variations in midwives' snkill during 2011-2013. The paired t-test was used to analyse changes in midwives' knowledge. The project interventions contributed to a significant increase in the overall service coverages, including improvements in midwifery knowledge and possibly in their skills. However, the service coverage was still limited as of the termination of the project. To instal the interventions and maximise the effect of them state-wide, it is recommended to undertake five tasks: (i) establishment of public primary health centres offering 24-h maternal health services; (ii) redeployment and recruitment of public health personnel; (iii) expansion of midwifery trainings and continuous education by the local trainers; (iv) review of grass-roots level activities; and (v) scrutiny of barriers to maternal health services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System.

Science.gov (United States)

Choi, H J; Adiyani, L; Sung, J; Choi, J Y; Kim, H B; Kim, Y K; Kwak, Y G; Yoo, H; Lee, Sang-Oh; Han, S H; Kim, S R; Kim, T H; Lee, H M; Chun, H K; Kim, J-S; Yoo, J D; Koo, H-S; Cho, E H; Lee, K W

2016-08-01

Surveillance of healthcare-associated infection has been associated with a reduction in surgical site infection (SSI). To evaluate the Korean Nosocomial Infection Surveillance System (KONIS) in order to assess its effects on SSI since it was introduced. SSI data after gastrectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) between 2008 and 2012 were analysed. The pooled incidence of SSI was calculated for each year; the same analyses were also conducted from hospitals that had participated in KONIS for at least three consecutive years. Standardized SSI rates for each year were calculated by adjusting for SSI risk factors. SSI trends were analysed using the Cochran-Armitage test. The SSI rate following gastrectomy was 3.12% (522/16,918). There was a significant trend of decreased crude SSI rates over five years. This trend was also evident in analysis of hospitals that had participated for more than three years. The SSI rate for THA was 2.05% (157/7656), which decreased significantly from 2008 to 2012. The risk factors for SSI after THA included the National Nosocomial Infections Surveillance risk index, trauma, reoperation, and age (60-69 years). The SSI rate for TKA was 1.90% (152/7648), which also decreased significantly during a period of five years. However, the risk-adjusted analysis of SSI did not show a significant decrease for all surgical procedures. The SSI incidence of gastrectomy and prosthetic joint replacement declined over five years as a result of active surveillance by KONIS. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Prevalence and Trends of Cigarette Smoking Among Military Personnel in Taiwan: Results of 10-Year Anti-Smoking Health Promotion Programs in Military.

Science.gov (United States)

Chu, Nain-Feng; Lin, Fu-Huang; Wu, Yi-Chang

2017-07-01

The purpose of this study is to evaluate the prevalence and trends of cigarette smoking among young military conscripts, military officers, and military university students during recently 10 years in Taiwan. Repeated cross-sectional surveys were conducted annually among young military conscripts and military university students from 2006 to 2014. All the young conscripts were reviewed within 1 month at the military training center and before retiring after 1 year of military services. The military officers were included using purposive sampling from 2004 to 2008 and 2013 to 2014 in different military services. Military university students were included in this study. Freshman and senior students were random sampled as the study subjects. Participants completed a structured questionnaire that included questions on general demographics and health-related behaviors. Current smokers is defined as subjects who smoked ≥1 cigarette/day during the past 30 days or had smoked ≥100 cigarettes in their lifetime or still have the habit of smoking during study. We used a χ 2 test to examine the difference between the prevalence of cigarette smoking among different groups. The Cochran-Armitage test for trend was applied to examine the change of prevalence of smoking after repeated cross-sectional surveys among populations. The prevalence of cigarette smoking within military training center and after 1-year military services was 48.6% and 48.1% on 2006, which became 39.2% and 38.6% on 2010, and then further declined to 31.0% and 30.1% on 2014. For military officers, the trends of prevalence of smoking among different military services showed slight decline from 2004 to 2008, but decreased significantly between 2013 and 2014. The prevalence of smoking in 2014 was 32.1%, 32.8%, and 32.4% for the Army, Navy, and Air Force, respectively. More interestingly, the prevalence of smoking of freshman and senior students increased during the first 5 years (2007-2011) of survey and then

Evaluation of Health Economics in Radiation Oncology: A Systematic Review

International Nuclear Information System (INIS)

Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.

2016-01-01

Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

Evaluation of Health Economics in Radiation Oncology: A Systematic Review

Energy Technology Data Exchange (ETDEWEB)

Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

2016-04-01

Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

The evidence for nursing interventions in the Cochrane database of systematic reviews.

NARCIS (Netherlands)

Mistiaen, P.; Poot, E.; Hickox, S.; Wagner, C.

2004-01-01

In this paper the authors describe how they conducted a search of the Cochrane Database of Systematic Reviews in order to explore the evidence for nursing interventions. They identify the number of studies, the number of participants, and the conclusions of systematic reviews concerning nursing

Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

Science.gov (United States)

Tugwell, Peter; Petkovic, Jennifer; Welch, Vivian; Vincent, Jennifer; Bhutta, Zulfiqar A; Churchill, Rachel; deSavigny, Don; Mbuagbaw, Lawrence; Pantoja, Tomas

2017-12-02

A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into 'friendly front end' summaries for policy makers. The following topic areas with high burdens of disease globally, were selected for the pilot: diabetes/obesity, HIV/AIDS, malaria, nutrition, and mental health/depression. For each topic area, a "stakeholder panel" was assembled that included policymakers and researchers. A systematic search of Cochrane reviews was conducted for each area to identify equity-relevant interventions with a meaningful impact. Panel chairs developed a rating sheet which was used by all panels to rank the importance of these interventions by: 1) Ease of Implementation; 2) Health System Requirements; 3)Universality/Generalizability/Share of Burden; and 4) Impact on Inequities/Effect on equity. The ratings of panel members were averaged for each intervention and criterion, and interventions were ordered according to the average overall ratings. Stakeholder panels identified the top 10 interventions from their respective topic areas. The evidence on these interventions is being summarized with an equity focus and the results posted online, at http://methods.cochrane.org/equity/e4e-series . This method provides an explicit approach to setting priorities by systematic review groups and funders for providing decision makers with evidence for the most important equity

Is identification of smoking, risky alcohol consumption and overweight and obesity by General Practitioners improving? A comparison over time.

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Bryant, Jamie; Yoong, Sze Lin; Sanson-Fisher, Rob; Mazza, Danielle; Carey, Mariko; Walsh, Justin; Bisquera, Alessandra

2015-12-01

Detection of lifestyle risk factors by GPs is the first step required for intervention. Despite significant investment in preventive health care in general practice, little is known about whether GP detection of lifestyle risk factors have improved over time. To examine whether sensitivity and specificity of GP detection of smoking, risky alcohol consumption and overweight and obesity has increased in patients presenting to see their GP, by comparing results from four Australian studies conducted between 1982 and 2011. Demographic characteristics of patient and GP samples and the prevalence, sensitivity and specificity of detection of each risk factor were extracted from published studies. Differences between GP and patient sample characteristics were examined. To identify trends over time in prevalence of risk factors, sensitivity and specificity of detection across studies and the Cochran-Armitage test for trend were calculated for each risk factor for the overall sample and by male and female subgroups. There were no statistically significant changes in the sensitivity of GP detection of smoking or overweight or obesity over time. Specificity of detection of smoking increased from 64.7% to 98% (P investment to increase GP detection and intervention for lifestyle risk factors, accurate detection of smoking, risky alcohol consumption and overweight and obesity occurs for less than two-thirds of all patients. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A comparison of the education and work experiences of immigrant and the United States of America-trained nurses.

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Mazurenko, O; Gupte, G; Shan, G

2014-12-01

This study examined the education and work experience of immigrant and American-trained registered nurses from 1988 to 2008. The USA increasingly relies on immigrant nurses to fill a significant nursing shortage. These nurses receive their training overseas, but can obtain licenses to practice in different countries. Although immigrant nurses have been in the USA workforce for several decades, little is known about how their education and work experience compares with USA-trained nurses. Yet much is presumed by policy makers and administrators who perpetuate the stereotype that immigrant nurses are not as qualified. We analysed the National Sample Survey of Registered Nurses datasets from 1988 to 2008 using the Cochran-Armitage trend tests. Our findings showed similar work experience and upward trends in education among both groups of nurses. However, American-trained nurses were more likely to further advance their education, whereas immigrant nurses were more likely to have more work experience and practice in a wider range of healthcare settings. Although we discovered differences between nurses trained in the USA and abroad, we theorize that these differences even out, as education and work experience each have their own distinct caregiving advantages. Immigrant nurses are not less qualified than their American-trained counterparts. However, healthcare providers should encourage them to further pursue their education and certifications. Even though immigrant nurses' education and work experience are comparable with their American counterparts, workforce development policies may be particularly beneficial for this group. © 2014 International Council of Nurses.

A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer.

Science.gov (United States)

Goldkuhle, Marius; Narayan, Vikram M; Weigl, Aaron; Dahm, Philipp; Skoetz, Nicole

2018-03-25

To compare cancer-related systematic reviews (SRs) published in the Cochrane Database of SRs (CDSR) and high-impact journals, with respect to type, content, quality and citation rates. Methodological SR with assessment and comparison of SRs and meta-analyses. Two authors independently assessed methodological quality using an Assessment of Multiple Systematic Reviews (AMSTAR)-based extraction form. Both authors independently screened search results, extracted content-relevant characteristics and retrieved citation numbers of the included reviews using the Clarivate Analytics Web of Science database. Cancer-related SRs were retrieved from the CDSR, as well as from the 10 journals which publish oncological SRs and had the highest impact factors, using a comprehensive search in both the CDSR and MEDLINE. We included all cancer-related SRs and meta-analyses published from January 2011 to May 2016. Methodological SRs were excluded. We included 346 applicable Cochrane reviews and 215 SRs from high-impact journals. Cochrane reviews consistently met more individual AMSTAR criteria, notably with regard to an a priori design (risk ratio (RR) 3.89; 95% CI 3.10 to 4.88), inclusion of the grey literature and trial registries (RR 3.52; 95% CI 2.84 to 4.37) in their searches, and the reporting of excluded studies (RR 8.80; 95% CI 6.06 to 12.78). Cochrane reviews were less likely to address questions of prognosis (RR 0.04; 95% CI 0.02 to 0.09), use individual patient data (RR 0.03; 95% CI 0.01 to 0.09) or be based on non-randomised controlled trials (RR 0.04; 95% CI 0.02 to 0.09). Citation rates of Cochrane reviews were notably lower than those for high-impact journals (Cochrane reviews: mean number of citations 6.52 (range 0-143); high-impact journal SRs: 74.45 (0-652)). When comparing cancer-related SRs published in the CDSR versus those published in high-impact medical journals, Cochrane reviews were consistently of higher methodological quality, but cited less

The Facultad Ciencias de la Salud and the Cochrane Collaboration

Directory of Open Access Journals (Sweden)

Mario Delgado-Noguera

2014-12-01

Full Text Available The Faculty of Health Sciences of the University of Cauca is an Associate Cochrane Group since January 2009 and ratified its membership in the network in November 2013. As an associated group it has promoted the Organized training workshops in systematic reviews, occasionally in conjunction with scientific societies such as the Cauca Pediatric Society. It has also participated with the authorship of two systematic reviews in the areas of Anesthesia, Child Nutrition and Pediatric Infectology.

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

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Jayaraman, Srinivasan

2015-01-01

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

77 FR 65545 - Mr. Jesse S. Capel and Mr. Hilton J. Cochran; EWP LLC; Notice of Transfer of Exemption

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2012-10-29

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 4815-009] Mr. Jesse S. Capel and Mr. Hilton J. Cochran; EWP LLC; Notice of Transfer of Exemption 1. By application filed on July 30, 2012 and supplemented on August 14, 2012, Mr. Jesse S. Capel and Mr. Hilton J. Cochran and EWP...

Reporting and Handling Missing Outcome Data in Mental Health: A Systematic Review of Cochrane Systematic Reviews and Meta-Analyses

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Spineli, Loukia M.; Pandis, Nikolaos; Salanti, Georgia

2015-01-01

Objectives: The purpose of the study was to provide empirical evidence about the reporting of methodology to address missing outcome data and the acknowledgement of their impact in Cochrane systematic reviews in the mental health field. Methods: Systematic reviews published in the Cochrane Database of Systematic Reviews after January 1, 2009 by…

Systematic reviews of physical and rehabilitation medicine Cochrane contents. Part 1. Disabilities due to spinal disorders and pain syndromes in adults.

Science.gov (United States)

Negrini, S; Imperio, G; Villafañe, J H; Negrini, F; Zaina, F

2013-08-01

This article is the first in a series presenting the strongest published evidence for physical and rehabilitation medicine (PRM) to date coming from the Cochrane Collaboration. The intent of the series is to stimulate ideas for reviews and research in neglected areas of PRM. To systematically review the rehabilitation contents of the Cochrane Collaboration on disabilities due to spinal disorders or pain syndromes in adults. The Cochrane Database of Systematic Reviews was searched at the end of June 2013 for articles relevant for PRM about disabilities resulting from spinal disorders or pain syndromes in adults. Retrieved papers were classified according to the PRM approach: active therapies, which require active participation by patients to achieve treatment goals, and passive treatments, which rely on the application of external forces. The quality of the reviews was checked against the AMSTAR checklist. Reviews on spinal disorders or pain syndromes were found in the Cochrane Back Group (CBG) and in the Pain, Palliative and Supportive Care Group (CPPSCG). Thirty-eight (42.8%) of 89 Cochrane reviews in the CBG and 7 (2.4%) of 293 Cochrane reviews in the CPPSCG were included. All were of high quality (range, 8-11 points out of 11 on the AMSTAR checklist). The contents of the reviews are given in detail. This review presents an overview of the current evidence for PRM in the treatment of disabilities due to spinal disorders or pain syndromes in adults. Within PRM there is ample space for research in the Cochrane Collaboration and for producing original studies (randomized controlled trials [RCTs]). To apply evidence-based clinical practice, clinicians must be familiar with the current best evidence.

Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews.

Science.gov (United States)

Foxcroft, David R; Tsertsvadze, Alexander

2012-05-01

Alcohol misuse by young people causes significant health and social harm, including death and disability. Therefore, prevention of youth alcohol misuse is a policy aim in many countries. Our aim was to examine the effectiveness of (1) school-based, (2) family-based and (3) multi-component universal alcohol misuse prevention programmes in children and adolescents. Three Cochrane systematic reviews were performed: searches in MEDLINE, EMBASE, PsycINFO, Project CORK and the Cochrane Register of Controlled Trials up to July 2010, including randomised trials evaluating universal alcohol misuse prevention programmes in school, family or multiple settings in youths aged 18 years or younger. Two independent reviewers identified eligible studies and any discrepancies were resolved via discussion. A total of 85 trials were included in the reviews of school (n = 53), family (n = 12) and multi-component (n = 20) programmes. Meta-analysis was not performed due to study heterogeneity. Most studies were conducted in North America. Risk of bias assessment revealed problems related to inappropriate unit of analysis, moderate to high attrition, selective outcome reporting and potential confounding. Certain generic psychosocial and life skills school-based programmes were effective in reducing alcohol use in youth. Most family-based programmes were effective. There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions. In these Cochrane reviews, some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies identified in these reviews and pay particular attention to content and context factors through rigorous evaluation.

Efficacy of interventions to combat tobacco addiction: Cochrane update of 2012 reviews.

Science.gov (United States)

Hartmann-Boyce, Jamie; Stead, Lindsay F; Cahill, Kate; Lancaster, Tim

2013-10-01

The Cochrane Collaboration is an international not-for-profit organization which produces and disseminates systematic reviews of health-care interventions. This paper is the first in a series of annual updates of Cochrane reviews on tobacco addiction interventions. It also provides an up-to-date overview of review findings in this area to date and summary statistics for cessation reviews in which meta-analyses were conducted. In 2012, the Group published seven new reviews and updated 13 others. This update summarizes and comments on these reviews. It also summarizes key findings from all the other reviews in this area. New reviews in 2012 found that in smokers using pharmacotherapy, behavioural support improves success rates [risk ratio (RR) 1.16, 95% confidence interval (CI) = 1.09-1.24], and that combining behavioural support and pharmacotherapy aids cessation (RR 1.82, 95% CI = 1.66-2.00). Updated reviews established mobile phones as potentially helpful in aiding cessation (RR 1.71, 95% CI = 1.47-1.99), found that cytisine (RR 3.98, 95% CI = 2.01-7.87) and low-dose varenicline (RR 2.09, 95% CI = 1.56-2.78) aid smoking cessation, and found that training health professionals in smoking cessation improves patient cessation rates (RR 1.60, 95% CI = 1.26-2.03). The updated reviews confirmed the benefits of nicotine replacement therapy, standard dose varenicline and providing cessation treatment free of charge. Lack of demonstrated efficacy remained for partner support, expired-air carbon monoxide feedback and lung function feedback. Cochrane systematic review evidence for the first time establishes the efficacy of behavioural support over and above pharmacotherapy, as well as the efficacy of cytisine, mobile phone technology, low-dose varenicline and health professional training in promoting smoking cessation. © 2013 Society for the Study of Addiction.

Do randomized controlled trials discuss healthcare costs?

Directory of Open Access Journals (Sweden)

G Michael Allan

Full Text Available BACKGROUND: Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in RCTs. METHODS AND FINDINGS: We randomly sampled 188 RCTs spanning three years (2003-2005 from six high impact journals. The sample size for RCTs was based on a calculation to estimate the inclusion of actual drug costs with a precision of +/-3%. Two reviewers independently extracted cost data and study characteristics. Frequencies were calculated and potential characteristics associated with the inclusion of costs were explored. Actual drug costs were included in 4.7% (9/188 of RCTs; any actual costs were included in 7.4% (14/188 of RCTs; and any mention of costs was included in 27.7% (52/188 of RCTs. As the amount of industry funding increased across RCTs, from non-profit to mixed to fully industry funded RCTs, there was a statistically significant reduction in the number of RCTs with any actual costs (Cochran-Armitage test, p = 0.005 and any mention of costs (Cochran-Armitage test, p = 0.02. Logistic regression analysis also indicated funding was associated with the inclusion of any actual cost (OR = 0.34, p = 0.009 or any mention of costs (OR = 0.63, p = 0.02. Journal, study conclusions, study location, primary author's country and product age were not associated with inclusion of cost information. CONCLUSION: While physicians are encouraged to consider costs when prescribing drugs for their patients, actual drug costs were provided in only 5% of RCTs and were not mentioned at all in 72% of RCTs. Industry funded trials were less likely to include cost information. No other factors were associated with the inclusion of cost information.

Do randomized controlled trials discuss healthcare costs?

Science.gov (United States)

Allan, G Michael; Korownyk, Christina; LaSalle, Kate; Vandermeer, Ben; Ma, Victoria; Klein, Douglas; Manca, Donna

2010-08-23

Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs) routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in RCTs. We randomly sampled 188 RCTs spanning three years (2003-2005) from six high impact journals. The sample size for RCTs was based on a calculation to estimate the inclusion of actual drug costs with a precision of +/-3%. Two reviewers independently extracted cost data and study characteristics. Frequencies were calculated and potential characteristics associated with the inclusion of costs were explored. Actual drug costs were included in 4.7% (9/188) of RCTs; any actual costs were included in 7.4% (14/188) of RCTs; and any mention of costs was included in 27.7% (52/188) of RCTs. As the amount of industry funding increased across RCTs, from non-profit to mixed to fully industry funded RCTs, there was a statistically significant reduction in the number of RCTs with any actual costs (Cochran-Armitage test, p = 0.005) and any mention of costs (Cochran-Armitage test, p = 0.02). Logistic regression analysis also indicated funding was associated with the inclusion of any actual cost (OR = 0.34, p = 0.009) or any mention of costs (OR = 0.63, p = 0.02). Journal, study conclusions, study location, primary author's country and product age were not associated with inclusion of cost information. While physicians are encouraged to consider costs when prescribing drugs for their patients, actual drug costs were provided in only 5% of RCTs and were not mentioned at all in 72% of RCTs. Industry funded trials were less likely to include cost information. No other factors were associated with the inclusion of cost information.

Interlocuções com Marilyn Cochran-Smith sobre aprendizagem e pesquisa do professor em comunidades investigativas

Directory of Open Access Journals (Sweden)

DARIO FIORENTINI

2016-01-01

Full Text Available Este artículo presenta y discute la vida y obra de Marilyn Cochran-Smith, así como sus principales constructos teóricos, desarrollados en colaboración con Susan Lytle, tales como: comunidades investigativas, investigación del profesor, postura investigativa y formación de profesores para la justicia social. También menciona estudios y autores brasileños que establecen diálogos con las ideas de esas autoras. Destacan algunas influencias y contribuciones de Cochran-Smith y Lytle relativas a estos estudios, sobre todo aquellas relacionadas con la investigación del profesor sobre su práctica, y a la investigación sobre el aprendizaje y el desarrollo del profesor en comunidades investigativas. Por último, para ampliar el debate sobre tales ideas y obtener su visión actual del movimiento de investigación del profesor y la política educativa del gobierno Obama, se presenta una entrevista completa realizada el 2012 por los autores a Cochran-Smith, en el Boston College.

Prevalence, patterns and predictors of substance use among Latino migrant men in a new receiving community.

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Kissinger, Patricia; Althoff, Meghan; Burton, Nicole; Schmidt, Norine; Hembling, John; Salinas, Oscar; Shedlin, Michele

2013-12-15

The purpose of this study was to evaluate the prevalence, patterns and predictors (individual, social, cultural, and environmental) of illicit drug use and binge drinking in a cohort of Latino migrant men (LMM) in a new receiving community. A cohort of LMM in New Orleans (n=125) was assembled in 2007 using respondent driven sampling and interviewed quarterly for 18 months regarding past month substance use and other potential covariates. Baseline frequencies were weighted using RDSAT and longitudinal analyses included generalized estimating equations (GEE) and the Cochran-Armitage test for trends. At baseline, substance use behaviors were: drug use 15.0% (range 7.3-25.0%) and binge drinking 58.3% (range 43.6-74.6%). All three of these behaviors decreased over follow-up (Pworker was associated with increased risk, whereas belonging to a club or organization was associated with less risk. Additional factors associated with increased drug use were: having a friend in New Orleans upon arrival, symptoms of depression, and working in construction. An additional factor associated with less binge drinking was having family in New Orleans upon arrival. Among LMM, substance use is influenced by social and environmental factors. Interventions increase community connectedness may help decrease usage. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Positive surgical margins in nephron-sparing surgery; the great unknown

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Dan Spinu

2018-04-01

Full Text Available There is a currently a general trend towards organ-preserving surgery, and urology is no exception. Specifically, nephron-sparing surgery (NSS has gained general acceptance for T1a renal cell carcinoma (guidelines recommendations. Moreover T1b, T2 and even T3 stage tumors have been included on the nephron sparing list at some centers. An unresolved issue is that of positive surgical margins (PSM, not only their detection but also the implications for follow up and treatment. This paper highlights data available on risk factors for PSM, their clinical relevance, and possible therapeutic consequences. From the surgeon’s viewpoint, NSS is a daring and risky surgical procedure. Urological guidelines stress the importance of NSS, and thus the trend is moving in that direction. Unresolved, however, is the problem of PSM. Trifecta, MIC, and pentafecta are applicable concepts which attempt to define the optimal endpoint of NSS, but further elaboration is necessary. Specifically, research needs to focus less on the concept of definitive margins and more on their identification and avoidance. Although some studies suggest that PSMs do not influence overall survival rate, the basic idea of preserving tissue that is not cancerous leads to further medical, social, and psychological considerations.

[The warning model and influence of climatic changes on hemorrhagic fever with renal syndrome in Changsha city].

Science.gov (United States)

Xiao, Hong; Tian, Huai-yu; Zhang, Xi-xing; Zhao, Jian; Zhu, Pei-juan; Liu, Ru-chun; Chen, Tian-mu; Dai, Xiang-yu; Lin, Xiao-ling

2011-10-01

To realize the influence of climatic changes on the transmission of hemorrhagic fever with renal syndrome (HFRS), and to explore the adoption of climatic factors in warning HFRS. A total of 2171 cases of HFRS and the synchronous climatic data in Changsha from 2000 to 2009 were collected to a climate-based forecasting model for HFRS transmission. The Cochran-Armitage trend test was employed to explore the variation trend of the annual incidence of HFRS. Cross-correlations analysis was then adopted to assess the time-lag period between the climatic factors, including monthly average temperature, relative humidity, rainfall and Multivariate Elño-Southern Oscillation Index (MEI) and the monthly HFRS cases. Finally the time-series Poisson regression model was constructed to analyze the influence of different climatic factors on the HFRS transmission. The annual incidence of HFRS in Changsha between 2000 - 2009 was 13.09/100 000 (755 cases), 9.92/100 000 (578 cases), 5.02/100 000 (294 cases), 2.55/100 000 (150 cases), 1.13/100 000 (67 cases), 1.16/100 000 (70 cases), 0.95/100 000 (58 cases), 1.40/100 000 (87 cases), 0.75/100 000 (47 cases) and 1.02/100 000 (65 cases), respectively. The incidence showed a decline during these years (Z = -5.78, P Climate factors significantly influence the incidence of HFRS. If the influence of variable-autocorrelation, seasonality, and long-term trend were controlled, the accuracy of forecasting by the time-series Poisson regression model in Changsha would be comparatively high, and we could forecast the incidence of HFRS in advance.

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

Science.gov (United States)

Costa, Anderson Adriano Leal Freitas da; Vasconcellos, Igor Martins; Pacheco, Rafael Leite; Bella, Zsuzsanna Ilona Katalin de Jármy Di; Riera, Rachel

2018-01-01

Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP). A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

The MAX Statistic is Less Powerful for Genome Wide Association Studies Under Most Alternative Hypotheses.

Science.gov (United States)

Shifflett, Benjamin; Huang, Rong; Edland, Steven D

2017-01-01

Genotypic association studies are prone to inflated type I error rates if multiple hypothesis testing is performed, e.g., sequentially testing for recessive, multiplicative, and dominant risk. Alternatives to multiple hypothesis testing include the model independent genotypic χ 2 test, the efficiency robust MAX statistic, which corrects for multiple comparisons but with some loss of power, or a single Armitage test for multiplicative trend, which has optimal power when the multiplicative model holds but with some loss of power when dominant or recessive models underlie the genetic association. We used Monte Carlo simulations to describe the relative performance of these three approaches under a range of scenarios. All three approaches maintained their nominal type I error rates. The genotypic χ 2 and MAX statistics were more powerful when testing a strictly recessive genetic effect or when testing a dominant effect when the allele frequency was high. The Armitage test for multiplicative trend was most powerful for the broad range of scenarios where heterozygote risk is intermediate between recessive and dominant risk. Moreover, all tests had limited power to detect recessive genetic risk unless the sample size was large, and conversely all tests were relatively well powered to detect dominant risk. Taken together, these results suggest the general utility of the multiplicative trend test when the underlying genetic model is unknown.

Divine intervention? A Cochrane review on intercessory prayer gone beyond science and reason

DEFF Research Database (Denmark)

Jørgensen, Karsten Juhl; Hróbjartsson, Asbjørn; Gøtzsche, Peter C

2009-01-01

We discuss in this commentary a recent Cochrane review of 10 randomised trials aimed at testing the religious belief that praying to a god can help those who are prayed for. The review concluded that the available studies merit additional research. However, the review presented a scientifically u...

Soft tissue management for dental implants: what are the most effective techniques? A Cochrane systematic review.

Science.gov (United States)

Esposito, Marco; Maghaireh, Hassan; Grusovin, Maria Gabriella; Ziounas, Ioannis; Worthington, Helen V

2012-01-01

This review is based on a Cochrane systematic review entitled 'Interventions for replacing missing teeth: management of soft tissues for dental implants' published in The Cochrane Library (see http:// www.cochrane.org/ for information). Cochrane systematic reviews are regularly updated to include new research, and in response to comments and criticisms from readers. If you wish to comment on this review, please send your comments to the Cochrane website or to Marco Esposito. The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by the Cochrane Collaboration. To evaluate whether flapless procedures are beneficial for patients and which is the ideal flap design, whether soft tissue correction/augmentation techniques are beneficial for patients and which are the best techniques, whether techniques to increase the peri-implant keratinised mucosa are beneficial for patients and which are the best techniques, and which are the best suturing techniques/ materials. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched up to the 9th of June 2011 for randomised controlled trials (RCTs) of rootform osseointegrated dental implants, with a follow-up of at least 6 months after function, comparing various techniques to handle soft tissues in relation to dental implants. Primary outcome measures were prosthetic failures, implant failures and biological complications. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted at least in duplicate and independently by two or more review authors. The statistical unit was the patient and not the prosthesis, the procedure or the implant. RESULTS were expressed

Descriptive analysis of cochrane child-relevant systematic reviews: an update and comparison between 2009 and 2013.

Science.gov (United States)

Crick, Katelynn; Thomson, Denise; Fernandes, Ricardo M; Nuspl, Megan; Eurich, Dean T; Rowe, Brian H; Hartling, Lisa

2017-07-11

Systematic reviews support health systems and clinical decision-making by identifying and summarizing all existing studies on a particular topic. In 2009, a comprehensive description of child-relevant systematic reviews published in the Cochrane Database of Systematic Reviews was compiled. This study aims to provide an update, and to describe these systematic reviews according to their content and methodological approaches. All child-relevant systematic reviews published by the Cochrane Collaboration in the Cochrane Database of Systematic Reviews (CDSR) as of March, 2013 were identified and described in relation to their content and methodological approaches. This step equated to an update of the Child Health Field Review Register (CHFRR). The content of the updated CHFRR was compared to the published 2009 CHFRR description regarding clinical and methodological characteristics, using bivariate analyses. As the Cochrane Collaboration has recognized that disease burden should guide research prioritization, we extracted data from the Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013 study in order to map the distribution of the burden of disease in child health to the distribution of evidence across Review Groups in the CHFRR. Of the 5,520 potential Cochrane systematic reviews identified, 1,293 (23.4%) were child-relevant (an increase of 24% since 2009). Overall, these reviews included 16,738 primary studies. The most commonly represented Review Groups were Airways (11.5%), Cystic Fibrosis and Genetic Diseases (7.9%), Acute Respiratory Infections (7.8%), Developmental, Psychological and Learning Problems (6.7%), and Infectious Diseases (6.2%). Corresponding authors were most often from Europe (51%), North America (15%), and Australia (15%). The majority of systematic reviews examined pharmacological interventions alone (52% compared to 59% in 2009). Out of 611 reviews that were assessed as up-to-date, GRADE was

Processo de Separação por Membrana (PSM: aplicação da tecnologia na indústria láctica

Directory of Open Access Journals (Sweden)

Jânio Sousa Santos

2015-01-01

Full Text Available The food industry is characterized by being a industry intensive technology , but the innovations in this area are often incremental, whose dynamics is based on new combinations of existing knowledge. Among the various sectors of the food industry, the dairy sector plays an important role in the Brazilian economy and stands out among the top four. Starting from the significant growth in this sector three points deserve more attention being: intolerance / allergy to protein (casein or lactose, coproduct whey and waste water. In order to minimize and solve these barriers industry in the processes membrane separation (PSM have been used in industry with the aim to separate, purify or concentrate determined components in the mixture of interest. The present work aims to bring to the fore the importance and the use of ultrafiltration in the dairy sector. Was delimited a qualitative approach to research, which gave through archival and bibliographic research .The ultrafiltration technology has provided great advances with regard to technology in dairy and becoming able to work with materials that were previously considered as waste in agro industries processing as whey, brine and residual water dairy others.

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

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Anderson Adriano Leal Freitas da Costa

Full Text Available ABSTRACT BACKGROUND: Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP. METHODS: A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy. The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. CONCLUSIONS: This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

Reporting of conflicts of interest from drug trials in Cochrane reviews : cross sectional study

NARCIS (Netherlands)

Roseman, Michelle; Turner, Erick H.; Lexchin, Joel; Coyne, James C.; Bero, Lisa A.; Thombs, Brett D.

2012-01-01

Objectives To investigate the degree to which Cochrane reviews of drug interventions published in 2010 reported conflicts of interest from included trials and, among reviews that reported this information, where it was located in the review documents. Design Cross sectional study. Data sources

Associations of lifestyle factors (smoking, alcohol consumption, diet and physical activity) with type 2 diabetes among American adults from National Health and Nutrition Examination Survey (NHANES) 2005-2014.

Science.gov (United States)

Liu, Ying; Wang, Kesheng; Maisonet, Mildred; Wang, Liang; Zheng, Shimin

2017-09-01

Over the long term, unhealthy lifestyles can lead to many health problems, especially type 2 diabetes (T2D). The aim of the present study was to determine associations between lifestyle factors (smoking, alcohol consumption, physical activity, and diet) and T2D in American adults (aged ≥20 years) in a nationally representative sample. Data for 12 987 American adults participating in the National Health and Nutrition Examination Survey 2005-2014 were evaluated. Weighted multiple logistic regression models were used to examine associations between the four lifestyle factors and T2D after adjusting for demographics and socioeconomic status (SES). Prevalence trends for T2D were examined using Cochran-Armitage tests. There was a significant increasing prevalence trend for T2D among American adults. Smokers and individuals consuming >12 alcoholic drinks in the past year were less likely to report having T2D than non-smokers (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.35-0.48) and those consuming diet were more likely to report having T2D than those eating an excellent diet (OR 1.18; 95% CI 1.02-1.41). All these relationships remained significant after adjustment for demographics and SES. All four lifestyle factors were significantly associated with T2D among American adults. The findings of the present study provide useful information for healthcare providers that may help them promote specific lifestyle modifications. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

A field survey of the partially edentate elderly: Investigation of factors related to the usage rate of removable partial dentures.

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Murai, S; Matsuda, K; Ikebe, K; Enoki, K; Hatta, K; Fujiwara, K; Maeda, Y

2015-11-01

Although the shortened dental arch (SDA) concept has been known to all over the world, acceptance of the SDA concept as an oral health standard can be questionable from the patients' point of view, even if it is biologically reasonable. Furthermore, because the health insurance system covers removable partial dentures (RPDs) for all citizens in Japan, SDA patients seem to prefer to receive prosthetic treatment to replace the missing teeth. However, there were few field surveys to investigate the usage rate of RPDs in Japan. The purpose of this study was to determine the usage rate of RPDs in older Japanese subjects and to investigate the factors related to the usage of RPDs. Partially edentate participants (n = 390) were included in this study. Oral examinations were conducted to record several indices. The Cochran-Armitage trend test was used to evaluate the relationship between the number of missing teeth and the usage rate of RPDs. Chi-squared tests and logistic regression analysis were conducted to evaluate the factors related to the usage rate of RPDs. Usage of RPDs had a significantly positive association with the number of missing distal extension teeth and bilaterally missing teeth. The usage rate of RPDs increased as the number of missing distal extension teeth increased (P for trend < 0·001). The conclusion of this study was that participants with missing distal extension teeth had higher usage rates of RPDs than other participants, and the usage rate increased as the number of missing distal extension teeth increased. © 2015 John Wiley & Sons Ltd.

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

Science.gov (United States)

Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

2017-01-01

Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

Corneal Sensitivity and Presence of Pathogenic Organisms Among Participants Who Have Undergone Trichiasis Surgery Differ by Surgical Outcome.

Science.gov (United States)

Schein, Yvette; Harding, Jennifer C; Merbs, Shannath L; Cassard, Sandra D; Mabula, Kasubi; Othman, Majid S; West, Sheila K; Gower, Emily W

2016-04-01

To explore the potential association between reduced corneal sensation and/or conjunctival bacterial colonization and postoperative trichiasis and eyelid contour abnormalities after corrective eyelid surgery among participants with a history of trachomatous trichiasis. As an ancillary study to the Partnership for Rapid Elimination of Trachoma (PRET) Surgery Trial in southern Tanzania, we collected data on 580 PRET participants who had undergone trichiasis surgery 1 year earlier and 200 age-group-matched individuals without trichiasis. Assessments included eyelid status evaluation (presence and severity of postoperative trichiasis and/or eyelid contour abnormality), corneal sensitivity by Cochet-Bonnet aesthesiometer, a questionnaire on symptoms of ocular irritation, and conjunctival microbiology. We divided PRET participants based on their eyelid status and compared results across PRET groups and versus normals. PRET participants had reduced corneal sensitivity compared with age-matched normals (mean sensitivity ranged from 2.8 to 3.8 cm in PRET participants vs. 5.9 cm in normals), and increasing severity of postoperative trichiasis was associated in a stepwise fashion with reduced corneal sensitivity (mean = 3.5 cm for mild and 2.6 cm for severe postoperative trichiasis). Conjunctival colonization with pathogenic bacteria was also associated with more severe postoperative trichiasis (Cochran-Armitage trend test P = 0.001) and with reduced corneal sensitivity (trend test P < 0.0001). Symptoms of ocular irritation were not associated with previous trichiasis surgery, postoperative trichiasis, or eyelid contour abnormality. These findings indicate that reduced corneal sensitivity accompanies trachomatous trichiasis and suggest that reduced corneal sensitivity may play an important role in the harboring of pathogenic bacteria on the ocular surface.

Chemical process safety management within the Department of Energy

International Nuclear Information System (INIS)

Piatt, J.A.

1995-07-01

Although the Department of Energy (DOE) is not well known for its chemical processing activities, the DOE does have a variety of chemical processes covered under OSHA's Rule for Process Safety Management of Highly Hazardous Chemicals (the PSM Standard). DOE, like industry, is obligated to comply with the PSM Standard. The shift in the mission of DOE away from defense programs toward environmental restoration and waste management has affected these newly forming process safety management programs within DOE. This paper describes the progress made in implementing effective process safety management programs required by the PSM Standard and discusses some of the trends that have supported efforts to reduce chemical process risks within the DOE. In June of 1994, a survey of chemicals exceeding OSHA PSM or EPA Risk Management Program threshold quantities (TQs) at DOE sites found that there were 22 processes that utilized toxic or reactive chemicals over TQs; there were 13 processes involving flammable gases and liquids over TQs; and explosives manufacturing occurred at 4 sites. Examination of the survey results showed that 12 of the 22 processes involving toxic chemicals involved the use of chlorine for water treatment systems. The processes involving flammable gases and liquids were located at the Strategic Petroleum Reserve and Naval petroleum Reserve sites

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

Science.gov (United States)

Gambrill, E

1999-03-01

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

Update of strategies to translate evidence from cochrane musculoskeletal group systematic reviews for use by various audiences.

Science.gov (United States)

Rader, Tamara; Pardo Pardo, Jordi; Stacey, Dawn; Ghogomu, Elizabeth; Maxwell, Lara J; Welch, Vivian A; Singh, Jasvinder A; Buchbinder, Rachelle; Légaré, France; Santesso, Nancy; Toupin April, Karine; O'Connor, Annette M; Wells, George A; Winzenberg, Tania M; Johnston, Renea; Tugwell, Peter

2014-02-01

For rheumatology research to have a real influence on health and well-being, evidence must be tailored to inform the decisions of various audiences. The Cochrane Musculoskeletal Group (CMSG), one of 53 groups of the not-for-profit international Cochrane Collaboration, prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. While systematic reviews provided by the CMSG fill a major gap in meeting the need for high-quality evidence syntheses, our work does not end at the completion of a review. The term "knowledge translation" (KT) refers to the activities involved in bringing research evidence to various audiences in a useful form so it can be used to support decision making and improve practices. Systematic reviews give careful consideration to research methods and analysis. Because the review is often long and detailed, the clinically relevant results may not be apparent or in the optimal form for use by patients and their healthcare practitioners. This paper describes 10 formats, many of them new, for ways that evidence from Cochrane Reviews can be translated with the intention of meeting the needs of various audiences, including patients and their families, practitioners, policy makers, the press, and members of the public (the "5 Ps"). Current and future knowledge tools include summary of findings tables, patient decision aids, plain language summaries, press releases, clinical scenarios in general medical journals, frequently asked questions (Cochrane Clinical Answers), podcasts, Twitter messages, Journal Club materials, and the use of storytelling and narratives to support continuing medical education. Future plans are outlined to explore ways of improving the influence and usefulness of systematic reviews by providing results in formats suitable to our varied audiences.

Baekkenbundstraening til gravide og barslende kvinder--en gennemgang af et Cochrane-review

DEFF Research Database (Denmark)

Brostrøm, Søren; Due, Ulla; Lose, Gunnar

2010-01-01

Urinary and anal incontinence are prevalent in pregnant and parturient women. Pelvic floor muscle training is frequently employed for prevention and treatment. A recent Cochrane review is discussed. Fifteen studies with a total of 6,181 women were included. Pregnant women without urinary...... incontinence experienced a reduction of the risk of developing urinary incontinence in later pregnancy or post partum. Peripartum patients with urinary and anal incontinence experienced a reduction of their symptoms following training....

Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews.

Science.gov (United States)

Costa, Marcelle Barrueco; Melnik, Tamara

2016-01-01

Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. RESUMO Transtornos alimentares são doenças psiquiátricas originadas de e perpetuadas por fatores individuais, familiares e socioculturais. A abordagem psicossocial é essencial para o tratamento e a prevenção de recaídas. Apresentar uma vis

Systemisk prokinetisk behandling af postoperativ ileus efter abdominalkirurgi. Gennemgang af et Cochrane-review

DEFF Research Database (Denmark)

Holte, Kathrine

2010-01-01

Based on the evidence presented in the Cochrane review "Systemic prokinetic pharmacologic treatment for postoperative adynamic ileus following abdominal surgery in adults", routine administration of systemic prokinetics for the prevention of postoperative ileus is not recommendable. The potential...... of selective opioid antagonists and intravenous lidocaine should be further investigated, particularly in conjunction with laparoscopic surgery, epidural pain management and fast-track surgery....

Uit de Cochrane Library: Marginaal grotere genezingskans door antibioticabehandeling bij acute bacteriële conjunctivitis

NARCIS (Netherlands)

Hamerlynck, J. V. T. H.; Rietveld, R. P.; Hooft, L.

2007-01-01

Acute bacterial conjunctivitis is one of the most frequently encountered ocular disorders in primary care. It is frequently self-limiting, and the widespread use of broad-spectrum antibiotics has led to concerns regarding antibiotic resistance. Therefore, a Cochrane systematic review of 5 randomised

Some in Saskatchewan Find The Cochrane Library Useful after Promotion, Access and Training Efforts. A review of: Forbes, Dorothy, Christine Neilson, Janet Bangma, Jennifer Forbes, Daniel Fuller, and Shari Furniss. “Saskatchewan Residents’ Use of The Cochrane Library.” Partnership: the Canadian Journal of Library and Information Practice and Research 2.2 (2007.

Directory of Open Access Journals (Sweden)

Shandra Protzko

2008-06-01

Full Text Available Objective – To evaluate the use of The Cochrane Library by librarians, health care providers and consumers in the Canadian province of Saskatchewan. Design – Volunteer telephone interviews and surveys of training participants at multiple time points; usage statistics.Setting – Saskatchewan.Subjects – Ninety-four volunteers participated in the study. Participants were self-selected from approximately 300 health practitioners and 100 public library staff attending training sessions, located primarily in rural areas. The majority of public library staff who attended training sessions were not professional librarians, although 31.5% of the study participants were librarians. Nurses made up the next largest group (16.3%, followed by therapists (7.6%, library support staff (5.4%,pharmacists (4.3%, physicians (3.3%, other health care providers (20.7%, and other (9.8%. Most were 40-65 years of age (71.6%and female (92.4%.Methods – Forty-six training sessions were provided upon request between October 2004 and December 2006. Attendees wereinvited to participate in the study. Telephone interviews were conducted at three, six, nine, and twelve months following training sessions. Demographic information and data on the use of andsatisfaction with The Cochrane Library were collected. Additionally, monthly statistics were tracked by Wiley-Blackwell for user sessions, number of searches, and the number of full-text articles and abstracts visited.Main Results – Telephone interviews revealed that 65.2% of participants had accessed The Cochrane Library at three months; 64.2% had at six months. At nine months access dropped to 45.2%. At twelve months only 27.4% of participants reported using the resource. Of those who used The Cochrane Library, 16.4% reported at the three month interview that it was not helpful. This number decreased at six months (11.6%, nine months (7.7% and twelve months (11.8%. 57.5% of respondents claimed to have learned something

Trends in traumatic brain injury mortality in China, 2006-2013: A population-based longitudinal study.

Directory of Open Access Journals (Sweden)

Peixia Cheng

2017-07-01

Full Text Available Traumatic brain injury (TBI is a significant global public health problem, but has received minimal attention from researchers and policy-makers in low- and middle-income countries (LMICs. Epidemiological evidence of TBI morbidity and mortality is absent at the national level for most LMICs, including China. Using data from China's Disease Surveillance Points (DSPs system, we conducted a population-based longitudinal analysis to examine TBI mortality, and mortality differences by sex, age group, location (urban/rural, and external cause of injury, from 1 January 2006 to 31 December 2013 in China.Mortality data came from the national DSPs system of China, which has coded deaths using the International Classification of Diseases-10th Revision (ICD-10 since 2004. Crude and age-standardized mortality with 95% CIs were estimated using the census population in 2010 as a reference population. The Cochran-Armitage trend test was used to examine the significance of trends in mortality from 2006 to 2013. Negative binomial models were used to examine the associations of TBI mortality with location, sex, and age group. Subgroup analysis was performed by external cause of TBI. We found the following: (1 Age-adjusted TBI mortality increased from 13.23 per 100,000 population in 2006 to 17.06 per 100,000 population in 2008 and then began to fall slightly. In 2013, age-adjusted TBI mortality was 12.99 per 100,000 population (SE = 0.13. (2 Compared to females and urban residents, males and rural residents had higher TBI mortality risk, with adjusted mortality rate ratios of 2.57 and 1.71, respectively. TBI mortality increased substantially with older age. (3 Motor vehicle crashes and falls were the 2 leading causes of TBI mortality between 2006 and 2013. TBI deaths from motor vehicle crashes in children aged 0-14 years and adults aged 65 years and older were most often in pedestrians, and motorcyclists were the first or second leading category of road user for

Trends in traumatic brain injury mortality in China, 2006-2013: A population-based longitudinal study.

Science.gov (United States)

Cheng, Peixia; Yin, Peng; Ning, Peishan; Wang, Lijun; Cheng, Xunjie; Liu, Yunning; Schwebel, David C; Liu, Jiangmei; Qi, Jinlei; Hu, Guoqing; Zhou, Maigeng

2017-07-01

Traumatic brain injury (TBI) is a significant global public health problem, but has received minimal attention from researchers and policy-makers in low- and middle-income countries (LMICs). Epidemiological evidence of TBI morbidity and mortality is absent at the national level for most LMICs, including China. Using data from China's Disease Surveillance Points (DSPs) system, we conducted a population-based longitudinal analysis to examine TBI mortality, and mortality differences by sex, age group, location (urban/rural), and external cause of injury, from 1 January 2006 to 31 December 2013 in China. Mortality data came from the national DSPs system of China, which has coded deaths using the International Classification of Diseases-10th Revision (ICD-10) since 2004. Crude and age-standardized mortality with 95% CIs were estimated using the census population in 2010 as a reference population. The Cochran-Armitage trend test was used to examine the significance of trends in mortality from 2006 to 2013. Negative binomial models were used to examine the associations of TBI mortality with location, sex, and age group. Subgroup analysis was performed by external cause of TBI. We found the following: (1) Age-adjusted TBI mortality increased from 13.23 per 100,000 population in 2006 to 17.06 per 100,000 population in 2008 and then began to fall slightly. In 2013, age-adjusted TBI mortality was 12.99 per 100,000 population (SE = 0.13). (2) Compared to females and urban residents, males and rural residents had higher TBI mortality risk, with adjusted mortality rate ratios of 2.57 and 1.71, respectively. TBI mortality increased substantially with older age. (3) Motor vehicle crashes and falls were the 2 leading causes of TBI mortality between 2006 and 2013. TBI deaths from motor vehicle crashes in children aged 0-14 years and adults aged 65 years and older were most often in pedestrians, and motorcyclists were the first or second leading category of road user for the other

Knowledge transfer to clinicians and consumers by the Cochrane Musculoskeletal Group.

Science.gov (United States)

Santesso, Nancy; Maxwell, Lara; Tugwell, Peter S; Wells, George A; O'connor, Annette M; Judd, Maria; Buchbinder, Rachelle

2006-11-01

The Cochrane Musculoskeletal Group (CMSG) is one of 50 groups of the Cochrane Collaboration that prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. Once systematic reviews are completed, the next challenge is presenting the results in useful formats to be integrated into the healthcare decisions of clinicians and consumers. The CMSG recommends 3 methods to aid knowledge translation and exchange between clinicians and patients: produce clinical relevance tables, create graphical displays using face figures, and write consumer summaries and patient decision aids. Accordingly, CMSG has developed specific guidelines to help researchers and authors convert the pooled estimates of metaanalyses in the systematic reviews to user-friendly numbers. First, clinical relevance tables are developed that include absolute and relative benefits or harms and the numbers needed to treat. Next, the numbers from the clinical relevance tables are presented graphically using faces. The faces represent a group of 100 people and are shaded according to how many people out of 100 benefited or were harmed by the interventions. The user-friendly numbers are also included in short summaries and decision aids written for patients. The different levels of detail in the summaries and decision aids provide patients with tools to prepare them to discuss treatment options with their clinicians. Methods to improve the effects and usability of systematic reviews by providing results in more clinically relevant formats are essential. Both clinicians and consumers can use these products to use evidence-based information in individual and shared decision-making.

Simple Algorithms to Calculate Asymptotic Null Distributions of Robust Tests in Case-Control Genetic Association Studies in R

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Wing Kam Fung

2010-02-01

Full Text Available The case-control study is an important design for testing association between genetic markers and a disease. The Cochran-Armitage trend test (CATT is one of the most commonly used statistics for the analysis of case-control genetic association studies. The asymptotically optimal CATT can be used when the underlying genetic model (mode of inheritance is known. However, for most complex diseases, the underlying genetic models are unknown. Thus, tests robust to genetic model misspecification are preferable to the model-dependant CATT. Two robust tests, MAX3 and the genetic model selection (GMS, were recently proposed. Their asymptotic null distributions are often obtained by Monte-Carlo simulations, because they either have not been fully studied or involve multiple integrations. In this article, we study how components of each robust statistic are correlated, and find a linear dependence among the components. Using this new finding, we propose simple algorithms to calculate asymptotic null distributions for MAX3 and GMS, which greatly reduce the computing intensity. Furthermore, we have developed the R package Rassoc implementing the proposed algorithms to calculate the empirical and asymptotic p values for MAX3 and GMS as well as other commonly used tests in case-control association studies. For illustration, Rassoc is applied to the analysis of case-control data of 17 most significant SNPs reported in four genome-wide association studies.

Aldosterone synthase gene is not a major susceptibility gene for progression of chronic kidney disease in patients with autosomal dominant polycystic kidney disease

Directory of Open Access Journals (Sweden)

Gnanasambandan Ramanathan

2017-01-01

Full Text Available Autosomal dominant polycystic kidney disease (ADPKD is the most common heritable kidney disease and is characterized by bilateral renal cysts. Hypertension is a frequent cause of chronic kidney disease (CKD and mortality in patients with ADPKD. The aldosterone synthase gene polymorphisms of the renin-angiotensin-aldosterone system have been extensively studied as hypertension candidate genes. The present study is aimed to investigate the potential modifier effect of CYP11B2 gene on the progression of CKD in ADPKD. One hundred and two ADPKD patients and 106 healthy controls were recruited based on Ravine inclusion and exclusion criteria. The three tag-SNPs within CYP11B2 gene (rs3802230, rs4543, and rs4544 were genotyped using FRET-based KASPar method. Cochran-Armitage trend test was used to assess the potential associations between these polymorphisms and CKD stages. Mantel- Haenszel stratified analysis was used to explore confounding and interaction effects of these polymorphisms. Of the three tag-SNPs genotyped, rs4544 polymorphism was monomorphic and rs3802230 deviated Hardy-Weinberg equilibrium. The CYP11B2 tag-SNPs did not show significant association with ADPKD or CKD. Further, these polymorphisms did not exhibit confounding effect on the relationship between CKD progression and hypertension. Our results suggest that aldosterone synthase gene is not a major susceptibility gene for progression of CKD in South Indian ADPKD patients.

Cardiopulmonary resuscitation in hospitalized infants.

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Hornik, Christoph P; Graham, Eric M; Hill, Kevin; Li, Jennifer S; Ofori-Amanfo, George; Clark, Reese H; Smith, P Brian

2016-10-01

Hospitalized infants requiring cardiopulmonary resuscitation (CPR) represent a high-risk group. Recent data on risk factors for mortality following CPR in this population are lacking. We hypothesized that infant demographic characteristics, diagnoses, and levels of cardiopulmonary support at the time of CPR requirement would be associated with survival to hospital discharge following CPR. Retrospective cohort study. All infants receiving CPR on day of life 2 to 120 admitted to 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. We collected data on demographics, interventions, center volume, and death prior to NICU discharge. We evaluated predictors of death after CPR using multivariable logistic regression with generalized estimating equations to account for clustering of the data by center. Our cohort consisted of 2231 infants receiving CPR. Of these, 1127 (51%) survived to hospital discharge. Lower gestational age, postnatal age, 5-min APGAR, congenital anomaly, and markers of severity of illness were associated with higher mortality. Mortality after CPR did not change significantly over time (Cochran-Armitage test for trend p=0.35). Mortality following CPR in infants is high, particularly for less mature, younger infants with congenital anomalies and those requiring cardiopulmonary support prior to CPR. Continued focus on at risk infants may identify targets for CPR prevention and improve outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ideology and Reform in Teacher Education in England: Some Reflections on Cochran-Smith and Fries.

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Furlong, John

2002-01-01

Presents an international perspective on Cochran-Smith and Fries' recent analysis of the ways that two competing ideologies (deregulation and professionalization) are being employed in the United States to support teacher education reform, noting important differences between the United States and England in how these ideologies have been advanced…

Cochrane systematic reviews are useful to map research gaps for decreasing maternal mortality.

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Chapman, Evelina; Reveiz, Ludovic; Chambliss, Amy; Sangalang, Stephanie; Bonfill, Xavier

2013-01-01

To use an "evidence-mapping" approach to assess the usefulness of Cochrane reviews in identifying research gaps in the maternal health. The article describes the general mapping, prioritizing, reconciling, and updating approach: (1) identifying gaps in the maternal health research using published systematic reviews and formulating research questions, (2) prioritizing questions using Delphi method, (3) reconciling identified research priorities with the existing literature (i.e., searching of ongoing trials in trials registries), (4) updating the process. A comprehensive search of Cochrane systematic reviews published or updated from January 2006 to March 2011 was performed. We evaluated the "Implications for Research" section to identify gaps in the research. Our search strategy identified 695 references; 178 systematic reviews identifying at least one research gap were used. We formulated 319 research questions, which were classified into 11 different categories based on the direct and indirect causes of maternal mortality: postpartum hemorrhage, abortion, hypertensive disorders, infection/sepsis, caesarean section, diabetes, pregnancy prevention, preterm labor, other direct causes, indirect causes, and health policies and systems. Most research questions concerned the effectiveness of clinical interventions, including drugs (42.6%), nonpharmacologic interventions (16.3%), and health system (14.7%). It is possible to identify gaps in the maternal health research by using this approach. Copyright © 2013 Elsevier Inc. All rights reserved.

Langtidseffekt af vægtreducerende behandlinghos patienter med hypertension--en gennemgang af et Cochrane-review

DEFF Research Database (Denmark)

Madsbad, Sten

2011-01-01

In eight studies included in the present Cochrane review the effects of orlistat or sibutramine versus placebo on mortality, cardiovascular mortality and adverse events were investigated in obese people with hypertension. No studies with rimonabant fulfilled the inclusion criteria. The weight loss...... of the effect on cardiovascular mortality and morbidity....

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

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Lyra, Larissa; Rizzo, Luiz Eduardo; Sunahara, Camila Sá; Pachito, Daniela Vianna; Latorraca, Carolina de Oliveira Cruz; Martimbianco, Ana Luiza Cabrera; Riera, Rachel

2017-01-01

Autism spectrum disorders (ASDs) include autistic disorder, Asperger's disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.

How useful are systematic reviews for informing palliative care practice? Survey of 25 Cochrane systematic reviews

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Hadley Gina

2008-08-01

Full Text Available Abstract Background In contemporary medical research, randomised controlled trials are seen as the gold standard for establishing treatment effects where it is ethical and practical to conduct them. In palliative care such trials are often impractical, unethical, or extremely difficult, with multiple methodological problems. We review the utility of Cochrane reviews in informing palliative care practice. Methods Published reviews in palliative care registered with the Cochrane Pain, Palliative and Supportive Care Group as of December 2007 were obtained from the Cochrane Database of Systematic Reviews, issue 1, 2008. We reviewed the quality and quantity of primary studies available for each review, assessed the quality of the review process, and judged the strength of the evidence presented. There was no prior intention to perform any statistical analyses. Results 25 published systematic reviews were identified. Numbers of included trials ranged from none to 54. Within each review, included trials were heterogeneous with respect to patients, interventions, and outcomes, and the number of patients contributing to any single analysis was generally much lower than the total included in the review. A variety of tools were used to assess trial quality; seven reviews did not use this information to exclude low quality studies, weight analyses, or perform sensitivity analysis for effect of low quality. Authors indicated that there were frequently major problems with the primary studies, individually or in aggregate. Our judgment was that the reviewing process was generally good in these reviews, and that conclusions were limited by the number, size, quality and validity of the primary studies. We judged the evidence about 23 of the 25 interventions to be weak. Two reviews had stronger evidence, but with limitations due to methodological heterogeneity or definition of outcomes. No review provided strong evidence of no effect. Conclusion Cochrane reviews

Mapping of the evidence from systematic reviews of the Cochrane Collaboration for decision-making within physiotherapy

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Ane Helena Valle Versiani

Full Text Available CONTEXT AND OBJECTIVEEvidence-based clinical practice emerged with the aim of guiding clinical issues in order to reduce the degree of uncertainty in decision-making. The Cochrane Collaboration has been developing systematic reviews on randomized controlled trials as high-quality intervention study subjects. Today, physiotherapy methods are widely required in treatments within many fields of healthcare. Therefore, it is extremely important to map out the situation regarding scientific evidence within physiotherapy. The aim of this study was to identify systematic reviews on physiotherapeutic interventions and investigate the scientific evidence and recommendations regarding whether further studies would be needed.TYPE OF STUDY AND SETTINGCross-sectional study conducted within the postgraduate program on Internal Medicine and Therapeutics and at the Brazilian Cochrane Center.METHODSSystematic reviews presenting physiotherapeutic interventions as the main investigation, in the Cochrane Reviews Group, edition 2/2009, were identified and classified.RESULTSOut of the 3,826 reviews, 207 (5.41% that fulfilled the inclusion criteria were selected. Only 0.5% of the reviews concluded that the intervention presented a positive effect and that further studies were not recommended; 45.9% found that there seemed to be a positive effect but recommended further research; and 46.9% found that the evidence was insufficient for clinical practice and suggested that further research should be conducted.CONCLUSIONOnly one systematic review (“Pulmonary rehabilitation for chronic obstructive pulmonary disease” indicated that the intervention tested could be used with certainty that it would be effective. Most of the systematic reviews recommended further studies with greater rigor of methodological quality.

Age and ethnic disparities in incidence of stroke over time: the South London Stroke Register.

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Wang, Yanzhong; Rudd, Anthony G; Wolfe, Charles D A

2013-12-01

Data on continuous monitoring of stroke risk among different age and ethnic groups are lacking. We aimed to investigate age and ethnic disparities in stroke incidence over time from an inner-city population-based stroke register. Trends in stroke incidence and before-stroke risk factors were investigated with the South London Stroke Register, a population-based register covering a multiethnic population of 357 308 inhabitants. Age-, ethnicity-, and sex-specific incidence rates with 95% confidence intervals were calculated, assuming a Poisson distribution and their trends over time tested by the Cochran-Armitage test. Four thousand two hundred forty-five patients with first-ever stroke were registered between 1995 and 2010. Total stroke incidence reduced by 39.5% during the 16-year period from 247 to 149.5 per 100 000 population (Pstroke incidence were observed in men, women, white groups, and those aged>45 years, but not in those aged 15 to 44 years (12.6-10.1; P=0.2034) and black groups (310.1-267.5; P=0.3633). The mean age at stroke decreased significantly from 71.7 to 69.6 years (P=0.0001). The reduction in prevalence of before-stroke risk factors was mostly seen in white patients aged>55 years, whereas an increase in diabetes mellitus was observed in younger black patients aged 15 to 54 years. Total stroke incidence decreased during the 16-year time period. However, this was not seen in younger age groups and black groups. The advances in risk factor reduction observed in white groups aged>55 years failed to be transferred to younger age groups and black groups.

Human immunodeficiency virus prevalence, incidence, and residual transmission risk in first-time and repeat blood donations in Zimbabwe: implications on blood safety.

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Mapako, Tonderai; Mvere, David A; Chitiyo, McLeod E; Rusakaniko, Simbarashe; Postma, Maarten J; van Hulst, Marinus

2013-10-01

National Blood Service Zimbabwe human immunodeficiency virus (HIV) risk management strategy includes screening and discarding of first-time donations, which are collected in blood packs without an anticoagulant (dry pack). To evaluate the impact of discarding first-time donations on blood safety the HIV prevalence, incidence, and residual risk in first-time and repeat donations (wet packs) were compared. Donor data from 2002 to 2010 were retrieved from a centralized national electronic donor database and retrospectively analyzed. Chi-square test was used to compare HIV prevalence with relative risk (RR), and the RR point estimates and 95% confidence interval (CI) are reported. Trend analysis was done using Cochran-Armitage trend test. HIV residual risk estimates were determined using published residual risk estimation models. Over the 9 years the overall HIV prevalence estimates are 1.29% (n = 116,058) and 0.42% (n = 434,695) for first-time and repeat donations, respectively. The overall RR was 3.1 (95% CI, 2.9-3.3; p donations in first-time was 1:7384 (range, 1:11,308-1:5356) and in repeat donors it was 1:5496 (range, 1:9943-1:3347). The significantly high HIV prevalence estimates recorded in first-time over repeat donations is indicative of the effectiveness of the HIV risk management strategy. However, comparable residual transmission risk estimates in first-time and repeat donors point to the need to further review the risk management strategies. Given the potential wastage of valuable resources, future studies should focus on the cost-effectiveness and utility of screening and discarding first-time donations. © 2013 American Association of Blood Banks.

Analysis of Macular Drusen and Blood Test Results in 945 Macaca fascicularis.

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Koji M Nishiguchi

Full Text Available Age-dependent formation of macular drusen caused by the focal accumulation of extracellular deposits beneath the retinal pigment epithelium precede the development of age-related macular degeneration (AMD, one of the leading causes of blindness worldwide. It is established that inflammation contributes to the pathogenesis of drusen and AMD. However, development of a preemptive therapeutic strategy targeting macular drusen and AMD has been impeded by the lack of relevant animal models because most laboratory animals lack macula, an anatomic feature present only in humans and a subset of monkeys. Reportedly, macular drusen and macular degeneration develop in monkeys in an age-dependent manner. In this study, we analyzed blood test results from 945 Macaca fascicularis, 317 with and 628 without drusen. First, a trend test for drusen frequency (the Cochran-Armitage test was applied to the quartile data for each parameter. We selected variables with an increasing or decreasing trend with higher quartiles at P < 0.05, to which multivariate logistic regression analysis was applied. This revealed a positive association of age (odds ratio [OR]: 1.10 per year, 95% confidence interval [CI]: 1.07-1.12 and white blood cell count (OR: 1.01 per 1 × 103/μl, 95% CI: 1.00-1.01 with drusen. When the monkeys were divided by age, the association between drusen and white blood cell count was only evident in younger monkeys (OR: 1.01 per 1 × 103/μl, 95% CI: 1.00-1.02. In conclusion, age and white blood cell count may be associated with drusen development in M. fascicularis. Systemic inflammation may contribute to drusen formation in monkeys.

Patterns and predictors of antimicrobial resistance among Staphylococcus spp. from canine clinical cases presented at a veterinary academic hospital in South Africa.

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Qekwana, Daniel N; Oguttu, James W; Sithole, Fortune; Odoi, Agricola

2017-04-28

Antimicrobial resistance in staphylococci, often associated with treatment failure, is increasingly reported in veterinary medicine. The aim of this study was to investigate patterns and predictors of antimicrobial resistance among Staphylococcus spp. isolates from canine samples submitted to the bacteriology laboratory at the University of Pretoria academic veterinary hospital between 2007 and 2012. Retrospective data of 334 Staphylococcus isolates were used to calculate the proportion of samples resistant to 15 antimicrobial agents. The Cochran-Armitage trend test was used to investigate temporal trends and logistic regression models were used to investigate predictors of antimicrobial resistance in Staphylococcus aureus and Staphylococcus pseudintermedius. Results show that 98.2% (55/56) of the S. aureus isolates were resistant to at least one drug while 42.9% were multidrug resistant. Seventy-seven percent (214/278) of the S. pseudintermedius isolates were resistant to at least one drug and 25.9% (72/278) were multidrug resistant. Resistance to lincospectin was more common among S. aureus (64.3%) than S. pseudintermedius (38.9%). Similarly, resistance to clindamycin was higher in S. aureus (51.8%) than S. pseudintermedius (31.7%) isolates. There was a significant (p = 0.005) increase in S. aureus resistance to enrofloxacin over the study period. Similarly, S. pseudintermedius exhibited significant increasing temporal trend in resistance to trimethoprim-sulphamethoxazole (p = 0.004), clindamycin (p = 0.022) and orbifloxacin (p = 0.042). However, there was a significant decreasing temporal trend in the proportion of isolates resistant to doxycycline (p = 0.041), tylosin (p = 0.008), kanamycin (p = 0.017) and amoxicillin/clavulanic acid (p = 0.032). High levels of multidrug resistance and the increasing levels of resistance to sulphonamides, lincosamides and fluoroquinolones among Staphylococcus spp. isolates in this study are concerning. Future

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

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Larissa Lyra

Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs include autistic disorder, Asperger’s disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI; this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence. Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.

Analysis of the Cochrane Review: Topical Treatments for Scalp Psoriasis. Cochrane Database Syst Rev. 2016;2:CD009687.

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Catarina Soares Queirós

2017-03-01

Full Text Available Regardless the psoriasis subtype, up to 79% of people with this skin condition present scalp involvement, which is often the first site to show symptoms of the disease. In addition to being itchy, the red and scaly lesions are usually easy to see, and may be embarrassing. Topical therapy is usually the first line of treatment; however the wide array of available interventions can make the choice difficult, and may even lead to an inadequate treatment. The objective of this review was to evaluate the efficacy and safety of topical treatments for scalp psoriasis. A systematic review was performed according to the methodology recommended by Cochrane in order to evaluate the clinical severity of psoriasis, quality of life, and adverse events that led to treatment discontinuation. To evaluate this, 59 studies were included, with a total of 11 561 participants, and 15 comparisons were made between the various drugs and application vehicles tested. The principal conclusion is that corticosteroids of high or very high potency are more effective than vitamin D. The combination of a corticosteroid with vitamin D has only a marginal benefit over corticosteroid monotherapy, but is superior to vitamin D alone. Given the similar safety profile and only marginal benefit of the combination of corticosteroid with vitamin D over the corticosteroid alone, topical corticosteroid monotherapy appears to be fully acceptable for short-term therapy of scalp psoriasis.

Discordance between location of positive cores in biopsy and location of positive surgical margin following radical prostatectomy.

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Kim, Ji Won; Park, Hyoung Keun; Kim, Hyeong Gon; Ham, Dong Yeub; Paick, Sung Hyun; Lho, Yong Soo; Choi, Woo Suk

2015-10-01

We compared location of positive cores in biopsy and location of positive surgical margin (PSM) following radical prostatectomy. This retrospective analysis included patients who were diagnosed as prostate cancer by standard 12-core transrectal ultrasonography guided prostate biopsy, and who have PSM after radical prostatectomy. After exclusion of number of biopsy cores location data, 46 patients with PSM were identified. Locations of PSM in pathologic specimen were reported as 6 difference sites (apex, base and lateral in both sides). Discordance of biopsy result and PSM was defined when no positive cores in biopsy was identified at the location of PSM. Most common location of PSM were right apex (n=21) and left apex (n=15). Multiple PSM was reported in 21 specimens (45.7%). In 32 specimens (69.6%) with PSM, one or more concordant positive biopsy cores were identified, but 14 specimens (28%) had no concordant biopsy cores at PSM location. When discordant rate was separated by locations of PSM, right apex PSM had highest rate of discordant (38%). The discordant group had significantly lower prostate volume and lower number of positive cores in biopsy than concordant group. This study showed that one fourth of PSM occurred at location where tumor was not detected at biopsy and that apex PSM had highest rate of discordant. Careful dissection to avoid PSM should be performed in every location, including where tumor was not identified in biopsy.

Social Media for the Dissemination of Cochrane Child Health Evidence: Evaluation Study.

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Dyson, Michele P; Newton, Amanda S; Shave, Kassi; Featherstone, Robin M; Thomson, Denise; Wingert, Aireen; Fernandes, Ricardo M; Hartling, Lisa

2017-09-01

Health care providers value ready access to reliable synthesized information to support point-of-care decision making. Web-based communities, facilitated by the adoption of social media tools such as Facebook, Twitter, and YouTube, are increasingly being used for knowledge dissemination, bridging the gap between knowledge generation and synthesis and knowledge implementation. Our objective was to implement and evaluate a structured social media strategy, using multiple platforms, to disseminate Cochrane Child Health evidence to health care providers caring for children. Our social media strategy had three components: daily "tweets" using the Cochrane Child Health Twitter account, weekly WordPress blog posts, and a monthly journal club on Twitter ("tweet chat"). Each tweet, blog, and journal club shared Cochrane evidence on a child health topic. We evaluated the strategy through (1) Twitter and blog site analytics, (2) traceable link (Bitly) statistics, (3) Altmetric.com scores for promoted evidence, and (4) participant feedback. We also tracked the resources required to write the blog, tweet content, and manage the strategy. The 22-week social media strategy ran between November 2014 and April 2015. We created 25 blog posts, sent 585 tweets, and hosted 3 tweet chats. Monthly blog visits and views and Twitter account followers increased over time. During the study period, the blog received 2555 visitors and 3967 page views from a geographically diverse audience of health care providers, academics, and health care organizations. In total, 183 traceable Bitly links received 3463 clicks, and the Twitter account gained 469 new followers. The most visited and viewed blog posts included gastrointestinal topics (lactose avoidance), research on respiratory conditions (honey for cough and treatments for asthma), and maternal newborn care (skin-to-skin contact). On Twitter, popular topics were related to public health (vaccination) and pain management. We collected Altmetric

Gender trends in authorship of spine-related academic literature-a 39-year perspective.

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Sing, David C; Jain, Deeptee; Ouyang, David

2017-11-01

Despite recent advances in gender equity in medicine, the representation of women in orthopedic and neurosurgery remains particularly low. Furthermore, compared with their male colleagues, female faculty members are less likely to publish research, limiting opportunities in the academic promotion process. Understanding disparities in research productivity provides insight into the "gender gap" in the spine surgeon workforce. This study aims to determine the representation and longevity of female physician-investigators among the authors of five spine-related research journals from 1978 to 2016. This is a retrospective bibliometric review. The authors of original research articles from five prominent spine-related journals (European Spine Journal, The Spine Journal, Spine, Journal of Spinal Disorders and Techniques, and Journal of Neurosurgery: Spine) were extracted from PubMed. For authors with a complete first name listed, gender was determined by matching first name using an online database containing 216,286 distinct names across 79 countries and 89 languages. The proportion of female first and senior authors was determined during the time periods 1978 to 1994, 1995 to 1999, 2000 to 2004, 2005 to 2009, and 2010 to 2016. The authors who had their first paper published between 2000 and 2009 were included in additional analyses for publication count and longevity (whether additional articles were published 5 years after first publication). Student t test, chi-square analysis, and Cochran-Armitage trend test were used to determine significance between groups. From 1978 to 2016, 28,882 original research articles were published in the five spine-related journals. A total of 24,334 abstracts (90.9%) had first names listed, identifying 120,723 authors, in total of which 100,286 were successfully matched to a gender. A total of 33,480 unique authors were identified (female authors: 31.8%). Female representation increased for first and senior authors from 6.5% and 4

What do Cochrane systematic reviews say about the clinical effectiveness of screening and diagnostic tests for cancer?

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André Tito Pereira Bueno

Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: The purpose of screening tests for cancer is to detect it at an early stage in order to increase the chances of treatment. However, their unrestrained use may lead to unnecessary examinations, overdiagnosis and higher costs. It is thus necessary to evaluate their clinical effects in terms of benefits and harm. DESIGN AND SETTING: Review of Cochrane systematic reviews, carried out in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: Cochrane reviews on the clinical effectiveness of cancer screening procedures were included. Study titles and abstracts were independently assessed by two authors. Conflicts were resolved by another two authors. Findings were summarized and discussed. RESULTS: Seventeen reviews were selected: fifteen on screening for specific cancers (bladder, breast, colorectal, hepatic, lung, nasopharyngeal, esophageal, oral, prostate, testicular and uterine and two others on cancer in general. The quality of evidence of the findings varied among the reviews. Only two reviews resulted in high-quality evidence: screening using low-dose computed tomography scans for high-risk individuals seems to reduce lung cancer mortality; and screening using flexible sigmoidoscopy and fecal occult blood tests seems to reduce colorectal cancer mortality. CONCLUSION: The evidence found through Cochrane reviews did not support most of the commonly used screening tests for cancer. It is recommended that patients should be informed of the possibilities of false positives and false negatives before they undergo the tests. Further studies to fully assess the effectiveness of cancer screening tests and adverse outcomes are required.

Significance and management of positive surgical margins at the time of radical prostatectomy.

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Silberstein, Jonathan L; Eastham, James A

2014-10-01

Positive surgical margins (PSM) at the time of radical prostatectomy (RP) result in an increased risk of biochemical recurrence (BCR) and secondary treatment. We review current literature with a focus on stratifying the characteristics of the PSM that may define its significance, the impact of modern imaging and surgical approaches in avoidance of PSM, and management strategies when PSM do occur. We performed a review of the available literature to identify factors associated with PSM and their management. PSM have been repeatedly demonstrated to be associated with an increased risk of BCR following RP. The specific characteristics (size, number, location, Gleason score at the margin) of the PSM may influence the risk of recurrence. Novel imaging and surgical approaches are being investigated and may allow for reductions of PSM in the future. The use of adjuvant treatment for a PSM remains controversial and should be decided on an individual basis after a discussion about the risks and benefits. The goal of RP is complete resection of the tumor. PSM are associated with increased risk of BCR and secondary treatments. Of the risk factors associated with BCR after RP, a PSM is directly influenced by surgical technique.

Significance and management of positive surgical margins at the time of radical prostatectomy

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Jonathan L. Silberstein

2014-01-01

Full Text Available Positive surgical margins (PSM at the time of radical prostatectomy (RP result in an increased risk of biochemical recurrence (BCR and secondary treatment. We review current literature with a focus on stratifying the characteristics of the PSM that may define its significance, the impact of modern imaging and surgical approaches in avoidance of PSM, and management strategies when PSM do occur. We performed a review of the available literature to identify factors associated with PSM and their management. PSM have been repeatedly demonstrated to be associated with an increased risk of BCR following RP. The specific characteristics (size, number, location, Gleason score at the margin of the PSM may influence the risk of recurrence. Novel imaging and surgical approaches are being investigated and may allow for reductions of PSM in the future. The use of adjuvant treatment for a PSM remains controversial and should be decided on an individual basis after a discussion about the risks and benefits. The goal of RP is complete resection of the tumor. PSM are associated with increased risk of BCR and secondary treatments. Of the risk factors associated with BCR after RP, a PSM is directly influenced by surgical technique.

An Iterated GMM Procedure for Estimating the Campbell-Cochrane Habit Formation Model, with an Application to Danish Stock and Bond Returns

DEFF Research Database (Denmark)

Engsted, Tom; Møller, Stig Vinther

2010-01-01

We suggest an iterated GMM approach to estimate and test the consumption based habit persistence model of Campbell and Cochrane, and we apply the approach on annual and quarterly Danish stock and bond returns. For comparative purposes we also estimate and test the standard constant relative risk...... covering more than 80 years there is absolutely no evidence of superior performance of the Campbell-Cochrane model. For the shorter and more recent quarterly data over a 20-30 year period, there is some evidence of counter-cyclical time-variation in the degree of risk-aversion, in accordance...

An iterated GMM procedure for estimating the Campbell-Cochrane habit formation model, with an application to Danish stock and bond returns

DEFF Research Database (Denmark)

Engsted, Tom; Møller, Stig V.

We suggest an iterated GMM approach to estimate and test the consumption based habit persistence model of Campbell and Cochrane (1999), and we apply the approach on annual and quarterly Danish stock and bond returns. For comparative purposes we also estimate and test the standard CRRA model...... than 80 years there is absolutely no evidence of superior performance of the Campbell-Cochrane model. For the shorter and more recent quarterly data over a 20-30 year period, there is some evidence of counter-cyclical time-variation in the degree of risk-aversion, in accordance with the Campbell...

Comparison of Dental Esthetic Perceptions of Young Adolescents and Their Parents

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Kavand, Golnaz; Broffitt, Barbara; Levy, Steven M.; Warren, John J.

2012-01-01

Objective To compare dental esthetic perceptions of adolescents at age 13 with those of parents and to assess associations with dental fluorosis. Methods As part of the Iowa Fluoride Study, 550 adolescents aged 13 underwent dental examinations for fluorosis on maxillary anterior teeth using the Fluorosis Risk Index. Adolescents and parents completed questionnaires concerning satisfaction with the adolescents’ dental appearance. McNemar and Bowker tests of symmetry were used for comparisons of esthetics ratings between parents and adolescents. Comparison of satisfaction between fluorosis and non-fluorosis subjects was made using Cochran-Armitage Trend and Fisher’s Exact tests. Results Excluding subjects with orthodontic treatment, 376 adolescents were included and 26% of them had definitive fluorosis, mostly at a mild level. Fifteen percent of adolescents were dissatisfied with dental appearance, and concerns were mainly about the tooth color (45%) and alignment (35%). Adolescents were less satisfied with overall dental appearance (P0.05). Parents of subjects with fluorosis were more dissatisfied with dental appearance (P=0.014) and color (P<0.001) than other parents. The number of maxillary anterior zones exhibiting fluorosis was negatively associated with both adolescent (P=0.03) and parent (P=0.002) satisfaction. Conclusion Adolescents generally had less satisfaction with dental appearance and color and they were more concerned with tooth shape than parents. For both parents and adolescents, decreased satisfaction was associated with the number of zones with definitive fluorosis. PMID:22364682

SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings

International Nuclear Information System (INIS)

Kim, Seong Hyun; Lee, Won Jae; Lim, Hyo K.; Park, Cheol Keun

2009-01-01

This study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings. Seventy-two patients with 84 pathologically proven well-differentiated HCCs underwent triple-phase MDCT and SPIO-enhanced MRI at a magnetic field strength of 1.5 Tesla (n = 49) and 3.0 Tesla (n = 23). Two radiologists in consensus retrospectively reviewed the CT and MR images for attenuation value and the signal intensity of each tumor. The proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images were compared in terms of tumor size ( 1 cm), five CT attenuation patterns based on arterial and equilibrium phases and magnetic field strength, by the use of univariate and multivariate analyses. Seventy-eight (93%) and 71 (85%) HCCs were identified by CT and on SPIO-enhanced T2- and T2*-weighted images, respectively. For the CT attenuation pattern, one (14%) of seven isodense-isodense, four (67%) of six hypodense- hypodense, four (80%) of five isodense-hypodense, 14 (88%) of 16 hyperdense- isodense and 48 (96%) of 50 hyperdense-hypodense HCCs were hyperintense (Cochran-Armitage test for trend, p 0.05). Most well-differentiated HCCs show hyperintensity on SPIOenhanced MRI, although the lesions show various CT attenuation patterns. The CT attenuation pattern is the main factor that affects the proportion of hyperintense well-differentiated HCCs as depicted on SPIO-enhanced MRI

[Relationship between domestic violence and posttraumatic stress disorder among women living in the communities of Wuhan city].

Science.gov (United States)

Wang, L L; Chang, X N; Yang, S B; Du, Y K; Shen, M

2016-12-10

Objective: To understand the prevalence of domestic violence and the correlation between domestic violence and posttraumatic stress disorder (PTSD) so as to improve the mental health status of women in Wuhan city of China. Methods: A cross-sectional study was conducted in the community health service center in Wuhan. Participants were women who came to the center for gynecological examination. Data on general condition, social support, injury, epidemiological characteristics of domestic violence and PTSD were gathered. Chi -square, student- t and Cochran-Armitage trend tests were employed to compare the distribution of each characteristic variable between PTSD and non-PTSD group. Binary logistic regression was used to analyze the correlation between domestic violence and PTSD. Results: A total of 1 015 women were effectively surveyed. The life-time incidence rates of events related to domestic, psychological, physical and sexual violence were 29.36%, 28.28%, 6.60% and 3.55%, respectively. The overall prevalence rate of PTSD was 4.73%. Women who suffered from domestic violence had higher risk of PTSD ( OR =2.11, 95 %CI : 1.04-4.29) than those who never experiencing domestic violence. Women who suffered from psychological or physical violence were 5.06 times more likely to suffer from PTSD ( OR =5.06, 95 % CI : 1.91-13.42). Conclusion: A strong correlation between domestic violence and PTSD was seen. Victims who suffered from domestic violence should be provided with psychological counseling to reduce the risk of PTSD.

Endothelin 1 gene is not a major modifier of chronic kidney disease advancement among the autosomal dominant polycystic kidney disease patients

Directory of Open Access Journals (Sweden)

Annapareddy Shiva Nagendra Reddy

2016-01-01

Full Text Available Introduction: Autosomal dominant polycystic kidney disease (ADPKD is characterized by the presence of numerous cysts in the kidney and manifest with various renal and extra-renal complications leading to ESRD. Endothelin may contribute to various renal and extra-renal manifestations pointing to genetic and environmental modifying factors that alter the risk of developing chronic kidney disease (CKD in ADPKD. In the present study we investigated six genes coding for endothelin 1 (EDN1 tagging-single nucleotide polymorphisms (tag-SNPs to unravel the EDN1 gene modifier effect for renal disease progression in ADPKD. Materials and Methods: The tag-SNPs were genotyped using FRET-based KASPar method in 108 ADPKD patients and 119 healthy subjects. Cochran-Armitage trend test was used to determine the association between ADPKD and EDN1 tag-SNPs. Multivariate logistic regression analysis was performed to assess the effect of tag-SNPs on CKD progression. The relationship between different CKD stages and hypertension and their interaction Mantel-Haenszel stratified analysis was performed. Results: All loci are polymorphic and followed Hardy-Weinberg equilibrium. Distribution of EDN1 genotypes and haplotypes in control and ADPKD is not statistically significant. Five SNPs covering 3.4 kb forming single LD block, but the LD was not strong between SNPs. The EDN1 genotypes are not contributing to the CKD advancement among the ADPKD patients. Conclusion: These results suggest that the EDN1 gene is not a major modifier of CKD advancement among ADPKD patients.

Current Practice Patterns Surrounding Fertility Concerns in Stage I Seminoma Patients: Survey of United States Radiation Oncologists.

Science.gov (United States)

Post, Carl M; Jain, Aditya; Degnin, Catherine; Chen, Yiyi; Craycraft, Mike; Hung, Arthur Y; Jaboin, Jerry J; Thomas, Charles R; Mitin, Timur

2018-01-16

Patients with testicular seminoma may face fertility issues because of their underlying disease as well as treatments they undergo. The current patterns of practice among U.S. radiation oncologists aimed at assessing and preserving fertility in patients with Stage I seminoma are unknown. We surveyed practicing U.S. radiation oncologists via an Institutional Review Board-approved online questionnaire. Respondents' characteristics and perceived patient infertility rates were analyzed for association with treatment recommendations. We received 353 responses, of whom one quarter (23%) consider themselves experts. A vast majority (84%) recommend observation as a default strategy. Fifty-two percent routinely advise fertility assessment for patients before observation or chemotherapy, and 74% routinely do so before adjuvant radiation therapy (RT). Forty-one percent and 43% believe that 10% and 30% of patients are infertile following orchiectomy, respectively. Thirty-seven percent and 22% believe infertility rates following para-aortic RT to be 30% and 50%, respectively. Eighty percent routinely use clamshell scrotal shielding. Responders with higher perceived infertility rates are more likely to recommend fertility assessment/sperm banking (Fisher's exact p < 0.0001). Responders who routinely advised fertility assessment were more likely to use clamshell shielding (Cochran-Armitage trend test p = 0.0007). Clamshell use was positively correlated with higher perceived infertility rates following para-aortic RT (Spearman's correlation coefficient = 0.006). Despite a clear knowledge of fertility issues in men diagnosed with seminoma, there is no universal adoption of fertility assessment among U.S. radiation oncologists.

Resynchronising returns to service in anoestrous dairy cows in the South Island of New Zealand.

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Bates, A J; Kenyon, A G; Laven, R A; McDowell, J C

2016-09-01

To investigate the effect of targeted resynchronisation of cows treated for non-observed oestrus before the planned start of mating (PSM), that were not detected in oestrus or pregnant 23 days after treatment (phantom cows), on the proportion pregnant at 42 days after PSM and the end of mating. Farm staff from eight herds in two regions of the South Island of New Zealand identified 1,819 cows not showing oestrus by 10 days before PSM. These cows were treated with intravaginal progesterone for 7 days, and I/M gonadorelin 10 days and 1 day before PSM. Three days before PSM they were injected with cloprostenol and equine chorionic gonadotrophin, with fixed time artificial insemination (FTAI) at PSM. By 23 days after PSM, 1,218 cows had not returned to oestrus. Of these, 161 cows confirmed not pregnant by transrectal ultrasonography were randomly assigned to no treatment (control group; n=74) or were resynchronised 25 days after PSM using the same treatment programme as above, with FTAI 35 days after PSM (n=87). All cows that returned to oestrus were artificially inseminated until 42 days after PSM, when natural mating was used. All cows were examined using transrectal ultrasonography 80 to 90 days after PSM to confirm conception dates. Of the 1,819 anoestrous cows treated before PSM, 526 (29 (95% CI=23.1-34.0)%) had not been observed in oestrus by 23 days after PSM and had not conceived, so were diagnosed as phantoms cows. For resynchronised cows, 42/87 (48 (95% CI=37.8-58.8)%) were pregnant by 42 days after PSM compared to 21/74 (28 (95% CI=18.1-38.7)%) control cows (p=0.009). At the end of mating 58/87 (67 (95% CI=56.6-76.7)%) cows in the resynchronised group were pregnant and 46/74 (62 (95% CI=50.9-73.2)%) in the control group (p=0.554). The hazard of conception from 21 to 42 days after PSM was 1.9 (95% CI=1.07-3.12) times greater for resynchronised than control cows (p=0.026). In cows not observed in oestrus and treated before PSM, resynchronisation increased the

Bækkenbundstræning til gravide og barslende kvinder--en gennemgang af et Cochrane-review

DEFF Research Database (Denmark)

Brostrøm, Søren; Due, Ulla; Lose, Gunnar

2010-01-01

Urinary and anal incontinence are prevalent in pregnant and parturient women. Pelvic floor muscle training is frequently employed for prevention and treatment. A recent Cochrane review is discussed. Fifteen studies with a total of 6,181 women were included. Pregnant women without urinary...... incontinence experienced a reduction of the risk of developing urinary incontinence in later pregnancy or post partum. Peripartum patients with urinary and anal incontinence experienced a reduction of their symptoms following training....

Bækkenbundstræning til gravide og barslende kvinder--en gennemgang af et Cochrane-review

DEFF Research Database (Denmark)

Brostrøm, Søren; Due, Ulla; Lose, G.

2010-01-01

Urinary and anal incontinence are prevalent in pregnant and parturient women. Pelvic floor muscle training is frequently employed for prevention and treatment. A recent Cochrane review is discussed. Fifteen studies with a total of 6,181 women were included. Pregnant women without urinary...... incontinence experienced a reduction of the risk of developing urinary incontinence in later pregnancy or post partum. Peripartum patients with urinary and anal incontinence experienced a reduction of their symptoms following training...

Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015

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Abara, Winston E.; Hess, Kristen L.; Neblett Fanfair, Robyn; Bernstein, Kyle T.; Paz-Bailey, Gabriela

2016-01-01

Globally, men who have sex with men (MSM) are disproportionately burdened with syphilis. This review describes the published literature on trends in syphilis infections among MSM in the US and Western Europe from 1998, the period with the fewest syphilis infections in both geographical areas, onwards. We also describe disparities in syphilis trends among various sub-populations of MSM. We searched electronic databases (Medline, Embase, Global Health, PsychInfo, CAB Abstracts, CINAHL, Sociological Abstracts, Web of Science, Cochrane Library, and LILACS) for peer-reviewed journal articles that were published between January 2004 and June 2015 and reported on syphilis cases among MSM at multiple time points from 1998 onwards. Ten articles (12 syphilis trend studies/reports) from the US and eight articles (12 syphilis trend studies/reports) from Western Europe were identified and included in this review. Taken together, our findings indicate an increase in the numbers and rates (per 100,000) of syphilis infections among MSM in the US and Western Europe since 1998. Disparities in the syphilis trends among MSM were also noted, with greater increases observed among HIV-positive MSM than HIV-negative MSM in both the US and Western Europe. In the US, racial minority MSM and MSM between 20 and 29 years accounted for the greatest increases in syphilis infections over time whereas White MSM accounted for most syphilis infections over time in Western Europe. Multiple strategies, including strengthening and targeting current syphilis screening and testing programs, and the prompt treatment of syphilis cases are warranted to address the increase in syphilis infections among all MSM in the US and Western Europe, but particularly among HIV-infected MSM, racial minority MSM, and young MSM in the US. PMID:27447943

Design and Formative Evaluation of the Policy Liaison Initiative: A Long-Term Knowledge Translation Strategy to Encourage and Support the Use of Cochrane Systematic Reviews for Informing

Science.gov (United States)

Brennan, Sue E.; Cumpston, Miranda; Misso, Marie L.; McDonald, Steve; Murphy, Matthew J.; Green, Sally E.

2016-01-01

The Policy Liaison Initiative (PLI) is a long-term knowledge translation initiative designed to support the use of Cochrane systematic reviews in health policy. A joint initiative between the Australasian Cochrane Centre and Australian Government Department of Health and Ageing, the PLI includes: 1) a community of practice for evidence-informed…

Investigating the Structure and Meaning of Public Service Motivation across Populations

DEFF Research Database (Denmark)

Kim, Sangmook; Vandenabeele, Wouter; Wright, Bradley E.

2013-01-01

The growth in international research on public service motivation (PSM) raises a number of important questions about the degree to which the theory and research developed in one country can contribute to our understanding of PSM in other counties. To help address this issue, this study revisits...... approach by combining the efforts of international PSM scholars to develop and then test a revised measurement instrument for PSM in 12 countries. Although the resulting four dimensional 16-item measure of PSM reported here provides a better theoretical and empirical foundation for the measurement of PSM...

Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

Science.gov (United States)

Mastropietro, Christopher W; Benneyworth, Brian D; Turrentine, Mark; Wallace, Amelia S; Hornik, Christoph P; Jacobs, Jeffrey P; Jacobs, Marshall L

2016-06-01

Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy." Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11% in 2000 to a high of 0.76% in 2012 (p tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26%), genetic abnormalities (n = 298, 46%), and preoperative mechanical ventilation (n = 275, 43%) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20%), extracorporeal support (n = 87, 13%), phrenic or laryngeal nerve injury (n = 114, 18%), and neurologic deficit (n = 51, 8%). The operative mortality was 25% (n = 153). Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.

Science.gov (United States)

Lacson, Ronilda; O'Connor, Stacy D; Sahni, V Anik; Roy, Christopher; Dalal, Anuj; Desai, Sonali; Khorasani, Ramin

2016-07-01

Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (pcommunicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States.

Science.gov (United States)

Desai, Rupak; Patel, Upenkumar; Sharma, Shobhit; Amin, Parth; Bhuva, Rushikkumar; Patel, Malav S; Sharma, Nitin; Shah, Manan; Patel, Smit; Savani, Sejal; Batra, Neha; Kumar, Gautam

2017-11-03

Background Marijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use. Methods We queried the 2010-2014 National Inpatient Sample (NIS) database for 11-70-year-old AMI patients. Pearson Chi-square test for categorical variables and Student T-test for continuous variables were used to compare the baseline demographic and hospital characteristics between two groups (without vs. with marijuana) of AMI patients. The univariate and multivariate analyses were used to assess and compare the clinical outcomes between two groups. We used Cochran-Armitage test to measure the trends. All statistical analyses were executed by IBM SPSS Statistics 22.0 (IBM Corp., Armonk, NY). We used weighted data to produce national estimates in our study. Results Out of 2,451,933 weighted hospitalized AMI patients, 35,771 patients with a history of marijuana and 2,416,162 patients without a history of marijuana use were identified. The AMI-marijuana group consisted more of younger, male, African American patients. The length of stay and mortality rate were lower in the AMI-marijuana group with more patients being discharged against medical advice. Multivariable analysis showed that marijuana use was a significant risk factor for AMI development when adjusted for age, sex, race (adjusted OR 1.079, 95% CI 1.065-1.093, pmarijuana group. Conclusion The lifetime AMI odds were increased in recreational marijuana users. Overall odds of mortality were not increased significantly in AMI-marijuana group. However, marijuana users showed higher trends of AMI prevalence and related mortality from 2010-2014. It is crucial to assess cardiovascular effects related to marijuana overuse and educate patients for the same.

Retrospective analysis of 56 edentulous dental arches restored with 344 single-stage implants using an immediate loading fixed provisional protocol: statistical predictors of implant failure.

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Kinsel, Richard P; Liss, Mindy

2007-01-01

The purpose of this retrospective study was to evaluate the effects of implant dimensions, surface treatment, location in the dental arch, numbers of supporting implant abutments, surgical technique, and generally recognized risk factors on the survival of a series of single-stage Straumann dental implants placed into edentulous arches using an immediate loading protocol. Each patient received between 4 and 18 implants in one or both dental arches. Periapical radiographs were obtained over a 2- to 10-year follow-up period to evaluate crestal bone loss following insertion of the definitive metal-ceramic fixed prostheses. Univariate tests for failure rates as a function of age ( or = 60 years), gender, smoking, bone grafting, dental arch, surface type, anterior versus posterior, number of implants per arch, and surgical technique were made using Fisher exact tests. The Cochran-Armitage test for trend was used to evaluate the presence of a linear trend in failure rates regarding implant length and implant diameter. Logistic regression modeling was used to determine which, if any, of the aforementioned factors would predict patient and implant failure. A significance criterion of P = .05 was utilized. Data were collected for 344 single-stage implants placed into 56 edentulous arches (39 maxillae and 17 mandibles) of 43 patients and immediately loaded with a 1-piece provisional fixed prosthesis. A total of 16 implants failed to successfully integrate, for a survival rate of 95.3%. Increased rates of failure were associated with reduced implant length, placement in the posterior region of the jaw, increased implant diameter, and surface treatment. Implant length emerged as the sole significant predictor of implant failure. In this retrospective analysis of 56 consecutively treated edentulous arches with multiple single-stage dental implants loaded immediately, reduced implant length was the sole significant predictor of failure.

Synthesis of plastic scintillation microspheres: Evaluation of scintillators

International Nuclear Information System (INIS)

Santiago, L.M.; Bagán, H.; Tarancón, A.; Garcia, J.F.

2013-01-01

The use of plastic scintillation microspheres (PSm) appear to be an alternative to liquid scintillation for the quantification of alpha and beta emitters because it does not generate mixed wastes after the measurement (organic and radioactive). In addition to routine radionuclide determinations, PSm can be used for further applications, e.g. for usage in a continuous monitoring equipment, for measurements of samples with a high salt concentration and for an extractive scintillation support which permits the separation, pre-concentration and measurement of the radionuclides without additional steps of elution and sample preparation. However, only a few manufacturers provide PSm, and the low number of regular suppliers reduces its availability and restricts the compositions and sizes available. In this article, a synthesis method based on the extraction/evaporation methodology has been developed and successfully used for the synthesis of plastic scintillation microspheres. Seven different compositions of plastic scintillation microspheres have been synthesised; PSm1 with polystyrene, PSm2 with 2,5-Diphenyloxazol(PPO), PSm3 with p-terphenyl (pT), PSm4 with PPO and 1,4-bis(5-phenyloxazol-2-yl) (POPOP), PSm5 pT and (1,4-bis [2-methylstyryl] benzene) (Bis-MSB), PSm6 with PPO, POPOP and naphthalene and PSm7 with pT, Bis-MSB and naphthalene. The synthesised plastic scintillation microspheres have been characterised in terms of their morphology, detection capabilities and alpha/beta separation capacity. The microspheres had a median diameter of approximately 130 μm. Maximum detection efficiency values were obtained for the PSm4 composition as follows 1.18% for 3 H, 51.2% for 14 C, 180.6% for 90 Sr/ 90 Y and 76.7% for 241 Am. Values of the SQP(E) parameter were approximately 790 for PSm4 and PSm5. These values show that the synthesised PSm exhibit good scintillation properties and that the spectra are at channel numbers higher than in commercial PSm. Finally, the addition

The Red Atlantic: Transoceanic Cultural Exchanges

Science.gov (United States)

Weaver, Jace

2011-01-01

The development of David Armitage's "white Atlantic" history parallels the Cold War origins of American studies with its mission to define and promote "American culture" or "American civilization." British scholar Paul Gilroy's "The Black Atlantic" served as a necessary corrective. Armitage's statement leads…

Prosocial Behavior and Public Service Motivation

NARCIS (Netherlands)

Esteve, Marc; Urbig, Diemo; van Witteloostuijn, Arjen; Boyne, George

2016-01-01

Although research on public service motivation (PSM) is vast, there is little evidence regarding the effects of PSM on observable behavior. This article contributes to the understanding of the behavioral implications of PSM by investigating whether PSM is associated with prosocial behavior.

Prosocial behavior and public service motivation

NARCIS (Netherlands)

Esteve, M.; Urbig, D.; van Witteloostuijn, Arjen; Boyne, George

Although research on public service motivation (PSM) is vast, there is little evidence regarding the effects of PSM on observable behavior. This article contributes to our understanding of the behavioral implications of PSM by investigating whether PSM is associated with prosocial behavior.

Spatiotemporal analysis of brucellosis incidence in Iran from 2011 to 2014 using GIS.

Science.gov (United States)

Pakzad, Reza; Pakzad, Iraj; Safiri, Saeid; Shirzadi, Mohammad Reza; Mohammadpour, Marzieh; Behroozi, Abbas; Sullman, Mark J M; Janati, Ali

2018-02-01

To investigate the distribution and trends associated with brucellosis incidence rates in Iran from 2011 to 2014. The reported incidence rates of brucellosis for the years 2011-2014 were collected and entered into GIS 10.1. The Cochran-Armitage test for linear trends, choropleth maps, hot-spot analysis, and high-low clustering analysis were used to investigate patterns of the disease over the study period and by season, and to identify high-risk areas and any clustering of the disease. The significance level was set at p<0.05. A total of 68493 cases of brucellosis were reported during the study period, giving an average brucellosis incidence rate for this period of 38.67/100000. In 2011, the highest rate of brucellosis was observed in Koohrang County of Chaharmahal-Bakhtiari Province, with 317/100 000. In the subsequent years, 2012-2014, Charuymaq County of East-Azerbaijan Province had incidence rates of 384, 534, and 583/100000, respectively. However, the incidence rate of the disease did not follow a linear trend (p<0.001). The maximum and minimum incidence rates of the disease occurred in mid-summer and mid-winter, respectively. The results of the hot-spot analysis showed that the distribution of the disease was highest in the mountainous areas of Iran, particularly along the Zagros mountain range and in most cities near the Zagros Mountains (p<0.01). In addition, the cluster analysis showed a clustering pattern in these high incidence areas (p<0.01). There were significant differences in the geographic distribution of brucellosis, with the incidence rates being highest in most of the cities in the west and north-west of the country. The incidence of this disease also increased during the summer. It is important to take these patterns into account when allocating resources to combat this disease and to ensure that health programs and other interventions focus on the areas of greatest need. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights

Using Cochran's Z Statistic to Test the Kernel-Smoothed Item Response Function Differences between Focal and Reference Groups

Science.gov (United States)

Zheng, Yinggan; Gierl, Mark J.; Cui, Ying

2010-01-01

This study combined the kernel smoothing procedure and a nonparametric differential item functioning statistic--Cochran's Z--to statistically test the difference between the kernel-smoothed item response functions for reference and focal groups. Simulation studies were conducted to investigate the Type I error and power of the proposed…

Public service motivation ad fonts : Personality traits as antecedents to serve the public interest

NARCIS (Netherlands)

van Witteloostuijn, Arjen; Esteve, M.; Boyne, G.

2017-01-01

Public Service Motivation (PSM) is a topic that has generated considerable interest among Public Administration scholars. Research on PSM has mainly focused on either defining what PSM is and how this construct can be measured or on testing how PSM affects individual and organizational variables.

Public sector motivation ad fonts : Personality traits as antecedents of the motivation to serve the public interest

NARCIS (Netherlands)

Van Witteloostuijn, Arjen; Esteve, Marc; Boyne, George

2017-01-01

Public Service Motivation (PSM) is a topic that has generated considerable interest among Public Administration scholars. Research on PSM has mainly focused on either defining what PSM is and how this construct can be measured or on testing how PSM affects individual and organizational variables.

Intervention for replacing missing teeth: Different types of implants - evidence summary of updated Cochrane review

Directory of Open Access Journals (Sweden)

Balendra Pratap Singh

2015-01-01

Full Text Available Around 1300 different types of dental implants are available worldwide and the implant manufacturers are resorting to aggressive marketing strategies; claiming their implants to provide a superior outcome. The clinician is left with a constant dilemma on which implant to choose for better clinical outcome and welfare of the patient. Moreover, in India, economical consideration is a concern too. The dentist has to select an implant that provides a good result and is economical. Cochrane systematic reviews provide the gold standard evidence for intervention, diagnosis, etc., and follow a strict quality control. A Cochrane systematic review was done to shed light on whether the different implant surface modifications, shapes or materials significantly influence clinical outcomes. All randomized controlled trials (RCTs till January 17, 2014 were searched and out of the 81 trials, only 27 met the inclusion criteria. This evidence summary from the review concludes that based on the available literature; there is no evidence of any one type of implant being superior to another. There is weak evidence showing roughened dental implants are more prone to bone loss due to periimplantitis. This review indicated that there is a need for well-designed RCTs, with long-term follow-up and low bias. Moreover, none of the included studies was from India, which also points out the need for improving the quality of RCTs conducted in India.

A review of the reporting of web searching to identify studies for Cochrane systematic reviews.

Science.gov (United States)

Briscoe, Simon

2018-03-01

The literature searches that are used to identify studies for inclusion in a systematic review should be comprehensively reported. This ensures that the literature searches are transparent and reproducible, which is important for assessing the strengths and weaknesses of a systematic review and re-running the literature searches when conducting an update review. Web searching using search engines and the websites of topically relevant organisations is sometimes used as a supplementary literature search method. Previous research has shown that the reporting of web searching in systematic reviews often lacks important details and is thus not transparent or reproducible. Useful details to report about web searching include the name of the search engine or website, the URL, the date searched, the search strategy, and the number of results. This study reviews the reporting of web searching to identify studies for Cochrane systematic reviews published in the 6-month period August 2016 to January 2017 (n = 423). Of these reviews, 61 reviews reported using web searching using a search engine or website as a literature search method. In the majority of reviews, the reporting of web searching was found to lack essential detail for ensuring transparency and reproducibility, such as the search terms. Recommendations are made on how to improve the reporting of web searching in Cochrane systematic reviews. Copyright © 2017 John Wiley & Sons, Ltd.

Saskatchewan Residents’ Use of The Cochrane Library

Directory of Open Access Journals (Sweden)

Dorothy Anne Forbes

2007-11-01

Full Text Available There is strong evidence of failure to translate research findings into the health care decision-making process of consumers, practitioners and policy makers (Grimshaw, 2007. Recognizing that The Cochrane Database of Systematic Reviews contained in The Cochrane Library (the Library are the “gold standard” of systematic reviews, Saskatchewan’s Health Quality Council provided funding for a provincial license and an evaluation study. In July 2004, Saskatchewan became the first province in Canada to provide all residents with access to the Library. The primary aim of the study was to enhance and evaluate the use of the Library over three years. Since September 2004, over 46 training sessions have been conducted on searching the Library online databases. Attendees at the workshops were informed of the evaluation study and invited to participate. Those who consented to participate were telephoned following the workshops and audio-taped interviews were conducted. Usage of the Library was also tracked using data available from Wiley InterScience. Three month (n=94, six month (n=71, nine month (n=79, and 12 month (n=72 telephone interviews were conducted. Most participants were librarians (n=31.5%, followed by nurses (16.3%, therapists (7.6%, library support staff (5.4%, pharmacists (4.3%, physicians (3.3%, and others (30.5. Most were between 40 to 65 years of age (71.6% and female (92.4%. Most respondents had accessed the Library at the three-month (65.2% and six-month (64.2% follow-up interviews. However, this percent fell to 45.2% at the nine-month and 27.4% at the twelve-month interview. MeSH searches were more frequent than standard keyword searches and HTML full text retrievals were more common than PDF versions. It is assumed that HTML versions were scanned for particular information whereas PDF versions were selected when the person wished to save and read the whole review. Librarians, practitioners and consumers are more likely to be

Virtual reality for stroke rehabilitation: an abridged version of a Cochrane review.

Science.gov (United States)

Laver, K; George, S; Thomas, S; Deutsch, J E; Crotty, M

2015-08-01

Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation settings over the last ten years. The primary objective of this review was to determine the effectiveness of virtual reality on upper limb function and activity after stroke. The impact on secondary outcomes including gait, cognitive function and activities of daily living was also assessed. Randomized and quasi-randomized controlled trials comparing virtual reality with an alternative intervention or no intervention were eligible to be included in the review. The authors searched a number of electronic databases including: the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, clinical trial registers, reference lists, Dissertation Abstracts and contacted key researchers in the field. Search results were independently examined by two review authors to identify studies meeting the inclusion criteria. A total of 37 randomized or quasi randomized controlled trials with a total of 1019 participants were included in the review. Virtual reality was found to be significantly more effective than conventional therapy in improving upper limb function (standardized mean difference [SMD] 0.28, 95% confidence intervals [CI] 0.08 to 0.49) based on 12 studies and significantly more effective than no therapy in improving upper limber function (SMD 0.44 [95% CI 0.15 to 0.73]) based on nine studies. The use of virtual reality also significantly improved activities of daily living function when compared to more conventional therapy approaches (SMD 0.43 [95% CI 0.18 to 0.69]) based on eight studies. While there are a large number of studies assessing the efficacy of virtual reality they tend to be small and many are at risk of bias. While there is evidence to support the use of virtual reality intervention as part of upper limb training programs, more research is required to determine whether it

Population-level interventions in government jurisdictions for dietary sodium reduction: a Cochrane Review.

Science.gov (United States)

Barberio, Amanda M; Sumar, Nureen; Trieu, Kathy; Lorenzetti, Diane L; Tarasuk, Valerie; Webster, Jacqui; Campbell, Norman R C; McLaren, Lindsay

2017-10-01

Worldwide, excessive salt consumption is common and is a leading cause of high blood pressure. Our objectives were to assess the overall and differential impact (by social and economic indicators) of population-level interventions for dietary sodium reduction in government jurisdictions worldwide. This is a Cochrane systematic review. We searched nine peer-reviewed databases, seven grey literature resources and contacted national programme leaders. We appraised studies using an adapted version of the Cochrane risk of bias tool. To assess impact, we computed the mean change in salt intake (g/day) from before to after intervention. Fifteen initiatives met the inclusion criteria and 10 provided sufficient data for quantitative analysis of impact. Of these, five showed a mean decrease in salt intake from before to after intervention including: China, Finland (Kuopio area), France, Ireland and the UK. When the sample was constrained to the seven initiatives that were multicomponent and incorporated activities of a structural nature (e.g. procurement policy), most (4/7) showed a mean decrease in salt intake. A reduction in salt intake was more apparent among men than women. There was insufficient information to assess differential impact by other social and economic axes. Although many initiatives had methodological strengths, all scored as having a high risk of bias reflecting the observational design. Study heterogeneity was high, reflecting different contexts and initiative characteristics. Population-level dietary sodium reduction initiatives have the potential to reduce dietary salt intake, especially if they are multicomponent and incorporate intervention activities of a structural nature. It is important to consider data infrastructure to permit monitoring of these initiatives. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Change within Purchasing and Supply Management Organisations – Assessing the Claims from Maturity Models

DEFF Research Database (Denmark)

Holm Andreasen, Peter; Gammelgaard, Britta

2018-01-01

It is a wide-held assumption that professional development and change within purchasing and supply management (PSM) organisations can be explained and guided by a maturity model. In this paper the guidance which the maturity model concept offers to understand a PSM organisation's performance...... an organisational change framework, composing 1) movement transitions, 2) scalability of change, 3) acceptability of change, and 4) the substantive element of change. The research found that extant PSM maturity models are too rigid for PSM managers to apply, and although maturity models are commonly accepted in PSM...... is assessed. The methodology is based on the outcomes of a literature review of PSM maturity models, development of an organisational change framework and the learning from three qualitative case studies. An alternative understanding of the development of the PSM organisation is offered through...

Causes and Consequences of Public Service Motivation: Governance Interventions and Performance Implications

DEFF Research Database (Denmark)

Jensen, Ulrich Thy

are based on combinations of survey and administrative data and the dissertation employs a variety of designs such as repeated measures across time and an experiment to advance insights into the effects of organizational leadership and national policies on individuals’ PSM and the behavioral implications...... interventions as causes of PSM and the implications of PSM for public service behaviors and contributes not only to our understanding of PSM as motivational lever for public service improvements but also offers answers to the question of how PSM is shaped in organizational contexts. The empirical results...... of PSM for the provision of public services to citizens. The dissertation disentangles causes and consequences of PSM and is of interest to people who wish to understand how governance interventions (including policies and leadership) can influence employee public service motivation and how this kind...

Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment, A Cochrane Review

NARCIS (Netherlands)

Drs. Maaike Angevaren; A. Aleman; Prof. Dr. Luc L.E.M.J. Vanhees; Geert Aufdemkampe; H.J.J. Verhaar

2008-01-01

Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005381. DOI: 10.1002/14651858.CD005381.pub2. Background: Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is

Analysis of the Cochrane Review: Omega-3 Fatty Acids for the Treatment of Dementia. Cochrane Database Syst Rev. 2016;4:CD009002.

Directory of Open Access Journals (Sweden)

David Cordeiro Sousa

2017-10-01

Full Text Available Dietary supplementation with omega-3 polyunsaturated fatty acids from fish and plant sources is commonly prescribed as a nonfarmacological alternative to improve brain functions and slow down the progression of dementia. This use is mostly based on findings of preclinical studies which established the role of omega-3 polyunsaturated fatty acids in the development and integrity of the brain, as well as epidemiological research that found evidence of malnutrition in patients with dementia. This Cochrane systematic review included three randomized, placebo-controlled trials at low risk of bias, in which omega-3 polyunsaturated fatty acids were administered to people with mild to moderate Alzheimer’s disease in the form of supplements. Of the main results of this systematic review we highlight the lack of convincing evidence for the efficacy of omega-3 polyunsaturated fatty acids supplementation in the treatment of patients with Alzheimer’s disease, as well as the low frequency of reported adverse events, with a comparable overall frequency between omega-3 polyunsaturated fatty acids and the placebo groups. The effects on other populations with dementia remain unclear. This paper aims to summarize and discuss the main results and conclusions of this systematic review, as well as its implications for the daily clinical practice.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea.

Science.gov (United States)

Kim, In-Sook; Park, MiJeong; Park, Mi-Young; Yoo, Hana; Choi, Jihea

2013-03-01

The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies. Copyright © 2013. Published by Elsevier B.V.

Uit de Cochrane Library: met postmenopauzale hormonale substitutietherapie geen bescherming tegen hart-vaatziekte, wel meer kans op veneuze trombo-embolie

NARCIS (Netherlands)

Hamerlynck, J. V. Th H.; Middeldorp, S.; Scholten, R. J. P. M.

2006-01-01

Observational studies in the early nineteen-nineties have strongly suggested that hormone replacement therapy (HRT) has benefits for reducing cardiovascular events in postmenopausal women. A recent Cochrane systematic review assessed the effects of HRT in primary and secondary prevention of

Langtidseffekt af vægtreducerende behandlinghos patienter med hypertension--en gennemgang af et Cochrane-review

DEFF Research Database (Denmark)

Madsbad, Sten

2011-01-01

In eight studies included in the present Cochrane review the effects of orlistat or sibutramine versus placebo on mortality, cardiovascular mortality and adverse events were investigated in obese people with hypertension. No studies with rimonabant fulfilled the inclusion criteria. The weight loss...... was larger in the groups treated with orlistat or sibutramine compared with placebo therapy. Orlistat reduced systolic and diastolic blood pressure more than placebo, while blood pressure increased during treatment with sibutramine. The studies were too small and of too short duration to allow an evaluation...

Intrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis.

Science.gov (United States)

Weng, Hong; Zeng, Xian-Tao; Li, Sheng; Meng, Xiang-Yu; Shi, Ming-Jun; He, Da-Lin; Wang, Xing-Huan

2017-09-13

The present study aimed to systematically evaluate the effectiveness and safety of the intrafascial and interfascial nerve sparing (ITR-NS and ITE-NS) radical prostatectomy. PubMed, Embase, and Cochrane Library databases were searched for eligible studies. Meta-analysis with random-effects model was performed. Six comparative trials were selected and embraced in this research, including one randomized controlled trial, three prospective comparative trials, and two retrospective comparative trials. With regard to perioperative parameters, no significant association of operative time, blood loss, transfusion rates, duration of catheterization, and hospital stay existed between ITR-NS and ITE-NS. With respect to the functional results, ITR-NS had advantages in terms of both continence and potency recovery compared with ITE-NS. In reference to the oncologic results, the ITR-NS showed lower overall positive surgical margin (PSM) compared with ITE-NS but pT2 PSM and biochemical recurrence free rates were similar to the two surgical types. This study demonstrates that ITR-NS has better continence at 6 mo and 36 mo and better potency recovery at 6 mo and 12 mo postoperatively, regardless of the surgical technique. The cancer control of ITR-NS was also better than that of ITE-NS. This may be explained by the fact that patients in ITE-NS group present higher risk cancer than patients in ITR-NS group.

Polarized phase shift mask: concept, design, and potential advantages to photolithography process and physical design

Science.gov (United States)

Wang, Ruoping; Grobman, Warren D.; Reich, Alfred J.; Thompson, Matthew A.

2002-03-01

In this paper we introduce the concept and design of a novel phase shift mask technology, Polarized Phase Shift Mask (P:PSM). The P:PSM technology utilizes non-interference between orthogonally polarized light sources to avoid undesired destructive interference seen in conventional two-phase shift mask technology. Hence P:PSM solves the well-known 'phase edge' or 'phase conflict' problem. By obviating the 2nd exposure and 2nd mask in current Complementary Phase Shift Mask (C:PSM) technology, this single mask/single exposure technology offers significant advantages towards photolithography process as well as pattern design. We use examples of typical design and process difficulties associated with the C:PSM technology to illustrate the advantages of the P:PSM technology. We present preliminary aerial image simulation results that support the potential of this new reticle technology for enhanced design flexibility. We also propose possible mask structures and manufacturing methods for building a P:PSM.

Immunostimulatory Effects of Polysaccharides Isolated from Makgeolli (Traditional Korean Rice Wine

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Chang-Won Cho

2014-04-01

Full Text Available Makgeolli is a traditional Korean rice wine, reported to have various biological functions. In this study, the immunostimulatory activity of a polysaccharide from makgeolli (PSM was investigated. The polysaccharide fraction was isolated from makgeolli by hot water extraction, ethanol precipitation, dialysis, and lyophilization. The major constituents in PSM were neutral sugars (87.3%. PSM was composed of five different sugars, glucose, mannose, galactose, xylose, and arabinose. In normal mice, PSM treatment increased the spleen index (p < 0.05 as well as splenocyte proliferation (p < 0.05 in combination with concanavalin A or lipopolysaccharide. The immunostimulatory activities of PSM were also examined in cyclophosphamide (CY-induced immunosuppressed mice. Mice treated with PSM exhibited increased splenocyte proliferation (p < 0.05, natural killer cell activity, and white blood cell counts (p < 0.01 compared with immunosuppressed mice. These results indicate that PSM can enhance immune function in normal mice and CY-induced immunosuppressed mice.

The relationship between prevalent medial meniscal intrasubstance signal changes and incident medial meniscal tears in women over a 1-year period assessed with 3.0 T MRI

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Crema, Michel D. [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Ribeirao Preto School of Medicine, University of Sao Paulo (USP), Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, and Department of Internal Medicine, Radiology Division, Ribeirao Preto (Brazil); Institute of Diagnostic Imaging (IDI), Ribeirao Preto (Brazil); Hunter, David J. [The University of Sydney, Sydney School of Medicine, Sydney (Australia); Roemer, Frank W. [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Li, Ling [New England Baptist Hospital, Division of Research, Boston, MA (United States); Marra, Monica D. [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Institute of Diagnostic Imaging (IDI), Ribeirao Preto (Brazil); Nogueira-Barbosa, Marcello H. [Ribeirao Preto School of Medicine, University of Sao Paulo (USP), Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, and Department of Internal Medicine, Radiology Division, Ribeirao Preto (Brazil); Hellio Le Graverand, Marie-Pierre; Wyman, Bradley T. [Pfizer Global Research and Development, New London, CT (United States); Guermazi, Ali [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States)

2011-08-15

Intrasubstance meniscal signal changes not reaching the articular surface on fast spin echo (FSE) sequences are considered to represent mucoid degeneration on MRI. The aim of this study was to evaluate the association of prevalent intrasubstance signal changes with incident tears of the medial meniscus detected on 3.0 T MRI over a 1-year period. A total of 161 women aged {>=}40 years participated in a longitudinal 1-year observational study of knee osteoarthritis. MRI (3.0 T) was performed at baseline and 12-month follow-up. The anterior horn, body, and posterior horn of the medial meniscus were scored by two experienced musculoskeletal radiologists using the Boston-Leeds Osteoarthritis Knee Score (BLOKS) system. Four grades were used to describe the meniscal morphology: grade 0 (normal), grade 1 (intrasubstance signal changes not reaching the articular surface), grade 2 (single tears), and grade 3 (complex tears and maceration). Fisher's exact test and the Cochran-Armitage trend test were performed to evaluate whether baseline intrasubstance signal changes (grade 1) predict incident meniscal tears/maceration (grades 2 and/or 3) in the same subregion of the medial meniscus, when compared to subregions without pathology as the reference group (grade 0). Medial meniscal intrasubstance signal changes at baseline did not predict tears at follow-up when evaluating the anterior and posterior horns (left-sided p-values 0.06 and 0.59, respectively). No incident tears were detected in the body. We could not demonstrate an association between prevalent medial meniscal intrasubstance signal changes with incident tears over a 1-year period. (orig.)

The relationship between prevalent medial meniscal intrasubstance signal changes and incident medial meniscal tears in women over a 1-year period assessed with 3.0 T MRI

International Nuclear Information System (INIS)

Crema, Michel D.; Hunter, David J.; Roemer, Frank W.; Li, Ling; Marra, Monica D.; Nogueira-Barbosa, Marcello H.; Hellio Le Graverand, Marie-Pierre; Wyman, Bradley T.; Guermazi, Ali

2011-01-01

Intrasubstance meniscal signal changes not reaching the articular surface on fast spin echo (FSE) sequences are considered to represent mucoid degeneration on MRI. The aim of this study was to evaluate the association of prevalent intrasubstance signal changes with incident tears of the medial meniscus detected on 3.0 T MRI over a 1-year period. A total of 161 women aged ≥40 years participated in a longitudinal 1-year observational study of knee osteoarthritis. MRI (3.0 T) was performed at baseline and 12-month follow-up. The anterior horn, body, and posterior horn of the medial meniscus were scored by two experienced musculoskeletal radiologists using the Boston-Leeds Osteoarthritis Knee Score (BLOKS) system. Four grades were used to describe the meniscal morphology: grade 0 (normal), grade 1 (intrasubstance signal changes not reaching the articular surface), grade 2 (single tears), and grade 3 (complex tears and maceration). Fisher's exact test and the Cochran-Armitage trend test were performed to evaluate whether baseline intrasubstance signal changes (grade 1) predict incident meniscal tears/maceration (grades 2 and/or 3) in the same subregion of the medial meniscus, when compared to subregions without pathology as the reference group (grade 0). Medial meniscal intrasubstance signal changes at baseline did not predict tears at follow-up when evaluating the anterior and posterior horns (left-sided p-values 0.06 and 0.59, respectively). No incident tears were detected in the body. We could not demonstrate an association between prevalent medial meniscal intrasubstance signal changes with incident tears over a 1-year period. (orig.)

The impact of maternal body mass index on external cephalic version success.

Science.gov (United States)

Chaudhary, Shahrukh; Contag, Stephen; Yao, Ruofan

2018-01-21

The purpose of this study is to determine the association between body mass index (BMI) and success of ECV. This is a cross-sectional analysis of singleton live births in the USA from 2010 to 2014 using birth certificate data. Patients were assigned a BMI category according to standard WHO classification. Comparisons of success of ECV between the BMI categories were made using chi-square analysis with normal BMI as the reference group. Cochran-Armitage test was performed to look for a trend of decreasing success of ECV as BMI increased. The odds for successful ECV were estimated using multivariate logistic regression analysis, adjusting for possible confounders. A total of 51,002 patients with documented ECV were available for analysis. There was a decreased success rate for ECV as BMI increased (p < .01). Women with a BMI of 40 kg/m 2 or greater had a 58.5% success rate of ECV; women with a normal BMI had 65.0% success rate of ECV. Multivariate analyses demonstrated significant decrease in success of ECV in women with BMI of 40 kg/m 2 or greater (OR 0.621, CI 0.542-0.712). Among women with BMI of 40 kg/m 2 or greater with successful ECV, 59.5% delivered vaginally. In contrast, 81.0% of women with normal BMI and successful ECV delivered vaginally. Morbidly obese women have decreased success rate of ECV as BMI increases and decreased vaginal delivery rates after successful ECV.

Infectious complications after vehicular trauma in the United States.

Science.gov (United States)

Fraser, Douglas R; Dombrovskiy, Viktor Y; Vogel, Todd R

2011-08-01

The purpose of this analysis was to evaluate and define the rates of infectious complications (IC) after vehicular trauma. Secondary goals were to identify the injuries associated with the greatest risk of nosocomial infection and to measure the utilization of hospital resources associated with IC and vehicular trauma. A secondary analysis of the Nationwide Inpatient Sample (2003-2007) was performed to classify major vehicular trauma injuries utilizing International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Emergency (E) codes. The post-traumatic IC evaluated were pneumonia, urinary tract infection (UTI), sepsis, and surgical site infection (SSI). All data were analyzed by χ(2) analysis, multivariable logistic regression, and the Cochran-Armitage test for trends. A total of 784,037 vehicular trauma patients were identified (462,543 [59.0%] motor vehicle drivers, 142,283 [18.2%] motor vehicle passengers, 98,767 [12.6%] motorcyclists; 6,568 [colon injuries. After adjustment by age, sex, and co-morbidities, patients with SCI were 4.4 times as likely (95% confidence interval [CI] 4.20-4.63) and those with cranial injuries were 2.1 times as likely (95% CI 2.06-2.19) to develop IC as patients without these injuries. Secondary infection increased significantly the length of stay and hospital charges in all groups. Patients sustaining vehicular trauma in combination with SCI had the highest rate of IC. Infectious complications increased hospital resource utilization significantly after vehicular trauma. Future root-cause analysis of high-risk groups may decrease complications and hospital utilization.

Associations of breakfast skipping with obesity and health-related quality of life: evidence from a national survey in Taiwan.

Science.gov (United States)

Huang, C-J; Hu, H-T; Fan, Y-C; Liao, Y-M; Tsai, P-S

2010-04-01

This study investigated the associations of breakfast skipping with obesity and health-related quality of life (QOL). We also tested the hypothesis that there is a dose-dependent relationship between frequency of breakfast consumption and prevalence of obesity. This cross-section study used a national representative sample (n=15 340) from the 2005 Taiwan National Health Interview Survey. Breakfast skippers were defined as those who ate breakfast about once a week or less often and those who never ate breakfast. Individuals were classified as 'obese' if their body mass index was >or=27. Health-related QOL was assessed using the Medical Outcome Studies 36-Item Short-Form (SF-36) Health Survey. Logistic regression was used to examine the odds ratio of obesity and associated 95% confidence intervals (CIs) in breakfast skippers compared with breakfast eaters. Multivariable logistic regression modeling was used to adjust all risk estimates for covariates. The unadjusted odds ratio of obesity in breakfast skippers was 1.23 (95% CI: 1.06, 1.43). The odds of developing obesity for breakfast skippers was 1.34 (95% CI: 1.15, 1.56) controlling for age, sex, marital status, educational level, monthly income, smoking, alcohol, betel nut chewing and exercise habit. The Cochran-Armitage trend test revealed that the prevalence rate of obesity decreased as the frequency of breakfast consumption increased (P=0.005). Breakfast skippers had significantly worse health-related QOL than breakfast eaters (Pbreakfast skippers had significantly lower scores in 5 out of 8 domain scores of the SF-36, namely general health perceptions (Pmental health (Pbreakfast eating in obesity prevention.

Preoperative depression symptom severity and its impact on adherence to preoperative beta-blocker therapy.

Science.gov (United States)

Schonberger, Robert B; Feinleib, Jessica; Holt, Natalie; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

2014-12-01

To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population. Prospective observational study. A veterans hospital. One hundred twenty patients on outpatient beta-blocker therapy presenting for surgery. The Patient Health Questionnaire (PHQ)-9, the D-Scale-14 (DS14), and Modified Morisky Scale (MMS) questionnaires. Of 99 participants who presented for surgery, the incidence of preoperative nonadherence was 14.1% (95% confidence interval 7%-21%), consistent with prior research. Nonadherence was 9.5% among those with no depression, 27.8% among those with mild depression, and 28.6% among those with moderate-to-severe depression (Cochran-Armitage test for trend p = 0.03). Distressed personality type was found in 35% of the cohort (95% confidence interval 26-45%) and was not associated with beta-blocker nonadherence (Fisher's exact test, p = 0.24). Among participants with symptoms of major depressive disorder (n = 25, 25.3%), more than half (n = 14, 56%) had no indication of depression listed at their most recent primary care visit. Patients with symptoms of depression on chronic beta-blocker therapy are susceptible to medication nonadherence on the day of surgery. Most surgical patients with symptoms of major depression lack a diagnosis of depression. Preoperative depression screening may thus (1) identify a population at increased risk of beta-blocker withdrawal, and (2) identify patients who may benefit from anesthesiologist-initiated referral for this treatable condition. Copyright © 2014 Elsevier Inc. All rights reserved.

Exploring treatment by covariate interactions using subgroup analysis and meta-regression in cochrane reviews: a review of recent practice.

Directory of Open Access Journals (Sweden)

Sarah Donegan

Full Text Available Treatment by covariate interactions can be explored in reviews using interaction analyses (e.g., subgroup analysis. Such analyses can provide information on how the covariate modifies the treatment effect and is an important methodological approach for personalising medicine. Guidance exists regarding how to apply such analyses but little is known about whether authors follow the guidance.Using published recommendations, we developed criteria to assess how well interaction analyses were designed, applied, interpreted, and reported. The Cochrane Database of Systematic Reviews was searched (8th August 2013. We applied the criteria to the most recently published review, with an accessible protocol, for each Cochrane Review Group. We excluded review updates, diagnostic test accuracy reviews, withdrawn reviews, and overviews of reviews. Data were summarised regarding reviews, covariates, and analyses.Each of the 52 included reviews planned or did interaction analyses; 51 reviews (98% planned analyses and 33 reviews (63% applied analyses. The type of analysis planned and the type subsequently applied (e.g., sensitivity or subgroup analysis was discrepant in 24 reviews (46%. No review reported how or why each covariate had been chosen; 22 reviews (42% did state each covariate a priori in the protocol but no review identified each post-hoc covariate as such. Eleven reviews (21% mentioned five covariates or less. One review reported planning to use a method to detect interactions (i.e., interaction test for each covariate; another review reported applying the method for each covariate. Regarding interpretation, only one review reported whether an interaction was detected for each covariate and no review discussed the importance, or plausibility, of the results, or the possibility of confounding for each covariate.Interaction analyses in Cochrane Reviews can be substantially improved. The proposed criteria can be used to help guide the reporting and

Experimental Demonstration of Capacity-Achieving Phase-Shifted Superposition Modulation

DEFF Research Database (Denmark)

Estaran Tolosa, Jose Manuel; Zibar, Darko; Caballero Jambrina, Antonio

2013-01-01

We report on the first experimental demonstration of phase-shifted superposition modulation (PSM) for optical links. Successful demodulation and decoding is obtained after 240 km transmission for 16-, 32- and 64-PSM.......We report on the first experimental demonstration of phase-shifted superposition modulation (PSM) for optical links. Successful demodulation and decoding is obtained after 240 km transmission for 16-, 32- and 64-PSM....

Light drinking versus abstinence in pregnancy - behavioural and cognitive outcomes in 7-year-old children: a longitudinal cohort study.

Science.gov (United States)

Kelly, Y; Iacovou, M; Quigley, M A; Gray, R; Wolke, D; Kelly, J; Sacker, A

2013-10-01

To assess whether light drinking in pregnancy is linked to unfavourable developmental outcomes in children. Prospective population-based cohort. UK. Ten thousand five hundred and thirty-four 7-year-olds. Quasi-experimental using propensity score matching (PSM) to compare children born to light (up to 2 units per week) and non-drinkers. Behavioural difficulties rated by parents and teachers; cognitive test scores for reading, maths and spatial skills. Ordinary least squares (OLS) regression and PSM analyses are presented. For behavioural difficulties, unadjusted estimates for percentage standard deviation (SD) score differences ranged from 2 to 14%. On adjustment for potential confounders, differences were attenuated, with a loss of statistical significance, except for teacher-rated boys' difficulties. For boys, parent-rated behavioural difficulties: unadjusted, -11.5; OLS, -4.3; PSM, -6.8; teacher-rated behavioural difficulties: unadjusted, -13.9; OLS, -9.6; PSM, -10.8. For girls, parent-rated behavioural difficulties: unadjusted, -9.6; OLS, -2.9; PSM, -4.5; teacher-rated behavioural difficulties: unadjusted, -2.4; OLS, 4.9; PSM, 3.9. For cognitive test scores, unadjusted estimates for differences ranged between 12 and 21% of an SD score for reading, maths and spatial skills. After adjustment for potential confounders, estimates were reduced, but remained statistically significantly different for reading and for spatial skills in boys. For boys, reading: unadjusted, 20.9; OLS, 8.3; PSM, 7.3; maths: unadjusted, 14.7; OLS, 5.0; PSM, 6.5; spatial skills: unadjusted, 16.2; OLS, 7.6; PSM, 8.1. For girls, reading: unadjusted, 11.6; OLS, -0.3; PSM, -0.5; maths: unadjusted, 12.9; OLS, 4.3; PSM, 3.9; spatial skills: unadjusted, 16.2; OLS, 7.7; PSM, 6.4. The findings suggest that light drinking during pregnancy is not linked to developmental problems in mid-childhood. These findings support current UK Department of Health guidelines on drinking during pregnancy. © 2013 The

Value added phytoremediation of metal stressed soils using phosphate solubilizing microbial consortium.

Science.gov (United States)

Gupta, Pratishtha; Kumar, Vipin

2017-01-01

The presence of heavy metals in the soil is a matter of growing concern due to their toxic and non-biodegradable nature. Lack of effectiveness of various conventional methods due to economic and technical constraints resulted in the search for an eco-friendly and cost-effective biological techniques for heavy metal removal from the environment. Until now, phytoremediation has emerged as an innovative technique to address the problem. However, the efficiency of phytoremediation process is hindered under the high metal concentration conditions. Hence, phosphate solubilizing microbes (PSM) assisted phytoremediation technique is gaining more insight as it can reduce the contamination load even under elevated metal stressed conditions. These microbes convert heavy metals into soluble and bioavailable forms, which consequently facilitate phytoremediation. Several studies have reported that the use of microbial consortium for remediation is considered more effective as compared to single strain pure culture. Therefore, this review paper focuses on the current trends in research related to PSM mediated uptake of heavy metal by plants. The efficiency of PSM consortia in enhancing the phytoremediation process has also been reviewed. Moreover, the role of phosphatase enzymes in the mineralization of organic forms of phosphate in soil is further discussed. Biosurfactant mediated bioremediation of metal polluted soils is a matter of extensive research nowadays. Hence, the recent advancement of using biosurfactants in enhanced phytoremediation of metal stressed soils is also described.

Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis.

Science.gov (United States)

Anderson, Lindsey; Oldridge, Neil; Thompson, David R; Zwisler, Ann-Dorthe; Rees, Karen; Martin, Nicole; Taylor, Rod S

2016-01-05

Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). The goal of this study is to update the Cochrane systematic review and meta-analysis of exercise-based CR for CHD. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included randomized controlled trials with at least 6 months of follow-up, comparing CR to no-exercise controls following myocardial infarction or revascularization, or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data, and assessed risk of bias. Studies were pooled using random effects meta-analysis, and stratified analyses were undertaken to examine potential treatment effect modifiers. A total of 63 studies with 14,486 participants with median follow-up of 12 months were included. Overall, CR led to a reduction in cardiovascular mortality (relative risk: 0.74; 95% confidence interval: 0.64 to 0.86) and the risk of hospital admissions (relative risk: 0.82; 95% confidence interval: 0.70 to 0.96). There was no significant effect on total mortality, myocardial infarction, or revascularization. The majority of studies (14 of 20) showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects. This study confirms that exercise-based CR reduces cardiovascular mortality and provides important data showing reductions in hospital admissions and improvements in quality of life. These benefits appear to be consistent across patients and intervention types and were independent of study quality, setting, and publication date. Copyright © 2016 American College of Cardiology

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a prospective study.

Science.gov (United States)

da Costa, Bruno R; Beckett, Brooke; Diaz, Alison; Resta, Nina M; Johnston, Bradley C; Egger, Matthias; Jüni, Peter; Armijo-Olivo, Susan

2017-03-03

The Cochrane risk of bias tool is commonly criticized for having a low reliability. We aimed to investigate whether training of raters, with objective and standardized instructions on how to assess risk of bias, can improve the reliability of the Cochrane risk of bias tool. In this pilot study, four raters inexperienced in risk of bias assessment were randomly allocated to minimal or intensive standardized training for risk of bias assessment of randomized trials of physical therapy treatments for patients with knee osteoarthritis pain. Two raters were experienced risk of bias assessors who served as reference. The primary outcome of our study was between-group reliability, defined as the agreement of the risk of bias assessments of inexperienced raters with the reference assessments of experienced raters. Consensus-based assessments were used for this purpose. The secondary outcome was within-group reliability, defined as the agreement of assessments within pairs of inexperienced raters. We calculated the chance-corrected weighted Kappa to quantify agreement within and between groups of raters for each of the domains of the risk of bias tool. A total of 56 trials were included in our analysis. The Kappa for the agreement of inexperienced raters with reference across items of the risk of bias tool ranged from 0.10 to 0.81 for the minimal training group and from 0.41 to 0.90 for the standardized training group. The Kappa values for the agreement within pairs of inexperienced raters across the items of the risk of bias tool ranged from 0 to 0.38 for the minimal training group and from 0.93 to 1 for the standardized training group. Between-group differences in Kappa for the agreement of inexperienced raters with reference always favored the standardized training group and was most pronounced for incomplete outcome data (difference in Kappa 0.52, p training on risk of bias assessment may significantly improve the reliability of the Cochrane risk of bias tool.

Cochrane Qualitative and Implementation Methods Group guidance series-paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings.

Science.gov (United States)

Noyes, Jane; Booth, Andrew; Flemming, Kate; Garside, Ruth; Harden, Angela; Lewin, Simon; Pantoja, Tomas; Hannes, Karin; Cargo, Margaret; Thomas, James

2018-05-01

The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

Trends in Ambulatory Prescribing of Antiplatelet Therapy among US Ischemic Stroke Patients: 2000–2007

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Sudeep Karve

2012-01-01

Full Text Available Objective. Study objectives were to assess temporal trends and identify patient- and practice-level predictors of the prescription of antiplatelet medications in a national sample of ischemic stroke (IS patients seeking ambulatory care. Methods. IS-related outpatient visits by adults were identified using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey for the years 2000–2007. We assessed prescribing of antiplatelet medications using the generic drug code and drug entry codes in these data. Temporal trends in antiplatelet prescribing were assessed using the Cochran-Mantel-Haenszel test for trend. Results. We identified 9.5 million IS-related ambulatory visits. Antiplatelet medications were prescribed at 35.5% of visits. Physician office prescribing of the clopidogrel-aspirin combination increased significantly from 0.5% in 2000 to 22.0% in 2007 (P=0.05, whereas prescribing of aspirin decreased from 17.9% to 7.0% (P=0.50 during the same period. Conclusion. We observed a continued increase in prescription of the aspirin-clopidogrel combination from 2000 to 2007. Clinical trial evidence suggests that the aspirin-clopidogrel combination does not provide any additional benefit compared with clopidogrel alone; however, our study findings indicate that even with lack of adequate clinical evidence physician prescribing of this combination has increased in real-world community settings.

What do Cochrane systematic reviews say about non-pharmacological interventions for treating cognitive decline and dementia?

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Vitória Carvalho Vilela

Full Text Available ABSTRACT BACKGROUND: Dementia is a highly prevalent condition worldwide. Its chronic and progressive presentation has an impact on physical and psychosocial characteristics and on public healthcare. Our aim was to summarize evidence from Cochrane reviews on non-pharmacological treatments for cognitive disorders and dementia. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: Cochrane reviews on non-pharmacological interventions for cognitive dysfunctions and/or type of dementia were included. For this, independent assessments were made by two authors. RESULTS: Twenty-four reviews were included. These showed that carbohydrate intake and validation therapy may be beneficial for cognitive disorders. For dementia, there is a potential benefit from physical activity programs, cognitive training, psychological treatments, aromatherapy, light therapy, cognitive rehabilitation, cognitive stimulation, hyperbaric oxygen therapy in association with donepezil, functional analysis, reminiscence therapy, transcutaneous electrical stimulation, structured decision-making on feeding options, case management approaches, interventions by non-specialist healthcare workers and specialized care units. No benefits were found in relation to enteral tube feeding, acupuncture, Snoezelen stimulation, respite care, palliative care team and interventions to prevent wandering behavior. CONCLUSION: Many non-pharmacological interventions for patients with cognitive impairment and dementia have been studied and potential benefits have been shown. However, the strength of evidence derived from these studies was considered low overall, due to the methodological limitations of the primary studies.

Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews.

Science.gov (United States)

Shepherd, Emily; Salam, Rehana A; Middleton, Philippa; Makrides, Maria; McIntyre, Sarah; Badawi, Nadia; Crowther, Caroline A

2017-08-08

Cerebral palsy is an umbrella term encompassing disorders of movement and posture, attributed to non-progressive disturbances occurring in the developing fetal or infant brain. As there are diverse risk factors and causes, no one strategy will prevent all cerebral palsy. Therefore, there is a need to systematically consider all potentially relevant interventions for their contribution to prevention. To summarise the evidence from Cochrane reviews regarding the effects of antenatal and intrapartum interventions for preventing cerebral palsy. We searched the Cochrane Database of Systematic Reviews on 7 August 2016, for reviews of antenatal or intrapartum interventions reporting on cerebral palsy. Two authors assessed reviews for inclusion, extracted data, assessed review quality, using AMSTAR and ROBIS, and quality of the evidence, using the GRADE approach. We organised reviews by topic, and summarised findings in text and tables. We categorised interventions as effective (high-quality evidence of effectiveness); possibly effective (moderate-quality evidence of effectiveness); ineffective (high-quality evidence of harm or of lack of effectiveness); probably ineffective (moderate-quality evidence of harm or of lack of effectiveness); and no conclusions possible (low- to very low-quality evidence). We included 15 Cochrane reviews. A further 62 reviews pre-specified the outcome cerebral palsy in their methods, but none of the included randomised controlled trials (RCTs) reported this outcome. The included reviews were high quality and at low risk of bias. They included 279 RCTs; data for cerebral palsy were available from 27 (10%) RCTs, involving 32,490 children. They considered interventions for: treating mild to moderate hypertension (two) and pre-eclampsia (two); diagnosing and preventing fetal compromise in labour (one); preventing preterm birth (four); preterm fetal maturation or neuroprotection (five); and managing preterm fetal compromise (one). Quality of

Public Service Motivation Differences BetweenPermanent and Contract Employees in the Local Government

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Wayu Eko Yudiatmaja

2017-12-01

Full Text Available This article examines the distinction of public service motivation (PSM on street-level bureaucracy in Indonesia. Focus of this study is to review the differentiation of public service motivation between permanent and contract employees in sub-districts of Tanjungpinang, Kepulauan Riau. The dimensions and indicators of Perry’s (1996 measurement of PSM is used to analyze the differentiation of public service motivation between permanent and contract employees. Independent sampel t-test has employed to 129 government employees and 74 non-government employees in Tanjungpinang. Unlike in developed countries that PSM of its civil services are higher than PSM of contract employees, the findings of this research proves that there is no differences between PSM of permanent and contract employees. The findings of this research rejects the conclusion of foreign scholars suggesting the PSM construct was viable for internationally environment.

Emotional labour strategies as mediators of the relationship between public service motivation and job satisfaction in Chinese teachers.

Science.gov (United States)

Li, Mingjun; Wang, Zhenhong

2016-06-01

The purpose of this study was to examine the relationship between teachers' public service motivation (PSM) and their job satisfaction levels and to investigate the mediating effects of surface acting (SA) and deep acting (DA) on that relationship. The teacher PSM scale, as well as emotional labour strategies and intrinsic satisfaction (IS) and extrinsic satisfaction (ES) scales, were administered to 317 primary and middle school teachers. Results indicated that PSM among Chinese teachers was significantly and positively related to both IS and ES. Furthermore, structural equation modelling analysis showed that SA and DA played mediating roles in the PSM-IS and PSM-ES relationships, respectively. These findings provide a new perspective that explains the mechanism underlying the association between PSM among teachers and their job satisfaction levels. Finally, the possible explanations and implications are discussed. © 2014 International Union of Psychological Science.

Algorithms and Public Service Media

DEFF Research Database (Denmark)

Sørensen, Jannick Kirk; Hutchinson, Jonathon

2018-01-01

When Public Service Media (PSM) organisations introduce algorithmic recommender systems to suggest media content to users, fundamental values of PSM are challenged. Beyond being confronted with ubiquitous computer ethics problems of causality and transparency, also the identity of PSM as curator...

Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis

DEFF Research Database (Denmark)

Kamper, S.J.; Apeldoorn, A.T.; Chiarotto, A.

2015-01-01

Objective To assess the long term effects of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain. Design Systematic review and random effects meta-analysis of randomised controlled trials. Data sources Electronic searches of Cochrane Back Review Group Trials...... usual care (moderate quality evidence) and physical treatments (low quality evidence) in decreasing pain and disability in people with chronic low back pain. For work outcomes, multidisciplinary rehabilitation seems to be more effective than physical treatment but not more effective than usual care....... Register, CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to February 2014, supplemented by hand searching of reference lists and forward citation tracking of included trials. Study selection criteria Trials published in full; participants with low back pain for more than three months...

Training practitioners in preparing systematic reviews: a cross-sectional survey of participants in the Australasian Cochrane Centre training program

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Silagy Chris

2002-06-01

Full Text Available Abstract Background Although systematic reviews of health care interventions are an invaluable tool for health care providers and researchers, many potential authors never publish reviews. This study attempts to determine why some people with interest in performing systematic reviews do not subsequently publish a review; and what steps could possibly increase review completion. Methods Cross-sectional survey by email and facsimile of the 179 participants in Australasian Cochrane Centre training events between 1998 and 2000. Results Ninety-two participants responded to the survey (51 percent. Response rate of deliverable surveys was 82 percent (92/112. The remainder of the participants had invalid or no contact information on file. More than 75 percent of respondents felt that the current workshops met their needs for training. The most critical barriers to completion of a Cochrane review were: lack of time (80 percent, lack of financial support (36 percent, methodological problems (23 percent and problems with group dynamics (10 percent. Conclusions Strategies to protect reviewer time and increase the efficiency of the review process may increase the numbers of trained reviewers completing a systematic review.

Porovnání efektivnosti měření cenové citlivosti u nových a zavedených značek

Directory of Open Access Journals (Sweden)

Elena Salamandic

2015-03-01

Full Text Available Purpose of the article: The Price Sensitivity Measurement (PSM evaluates consumers’ expectations to set the optimal price. Applied to a brand’s different lifecycle stages, it can show different feasibility. The aim of this paper is showing that PSM is more effective for newly introduced brand products compared to established ones. Methodology: The difference in PSM effectiveness is tested for a newly introduced Lithuanian cosmetics brand, Ziede, and a well-known vitamin distributor brand, Jamieson. The authors selected 3 products, based on product category, consumer segment and product lifecycle stage. PSM was applied for different consumer categories by differentiating respondents who were familiar with the brands from those who weren’t. Scientific aim: Empirical results show that optimal prices are higher for brand-familiar consumers, since they incorporate the brand value in their perception of optimal price (Salamandic, Alijosiene, Gudonaviciene, 2014. However, as the brand moves along the lifecycle stages, the price perceived by consumers as optimal moves closer to the actual market price. The scientific problem is to find how to reach maximum effectiveness of PSM when setting the optimal price. Findings: Empirical research confirmed two important recommendations for PSM applications. Firstly, since price sensitivity decreases with increasing brand awareness, PSM should be applied for different consumer categories. Secondly, product lifecycle advances together with brand awareness; therefore, PSM is more effective for newly introduced brand products. Conclusions: By comparing PSM feasibility for new vs. established brands, it was obtained that PSM is more effective when applied at the early stage of a brand’s lifecycle. Mispricing is detected more accurately when information is collected from more respondents who are unfamiliar with the brand, which happens more often when the brand is newly introduced. To avoid future losses, price

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

OpenAIRE

Jayaraman, Srinivasan

2015-01-01

The failure of dental implant can occurs at the preoperative planning stage, at the surgical stage, and at the postoperative stage. The success of this treatment can be increased if the clinical implant practice guidelines are prepared based on the recommendations from the highest level of research evidence (i.e.,) from systematic review of randomized controlled trials (RCTs) with meta-analysis. The Cochrane reviews of interventions are basically systematic reviews of RCTs with meta-analysis ...

The strong anti-glioblastoma capacity of the plasma-stimulated lysine-rich medium

International Nuclear Information System (INIS)

Yan, Dayun; Keidar, Michael; Nourmohammadi, Niki; Talbot, Annie; Sherman, Jonathan H

2016-01-01

Plasma-stimulated medium (PSM) shows a remarkable anti-cancer capacity as strong as the direct cold atmospheric plasma (CAP) treatment of cancer cells. PSM is able to effectively resist the growth of several cancer cell lines. To date, the sole approach to strengthen the anti-cancer capacity of PSM is extending the plasma treatment time. In this study, we demonstrated that the anti-glioblastoma capacity of PSM could be significantly increased by adding 20 mM lysine in Dulbecco’s modified Eagle’s medium (DMEM). This study provides clear evidence that the anti-glioblastoma capacity of PSM could be noticeably enhanced by modifying the composition of medium without increasing the CAP treatment time. (paper)

Radical prostatectomy: positive surgical margins matter.

Science.gov (United States)

Meeks, Joshua J; Eastham, James A

2013-10-01

A positive surgical margin (PSM) in the radical prostatectomy (RP) specimen is associated with biochemical recurrence (BCR) and the need for adjuvant radiation therapy, and is a surrogate for surgical quality. We review the available data describing the identification, anatomy, and management of PSM after RP. A PubMed search (using English language as a filter) was performed to identify factors affecting PSMs and their management. PSMs are associated with an increased likelihood of BCR after RP. The most common location for a PSM is the apex, followed by the posterolateral edge of the prostate. The risk of recurrence in a patient with a PSM is associated with the location, length, and Gleason score of the PSM. The management of a patient with a PSM remains controversial, with some recommending adjuvant radiation therapy for all PSMs and others suggesting only salvage radiation therapy for men who experience BCR. PSMs are associated with an increased likelihood of BCR and often result in initiation of adjuvant treatment. Therefore, the goal of surgery should be to minimize the likelihood of a PSM. Copyright © 2013 Elsevier Inc. All rights reserved.

Systematic Review of Studies Reporting Positive Surgical Margins After Bladder Neck Sparing Radical Prostatectomy.

Science.gov (United States)

Bellangino, Mariangela; Verrill, Clare; Leslie, Tom; Bell, Richard W; Hamdy, Freddie C; Lamb, Alastair D

2017-11-07

Bladder neck preservation (BNP) during radical prostatectomy (RP) has been proposed as a method to improve early recovery of urinary continence after radical prostatectomy. However, there is concern over a possible increase in the risk of positive surgical margins and prostate cancer recurrence rate. A recent systematic review and meta-analysis reported improved early recovery and overall long-term urinary continence without compromising oncologic control. The aim of our study was to perform a critical review of the literature to assess the impact on bladder neck and base margins after bladder neck sparing radical prostatectomy. We carried out a systematic review of the literature using Pubmed, Scopus and Cochrane library databases in May 2017 using medical subject headings and free-text protocol according to PRISMA guidelines. We used the following search terms: bladder neck preservation, prostate cancer, radical prostatectomy and surgical margins. Studies focusing on positive surgical margins (PSM) in bladder neck sparing RP pertinent to the objective of this review were included. Overall, we found 15 relevant studies reporting overall and site-specific positive surgical margins rate after bladder neck sparing radical prostatectomy. This included two RCTs, seven prospective comparative studies, two retrospective comparative studies and four case series. All studies were published between 1993 and 2015 with sample sizes ranging between 50 and 1067. Surgical approaches included open, laparoscopic and robot-assisted radical prostatectomy. The overall and base-specific PSM rates ranged between 7-36% and 0-16.3%, respectively. Mean base PSM was 4.9% in those patients where bladder neck sparing was performed, but only 1.85% in those without sparing. Bladder neck preservation during radical prostatectomy may increase base-positive margins. Further studies are needed to better investigate the impact of this technique on oncological outcomes. A future paradigm could

Service Engagement in Interventions for Street-Connected Children and Young People: A Summary of Evidence Supplementing a Recent Cochrane-Campbell Review

Science.gov (United States)

Hossain, Rosa; Coren, Esther

2015-01-01

Background: This paper builds on a Cochrane-Campbell systematic review of interventions that reduce harms and promote reintegration in street-connected children and young people focusing on intervention outcomes. The aim of the present analysis is to explore questions raised in the systematic review over the potential role of service engagement in…

Manipulation in political stock markets: Preconditions and evidence

OpenAIRE

Hansen, Jan; Schmidt, Carsten; Strobel, Martin

2001-01-01

Political stock markets (PSM) are sometimes seen as substitutes for opinion polls. On the bases of a behavioral model, specific preconditions were drawn out under which manipulation in PSM can weaken this argument. Evidence for manipulation is reported from the data of two separate PSM during the Berlin 99 state elections.

A fluorescent colorimetric pH sensor and the influences of matrices on sensing performances

Science.gov (United States)

Tian, Yanqing; Fuller, Emily; Klug, Summer; Lee, Fred; Su, Fengyu; Zhang, Liqiang; Chao, Shih-hui; Meldrum, Deirdre R.

2013-01-01

A fluorescent colorimetric pH sensor was developed by a polymerization of a monomeric fluorescein based green emitter (SM1) with a monomeric 2-dicyanomethylene-3-cyano-4,5,5-trimethyl-2,5-dihydrofuran derived red emitter (SM2) in poly(2-hydroxyethyl methacrylate)-co-polyacrylamide (PHEMA-co-PAM) matrices. Polymerized SM1 (PSM1) in the polymer matrices showed bright emissions at basic conditions and weak emissions at acidic conditions. Polymerized SM2 (PSM2) in the polymer matrices exhibited a vastly different response when compared to PSM1. The emissions of PSM2 are stronger under acidic conditions than those under basic conditions. When SM1 and SM2 were polymerized in the same polymer matrix, a dual emission sensor acting as a ratiometric pH sensor (PSM1,2) was successfully developed. Because the PSM1 and PSM2 exhibited different pH responses and separated emission windows, the changes in the emission colors were clearly observed in their dual color sensor of PSM1,2, which changed emission colors dramatically from green at pH 7 to red at pH 4, which was detected visually and/or by using a color camera under an excitation of 488 nm. In addition to the development of the dual color ratiometric pH sensor, we also studied the effects of different matrix compositions, crosslinkers, and charges on the reporting capabilities of the sensors (sensitivity and pKa). PMID:24078772

A fluorescent colorimetric pH sensor and the influences of matrices on sensing performances.

Science.gov (United States)

Tian, Yanqing; Fuller, Emily; Klug, Summer; Lee, Fred; Su, Fengyu; Zhang, Liqiang; Chao, Shih-Hui; Meldrum, Deirdre R

2013-10-01

A fluorescent colorimetric pH sensor was developed by a polymerization of a monomeric fluorescein based green emitter ( SM1 ) with a monomeric 2-dicyanomethylene-3-cyano-4,5,5-trimethyl-2,5-dihydrofuran derived red emitter ( SM2 ) in poly(2-hydroxyethyl methacrylate)- co -polyacrylamide (PHEMA-co-PAM) matrices. Polymerized SM1 ( PSM1 ) in the polymer matrices showed bright emissions at basic conditions and weak emissions at acidic conditions. Polymerized SM2 ( PSM2 ) in the polymer matrices exhibited a vastly different response when compared to PSM1 . The emissions of PSM2 are stronger under acidic conditions than those under basic conditions. When SM1 and SM2 were polymerized in the same polymer matrix, a dual emission sensor acting as a ratiometric pH sensor ( PSM1,2 ) was successfully developed. Because the PSM1 and PSM2 exhibited different pH responses and separated emission windows, the changes in the emission colors were clearly observed in their dual color sensor of PSM1,2 , which changed emission colors dramatically from green at pH 7 to red at pH 4, which was detected visually and/or by using a color camera under an excitation of 488 nm. In addition to the development of the dual color ratiometric pH sensor, we also studied the effects of different matrix compositions, crosslinkers, and charges on the reporting capabilities of the sensors (sensitivity and p K a ).

Middle Eastern Geographies of World War I

Science.gov (United States)

2010-05-21

and ill-equipped forces. Within this atmosphere of persecution and economic depression caused by the war’s stoppage of religious pilgrimages...St. J.B. Armitage, "T.E. Lawrence: a centennial lecture," Asian Affairs 20, no. 1 (1989): 14. This Turkish offensive severely threatened the...British invade Syria. The Arabs working from Akaba became virtually the 163 St. J.B. Armitage, “Lawrence: a centennial lecture,” 18. 164 Wavell

Public Service Motivation and Employment Sector: Attraction or Socialization?

DEFF Research Database (Denmark)

Kjeldsen, Anne Mette; Jacobsen, Christian Bøtcher

2013-01-01

Numerous studies have shown that public service motivation (PSM) is positively associated with public sector employment. However, the question of whether PSM influences or is influenced by employment decisions remains open, since previous studies have mostly relied on cross-sectional samples...... with experienced employees. This article investigates the relationship between PSM and employment sector in pre-entry and post-entry settings using data from a panel of Danish physiotherapy students surveyed before and after their first job in the public or private sector. The analyses show that PSM is neither...

Dynamics of Public Service Motivation: Attraction, Selection, and Socialization in the Production and Regulation of Social Services

DEFF Research Database (Denmark)

Kjeldsen, Anne Mette

2014-01-01

The literature on public service motivation (PSM) has typically focused on the relationship between this motivation and public/private sector of employment, while the character of the work being performed has been neglected. Through panel surveys with pre- and post-entry measures of PSM among...... that the PSM profiles of social work students predict their preference for one of the two types of work tasks, but do not predict first employment in the preferred job. Conversely, post-entry shifts in social workers’ PSM profiles result from a complex interplay between influences from both work task...

Activating the Forces of Public Service Motivation

DEFF Research Database (Denmark)

Pedersen, Mogens Jin

2015-01-01

Employees with higher public service motivation (PSM) are likely to perform better in public service jobs. However, research on how practitioners may capitalize on this knowledge is sparse. This article expands the understanding of how to activate employee PSM, which is understood as a human...... resource that is present in the work environment. Using a randomized survey experiment with 528 law students, this article shows how low-intensity treatments may activate PSM and how the effect of PSM activation efforts compares with efforts to activate another, less self-determined type of motivation...

User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews.

Science.gov (United States)

Rosenbaum, Sarah E; Glenton, Claire; Nylund, Hilde Kari; Oxman, Andrew D

2010-06-01

To develop a Summary of Findings (SoF) table for use in Cochrane reviews that is understandable and useful for health professionals, acceptable to Cochrane Collaboration stakeholders, and feasible to implement. We gathered stakeholder feedback on the format and content of an SoF table from an advisory group of more than 50 participants and their constituencies through e-mail consultations. We conducted user tests using a think-aloud protocol method, collecting feedback from 21 health professionals and researchers in Norway and the UK. We analyzed the feedback, defined problem areas, and generated new solutions in brainstorming workshops. Stakeholders were concerned about precision in the data representation and about production feasibility. User testing revealed unexpected comprehension problems, mainly confusion about what the different numbers referred to (class reference). Resolving the tension between achieving table precision and table simplicity became the main focus of the working group. User testing led to a table more useful and understandable for clinical audiences. We arrived at an SoF table that was acceptable to the stakeholders and in principle feasible to implement technically. Some challenges remain, including presenting continuous outcomes and technical/editorial implementation.

Herbal Medicine for Low Back Pain: A Cochrane Review.

Science.gov (United States)

Gagnier, Joel J; Oltean, Hanna; van Tulder, Maurits W; Berman, Brian M; Bombardier, Claire; Robbins, Christopher B

2016-01-01

Systematic review of randomized controlled trials (RCTs). To determine the effectiveness of herbal medicine for nonspecific low back pain (LBP). Many people with chronic LBP use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in treating people with LBP. This is an update of a Cochrane Review first published in 2006. We searched numerous electronic databases up to September 2014; checked reference lists in review articles, guidelines and retrieved trials; and personally contacted individuals with expertise in this area. We included RCTs examining adults (over 18 years of age) suffering from acute, sub-acute, or chronic nonspecific LBP. The interventions were herbal medicines that we defined as plants used for medicinal purposes in any form. Primary outcome measures were pain and function. Two review authors assessed risk of bias, GRADE criteria (GRADE 2004), and CONSORT compliance and a random subset were compared with assessments by a third individual. Two review authors assessed clinical relevance and resolved any disagreements by consensus. Fourteen RCTs (2050 participants) were included. Capsicum frutescens (cayenne) reduces pain more than placebo. Although Harpagophytum procumbens (devil's claw), Salix alba (white willow bark), Symphytum officinale L. (comfrey), Solidago chilensis (Brazilian arnica), and lavender essential oil also seem to reduce pain more than placebo, evidence for these substances was of moderate quality at best. No significant adverse events were noted within the included trials. Additional well-designed large trials are needed to test these herbal medicines against standard treatments. In general, the completeness of reporting in these trials was poor. Trialists should refer to the CONSORT statement extension for reporting trials of herbal medicine interventions. N/A.

Socioeconomic disparities in maternity care among Indian adolescents, 1990-2006.

Directory of Open Access Journals (Sweden)

Chandan Kumar

Full Text Available BACKGROUND: India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010; and adolescent (aged 15-19 mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG-5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15-19 in India during 1990-2006. METHODS AND FINDINGS: Data from three rounds of the National Family Health Survey of India conducted during 1992-93, 1998-99, and 2005-06 were analyzed. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends were applied, respectively, to understand the trend in the proportion of adolescent mothers utilizing select maternity care services during 1990-2006. Using pooled multivariate logistic regression models, the probability of select maternal healthcare utilization among women by key socioeconomic characteristics was appraised. After adjusting for potential socio-demographic and economic characteristics, the likelihood of adolescents accessing full antenatal care increased by only 4% from 1990 to 2006. However, the probability of adolescent women availing themselves of professional attendance at delivery increased by 79% during the same period. The study also highlights the desolate disparities in maternity care services among adolescents across the most and the least favoured groups. CONCLUSION: Maternal care interventions in India need focused programs for rural, uneducated, poor adolescent women so that they can avail themselves of measures to delay child bearing, and for better antenatal consultation and delivery care in case of pregnancy. This study strongly advocates the promotion of a comprehensive 'adolescent scheme' along the lines of 'Continuum of Maternal, Newborn and Child

From Product Models to Product State Models

DEFF Research Database (Denmark)

Larsen, Michael Holm

1999-01-01

A well-known technology designed to handle product data is Product Models. Product Models are in their current form not able to handle all types of product state information. Hence, the concept of a Product State Model (PSM) is proposed. The PSM and in particular how to model a PSM is the Research...

Chemical process hazards analysis

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-02-01

The Office of Worker Health and Safety (EH-5) under the Assistant Secretary for the Environment, Safety and Health of the US Department (DOE) has published two handbooks for use by DOE contractors managing facilities and processes covered by the Occupational Safety and Health Administration (OSHA) Rule for Process Safety Management of Highly Hazardous Chemicals (29 CFR 1910.119), herein referred to as the PSM Rule. The PSM Rule contains an integrated set of chemical process safety management elements designed to prevent chemical releases that can lead to catastrophic fires, explosions, or toxic exposures. The purpose of the two handbooks, ``Process Safety Management for Highly Hazardous Chemicals`` and ``Chemical Process Hazards Analysis,`` is to facilitate implementation of the provisions of the PSM Rule within the DOE. The purpose of this handbook ``Chemical Process Hazards Analysis,`` is to facilitate, within the DOE, the performance of chemical process hazards analyses (PrHAs) as required under the PSM Rule. It provides basic information for the performance of PrHAs, and should not be considered a complete resource on PrHA methods. Likewise, to determine if a facility is covered by the PSM rule, the reader should refer to the handbook, ``Process Safety Management for Highly Hazardous Chemicals`` (DOE- HDBK-1101-96). Promulgation of the PSM Rule has heightened the awareness of chemical safety management issues within the DOE. This handbook is intended for use by DOE facilities and processes covered by the PSM rule to facilitate contractor implementation of the PrHA element of the PSM Rule. However, contractors whose facilities and processes not covered by the PSM Rule may also use this handbook as a basis for conducting process hazards analyses as part of their good management practices. This handbook explains the minimum requirements for PrHAs outlined in the PSM Rule. Nowhere have requirements been added beyond what is specifically required by the rule.

An Algorithmic Diversity Diet?

DEFF Research Database (Denmark)

Sørensen, Jannick Kirk; Schmidt, Jan-Hinrik

2016-01-01

With the growing influence of personalized algorithmic recommender systems on the exposure of media content to users, the relevance of discussing the diversity of recommendations increases, particularly as far as public service media (PSM) is concerned. An imagined implementation of a diversity...... diet system however triggers not only the classic discussion of the reach – distinctiveness balance for PSM, but also shows that ‘diversity’ is understood very differently in algorithmic recommender system communities than it is editorially and politically in the context of PSM. The design...... of a diversity diet system generates questions not just about editorial power, personal freedom and techno-paternalism, but also about the embedded politics of recommender systems as well as the human skills affiliated with PSM editorial work and the nature of PSM content....

Public Service Motivation and Attraction to Public Versus Private Sector Employment

DEFF Research Database (Denmark)

Pedersen, Mogens Jin

2013-01-01

of economics, political science, and law, this article tests (1) the relationship between PSM and attraction to public versus private sector employment, and (2) the moderating effect on this relationship of students’ academic field of study (i.e., their profession once graduated). Overall, results underscore...... the multidimensionality of the PSM construct, as the PSM dimension of “public interest” is positively associated with attraction to public sector employment and negatively associated with attraction to private sector employment, while the PSM dimension of “compassion” is unrelated to both. Importantly, however......Despite extensive public service motivation (PSM) research, our knowledge of PSM’s influence on individuals’ sector employment preferences is limited. Few studies examine this relationship by suitable research designs and the empirical findings are mixed. Using a sample of 718 Danish students...

The relationship between physical activity level and completion rate of small bowel examination in patients undergoing capsule endoscopy.

Science.gov (United States)

Shibuya, Tomoyoshi; Mori, Hiroki; Takeda, Tsutomu; Konishi, Masae; Fukuo, Yuka; Matsumoto, Kenshi; Beppu, Kazuko; Sakamoto, Naoto; Osada, Taro; Nagahara, Akihito; Otaka, Michiro; Ogihara, Tatsuo; Watanabe, Sumio

2012-01-01

Capsule endoscopy (CE) allows direct examination of the small bowel in a safe, noninvasive and well-tolerated manner. Nonetheless, experience indicates failure to reach the cecum in 20-30% of patients within the 8 hour battery life. Attempts to improve the completion rate (CR) as defined by reaching the cecum have been unsuccessful. This study was to investigate the relationship between patients' physical activity and CR. Between January 2009 and January 2010, 76 patients (44 men, 32 women; median age 64.5 yr) underwent CE for the diagnosis of small intestinal disorders. Indications for CE were obscure gastrointestinal bleeding/anemia (62 cases), others (14 cases). Patients were divided into an outpatient group (n=23), mild bed rest group (n=35) and strict bed rest group (n=18). For all patients, the average gastric transit time was 65.5 minutes, small bowel transit time was 301.4 minutes and the CR was 86.8%. However, the CR was 100% (23/23) in the outpatient group, an 85.7% (30/35) in the mild bed rest group, and 72.2% (13/18) in the strict bed rest group. The CR increased with physical activity of patients by Cochran-Armitage Trend Test (p=0.009). In multivariate logistic regression analyses, low physical activity was a significant risk factor for failure to reach the cecum during CE examination; adjusted OR: 3.39, 95% CI: 1.01-11.42 (p=0.048). Our observations suggested that increasing physical activity would increase the likelihood of a complete bowel examination by CE. Further, for CE, inconvenient bowel preparations like the use of polyethylene glycol may be avoided.

Efficacy and safety of intravenous daptomycin in Japanese patients with skin and soft tissue infections.

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Aikawa, Naoki; Kusachi, Shinya; Mikamo, Hiroshige; Takesue, Yoshio; Watanabe, Shinichi; Tanaka, Yoshiyuki; Morita, Akiko; Tsumori, Keiko; Kato, Yoshiaki; Yoshinari, Tomoko

2013-06-01

Daptomycin is a lipopeptide antibiotic active against gram-positive organisms and recently approved for marketing in Japan. This study investigates the efficacy and safety of daptomycin in Japanese patients with skin and soft tissue infections (SSTIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) for regulatory filing in Japan. Overall, 111 Japanese patients with SSTI were randomized in this open-label, randomized, active-comparator controlled, parallel-group, multicenter, phase III study. Patients received intravenous daptomycin 4 mg/kg once daily or vancomycin 1 g twice daily for 7-14 days. Efficacy was determined by a blinded Efficacy Adjudication Committee. Among patients with SSTIs caused by MRSA, 81.8 % (95 % CI, 69.1-90.9) of daptomycin recipients and 84.2 % (95 % CI, 60.4-96.6) of vancomycin recipients achieved a successful clinical response at the test-of-cure (TOC) visit. The microbiological success rate against MRSA at the TOC visit was 56.4 % (95 % CI, 42.3-69.7) with daptomycin and 47.4 % (95 % CI, 24.4-71.1) with vancomycin. Daptomycin was generally well tolerated; most adverse events were of mild to moderate severity. The measurement of daptomycin concentration in plasma revealed that patients with mild or moderate impaired renal function showed similar pharmacokinetics profiles to patients with normal renal function. Clinical and microbiological responses, stratified by baseline MRSA susceptibility, suggested that patients infected with MRSA of higher daptomycin MIC showed a trend of lower clinical success with a P value of 0.052 by Cochran-Armitage test. Daptomycin was clinically and microbiologically effective for the treatment of MRSA-associated SSTIs in Japanese patients.

Relationship between consecutive deterioration of mean deviation value and progression of visual field defect in open-angle glaucoma.

Science.gov (United States)

Naito, Tomoko; Yoshikawa, Keiji; Mizoue, Shiro; Nanno, Mami; Kimura, Tairo; Suzumura, Hirotaka; Takeda, Ryuji; Shiraga, Fumio

2015-01-01

To analyze the relationship between consecutive deterioration of mean deviation (MD) value and glaucomatous visual field (VF) progression in open-angle glaucoma (OAG), including primary OAG and normal tension glaucoma. The subjects of the study were patients undergoing treatment for OAG who had performed VF tests at least 10 times with a Humphrey field analyzer (SITA standard, C30-2 program). The VF progression was defined by a significantly negative MD slope (MD slope worsening) at the final VF test during the follow-up period. The relationship between the MD slope worsening and the consecutive deterioration of MD value were retrospectively analyzed. A total of 165 eyes of 165 patients were included in the analysis. Significant progression of VF defects was observed in 72 eyes of 72 patients (43.6%), while no significant progression was evident in 93 eyes of 93 patients (56.4%). There was significant relationship between the frequency of consecutive deterioration of MD value and MD slope worsening (P<0.0001, Cochran-Armitage trend test). A significant association was observed for MD slope worsening in the eyes with three (odds ratio: 2.1, P=0.0224) and four (odds ratio: 3.6, P=0.0008) consecutive deterioration of MD value in multiple logistic regression analysis, but no significant association in the eyes with two consecutive deterioration (odds ratio: 1.1, P=0.8282). The eyes with VF progression had significantly lower intraocular pressure reduction rate (P<0.01). This retrospective study has shown that three or more consecutive deterioration of MD value might be a predictor to future significant MD slope worsening in OAG.

Efforts to reduce the disparity between permanent residents and temporary migrants: Stop TB experiences in Shanghai, China.

Science.gov (United States)

Lu, Hui; Chen, Jing; Wang, Wei; Wu, Laiwa; Shen, Xin; Yuan, Zhengan; Yan, Fei

2015-08-01

Eight of 17 districts of Shanghai have offered transportation and living allowances subsidies to patients with tuberculosis (TB) among the migrant population. The study aimed to assess the impact of the subsidising initiative on the treatment success rate (TSR) and identify the social determinants of treatment outcomes. The participants included 7072 residents and 5703 migrants who were registered in the TB Information Management System with smear-positive pulmonary TB from January 2006 to December 2010. The Cochran-Armitage test was employed to test the trends of TSR and logistic regressions to identify the factors associated with treatment outcome. Without subsidies, migrant TB cases had lower odds of successful treatment [OR = 0.20 (95% CI 0.18-0.23)] than resident cases. Subsidisation was associated with a 65% increased odds ratio of success [1.65 (1.40-1.95)] among migrant cases. The TSR has stabilised at 87% for both permanent residents and temporary migrants since 2009. Living in districts with a population density ≥20,000/km(2) was associated with a low odds ratio [0.42 (0.26-0.68)] among resident cases, whereas among migrant cases those living in districts out of central downtown had a higher odds ratio of treatment success [peripheral downtown: 1.73 (1.36-2.20), suburban: 1.69 (1.16-2.46)]. The TB cases in districts with 2.0-2.9 TB specialists/100 cases had a higher odds ratio [2.99 (1.91-4.69)] of successful treatment than cases from districts with fewer specialists. Besides free medical services, transport and living allowance subsidies to migrant patients with TB improved the treatment outcome significantly. © 2015 John Wiley & Sons Ltd.

Assessing Correlation of Residency Applicants' Interview Dates With Likelihood of Matching.

Science.gov (United States)

Avasarala, Sameer; Thompson, Elizabeth; Whitehouse, Sarah; Drake, Sean

2018-02-01

This study aimed to determine whether the timing of an interview relative to the recruitment season was associated with being ranked or matched at an academic medical center. Eleven specialties (anesthesiology, diagnostic radiology, emergency medicine, family medicine, general surgery, internal medicine, neurology, neurosurgery, obstetrics-gynecology, orthopedic surgery, and psychiatry) that participated in the National Resident Matching Program were included in the study. Each program's total number of interview days during the October 2014-January 2015 interview season were divided equally into three interview time periods. The Cochran-Armitage trend test was used to evaluate associations among the three interview time periods (early, middle, and late) and interviewee outcomes (ranked or matched at our institution) for all subjects combined for each of the 11 programs and for specialty groups (medical, surgical, and hospital). Of 1034 applicants included in the analyses, 60% were men. Most were graduated from US medical schools (59.8%; a total of 103 applicants obtained first-year training positions through the Match [95.4% combined fill rate]). Twenty-nine interviewed early, 38 in the middle, and 36 in the late period ( P = 0.3877). A total of 864 applicants were ranked by 1 of the 11 residency programs at the study site: 267 in the early period, 319 in the middle, and 278 in the late period ( P = 0.4184). Being ranked in association with specialty classification also showed no significant differences. Interview timing had no relation to the likelihood of a match or being ranked by 1 of the 11 programs studied at our institution. These findings help dispel misconceptions about the importance of the interview date for a successful match.

Characteristics of meta-analyses and their component studies in the Cochrane Database of Systematic Reviews: a cross-sectional, descriptive analysis

Directory of Open Access Journals (Sweden)

Davey Jonathan

2011-11-01

Full Text Available Abstract Background Cochrane systematic reviews collate and summarise studies of the effects of healthcare interventions. The characteristics of these reviews and the meta-analyses and individual studies they contain provide insights into the nature of healthcare research and important context for the development of relevant statistical and other methods. Methods We classified every meta-analysis with at least two studies in every review in the January 2008 issue of the Cochrane Database of Systematic Reviews (CDSR according to the medical specialty, the types of interventions being compared and the type of outcome. We provide descriptive statistics for numbers of meta-analyses, numbers of component studies and sample sizes of component studies, broken down by these categories. Results We included 2321 reviews containing 22,453 meta-analyses, which themselves consist of data from 112,600 individual studies (which may appear in more than one meta-analysis. Meta-analyses in the areas of gynaecology, pregnancy and childbirth (21%, mental health (13% and respiratory diseases (13% are well represented in the CDSR. Most meta-analyses address drugs, either with a control or placebo group (37% or in a comparison with another drug (25%. The median number of meta-analyses per review is six (inter-quartile range 3 to 12. The median number of studies included in the meta-analyses with at least two studies is three (inter-quartile range 2 to 6. Sample sizes of individual studies range from 2 to 1,242,071, with a median of 91 participants. Discussion It is clear that the numbers of studies eligible for meta-analyses are typically very small for all medical areas, outcomes and interventions covered by Cochrane reviews. This highlights the particular importance of suitable methods for the meta-analysis of small data sets. There was little variation in number of studies per meta-analysis across medical areas, across outcome data types or across types of

Associations among body condition score, body weight, and reproductive performance in seasonal-calving dairy cattle.

Science.gov (United States)

Roche, J R; Macdonald, K A; Burke, C R; Lee, J M; Berry, D P

2007-01-01

The objective of the present study was to identify and quantify relationships between body condition score (BCS) and body weight (BW) in dairy cows with reproduction variables in pasture-based, seasonal-calving dairy herds. Over 2,500 lactation records from 897 spring-calving Holstein-Friesian dairy cows were used in the analyses. Eleven BCS- and 11 BW-related variables were generated, including observations at calving, nadir, planned start of mating (PSM), and first service, as well as days to nadir and the amount and rate of change between periods. The binary reproductive variables were cycling by PSM, mated in the first 21 d from PSM, pregnant to first service, and pregnant in the first 21, 42, and 84 d of the seasonal mating period. Generalized estimating equations were used to identify BCS and BW variables that significantly affected the probability of a successful reproductive outcome. After adjusting for the fixed effect of year of calving, parity (for cycling by PSM only), and the interval from calving to either first service or PSM, reproductive performance was found to be significantly affected by BW or BCS at key points, and by BCS and BW change during lactation. All reproductive response measures were negatively affected when BCS and BW measures indicated an increased severity and duration of the postpartum negative energy balance. In particular, cycling by PSM was positively associated with calving BCS, whereas pregnancy at 21, 42, and 84 d post-PSM were positively associated with nadir BCS and BW gain post-PSM, and negatively associated with BCS loss between calving and nadir. The results highlight the important role that BCS and BW loss has on reproductive performance, especially in seasonal-calving dairy systems because of the short period between calving and PSM.

Non-apical positive surgical margins after radical prostatectomy for pT2 prostate cancer is associated with the highest risk of recurrence

DEFF Research Database (Denmark)

Roder, Martin Andreas; Kawa, Sandra; Scheike, Thomas

2014-01-01

BACKGROUND AND OBJECTIVE: To investigate how location of positive surgical margins (PSM) in pT2 tumors affect the risk of biochemical recurrence (BR). METHODS: The study includes 1,133 consecutive patients from 1995 until end of 2011, who had organ-confined disease (pT2) following RP. The location...... a 3.1-fold increased risk of BR compared to margin negative patients. Patients with pT2 apical and non-apical PSM had a 5-year biochemical recurrence-free survival of 84.9% (95% CI: 77.6-92.2%) and 78.6% (95% CI: 71.3-85.9%), respectively. In multivariate analysis, pT2 apical and non-apical PSM...... was individually associated with a 2.2- and 3.8-fold increased risk of BR compared to margin negative patients. CONCLUSION: In our cohort the location of pT2 PSM was associated with time to BR, that is, patients with non-apical pT2 PSM endured the highest risk of BR compared to apical PSM. This may indicate...

Time-trend of melanoma screening practice by primary care physicians: a meta-regression analysis.

Science.gov (United States)

Valachis, Antonis; Mauri, Davide; Karampoiki, Vassiliki; Polyzos, Nikolaos P; Cortinovis, Ivan; Koukourakis, Georgios; Zacharias, Georgios; Xilomenos, Apostolos; Tsappi, Maria; Casazza, Giovanni

2009-01-01

To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time. Meta-regression analyses of available data. MEDLINE, ISI, Cochrane Central Register of Controlled Trials. Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%-82% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were -0.68% (P =0.494), -2.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines. Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon.

Incorporation of Collision Probability Method in STREAM to Consider Non-uniform Material Composition in Fuel Subregions

International Nuclear Information System (INIS)

Choi, Sooyoung; Choe, Jiwon; Lee, Deokjung

2016-01-01

STREAM uses a pin-based slowing-down method (PSM) which solves pointwise energy slowing-down problems with sub-divided fuel pellet, and shows a great performance in calculating effective cross-section (XS). Various issues in the conventional resonance treatment methods (i.e., approximations on resonance scattering source, resonance interference effect, and intrapellet self-shielding effect) were successfully resolved by PSM. PSM assumes that a fuel rod has a uniform material composition and temperature even though PSM calculates spatially dependent effective XSs of fuel subregions. When the depletion calculation or thermal/hydraulic (T/H) coupling are performed with sub-divided material meshes, each subregion has its own material condition depending on position. It was reported that the treatment of distributed temperature is important to calculate an accurate fuel temperature coefficient (FTC). In order to avoid the approximation in PSM, the collision probability method (CPM) has been incorporated as a calculation option. The resonance treatment method, PSM, used in the transport code STREAM has been enhanced to accurately consider a non-uniform material condition. The method incorporates CPM in computing collision probability of isolated fuel pin. From numerical tests with pin-cell problems, STREAM with the method showed very accurate multiplication factor and FTC results less than 83 pcm and 1.43 % differences from the references, respectively. The original PSM showed larger differences than the proposed method but still has a high accuracy

Incorporation of Collision Probability Method in STREAM to Consider Non-uniform Material Composition in Fuel Subregions

Energy Technology Data Exchange (ETDEWEB)

Choi, Sooyoung; Choe, Jiwon; Lee, Deokjung [UNIST, Ulsan (Korea, Republic of)

2016-10-15

STREAM uses a pin-based slowing-down method (PSM) which solves pointwise energy slowing-down problems with sub-divided fuel pellet, and shows a great performance in calculating effective cross-section (XS). Various issues in the conventional resonance treatment methods (i.e., approximations on resonance scattering source, resonance interference effect, and intrapellet self-shielding effect) were successfully resolved by PSM. PSM assumes that a fuel rod has a uniform material composition and temperature even though PSM calculates spatially dependent effective XSs of fuel subregions. When the depletion calculation or thermal/hydraulic (T/H) coupling are performed with sub-divided material meshes, each subregion has its own material condition depending on position. It was reported that the treatment of distributed temperature is important to calculate an accurate fuel temperature coefficient (FTC). In order to avoid the approximation in PSM, the collision probability method (CPM) has been incorporated as a calculation option. The resonance treatment method, PSM, used in the transport code STREAM has been enhanced to accurately consider a non-uniform material condition. The method incorporates CPM in computing collision probability of isolated fuel pin. From numerical tests with pin-cell problems, STREAM with the method showed very accurate multiplication factor and FTC results less than 83 pcm and 1.43 % differences from the references, respectively. The original PSM showed larger differences than the proposed method but still has a high accuracy.

Cochrane Review: Osmotic and stimulant laxatives for the management of childhood constipation (Review).

Science.gov (United States)

Gordon, Morris; Naidoo, Khimara; Akobeng, Anthony K; Thomas, Adrian G

2013-01-01

Constipation within childhood is an extremely common problem. Despite the widespread use of osmotic and stimulant laxatives by health professionals to manage constipation in children, there has been a long standing paucity of high quality evidence to support this practice. We set out to evaluate the efficacy and safety of osmotic and stimulant laxatives used to treat functional childhood constipation. The search (inception to May 7, 2012) was standardised and not limited by language and included electronic searching (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register), reference searching of all included studies, personal contacts and drug companies. Randomised controlled trials (RCTs) which compared osmotic or stimulant laxatives with either placebo or another intervention, with patients aged 0 to 18 years old were considered for inclusion. The primary outcome was frequency of defecation. Secondary endpoints included faecal incontinence, disimpaction, need for additional therapies and adverse events. Relevant papers were identified and the authors independently assessed the eligibility of trials. Methodological quality was assessed using the Cochrane risk of bias tool.The Cochrane RevMan software was used for analyses. Patients with final missing outcomes were assumed to have relapsed. For continuous outcomes we calculated a mean difference (MD) and 95% confidence interval (CI) using a fixed-effect model. For dichotomous outcomes we calculated an odds ratio (OR) and 95% confidence intervals (95% CI) using a fixed-effect model. The chi square and I(2) statistics were used to assess statistical heterogeneity. A random-effects model was used in situations of unexplained heterogeneity Eighteen RCTs (1643 patients) were included in the review. Nine studies were judged to be at high risk of bias due to lack of blinding, incomplete outcome data and selective

Is a shift from research on individual medical error to research on health information technology underway? A 40-year analysis of publication trends in medical journals.

Science.gov (United States)

Erlewein, Daniel; Bruni, Tommaso; Gadebusch Bondio, Mariacarla

2018-06-07

In 1983, McIntyre and Popper underscored the need for more openness in dealing with errors in medicine. Since then, much has been written on individual medical errors. Furthermore, at the beginning of the 21st century, researchers and medical practitioners increasingly approached individual medical errors through health information technology. Hence, the question arises whether the attention of biomedical researchers shifted from individual medical errors to health information technology. We ran a study to determine publication trends concerning individual medical errors and health information technology in medical journals over the last 40 years. We used the Medical Subject Headings (MeSH) taxonomy in the database MEDLINE. Each year, we analyzed the percentage of relevant publications to the total number of publications in MEDLINE. The trends identified were tested for statistical significance. Our analysis showed that the percentage of publications dealing with individual medical errors increased from 1976 until the beginning of the 21st century but began to drop in 2003. Both the upward and the downward trends were statistically significant (P information technology doubled between 2003 and 2015. The upward trend was statistically significant (P information technology in the USA and the UK. © 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Current use was established and Cochrane guidance on selection of social theories for systematic reviews of complex interventions was developed.

Science.gov (United States)

Noyes, Jane; Hendry, Maggie; Booth, Andrew; Chandler, Jackie; Lewin, Simon; Glenton, Claire; Garside, Ruth

2016-07-01

To identify examples of how social theories are used in systematic reviews of complex interventions to inform production of Cochrane guidance. Secondary analysis of published/unpublished examples of theories of social phenomena for use in reviews of complex interventions identified through scoping searches, engagement with key authors and methodologists supplemented by snowballing and reference searching. Theories were classified (low-level, mid-range, grand). Over 100 theories were identified with evidence of proliferation over the last 5 years. New low-level theories (tools, taxonomies, etc) have been developed for classifying and reporting complex interventions. Numerous mid-range theories are used; one example demonstrated how control theory had changed the review's findings. Review-specific logic models are increasingly used, but these can be challenging to develop. New low-level and mid-range psychological theories of behavior change are evolving. No reviews using grand theory (e.g., feminist theory) were identified. We produced a searchable Wiki, Mendeley Inventory, and Cochrane guidance. Use of low-level theory is common and evolving; incorporation of mid-range theory is still the exception rather than the norm. Methodological work is needed to evaluate the contribution of theory. Choice of theory reflects personal preference; application of theory is a skilled endeavor. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

The reporting characteristics and methodological quality of Cochrane reviews about health policy research.

Science.gov (United States)

Xiu-xia, Li; Ya, Zheng; Yao-long, Chen; Ke-hu, Yang; Zong-jiu, Zhang

2015-04-01

The systematic review has increasingly become a popular tool for researching health policy. However, due to the complexity and diversity in the health policy research, it has also encountered more challenges. We set out the Cochrane reviews on health policy research as a representative to provide the first examination of epidemiological and descriptive characteristics as well as the compliance of methodological quality with the AMSTAR. 99 reviews were included by inclusion criteria, 73% of which were Implementation Strategies, 15% were Financial Arrangements and 12% were Governance Arrangements; involved Public Health (34%), Theoretical Exploration (18%), Hospital Management (17%), Medical Insurance (12%), Pharmaceutical Policy (9%), Community Health (7%) and Rural Health (2%). Only 39% conducted meta-analysis, and 49% reported being updates, and none was rated low methodological quality. Our research reveals that the quantity and quality of the evidence should be improved, especially Financial Arrangements and Governance Arrangements involved Rural Health, Health Care Reform and Health Equity, etc. And the reliability of AMSTAR needs to be tested in larger range in this field. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effect of Beam Scanning on Target Polarization Scattering Matrix Observed by Fully Polarimetric Phased-array Radar

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Li Mianquan

2016-04-01

Full Text Available The polarization feature of a fully Polarimetric Phased-Array Radar (PPAR antenna varies according to the beam-scanning angle, thereby introducing two problems on the target Polarization Scattering Matrix (PSM measurement. First, the antenna polarization basis is defined within the vertical cross-section of an electromagnetic wave propagation direction, and the polarization basis of each beam direction angle is not identical, resulting in the PSM of a fixed-posture target observed by PPAR being not identical for different beam-scanning angles. Second, the cross polarization of the PPAR antenna increases with increasing beamscanning angle, resulting in a crosstalk among the elements of PSM observed by PPAR. This study focuses on the analysis of the abovementioned two aspects of the effect of beam scanning on target PSM observed by PPAR. The results will establish a more accurate observation of the equation for the precision PSM measurement of PPAR.

Investigation of the computer experiences and attitudes of pre-service mathematics teachers: new evidence from Turkey.

Science.gov (United States)

Birgin, Osman; Catlioğlu, Hakan; Gürbüz, Ramazan; Aydin, Serhat

2010-10-01

This study aimed to investigate the experiences of pre-service mathematics (PSM) teachers with computers and their attitudes toward them. The Computer Attitude Scale, Computer Competency Survey, and Computer Use Information Form were administered to 180 Turkish PSM teachers. Results revealed that most PSM teachers used computers at home and at Internet cafes, and that their competency was generally intermediate and upper level. The study concludes that PSM teachers' attitudes about computers differ according to their years of study, computer ownership, level of computer competency, frequency of computer use, computer experience, and whether they had attended a computer-aided instruction course. However, computer attitudes were not affected by gender.

Trend analysis

International Nuclear Information System (INIS)

Smith, M.; Jones, D.R.

1991-01-01

The goal of exploration is to find reserves that will earn an adequate rate of return on the capital invested. Neither exploration nor economics is an exact science. The authors must therefore explore in those trends (plays) that have the highest probability of achieving this goal. Trend analysis is a technique for organizing the available data to make these strategic exploration decisions objectively and is in conformance with their goals and risk attitudes. Trend analysis differs from resource estimation in its purpose. It seeks to determine the probability of economic success for an exploration program, not the ultimate results of the total industry effort. Thus the recent past is assumed to be the best estimate of the exploration probabilities for the near future. This information is combined with economic forecasts. The computer software tools necessary for trend analysis are (1) Information data base - requirements and sources. (2) Data conditioning program - assignment to trends, correction of errors, and conversion into usable form. (3) Statistical processing program - calculation of probability of success and discovery size probability distribution. (4) Analytical processing - Monte Carlo simulation to develop the probability distribution of the economic return/investment ratio for a trend. Limited capital (short-run) effects are analyzed using the Gambler's Ruin concept in the Monte Carlo simulation and by a short-cut method. Multiple trend analysis is concerned with comparing and ranking trends, allocating funds among acceptable trends, and characterizing program risk by using risk profiles. In summary, trend analysis is a reality check for long-range exploration planning

USE OF SOIL MICROORGANISMS AS A BIOTECHNOLOGICAL STRATEGY TO ENHANCE AVOCADO (Persea americana-PLANT PHOSPHATE UPTAKE AND GROWTH USO DE MICROORGANISMOS DEL SUELO COMO ESTRATEGIA BIOTECNOLÓGICA PARA MEJORAR LA ABSORCIÓN DE FÓSFORO Y EL CRECIMIENTO DE PLANTAS DE AGUACATE (Persea americana

Directory of Open Access Journals (Sweden)

Nelson Walter Osorio Vega

2012-06-01

Full Text Available Abstract. In recent years the area cultivated with avocado has increased significantly in Colombia and this trend is expected to continue in the coming years. However, most of the soils in the highlands of the Colombian Andean, that have been used to grow avocado, are strongly acidic and nutrient deficient, particularly phosphorus (P. To alleviate these problems, high rates of lime and P fertilizers are frequently applied, in many cases the applied dose are excessive. This increases production costs, produces plant nutrient imbalance in the plant, and increases the risk of polluting surface waters. A biotechnological alternative is the combined use of phosphate solubilizing microorganisms (PSM and arbuscular mycorhizal fungi (AMF. This work describes a series of experiments carried out to isolate, characterize, and evaluate the effectiveness of AMF and PSM in increasing plant growth and P uptake of avocado plants. The results indicate that the mycorrhizal association is an effective alternative that can easily be established in the crops; however, the excessive use of P fertilizer in these soils may limit the benefits of these fungi on avocado plants. Currently, effective PSM of avocado rhizosphere have not been detected. In some cases, these microorganisms are absent in the avocado rhizosphere and in other cases their low capacity to solubilize P discourage their use in the crop.Resumen. En los últimos años el área cultivada con aguacate en Colombia ha crecido notoriamente y se espera que esta tendencia continúe en los próximos años. Sin embargo, muchos de los suelos de la zona andina utilizados para su siembra exhiben fuerte acidez y niveles deficientes de varios nutrientes, particularmente fósforo (P. Para corregir este problema se hacen aplicaciones de cales y fertilizantes fosfóricos solubles, en mucho casos las dosis aplicadas son altas. Esto eleva innecesariamente los costos de producción, crea desbalance nutricional en la planta

Information Literacy for Users at the National Medical Library of Cuba: Cochrane Library Course for the Search of Best Evidence for Clinical Decisions

Science.gov (United States)

Santana Arroyo, Sonia; del Carmen Gonzalez Rivero, Maria

2012-01-01

The National Medical Library of Cuba is currently developing an information literacy program to train users in the use of biomedical databases. This paper describes the experience with the course "Cochrane Library: Evidence-Based Medicine," which aims to teach users how to make the best use of this database, as well as the evidence-based…

Exploring the Relationship Between Public Service Motivation and Formal and Informal Volunteering

Directory of Open Access Journals (Sweden)

Richard M. Clerkin

2017-03-01

Full Text Available In this paper, we apply public service motivation to the ongoing discussion of formal and informal volunteering and whether these are two distinct constructs or variations on the same theme. This exploratory research uses survey data of undergraduate students reporting their participation in both types of volunteering activities. Using structural equation modeling, these formal and informal volunteering activities show different influences on three dimensions of PSM. In addition to PSM, high school volunteering and religiosity have direct effects on rates of formal volunteering, which in turn positively influence the PSM dimensions of civic duty and self-sacrifice. Being an Evangelical Christian is associated with increased informal volunteering, which is positively related to the PSM compassion dimension. These results indicate that the different dimensions of PSM, and how formal and informal volunteering influences them, should be useful tools for scholars and practitioners seeking to understand these distinct types of pro-social behaviors.

A stochastic model with a low-frequency amplification feedback for the stratospheric northern annular mode

Science.gov (United States)

Yu, Yueyue; Cai, Ming; Ren, Rongcai

2017-08-01

We consider three indices to measure the polar stratospheric mass and stratospheric meridional mass circulation variability: anomalies of (1) total mass in the polar stratospheric cap (60-90°N, above the isentropic surface 400 K, PSM), (2) total adiabatic mass transport across 60°N into the polar stratosphere cap (AMT), (3) and total diabetic mass transport across 400 K from the polar stratosphere into the troposphere below (DMT). It is confirmed that the negative stratospheric Northern Annular Mode (NAM) and PSM indices have a nearly indistinguishable temporal evolution and a similar red-noise-like spectrum with a de-correlation timescale of 4 weeks. This enables us to examine the low-frequency nature of the NAM in the framework of mass circulation, namely, d/{dt}{PSM}={AMT} - {DMT} . The DMT index tends to be positively correlated with the PSM with a red-noise-like spectrum, representing slow radiative cooling processes giving rise to a de-correlation timescale of 3-4 weeks. The AMT is nearly perfectly correlated with the day-to-day tendency of PSM, reflecting a robust quasi 90° out-of-phase relation between the AMT and PSM at all frequency bands. Variations of vertically westward tilting of planetary waves contribute mainly to the high-frequency portion of AMT. It is the wave amplitude's slow vacillation that plays the leading role in the quasi 90° out-of-phase relation between the AMT and PSM. Based on this, we put forward a linear stochastic model with a low-frequency amplification feedback from low-frequency amplitude vacillations of planetary waves to explain the amplified low-frequency response of PSM/NAM to a stochastic forcing from the westward tilting variability.

Evaluation of a wearable physiological status monitor during simulated fire fighting activities.

Science.gov (United States)

Smith, Denise L; Haller, Jeannie M; Dolezal, Brett A; Cooper, Christopher B; Fehling, Patricia C

2014-01-01

A physiological status monitor (PSM) has been embedded in a fire-resistant shirt. The purpose of this research study was to examine the ability of the PSM-shirt to accurately detect heart rate (HR) and respiratory rate (RR) when worn under structural fire fighting personal protective equipment (PPE) during the performance of various activities relevant to fire fighting. Eleven healthy, college-aged men completed three activities (walking, searching/crawling, and ascending/descending stairs) that are routinely performed during fire fighting operations while wearing the PSM-shirt under structural fire fighting PPE. Heart rate and RR recorded by the PSM-shirt were compared to criterion values measured concurrently with an ECG and portable metabolic measurement system, respectively. For all activities combined (overall) and for each activity, small differences were found between the PSM-shirt and ECG (mean difference [95% CI]: overall: -0.4 beats/min [-0.8, -0.1]; treadmill: -0.4 beats/min [-0.7, -0.1]; search: -1.7 beats/min [-3.1, -.04]; stairs: 0.4 beats/min [0.04, 0.7]). Standard error of the estimate was 3.5 beats/min for all tasks combined and 1.9, 5.9, and 1.9 beats/min for the treadmill walk, search, and stair ascent/descent, respectively. Correlations between the PSM-shirt and criterion heart rates were high (r = 0.95 to r = 0.99). The mean difference between RR recorded by the PSM-shirt and criterion overall was 1.1 breaths/min (95% CI: -1.9 to -0.4). The standard error of the estimate for RR ranged from 4.2 breaths/min (treadmill) to 8.2 breaths/min (search), with an overall value of 6.2 breaths/min. These findings suggest that the PSM-shirt provides valid measures of HR and useful approximations of RR when worn during fire fighting duties.

Cochrane Qualitative and Implementation Methods Group guidance series-paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis.

Science.gov (United States)

Harris, Janet L; Booth, Andrew; Cargo, Margaret; Hannes, Karin; Harden, Angela; Flemming, Kate; Garside, Ruth; Pantoja, Tomas; Thomas, James; Noyes, Jane

2018-05-01

This paper updates previous Cochrane guidance on question formulation, searching, and protocol development, reflecting recent developments in methods for conducting qualitative evidence syntheses to inform Cochrane intervention reviews. Examples are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry and mapping the available information to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility, and implementation. Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Furthermore, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route map, particularly in qualitative reviews that ask more exploratory and open-ended questions. Copyright © 2017 Elsevier Inc. All rights reserved.

Online Marketing Trends

OpenAIRE

Horecká, Ivana

2015-01-01

This thesis deals with online marketing trends. Its main goal is to define the latest online marketing trends, create a website with the free online marketing trends, and analyse their effectiveness. The theoretical part brings a thorough description of the latest online marketing trends. Moreover, it provides an insight into the latest trends in the website development. The chosen online marketing trends defined in the theoretical part are subsequently applied on a newly created website. All...

Cochrane Rapid Reviews Methods Group to play a leading role in guiding the production of informed high-quality, timely research evidence syntheses.

Science.gov (United States)

Garritty, Chantelle; Stevens, Adrienne; Gartlehner, Gerald; King, Valerie; Kamel, Chris

2016-10-28

Policymakers and healthcare stakeholders are increasingly seeking evidence to inform the policymaking process, and often use existing or commissioned systematic reviews to inform decisions. However, the methodologies that make systematic reviews authoritative take time, typically 1 to 2 years to complete. Outside the traditional SR timeline, "rapid reviews" have emerged as an efficient tool to get evidence to decision-makers more quickly. However, the use of rapid reviews does present challenges. To date, there has been limited published empirical information about this approach to compiling evidence. Thus, it remains a poorly understood and ill-defined set of diverse methodologies with various labels. In recent years, the need to further explore rapid review methods, characteristics, and their use has been recognized by a growing network of healthcare researchers, policymakers, and organizations, several with ties to Cochrane, which is recognized as representing an international gold standard for high-quality, systematic reviews. In this commentary, we introduce the newly established Cochrane Rapid Reviews Methods Group developed to play a leading role in guiding the production of rapid reviews given they are increasingly employed as a research synthesis tool to support timely evidence-informed decision-making. We discuss how the group was formed and outline the group's structure and remit. We also discuss the need to establish a more robust evidence base for rapid reviews in the published literature, and the importance of promoting registration of rapid review protocols in an effort to promote efficiency and transparency in research. As with standard systematic reviews, the core principles of evidence-based synthesis should apply to rapid reviews in order to minimize bias to the extent possible. The Cochrane Rapid Reviews Methods Group will serve to establish a network of rapid review stakeholders and provide a forum for discussion and training. By facilitating

Organizational Concepts for Purchasing and Supply Management Implementation

National Research Council Canada - National Science Library

Leftwich, Lynne M; Leftwich, James A; Moore, Nancy Y; Roll, C. R., Jr

2004-01-01

.... The report draws on spares Campaign process-based analysis supporting the decision to implement PSM and suggests organizational options for implementing PSM to better align contracting and logistics...

Algorithms and Public Service Media

OpenAIRE

Sørensen, Jannick Kirk; Hutchinson, Jonathon

2018-01-01

When Public Service Media (PSM) organisations introduce algorithmic recommender systems to suggest media content to users, fundamental values of PSM are challenged. Beyond being confronted with ubiquitous computer ethics problems of causality and transparency, also the identity of PSM as curator and agenda-setter is challenged. The algorithms represents rules for which content to present to whom, and in this sense they may discriminate and bias the exposure of diversity. Furthermore, on a pra...

Strategies for Integrating Preparation and Realisation in a Manufacturing

DEFF Research Database (Denmark)

Larsen, Michael Holm; Kirkby, Phillip; Vesterager, Johan

1999-01-01

The purpose of this paper is to discuss the integration of the Product Model (PM) and the Product State Model (PSM). Focus is on information exchange from the PSM to the PM within the manufacturing of a single ship. The paper distinguishes between information and knowledge integration. The paper...... provides some overall strategies for integrating PM and PSM. The context of this discussion is a development project at Odense Steel Shipyard (OSS)....

Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review.

Science.gov (United States)

Rasmussen-Barr, Eva; Held, Ulrike; Grooten, Wilhelmus J A; Roelofs, Pepijn D D M; Koes, Bart W; van Tulder, Maurits W; Wertli, Maria M

2017-04-15

Systematic review and meta-analysis. To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. NSAIDs are one of the most frequently prescribed drugs for sciatica. We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included. Outcomes included pain using mean difference (MD, 95% confidence intervals [95% CI]). For global improvement and adverse effects risk ratios (RR, 95% CI) were used. We assessed level of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Ten trials were included (N = 1651). Nine out of 10 trials were assessed at high risk of bias. For pain reduction (visual analog scale, 0 to 100) NSAIDs were no more effective than placebo (MD -4.56, 95% CI -11.11 to 1.99, quality of evidence: very low). For global improvement NSAIDs were more effective than placebo (RR 1.14 [95% CI 1.03 to 1.27], low quality of evidence). One trial reported the effect of NSAIDs on disability with very low-quality evidence that NSAIDs are no more effective than placebo. There was low-quality evidence that the risk for adverse effects is higher for NSAID than placebo (RR 1.40, 95% CI 1.02 to 1.93). Our findings show very low-quality evidence that the efficacy of NSAIDs for pain reduction is comparable with that of placebo, low-quality evidence that NSAIDs is better than placebo for global improvement and low-quality evidence for higher risk of adverse effects using NSAIDs compared with placebo. The findings must be interpreted with caution, due to small study samples, inconsistent results, and a high risk of bias in the included trials. 1.

Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study

Directory of Open Access Journals (Sweden)

Malý Marek

2002-07-01

Full Text Available Abstract Background The parasite Toxoplasma gondii infects 30–60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not known, however, whether the changes observed in the laboratory influence the performance of subjects in real-life situations. Methods The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N = 146 and in the general population living in the same area (N = 446 was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accidents and level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trends. Results A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH = 21.45, p 95= 1.76–4.01 times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p 95 = 1.14–3.03 for the 99 subjects with low antibody titres (8 and 16, higher (OR = 4.78, C.I.95 = 2.39–9.59 for the 37 subjects with moderate titres (32 and 64, and very high (OR = 16.03, C.I.95 = 1.89–135.66 for the 6 subjects with titres higher than 64. Conclusion The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health problem, as well as an economic problem.

90-day Readmission After Lumbar Spinal Fusion Surgery in New York State Between 2005 and 2014: A 10-year Analysis of a Statewide Cohort.

Science.gov (United States)

Baaj, Ali A; Lang, Gernot; Hsu, Wei-Chun; Avila, Mauricio J; Mao, Jialin; Sedrakyan, Art

2017-11-15

MINI: We assessed 90-day readmission and evaluated risk factors associated with readmission after lumbar spinal fusion surgery in New York State. The overall 90-day readmission rate was 24.8%. Age, sex, race, insurance, procedure, number of operated spinal levels, health service area, and comorbidities are major risk factors for 90-day readmission. Retrospective cohort study. The aim of this study was to assess 90-day readmission and evaluate risk factors associated with readmission after lumbar fusion in New York State. Readmission is becoming an important metric for quality and efficiency of health care. Readmission and its predictors following spine surgery are overall poorly understood and limited evidence is available specifically in lumbar fusion. The New York Statewide Planning and Research Cooperative System (SPARCS) was utilized to capture patients undergoing lumbar fusion from 2005 to 2014. Temporal trend of 90-day readmission was assessed using Cochran-Armitage test. Logistic regression was used to examine predictors associated with 90-day readmission. There were 86,869 patients included in this cohort study. The overall 90-day readmission rate was 24.8%. On a multivariable analysis model, age (odds ratio [OR] comparing ≥75 versus New York-Pennsylvania border: 0.67, 95% CI: 0.61-0.73), and comorbidity, i.e., coronary artery disease (OR: 1.26, 95% CI: 1.19-1.33) were significantly associated with 90-day readmission. Directions of the odds ratios for these factors were consistent after stratification by procedure type. Age, sex, race, insurance, procedure, number of operated spinal levels, HSA, and comorbidities are major risk factors for 90-day readmission. Our study allows risk calculation to determine high-risk patients before undergoing spinal fusion surgery to prevent early readmission, improve quality of care, and reduce health care expenditures. 3.

The incidence and functional consequences of RT-associated cardiac perfusion defects

International Nuclear Information System (INIS)

Marks, Lawrence B.; Yu Xiaoli; Prosnitz, Robert G.; Zhou Sumin; Hardenbergh, Patricia H.; Blazing, Michael; Hollis, Donna; Lind, Pehr; Tisch, Andrea; Wong, Terence Z.; Borges-Neto, Salvador

2005-01-01

Purpose: Radiation therapy (RT) for left-sided breast cancer has been associated with cardiac dysfunction. We herein assess the temporal nature and volume dependence of RT-induced left ventricular perfusion defects and whether these perfusion defects are related to changes in cardiac wall motion or alterations in ejection fraction. Methods: From 1998 to 2001, 114 patients were enrolled onto an IRB-approved prospective clinical study to assess changes in regional and global cardiac function after RT for left-sided breast cancer. Patients were imaged 30 to 60 minutes after injection of technetium 99m sestamibi or tetrofosmin. Post-RT perfusion scans were compared with the pre-RT studies to assess for RT-induced perfusion defects as well as functional changes in wall motion and ejection fraction. Two-tailed Fisher's exact test and the Cochran-Armitage test for linear trends were used for statistical analysis. Results: The incidence of new perfusion defects 6, 12, 18, and 24 months after RT was 27%, 29%, 38%, and 42%, respectively. New defects occurred in approximately 10% to 20% and 50% to 60% of patients with less than 5%, and greater than 5%, of their left ventricle included within the RT fields, respectively (p = 0.33 to 0.00008). The rates of wall motion abnormalities in patients with and without perfusion defects were 12% to 40% versus 0% to 9%, respectively; p values were 0.007 to 0.16, depending on the post-RT interval. Conclusions: Radiation therapy causes volume-dependent perfusion defects in approximately 40% of patients within 2 years of RT. These perfusion defects are associated with corresponding wall-motion abnormalities. Additional study is necessary to better define the long-term functional consequences of RT-induced perfusion defects

Are Future Bureaucrats More Prosocial?

DEFF Research Database (Denmark)

Tepe, Markus; Vanhuysse, Pieter

2017-01-01

robust subject pool effects. Even after controlling for PSM, public administration students both behave more altruistically and display less merely strategic fairness than business students. And they behave more cooperatively than students of both business and law. These behavioral findings about future......This article explores the associations between self-reported Public Service Motivation (PSM), study choice, and observable prosocial behavior across three subject pools covering over 250 university students in Germany. We use laboratory experiments with monetary rewards to measure altruism......, fairness, strategic fairness, and cooperation towards public goods, and a post-experimental survey on subjects’ PSM. Higher levels of PSM are not associated with studying public administration but are positively associated with altruism, and negatively with strategic fairness. The experimental data reveals...

Analysis of the Cochrane Review: Fibrates for secondary prevention of cardiovascular disease and stroke.

Science.gov (United States)

Pires da Rosa, Gilberto; Libânio, Diogo; Filipe Azevedo, Luís

2017-01-01

The influence of fibrates on cardiovascular risk has been the focus of several clinical trials. This Cochrane Collaboration Systematic Review evaluated the efficacy of fibrates for secondary prevention of cardiovascular events and stroke, analyzing 13 randomized controlled trials, in a total of 16 112 participants with a history of cardiovascular disease. Fibrates showed a protective effect for the composite outcome of non-fatal stroke, non-fatal myocardial infarction (MI) and vascular death, mainly due to reduction in the risk of non-fatal or fatal MI. Nonetheless, these results largely relied on studies including clofibrate, a drug withdrawn from the market in 2002. No statistically significant differences regarding adverse events were found between fibrates and placebo. Although insufficient to support the routine prescription of fibrates in this setting, this evidence should be taken into account when deciding on lipid-modifying therapy in dyslipidemic patients with a history of cardiovascular disease. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Analytical Solutions for Systems of Singular Partial Differential-Algebraic Equations

Directory of Open Access Journals (Sweden)

U. Filobello-Nino

2015-01-01

Full Text Available This paper proposes power series method (PSM in order to find solutions for singular partial differential-algebraic equations (SPDAEs. We will solve three examples to show that PSM method can be used to search for analytical solutions of SPDAEs. What is more, we will see that, in some cases, Padé posttreatment, besides enlarging the domain of convergence, may be employed in order to get the exact solution from the truncated series solutions of PSM.

Core outcome sets in dermatology: report from the second meeting of the International Cochrane Skin Group Core Outcome Set Initiative.

Science.gov (United States)

Kottner, J; Jacobi, L; Hahnel, E; Alam, M; Balzer, K; Beeckman, D; Busard, C; Chalmers, J; Deckert, S; Eleftheriadou, V; Furlan, K; Horbach, S E R; Kirkham, J; Nast, A; Spuls, P; Thiboutot, D; Thorlacius, L; Weller, K; Williams, H C; Schmitt, J

2018-04-01

Results of clinical trials are the most important information source for generating external clinical evidence. The use of different outcomes across trials, which investigate similar interventions for similar patient groups, significantly limits the interpretation, comparability and clinical application of trial results. Core outcome sets (COSs) aim to overcome this limitation. A COS is an agreed standardized collection of outcomes that should be measured and reported in all clinical trials for a specific clinical condition. The Core Outcome Set Initiative within the Cochrane Skin Group (CSG-COUSIN) supports the development of core outcomes in dermatology. In the second CSG-COUSIN meeting held in 2017, 11 COS development groups working on skin diseases presented their current work. The presentations and discussions identified the following overarching methodological challenges for COS development in dermatology: it is not always easy to define the disease focus of a COS; the optimal method for outcome domain identification and level of detail needed to specify such domains is challenging to many; decision rules within Delphi surveys need to be improved; appropriate ways of patient involvement are not always clear. In addition, there appear to be outcome domains that may be relevant as potential core outcome domains for the majority of skin diseases. The close collaboration between methodologists in the Core Outcome Set Initiative and the international Cochrane Skin Group has major advantages for trialists, systematic reviewers and COS developers. © 2018 British Association of Dermatologists.

Desafio para a atenção básica: incorporação da assistência em saúde mental

Directory of Open Access Journals (Sweden)

Oswaldo Yoshimi Tanaka

Full Text Available Com o objetivo de avaliar a atenção em saúde mental na atenção básica de saúde foi realizado um estudo comparativo entre os diagnósticos de Problemas de Saúde Mental (PSM, realizados pelos pediatras, e os prováveis PSM identificados por meio da aplicação de um questionário padronizado (CBCL. O estudo foi realizado com crianças de 5 a 11 anos atendidas em uma unidade básica de saúde (UBS, entre agosto e outubro de 2002, no Município de São Paulo, Brasil. Para aprofundar a análise foram realizadas 11 entrevistas com os pediatras da UBS. A análise de 411 prontuários e dos 206 questionários aplicados aos pais, mostram que os pediatras realizaram diagnóstico de PSM em 17,5% das crianças atendidas. Quando comparado com os prováveis PSM identificados pelo CBCL, apenas 25,3% das crianças são identificadas com PSM pelos médicos. A entrevista realizada com os pediatras identifica dificuldades na definição de PSM, a carência de instrumentos para o reconhecimento dos problemas e falta de um sistema de encaminhamento, e carecem de apoio técnico específico.

Enhancement of Radiotherapeutic Efficacy by Paclitaxel-Loaded ph-Sensitive Block Copolymer Micelles

International Nuclear Information System (INIS)

Jinhyang, C.; Jaesook, P.; Dong-Hoon, J.

2012-01-01

Radiotherapy (RT) is a major modality for cancer treatment, but its efficacy is often compromised by the resistance caused by tumor-specific microenvironment including acidosis and hypoxia. For an effective RT, concurrent administration of radiosensitizer with RT has been emphasized. However, most anticancer agents enhancing radiotherapeutic efficacy have obstacles such as poor solubility and severe toxicity. Paclitaxel (PTX), a well-known radiosensitizer, is insoluble in water and needs toxic solvent like Cremophor EL. Nano materials in drug delivery systems have been utilized for improving the drawbacks of anti-cancer drugs. Solubilization, tumor accumulation, and toxicity attenuation of drug by nano materials are suitable for enhancement of radiotherapeutic efficacy. In this study, PTX was incorporated into ph-sensitive block copolymer micelle (psm-PTX), polyethylene glycol-graft-poly(β-amino ester), and pre clinically evaluated for its effect on RT. The size of psm-PTX was 125. 4.4±nm at ph 7.4. psm-PTX released PTX rapidly in the acidic condition (ph 6.5), while it was reasonably stable in the physiologic condition (ph 7.4). The clonogenic assay showed that psm-PTX greatly sensitized human non-small-cell lung cancer A549 cells to radiation. In the xenograft tumor model, the combination of psm-PTX and radiation significantly delayed the tumor growth. These results demonstrated the feasibility of psm-PTX to enhance the chemo radiotherapeutic efficacy.

Kinetic analysis of strains of lactic acid bacteria and acetic acid bacteria in cocoa pulp simulation media toward development of a starter culture for cocoa bean fermentation.

Science.gov (United States)

Lefeber, Timothy; Janssens, Maarten; Camu, Nicholas; De Vuyst, Luc

2010-12-01

The composition of cocoa pulp simulation media (PSM) was optimized with species-specific strains of lactic acid bacteria (PSM-LAB) and acetic acid bacteria (PSM-AAB). Also, laboratory fermentations were carried out in PSM to investigate growth and metabolite production of strains of Lactobacillus plantarum and Lactobacillus fermentum and of Acetobacter pasteurianus isolated from Ghanaian cocoa bean heap fermentations, in view of the development of a defined starter culture. In a first step, a selection of strains was made out of a pool of strains of these LAB and AAB species, obtained from previous studies, based on their fermentation kinetics in PSM. Also, various concentrations of citric acid in the presence of glucose and/or fructose (PSM-LAB) and of lactic acid in the presence of ethanol (PSM-AAB) were tested. These data could explain the competitiveness of particular cocoa-specific strains, namely, L. plantarum 80 (homolactic and acid tolerant), L. fermentum 222 (heterolactic, citric acid fermenting, mannitol producing, and less acid tolerant), and A. pasteurianus 386B (ethanol and lactic acid oxidizing, acetic acid overoxidizing, acid tolerant, and moderately heat tolerant), during the natural cocoa bean fermentation process. For instance, it turned out that the capacity to use citric acid, which was exhibited by L. fermentum 222, is of the utmost importance. Also, the formation of mannitol was dependent not only on the LAB strain but also on environmental conditions. A mixture of L. plantarum 80, L. fermentum 222, and A. pasteurianus 386B can now be considered a mixed-strain starter culture for better controlled and more reliable cocoa bean fermentation processes.

Kinetic Analysis of Strains of Lactic Acid Bacteria and Acetic Acid Bacteria in Cocoa Pulp Simulation Media toward Development of a Starter Culture for Cocoa Bean Fermentation ▿

Science.gov (United States)

Lefeber, Timothy; Janssens, Maarten; Camu, Nicholas; De Vuyst, Luc

2010-01-01

The composition of cocoa pulp simulation media (PSM) was optimized with species-specific strains of lactic acid bacteria (PSM-LAB) and acetic acid bacteria (PSM-AAB). Also, laboratory fermentations were carried out in PSM to investigate growth and metabolite production of strains of Lactobacillus plantarum and Lactobacillus fermentum and of Acetobacter pasteurianus isolated from Ghanaian cocoa bean heap fermentations, in view of the development of a defined starter culture. In a first step, a selection of strains was made out of a pool of strains of these LAB and AAB species, obtained from previous studies, based on their fermentation kinetics in PSM. Also, various concentrations of citric acid in the presence of glucose and/or fructose (PSM-LAB) and of lactic acid in the presence of ethanol (PSM-AAB) were tested. These data could explain the competitiveness of particular cocoa-specific strains, namely, L. plantarum 80 (homolactic and acid tolerant), L. fermentum 222 (heterolactic, citric acid fermenting, mannitol producing, and less acid tolerant), and A. pasteurianus 386B (ethanol and lactic acid oxidizing, acetic acid overoxidizing, acid tolerant, and moderately heat tolerant), during the natural cocoa bean fermentation process. For instance, it turned out that the capacity to use citric acid, which was exhibited by L. fermentum 222, is of the utmost importance. Also, the formation of mannitol was dependent not only on the LAB strain but also on environmental conditions. A mixture of L. plantarum 80, L. fermentum 222, and A. pasteurianus 386B can now be considered a mixed-strain starter culture for better controlled and more reliable cocoa bean fermentation processes. PMID:20889778

A porous silicon optical microcavity for sensitive bacteria detection

International Nuclear Information System (INIS)

Li Sha; Huang Jianfeng; Cai Lintao

2011-01-01

A porous silicon microcavity (PSM) is highly sensitive to subtle interface changes due to its high surface area, capillary condensation ability and a narrow resonance peak (∼10 nm). Based on the well-defined optical properties of a PSM, we successfully fabricated a bacteria detection chip for molecular or subcellular analysis by surface modification using undecylenic acid (UA), and the specific recognition binding of vancomycin to the D-alanyl-D-alanine of bacteria. The red shift of the PSM resonance peak showed a good linear relationship with bacteria concentration ranging from 100 to 1000 bacteria ml -1 at the level of relative standard deviation of 0.994 and detection limit of 20 bacteria ml -1 . The resulting PSM sensors demonstrated high sensitivity, good reproducibility, fast response and low cost for biosensing.

A porous silicon optical microcavity for sensitive bacteria detection

Science.gov (United States)

Li, Sha; Huang, Jianfeng; Cai, Lintao

2011-10-01

A porous silicon microcavity (PSM) is highly sensitive to subtle interface changes due to its high surface area, capillary condensation ability and a narrow resonance peak (~10 nm). Based on the well-defined optical properties of a PSM, we successfully fabricated a bacteria detection chip for molecular or subcellular analysis by surface modification using undecylenic acid (UA), and the specific recognition binding of vancomycin to the D-alanyl-D-alanine of bacteria. The red shift of the PSM resonance peak showed a good linear relationship with bacteria concentration ranging from 100 to 1000 bacteria ml - 1 at the level of relative standard deviation of 0.994 and detection limit of 20 bacteria ml - 1. The resulting PSM sensors demonstrated high sensitivity, good reproducibility, fast response and low cost for biosensing.

A porous silicon optical microcavity for sensitive bacteria detection

Energy Technology Data Exchange (ETDEWEB)

Li Sha; Huang Jianfeng; Cai Lintao, E-mail: lt.cai@siat.ac.cn [CAS Key Lab of Health Informatics, Shenzhen Key Laboratory of Cancer Nanotechnology, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055 (China)

2011-10-21

A porous silicon microcavity (PSM) is highly sensitive to subtle interface changes due to its high surface area, capillary condensation ability and a narrow resonance peak ({approx}10 nm). Based on the well-defined optical properties of a PSM, we successfully fabricated a bacteria detection chip for molecular or subcellular analysis by surface modification using undecylenic acid (UA), and the specific recognition binding of vancomycin to the D-alanyl-D-alanine of bacteria. The red shift of the PSM resonance peak showed a good linear relationship with bacteria concentration ranging from 100 to 1000 bacteria ml{sup -1} at the level of relative standard deviation of 0.994 and detection limit of 20 bacteria ml{sup -1}. The resulting PSM sensors demonstrated high sensitivity, good reproducibility, fast response and low cost for biosensing.

Public Service Motivation, User Orientation and Job Satisfaction: A Question of Employment Sector?

DEFF Research Database (Denmark)

Andersen, Lotte Bøgh; Kjeldsen, Anne Mette

2013-01-01

not differ significantly between the private and public sector, while the user orientation/job satisfaction association is strongest for private employees. This suggests that to understand the relationships between pro-social motivation, employment sector and job satisfaction, future studies could fruitfully...... satisfaction. Second, the relationship between job satisfaction and these two types of pro-social motivation, PSM and user orientation, may also be found in the private sector. This study tests whether job satisfaction is associated with PSM and user orientation, and whether these associations differ between......Public service motivation (PSM) has been shown to be positively related to job satisfaction in the public sector, but there are two gaps in the literature. First, not only PSM but also pro-social motivation directed towards helping specific others (called user orientation) may affect job...

Temperature profile and water depth data collected from COCHRANE in the South China Sea and other seas from 09 January 1987 to 22 February 1987 (NODC Accession 8700095)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Temperature profile and water depth data were collected using BT and XBT from the COCHRANE in the South China and other seas. Data were collected from 09 January...

Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery

Directory of Open Access Journals (Sweden)

Gaetana Cognetti

2015-03-01

Full Text Available Introduction. Systematic reviews are fundamental sources of knowledge on the state-of-the-art interventions for various clinical problems. One of the essential components in carrying out a systematic review is that of developing a comprehensive literature search. Materials and methods. Three Cochrane systematic reviews published in 2012 were retrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respect to the information sources used and the search strategies adopted. In March 2014, an update of one of the reviews retrieved was also considered in the study. Results. The number of databases queried for each review ranged between three and seven. All the reviews reported the search strategies adopted, however some only partially. All the reviews explicitly claimed that the searches applied no language restriction although sources such as the free database Lilacs (in Spanish and Portuguese was not consulted. Conclusion. To improve the quality it is necessary to apply standards in carrying out systematic reviews (as laid down in the MECIR project. To meet these standards concerning literature searching, professional information retrieval specialist staff should be involved. The peer review committee in charge of evaluating the publication of a systematic review should also include specialists in information retrieval for assessing the quality of the literature search.

Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery.

Science.gov (United States)

Cognetti, Gaetana; Grossi, Laura; Lucon, Antonio; Solimini, Renata

2015-01-01

Systematic reviews are fundamental sources of knowledge on the state-of-the-art interventions for various clinical problems. One of the essential components in carrying out a systematic review is that of developing a comprehensive literature search. Three Cochrane systematic reviews published in 2012 were retrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respect to the information sources used and the search strategies adopted. In March 2014, an update of one of the reviews retrieved was also considered in the study. The number of databases queried for each review ranged between three and seven. All the reviews reported the search strategies adopted, however some only partially. All the reviews explicitly claimed that the searches applied no language restriction although sources such as the free database Lilacs (in Spanish and Portuguese) was not consulted. To improve the quality it is necessary to apply standards in carrying out systematic reviews (as laid down in the MECIR project). To meet these standards concerning literature searching, professional information retrieval specialist staff should be involved. The peer review committee in charge of evaluating the publication of a systematic review should also include specialists in information retrieval for assessing the quality of the literature search.

Descrição da larva de Scinax similis (Cochran com notas comparativas sobre o grupo "ruber" no sudeste do Brasil (Amphibia, Anura, Hylidae Description of the larva of Scinax similis (Cochran with comparative notes on the Scinax ruber group in Southeastern Brazil (Amphibia, Anura, Hylidae

Directory of Open Access Journals (Sweden)

Ana C.R Alves

1999-06-01

Full Text Available The larva of Scinax similis (Cochran, 1952 is described from Ilha do Fundão (Rio de Janeiro, Rio de Janeiro State, Brazil. Comparisons with other species of the group that occur in Southeastern Brazil are added. The larva of S. similis can be distinguished by the following diagnostic features: (1 eyes large in relation to body length (17,3%, body height (26,8%, and body width (29,7%, interocular distance three times larger than eye diameter; (2 lower beak with two transverse stripes, proximal half white and distal half black.

Five Steps to Successfully Implement and Evaluate Propensity Score Matching in Clinical Research Studies.

Science.gov (United States)

Staffa, Steven J; Zurakowski, David

2018-01-09

In clinical research, the gold standard level of evidence is the randomized controlled trial (RCT). The availability of nonrandomized retrospective data is growing; however, a primary concern of analyzing such data is comparability of the treatment groups with respect to confounding variables. Propensity score matching (PSM) aims to equate treatment groups with respect to measured baseline covariates to achieve a comparison with reduced selection bias. It is a valuable statistical methodology that mimics the RCT, and it may create an "apples to apples" comparison while reducing bias due to confounding. PSM can improve the quality of anesthesia research and broaden the range of research opportunities. PSM is not necessarily a magic bullet for poor-quality data, but rather may allow the researcher to achieve balanced treatment groups similar to a RCT when high-quality observational data are available. PSM may be more appealing than the common approach of including confounders in a regression model because it allows for a more intuitive analysis of a treatment effect between 2 comparable groups.We present 5 steps that anesthesiologists can use to successfully implement PSM in their research with an example from the 2015 Pediatric National Surgical Quality Improvement Program: a validated, annually updated surgery and anesthesia pediatric database. The first step of PSM is to identify its feasibility with regard to the data at hand and ensure availability of data on any potential confounders. The second step is to obtain the set of propensity scores from a logistic regression model with treatment group as the outcome and the balancing factors as predictors. The third step is to match patients in the 2 treatment groups with similar propensity scores, balancing all factors. The fourth step is to assess the success of the matching with balance diagnostics, graphically or analytically. The fifth step is to apply appropriate statistical methodology using the propensity

Radical prostatectomy for clinically localised prostate cancer at Rigshospitalet 1995-2011 - an analysis of surgical and oncological outcome.

Science.gov (United States)

Røder, Martin Andreas

2013-12-01

RP for localized PCa was introduced at Rigshospitalet in 1995. Since then, the incidence of PCa and number of RPs performed every year has increased enormously. Presently, RP is performed a six different hospitals in Denmark. No previous studies have meticulously described outcomes of RP in Denmark. This PhD-thesis focuses on surgical and oncological outcome after RP at Rigshospitalet. The primary purpose was to describe biochemical outcome, risk factors associated with positive surgical margins, and the impact of margin location on risk of biochemical recurrence. The PhD-thesis is based on results from approximately 1,300 men who underwent RP between 1995 and 2011 at Rigshospitalet. The patients have been followed prospectively in a local database. BR was defined as the first PSA ≥ 0.2 ng/ml and time to BR was calculated from the date of surgery. Analysis of time to BR was done using Kaplan-Meier estimation and Cox regression analysis including both pre- and postoperative parameters. The association between preoperative and surgical parameters, including surgeon and nerve-sparing surgery, and PSM was analysed using logistic regression analysis. The 10-year estimated BRFS was 75%, 60% and 39% for low-, intermediate-, and high-risk patients, respectively. An in-depth analysis of high-risk patients demonstrated a 10-year metastasis-free and cancer-specific survival of 85% and 90%, respectively. A PSM was demonstrated to increase the risk of BR up to 3 fold. The location of PSM was found to be associated with the risk of BR, i.e. non-apical PSM had the highest risk of BR compared to margin negative and apical PSM, especially in pT2 tumours. A number of factors were found to correlate with the risk of PSM, especially preoperative PSA, surgeon and nerve-sparing surgery. This thesis demonstrates that outcome of RP at Rigshospitalet is comparable to international results. Our studies confirm the prognostic importance of PSM, also in pT2 disease, and indicate that

Surgical outcomes of patients with superficial esophageal cancer. A comparison between trans-thoracic esophagectomy and trans-hiatal esophagectomy

International Nuclear Information System (INIS)

Matsumoto, Hideo; Kubota, Hisako; Murakami, Haruaki

2010-01-01

We inspected the feasibility of minimally invasive surgery for superficial esophageal cancer, the trans-hiatal approach without thoracotomy. We examined the surgical outcomes of 33 superficial esophageal cancer whose cancer had invaded the submucosal layer and who underwent resection in our hospital between April 2003 and April 2009. The patients who had tumor invasion of within the sm1 and no metastasis to the upper and middle mediastinum lymph nodes were operated on by the trans-hiatal esophagectomy (THE). The other patients were underwent ordinary trans-thoracic esophagectomy (TTE). After the operations, we recommended adjuvant chemoradiation therapy for all patients whose tumor were histopathologically proved to involve the sm2 layer as well as the vessels and/or lymphatic duct. Of our 33 cases, nine were diagnosed as pM1 or pM2. Two were diagnosed as pM3, one of which had lymph node metastasis. Eleven cases were diagnosed as pSM1, four as pSM2, and seven as pSM3; and lymph node metastasis was observed in 4 pSM1 cases (36%), 2 pSM2 cases (50%) and 5 pSM3 cases (71.4%). The five-year survival rate in all cases was 89.6%. The five-year survival rate by operating method was 100% in THE cases or 80.9% in TTE cases. The rates by tumor depth of invasion was 100% in pM1-2 cases, 92.3% in pM3-SM1 cases and 78.8% in pSM2-3 cases. It is concluded that the surgical outcome of THE in accordance with our indication criteria is equal to that of TTE for superficial esophageal cancer. (author)

A physiological skeletal model for radionuclide and stable element biokinetics in children and adults

International Nuclear Information System (INIS)

Richardson, R.B.

2010-01-01

A physiological skeletal model (PSM) is described that represents the skeletal uptake, retention and clearance of both bone-surface-seeking and bone-volume-seeking radionuclides and stable elements. A key objective of the PSM is to model the higher skeletal growth and bone turnover in infants and children (compared to adults) in order to to account for their greater uptake and cancer risk from bone-seeking contaminants such as lead and plutonium. The PSM is a compartmental model that allows for the incorporation of organic and inorganic material in the bone volume via quiescent bone surfaces, forming bone surfaces and the lacuno-canaliculi system. The model uniquely incorporates a tertiary phase of mineralization via bone fluids. The PSM's structural concepts and biokinetic parameters - such as realistic mass transfers, organ and tissue masses, and bone remodelling half times - are selected mainly on the basis of physiological and anatomical criteria. For brevity, model parameter values or evaluated for adults only. The PSM is an improvement on existing skeletal models that are based more on compartment structures and pathways that rendered good fits to biokinetic data rather than on being anatomically and physiologically accurate. (author)

N- and O-methylation of sphingomyelin markedly affects its membrane properties and interactions with cholesterol

DEFF Research Database (Denmark)

Bjorkbom, A.; Rog, T.; Kankaanpaa, P.

2011-01-01

-phase instability (T(m), was lowered by similar to 7 degrees C). Atomistic molecular dynamics simulations showed that fluid phase bilayers with methylated SM analogs were more expanded but thinner compared to PSM bilayers. It was further revealed that 3-OH methylation dramatically attenuated hydrogen bonding also...... containing PSM. Molecular dynamics simulations revealed further that cholesterol's bilayer location was deeper in PSM bilayers as compared to the location in bilayers made from methylated SM analogs. This study shows that the interfacial properties of SMs are very important for interlipid interactions...

Plants status monitor: Modelling techniques and inherent benefits

International Nuclear Information System (INIS)

Breeding, R.J.; Lainoff, S.M.; Rees, D.C.; Prather, W.A.; Fickiessen, K.O.E.

1987-01-01

The Plant Status Monitor (PSM) is designed to provide plant personnel with information on the operational status of the plant and compliance with the plant technical specifications. The PSM software evaluates system models using a 'distributed processing' technique in which detailed models of individual systems are processed rather than by evaluating a single, plant-level model. In addition, development of the system models for PSM provides inherent benefits to the plant by forcing detailed reviews of the technical specifications, system design and operating procedures, and plant documentation. (orig.)

Relationship between visual field progression and baseline refraction in primary open-angle glaucoma.

Science.gov (United States)

Naito, Tomoko; Yoshikawa, Keiji; Mizoue, Shiro; Nanno, Mami; Kimura, Tairo; Suzumura, Hirotaka; Umeda, Yuzo; Shiraga, Fumio

2016-01-01

To analyze the relationship between visual field (VF) progression and baseline refraction in Japanese patients with primary open-angle glaucoma (POAG) including normal-tension glaucoma. In this retrospective study, the subjects were patients with POAG who had undergone VF tests at least ten times with a Humphrey Field Analyzer (Swedish interactive thresholding algorithm standard, Central 30-2 program). VF progression was defined as a significantly negative value of mean deviation (MD) slope at the final VF test. Multivariate logistic regression models were applied to detect an association between MD slope deterioration and baseline refraction. A total of 156 eyes of 156 patients were included in this analysis. Significant deterioration of MD slope was observed in 70 eyes of 70 patients (44.9%), whereas no significant deterioration was evident in 86 eyes of 86 patients (55.1%). The eyes with VF progression had significantly higher baseline refraction compared to those without apparent VF progression (-1.9±3.8 diopter [D] vs -3.5±3.4 D, P=0.0048) (mean ± standard deviation). When subject eyes were classified into four groups by the level of baseline refraction applying spherical equivalent (SE): no myopia (SE > -1D), mild myopia (-1D ≥ SE > -3D), moderate myopia (-3D ≥ SE > -6D), and severe myopia (-6D ≥ SE), the Cochran-Armitage trend analysis showed a decreasing trend in the proportion of MD slope deterioration with increasing severity of myopia (P=0.0002). The multivariate analysis revealed that baseline refraction (P=0.0108, odds ratio [OR]: 1.13, 95% confidence interval [CI]: 1.03-1.25) and intraocular pressure reduction rate (P=0.0150, OR: 0.97, 95% CI: 0.94-0.99) had a significant association with MD slope deterioration. In the current analysis of Japanese patients with POAG, baseline refraction was a factor significantly associated with MD slope deterioration as well as intraocular pressure reduction rate. When baseline refraction was classified into

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews

Science.gov (United States)

Geneen, Louise J; Moore, R Andrew; Clarke, Clare; Martin, Denis; Colvin, Lesley A; Smith, Blair H

2017-01-01

Background Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%. For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning. Physical activity and exercise programmes are increasingly being promoted and offered in various healthcare systems, and for a variety of chronic pain conditions. It is therefore important at this stage to establish the efficacy and safety of these programmes, and furthermore to address the critical factors that determine their success or failure. Objectives To provide an overview of Cochrane Reviews of adults with chronic pain to determine (1) the effectiveness of different physical activity and exercise interventions in reducing pain severity and its impact on function, quality of life, and healthcare use; and (2) the evidence for any adverse effects or harm associated with physical activity and exercise interventions. Methods We searched theCochrane Database of Systematic Reviews (CDSR) on the Cochrane Library (CDSR 2016, Issue 1) for systematic reviews of randomised controlled trials (RCTs), after which we tracked any included reviews for updates, and tracked protocols in case of full review publication until an arbitrary cut-off date of 21 March 2016 (CDSR 2016, Issue 3). We assessed the methodological quality of the reviews using the AMSTAR tool, and also planned to analyse data for each painful condition based on quality of the evidence. We extracted data for (1) self-reported pain severity, (2) physical function (objectively or subjectively measured), (3

Incidence of flare-ups and evaluation of quality after retreatment of resorcinol-formaldehyde resin ("Russian Red Cement") endodontic therapy.

Science.gov (United States)

Gound, Tom G; Marx, David; Schwandt, Nathan A

2003-10-01

The purpose of this retrospective study was to evaluate the quality of treatment and incidence of flare-ups when teeth with resorcinol-formaldehyde resin are retreated in a postgraduate endodontic clinic. Fifty-eight cases were included in this study. Obturated and unfilled canal space was measured on radiographs. Forty-eight percent of the total canal space was filled before retreatment; 90% was filled after retreatment. After retreatment, obturations were rated as optimal in 59%, improved in 33%, unchanged in 6%, and worse in 2%. Seven patients (12%) had postretreatment flare-ups. Data were statistically analyzed using the Cochran-Armitage Test for Discrete Variables. No statistical difference in the incidence of flare-ups was found in teeth that before treatment had more than half the canal space filled compared to teeth with less than half, cases with pre-existing periradicular radiolucencies compared to cases with normal periradicular appearance, symptomatic cases compared to asymptomatic cases, or cases with optimal fillings after retreatment compared to less than optimal cases. It was concluded that teeth with resorcinol-formaldehyde fillings might be retreated with a good prognosis for improving the radiographic quality, but a higher than normal incidence of flare-ups may occur.

Comparison of ELISA, radioimmunoassay and stool examination for Schistosoma mansoni infection

Energy Technology Data Exchange (ETDEWEB)

Long, E G [Ministry of Health, St. Lucia (West Indies); McLaren, M M; Goddard, M J [London School of Hygiene and Tropical Medicine (UK); Bartholomew, R K; Goodgame, R [Rockefeller Foundation, New York (USA); Peters, P [Case Western Reserve Univ., Cleveland, OH (USA)

1981-01-01

A comparison was made of the sensitivity and specificity of four diagnostic tests for Schistosoma mansoni infection in a community of 516 untreated persons in St. Lucia, West Indies. Prevalence of infection as obtained by: (i) the Bell filtration technique was 44.4% (one filter) and 63.2% (three filters); (ii) the Kato thick smear, 60.2%; (iii) by radioimmunoassay (RIA), using /sup 125/I, 73.3%; and (iv) enzyme-immunoassay (ELISA) 70.9%. The age distribution of persons serologically positive but parasitologically negative showed these to be mostly children and persons 40 years old and over. By means of a statistical test due to Cochrane it was concluded that there was no evidence to indicate a difference between paired serological tests and paired parasitological tests in their diagnostic capability. There was a very significant difference between the Bell technique and the other three tests. The ELISA emerged as a less satisfactory test than the RIA or the Kato thick smear. The levels of sensitivity and specificity of each test were measured by Armitage's ''J'' index. The reliability of the Bell filtration technique was 64%, of the ELISA 68%, of the RIA 78% and of the Kato 85%.

Citizenship behavior and turnover intention : The role of public service motivation and career commitments

NARCIS (Netherlands)

Birhane, Lakew Alemu

2017-01-01

This dissertation sought to examine the mechanisms for how public service motivation (PSM) in general, individual PSM dimensions, and career commitments influence organizational citizenship behavior, which, in turn, is shown to be related to the turnover intention of public employees. The

Plant secondary metabolites in alfalfa, birdsfoot trefoil, reed canarygrass, and tall fescue unaffected by two different nitrogen sources

Science.gov (United States)

Plant secondary metabolites (PSM) may increase the sustainability of agriculture systems by reducing inputs, as PSM protect plants against herbivores and pathogens, act as pesticides, insecticides, and anthelmintics, while also attracting pollinators and seed dispersers. Therefore, it is important t...

Reporting and methodologic quality of Cochrane Neonatal review group systematic reviews

Directory of Open Access Journals (Sweden)

Al Faleh Khalid

2009-06-01

Full Text Available Abstract Background The Cochrane Neonatal Review Group (CNRG has achieved a lot with limited resources in producing high quality systematic reviews to assist clinicians in evidence-based decision-making. A formal assessment of published CNRG systematic reviews has not been undertaken; we sought to provide a comprehensive assessment of the quality of systematic reviews (both methodologic and reporting quality published in CNRG. Methods We selected a random sample of published CNRG systematic reviews. Items of the QUOROM statement were utilized to assess quality of reporting, while items and total scores of the Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ were used to assess methodologic quality. Two reviewers independently extracted data and assessed quality. A Student t-test was used to compare quality scores pre- and post-publication of the QUOROM statement. Results Sixty-one systematic reviews were assessed. Overall, the included reviews had good quality with minor flaws based on OQAQ total scores (mean, 4.5 [0.9]; 95% CI, 4.27–4.77. However, room for improvement was noted in some areas, such as the title, abstract reporting, a priori plan for heterogeneity assessment and how to handle heterogeneity in case it exists, and assessment of publication bias. In addition, reporting of agreement among reviewers, documentation of trials flow, and discussion of possible biases were addressed in the review process. Reviews published post the QUOROM statement had a significantly higher quality scores. Conclusion The systematic reviews published in the CNRG are generally of good quality with minor flaws. However, efforts should be made to improve the quality of reports. Readers must continue to assess the quality of published reports on an individual basis prior to implementing the recommendations.

Distribution of country of origin in studies used in Cochrane Reviews.

Directory of Open Access Journals (Sweden)

Robert F Wolff

Full Text Available BACKGROUND AND OBJECTIVE: Inclusion in systematic reviews is one important component in judging the potential impact of clinical studies upon practice and hence the 'value for money' of spending for clinical research. This study aims to quantify the distribution of countries of origin of clinical studies used in Cochrane Reviews (CRs, and to link these data to the size of a country and to its spending on research. METHODS: Random sample of publications used for CRs published in Issue 1 2008 and of publications used in CRs in the field of complementary and alternative medicine (CAM. Publications without original data were excluded. Likely countries of origin determined based on abstracts/full texts. CIA World Factbook (population data and OECD database (economic data were used. RESULTS: 1,000 random entries out of 140,005 references available in all specialities. In 876 (91.4% of 959 eligible studies, country of origin was determined. The USA was the leading contributor (36.0% of the studies, followed by UK (13.4%, Canada (5.3%, Australia and Sweden (3.7%. In the CAM sample, country of origin was determined in 458 (93.5% of 497 assessed studies. Again, the USA was the leading contributor (24.9%, with China also emerging as a significant contributor (24.7% in this field. For both samples, the contribution of smaller countries (especially Scandinavian countries, Greece, and Ireland became more noteworthy when considered in relation to population size and research spending. CONCLUSIONS: Our results support the leading roles of both the USA and the UK in publishing clinical papers. The emerging role of China can be seen, particularly related to CAM studies. Taking into account size of population and economic power, countries like France, Germany, Italy, and Spain provide small contributions. In contrast, smaller countries like Australia, Denmark, Finland, Ireland, New Zealand, and Sweden also play major roles.

Energy Trends 2012; Energie Trends 2012

Energy Technology Data Exchange (ETDEWEB)

Van Dril, T. (ed.); Gerdes, J. (ed.) [ECN Beleidsstudies, Petten (Netherlands); Marbus, S. (ed.) [Energie-Nederland, Den Haag (Netherlands); Boelhouwer, M. (ed.) [Netbeheer Nederland, Arnhem (Netherlands)

2012-11-15

In Energy Trends 2012, all figures and developments in the field of energy in the Netherlands are presented in conjunction. The book provides information on energy use by consumers and businesses, provides insight into the international energy trade, energy production and development of energy networks [Dutch] In Energie Trends 2012 staan alle cijfers en ontwikkelingen op het gebied van energie in Nederland in samenhang gepresenteerd. Het boek biedt informatie over energiegebruik door consumenten en bedrijven, geeft inzage in de internationale energiehandel en energieproductie en biedt inzicht in de ontwikkeling van de energienetten.

Explaining Public Service Motivation : The Role of Leadership and Basic Needs Satisfaction

NARCIS (Netherlands)

Vandenabeele, Wouter

2014-01-01

Both leadership and public service motivation (PSM) are important issues in contemporary public administration. By connecting these issues, the aim of this article is to assess the impact of one particular type of transformational leadership behavior-promoting public values-on PSM development. Two

A new approach on stress-related depression and anxiety: Neuro-Psycho- Physical-Optimization with Radio Electric Asymmetric-Conveyer.

Science.gov (United States)

Rinaldi, Salvatore; Fontani, Vania; Moretti, Elena; Rosettani, Barbara; Aravagli, Lucia; Saragò, Giorgio; Collodel, Giulia

2010-08-01

Chronic social stress is an important factor responsible for the worsening of depressive disorders in humans. In this study we present the relational Neuro-Psycho-Physical Optimization (NPPO) with Radio Electric Asymmetric Conveyer (REAC-CRM) as the treatment to tackle the unconscious dysfunction adjustments carried out by the central nervous system as a response to environmental stresses. Psychological stress was measured in a group of 888 patients using the Psychological Stress Measure (PSM) test, a self-administered questionnaire. Data were collected immediately before and after the 4-wk therapy cycle. The detection of anxiety and depression clusters by PSM test has been based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, APA, 2000) criteria. Six hundred and eighty eight patients (212 males, 476 females, average PSM test total scores 107.9 +/- 23.13) were treated with REAC-CRM therapy; 200 (64 males, 136 females, average PSM test total scores 107.86 +/- 25.80) were treated with "placebo REAC-CRM therapy"and used as control. This study showed a significant reduction in scores measuring subjective perceptions of stress in the patients treated with a cycle of REAC-CRM therapy. At the end-point the number of patients reporting symptoms of stress-related anxiety and depression on the PSM test was significantly reduced (P<0.001); in the placebo group no significant difference was highlighted. NPPO therapy with a cycle of REAC-CRM was shown to reduce subjective perceptions of stress measured by the PSM test and in particular, symptoms of stress-related anxiety and depression.

Example process hazard analysis of a Department of Energy water chlorination process

Energy Technology Data Exchange (ETDEWEB)

1993-09-01

On February 24, 1992, the Occupational Safety and Health Administration (OSHA) released a revised version of Section 29 Code of Federal Regulations CFR Part 1910 that added Section 1910.119, entitled ``Process Safety Management of Highly Hazardous Chemicals`` (the PSM Rule). Because US Department of Energy (DOE) Orders 5480.4 and 5483.1A prescribe OSHA 29 CFR 1910 as a standard in DOE, the PSM Rule is mandatory in the DOE complex. A major element in the PSM Rule is the process hazard analysis (PrHA), which is required for all chemical processes covered by the PSM Rule. The PrHA element of the PSM Rule requires the selection and application of appropriate hazard analysis methods to systematically identify hazards and potential accident scenarios associated with processes involving highly hazardous chemicals (HHCs). The analysis in this report is an example PrHA performed to meet the requirements of the PSM Rule. The PrHA method used in this example is the hazard and operability (HAZOP) study, and the process studied is the new Hanford 300-Area Water Treatment Facility chlorination process, which is currently in the design stage. The HAZOP study was conducted on May 18--21, 1993, by a team from the Westinghouse Hanford Company (WHC), Battelle-Columbus, the DOE, and Pacific Northwest Laboratory (PNL). The chlorination process was chosen as the example process because it is common to many DOE sites, and because quantities of chlorine at those sites generally exceed the OSHA threshold quantities (TQs).

Wrong to be Right: Margin Laterality is an Independent Predictor of Biochemical Failure After Radical Prostatectomy.

Science.gov (United States)

Kang, Jung J; Reiter, Robert E; Kummer, Nicolas; DeKernion, Jean; Steinberg, Michael L; King, Christopher R

2018-01-01

To examine the impact of positive surgical margin (PSM) laterality on failure after radical prostatectomy (RP). A PSM can influence local recurrence and outcomes after salvage radiation. Unlike intrinsic risk factors, a PSM is caused by intervention and thus iatrogenic failures may be elucidated by analyzing margin laterality as surgical approach is itself lateralized. We reviewed 226 RP patients between 1991 and 2013 with PSM. Data includes operation type, pre/postoperative PSA, surgical pathology, and margin type (location, focality, laterality). The median follow-up was 47 months. Biochemical recurrence after RP was defined as PSA≥0.1 ng/mL or 2 consecutive rises above nadir. Ninety-two patients received salvage radiation therapy (SRT). Failure after SRT was defined as any PSA≥0.2 ng/mL or greater than presalvage. Kaplan-Meier and Cox multivariate analyses compared relapse rates. The majority of PSM were iatrogenic (58%). Laterality was associated with differences in median relapse: right 20 versus left 51 versus bilateral 14 months (PRight-sided margins were more likely to progress than left (hazard ratio, 1.67; P=0.04). More right-sided margins were referred for SRT (55% right vs. 23% left vs. 22% bilateral), but were equally salvaged. Only T-stage and pre-SRT PSA independently influenced SRT success. Most PSM are iatrogenic, with right-sided more likely to progress (and sooner) than left sided. Margin laterality is a heretofore unrecognized independent predictor of biochemical relapse and hints at the need to modify the traditional unilateral surgical technique.

The Development of Psychosomatic Reasoning in General Practitioners: An Empirical Study

Directory of Open Access Journals (Sweden)

Alireza Monajemi

2017-08-01

Full Text Available Background: Monajemi, Goli, and Scheidt (2014 proposed a theory of development of psychosomatic (PSM reasoning. They hypothesized that the integration of psychosocial knowledge with biomedical (BM knowledge may have started at the level of GPs. An experimental study was conducted to explore and compare junior and senior practitioners regarding their shift from BM to PSM in terms of their decision-making.Methods: Two cases were presented to GPs in a sequential manner based on the reports of different settings (inpatient vs. outpatient. Each participant read each part of the case carefully in order to provide the management plan (Mx, determine which parts of the scenario were the most important, and write down, first, an explanatory model, and then, the management plan for the patient. The accuracy of item selection, explanatory models, and management plans were analysed.Results: GPs have already acquired some PSM knowledge, and thus, they will be able to differentiate between the two focuses (i.e., BM and PSM, but are not yet proficient enough to deal with a case in a PSM focus efficiently. This results in ineffective judgment. In other words, GPs discern the importance that should be given to psychosocial factors when examining their patients; however, they do not take into consideration such factors in the management plan.Conclusion: The results were largely in line with our assumptions based on the theory of the development of PSM reasoning; however, there is a definite need for more experimental studies here to support this argument.

Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review

NARCIS (Netherlands)

van Wingerden, Jan J.; Ubbink, Dirk T.; van der Horst, Chantal M. A. M.; de Mol, Bas A. J. M.

2014-01-01

Early recognition and, where possible, avoidance of risk factors that contribute to the development of poststernotomy mediastinitis (PSM) form the basis for successful prevention. Once the presence of PSM is diagnosed, the known risk factors have been shown to have limited influence on management

The public service-motivated volunteer devoting time or effort

DEFF Research Database (Denmark)

Costello, Joyce; Homberg, Fabian; Secchi, Davide

2017-01-01

and thus may inform subsequent empirical work. First, we address academic debates concerning the measurement of volunteer effort. Second, we propose using public service motivation (PSM) theory as a means to understand the motivation of volunteers across sectors. We suggest that different PSM dimensions...

Comparison of soymilk and probiotic soymilk effects on serum high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in diabetic Wistar rats

Directory of Open Access Journals (Sweden)

Mina Babashahi

2015-04-01

Full Text Available BACKGROUND: Soy milk (SM and its fermented products are identified as rich sources of bioactive compounds helping to manage and to reduce the risk of chronic disease. This study aimed to compare the effects of SM and probiotic SM (PSM consumption on serum low-density lipoprotein cholesterol (LDL-C and high-density lipoprotein cholesterol (HDL-C in diabetic Wistar rats. METHODS: Probiotic SM was prepared by fermentation of the plain SM with a native strain of Lactobacillus plantarum. 20 streptozotocin-nicotinamide-induced diabetic Wistar rats were divided into two groups based on the type of administered SM (SM group and PSM group. The animals were fed with 1 ml/day of either soy or PSM for 21 days. The serum lipoprotein levels were analyzed at baseline and the end of the intervention period. RESULTS: HDL-C increased significantly in PSM group. Furthermore, this group showed more percent of change in increased HDL-C in compression with SM group (P < 0.050. Regarding LDL-C level, rats fed with SM was not significantly different from the PSM group (P < 0.050; though, this biomarker was reduced in both group. CONCLUSION: Probiotic SM could modulate blood lipoprotein levels. Thus, it may be considered in managing diabetes complications and atherosclerotic risks. 

Lessons Learned from Process Safety Management: A Practical Guide to Defence in Depth

Energy Technology Data Exchange (ETDEWEB)

Langerman, N., E-mail: neal@chemical-safety.com [Advanced Chemical Safety, Inc., San Diego (United States)

2014-10-15

Full text: Beginning with the experiences of Alfred Nobel, the chemical enterprise has learned from failures and implemented layers of protection to prevent unwanted incidents. Nobel developed dynamite as a more stable alternative to nitroglycerin, a process we would today call “inherently safer technology”. In recent years, the USA has issued regulations requiring formal “risk management plans” to identify and mitigate production risks. The USA set up the “Chemical Safety and Hazard Investigation Board” as an independent investigator of serious chemical enterprise incidents with a mission to issue recommendations aimed at preventing repeated incidents based on lessons learned. Following a particularly violent explosion in Texas in 1989, the US Occupational Safety and Health Administration issued the “Process Safety Management” (PSM) rule. PSM is a singular guide to defence in depth for preventing large-scale production incidents. The formalism is equally applicable to the chemical enterprise and the nuclear installation enterprise. This presentation will discuss the key elements of PSM and offer suggestions on using PSM as a guide to developing multiple layers of protection. The methods of PSM are applicable to Nuclear Generating Stations, research reactors, fuel reprocessing plants and fissile material storage and handling. Examples from both the chemical and nuclear enterprises will be used to illustrate key points. (author)

MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint

Energy Technology Data Exchange (ETDEWEB)

Nakanishi, Katsuyuki; Inoue, Masahiro; Murakami, Takamichi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

1992-12-01

To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26,70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90deg). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM. (author).

MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint

International Nuclear Information System (INIS)

Nakanishi, Katsuyuki; Inoue, Masahiro; Murakami, Takamichi

1992-01-01

To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26,70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90deg). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM. (author)

The trend of quality of publications in endodontic surgery: a 10-year systematic survey of the literature.

Science.gov (United States)

Del Fabbro, Massimo; Corbella, Stefano; Tsesis, Igor; Taschieri, Silvio

2015-03-01

The aims of the present systematic literature analysis were to evaluate, over a 10-year period, the trend of the proportion of RCT, SR, MA published on endodontic surgery, and to investigate if the impact factor (IF) of the main endodontic Journals correlates with the proportion of RCT, SR, MA they publish. An electronic search of the RCT, SR and MA published on the topic "endodontic surgery" from 2001 to 2010 was performed on Medline and Cochrane CENTRAL database using specific search terms combined with Boolean operators. Endodontic Journals impact factor was retrieved by the Thomson Scientific database. The proportion of each study type over the total number of articles on endodontic surgery published per year was estimated. The correlation between the number of high-evidence level studies published on the main endodontic Journals and the IF of such Journals per year was estimated. From a total of 900 articles published in 2001-2010 on endodontic surgery, there were 114 studies of high evidence level. A significant increase of the proportion of either RCT, SR and MA over the years was found. A modest to unclear correlation was found between the Journal IF and the number of high-evidence articles published. There is a positive trend over the years among researchers in performing studies of good quality in endodontic surgery. The impact factor of endodontic Journals is not consistently influenced by publication of high-evidence level articles. Copyright © 2015 Elsevier Inc. All rights reserved.

Exploring the use of systems thinking approaches in the management of alternative food networks

DEFF Research Database (Denmark)

Tavella, Elena

. The analysis shows that the expert and the novices behave differently, as well as similarly while facilitating the workshop, thus supporting and contrasting the explored claim. In identifying differences this research contributes to PSM theory by extending the definition of ‘expert vs. novice’ PSM facilitator...

Review : Public service motivation—practical problems, scientific evidence and the role of a research community

NARCIS (Netherlands)

Vandenabeele, Wouter; Skelcher, Chris

2015-01-01

This review article introduces Public Money & Management's theme papers and articles on public service motivation (PSM). PSM has proven to be a promising road in creating public performance and public value and this theme brings it to an even wider audience, ensuring that policy-makers and those

Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review.

Science.gov (United States)

van Wingerden, Jan J; Ubbink, Dirk T; van der Horst, Chantal M A M; de Mol, Bas A J M

2014-11-23

Early recognition and, where possible, avoidance of risk factors that contribute to the development of poststernotomy mediastinitis (PSM) form the basis for successful prevention. Once the presence of PSM is diagnosed, the known risk factors have been shown to have limited influence on management decisions. Evidence-based knowledge on treatment decisions, which include the extent and type of surgical intervention (other than debridement), timing and others is available but has not yet been incorporated into a classification on management decisions regarding PSM. Ours is a first attempt at developing a classification system for management of PSM, taking the various evidence-based reconstructive options into consideration. The classification is simple to introduce (there are four Types) and relies on the careful establishment of two variables (sternal stability and sternal bone viability and stock) prior to deciding on the best available reconstructive option. It should allow better insight into why treatment decisions fail or have to be altered and will allow better comparison of treatment outcomes between various institutions.

On the Nature of Trends

DEFF Research Database (Denmark)

Mackinney-Valentin, Maria

2010-01-01

A consolidation of the field Trend Studies through mapping, updating and developing trend theory.......A consolidation of the field Trend Studies through mapping, updating and developing trend theory....

Evolution of poor reporting and inadequate methods over time in 20 920 randomised controlled trials included in Cochrane reviews: research on research study.

Science.gov (United States)

Dechartres, Agnes; Trinquart, Ludovic; Atal, Ignacio; Moher, David; Dickersin, Kay; Boutron, Isabelle; Perrodeau, Elodie; Altman, Douglas G; Ravaud, Philippe

2017-06-08

Objective  To examine how poor reporting and inadequate methods for key methodological features in randomised controlled trials (RCTs) have changed over the past three decades. Design  Mapping of trials included in Cochrane reviews. Data sources  Data from RCTs included in all Cochrane reviews published between March 2011 and September 2014 reporting an evaluation of the Cochrane risk of bias items: sequence generation, allocation concealment, blinding, and incomplete outcome data. Data extraction  For each RCT, we extracted consensus on risk of bias made by the review authors and identified the primary reference to extract publication year and journal. We matched journal names with Journal Citation Reports to get 2014 impact factors. Main outcomes measures  We considered the proportions of trials rated by review authors at unclear and high risk of bias as surrogates for poor reporting and inadequate methods, respectively. Results  We analysed 20 920 RCTs (from 2001 reviews) published in 3136 journals. The proportion of trials with unclear risk of bias was 48.7% for sequence generation and 57.5% for allocation concealment; the proportion of those with high risk of bias was 4.0% and 7.2%, respectively. For blinding and incomplete outcome data, 30.6% and 24.7% of trials were at unclear risk and 33.1% and 17.1% were at high risk, respectively. Higher journal impact factor was associated with a lower proportion of trials at unclear or high risk of bias. The proportion of trials at unclear risk of bias decreased over time, especially for sequence generation, which fell from 69.1% in 1986-1990 to 31.2% in 2011-14 and for allocation concealment (70.1% to 44.6%). After excluding trials at unclear risk of bias, use of inadequate methods also decreased over time: from 14.8% to 4.6% for sequence generation and from 32.7% to 11.6% for allocation concealment. Conclusions  Poor reporting and inadequate methods have decreased over time, especially for sequence generation

Assessment of educational games for health professions: a systematic review of trends and outcomes.

Science.gov (United States)

Abdulmajed, Hind; Park, Yoon Soo; Tekian, Ara

2015-04-01

Traditional lecturing used in teaching has the lowest retention rate; the use of games as part of an instruction method may enhance retention and reinforce learning by creating a dynamic educational environment. This study aims to systematically review the literature on educational games for the health professions to identify trends and investigate assessment tools used to measure its learning outcomes. Seven databases were used in the search: ERIC, Education Research Complete, Medline, Medline Complete, Academic Search Complete, The Cochrane Library and PubMed. The search identified 2865 papers; among them, 1259 were excluded and 22 were evaluated. The selection incorporated five full papers which focused directly on the health professionals. Two studies involved the use of board games and two studies involved card games, crossword puzzles and one study involved a team quiz competition. Overall, studies lacked a strong link between the use of games for both instructional and assessment purposes. Gaming makes a positive impact on the teaching/learning process. However, existing assessment methodologies have been not fully captured the learning that may occur in these games. Robust research is needed to address the use of games that have been assessed objectively.

The dark sides of public service motivation: A multi-level theoretical framework

NARCIS (Netherlands)

Schott, C.; Ritz, Adrian

2017-01-01

Over the past decade, research on public service motivation (PSM) has made substantial progress in terms of explaining the desired work outcomes of the concept such as individual performance and satisfaction. In light of Perry and Wise’s warning, already voiced in 1990, that high levels of PSM may

Incidence of positive surgical margins after robotic assisted radical prostatectomy: Does the surgeon's experience have an influence on all pathological stages?

Science.gov (United States)

Villamil, A W; Costabel, J I; Billordo Peres, N; Martínez, P F; Giudice, C R; Damia, O H

2014-03-01

The aim of this study is to analyze the clinical and surgical features of patients who underwent robotic-assisted radical prostatectomy (RARP) at our institution, and the impact of the surgeon's experience in the oncological results related to pathological stage. An analysis of 300 RARP consecutively performed by the same urologist was conducted. Patients were divided into 3 groups of 100 patients in chronological order, according to surgery date. All patients had organ-confined clinical stage. Variables which could impact in positive margins rates were analyzed. Finally, positive surgical margins (PSM) in regard to pathological stage and surgeon's experience were compared and analyzed. No significant differences were found in variables which could impact in PSM rates. The overall PSM rate was 21%, with 28% in the first group, 20% in the second, and 16% in the third (P = .108). Significant lineal decreasing tendency was observed (P = .024). In pT2 patients, the overall PSM rate was 16.6%, with 27%, 13.8%, and 7.3% in each group respectively (P = .009). A significant difference was found between group 1 and group 3 (P = .004). In pT3 patients, the surgeon's experience was not significantly associated with margin reductions with an overall PSM rate of 27.7% (28.2%, 28.6%, and 26.7% in each group respectively). Clinical and surgical features in our patients did not vary over time. We found a significant reduction of PSM related to surgeon's experience in pT2 patients. Contrariwise, the margin status remained stable despite increasing experience in pT3 patients. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Petroleum supply monthly, April 1998, with data for February 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-04-01

The Petroleum Supply Monthly (PSM) is one of a family of four publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. Data presented in the PSM describe the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. Most time series include preliminary estimates for one month based on the Weekly Petroleum Supply Reporting System; statistics based on the most recent data from the Monthly Petroleum Supply Reporting System (MPSRS); and statistics published in prior issues of the PSM and PSA. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. In most cases, the statistics are presented for several geographic areas--the US (50 States and District of Columbia), 5 PAD Districts and 12 Refining Districts. 16 figs., 56 tabs.

In Ovo Electroporation for Targeting the Somitic Mesoderm

Science.gov (United States)

Ohata, Emi; Takahashi, Yoshiko

The somite is a transient structure present in early vertebrate embryos, giving rise to a variety of essential tissues including skeletal muscles, dermis, axial bones and blood vessels. The term “somite” refers to a tissue of spherical structure that forms by pinching off from the continuous tissue called presomitic mesoderm (PSM, also called segmental plate in avian embryos). The PSM is recognized as a pair of longitudinal stripes along the midline of the body. Thus, each somite forms at the anterior end of PSM, and this process recurs periodically in time and space, gener ating the segmented pattern of the body along the antero-posterior axis.

Public service motivation and job performance of public sector employees in the Netherlands

NARCIS (Netherlands)

Leisink, P.L.M.; Steijn, B.

2009-01-01

This article contributes in three ways to our understanding of public service motivation (PSM) and its effects. In the first place, it applies an abridged version of Perry's measurement scale in the Dutch public sector. Although the results of the analysis show that PSM is a valid concept in this

Zika pandemic online trends, incidence and health risk communication: a time trend study.

Science.gov (United States)

Adebayo, Gbenga; Neumark, Yehuda; Gesser-Edelsburg, Anat; Abu Ahmad, Wiessam; Levine, Hagai

2017-01-01

We aimed to describe the online search trends of Zika and examine their association with Zika incidence, assess the content of Zika-related press releases issued by leading health authorities and examine the association between online trends and press release timing. Using Google Trends, the 1 May 2015 to 30 May 2016 online trends of Zika and associated search terms were studied globally and in the five countries with the highest numbers of suspected cases. Correlations were then examined between online trends and Zika incidence in these countries. All Zika-related press releases issued by WHO/Pan America Health Organization (PAHO) and Centers for Disease Control and Prevention (CDC) during the study period were assessed for transparency, uncertainty and audience segmentation. Witte's Extended Parallel Process Model was applied to assess self-efficacy, response efficacy, susceptibility and severity. AutoRegressive Integrated Moving Average with an eXogenous predictor variable (ARIMAX) (p,d,q) regression modelling was used to quantify the association between online trends and the timing of press releases. Globally, Zika online search trends were low until the beginning of 2016, when interest rose steeply. Strong correlations (r=0.748-0.922; ponline trends and the number of suspected Zika cases in four of the five countries studied. Compared with press releases issued by WHO/PAHO, CDC press releases were significantly more likely to provide contact details and links to other resources, include figures/graphs, be risk-advisory in nature and be more readable and briefer. ARIMAX modelling results indicate that online trends preceded by 1 week press releases by WHO (stationary-R 2 =0.345; ponline trends can aid in pandemic surveillance. Identification of shortcomings in the content and timing of Zika press releases can help guide health communication efforts in the current pandemic and future public health emergencies.

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a study protocol.

Science.gov (United States)

da Costa, Bruno R; Resta, Nina M; Beckett, Brooke; Israel-Stahre, Nicholas; Diaz, Alison; Johnston, Bradley C; Egger, Matthias; Jüni, Peter; Armijo-Olivo, Susan

2014-12-13

The Cochrane risk of bias (RoB) tool has been widely embraced by the systematic review community, but several studies have reported that its reliability is low. We aim to investigate whether training of raters, including objective and standardized instructions on how to assess risk of bias, can improve the reliability of this tool. We describe the methods that will be used in this investigation and present an intensive standardized training package for risk of bias assessment that could be used by contributors to the Cochrane Collaboration and other reviewers. This is a pilot study. We will first perform a systematic literature review to identify randomized clinical trials (RCTs) that will be used for risk of bias assessment. Using the identified RCTs, we will then do a randomized experiment, where raters will be allocated to two different training schemes: minimal training and intensive standardized training. We will calculate the chance-corrected weighted Kappa with 95% confidence intervals to quantify within- and between-group Kappa agreement for each of the domains of the risk of bias tool. To calculate between-group Kappa agreement, we will use risk of bias assessments from pairs of raters after resolution of disagreements. Between-group Kappa agreement will quantify the agreement between the risk of bias assessment of raters in the training groups and the risk of bias assessment of experienced raters. To compare agreement of raters under different training conditions, we will calculate differences between Kappa values with 95% confidence intervals. This study will investigate whether the reliability of the risk of bias tool can be improved by training raters using standardized instructions for risk of bias assessment. One group of inexperienced raters will receive intensive training on risk of bias assessment and the other will receive minimal training. By including a control group with minimal training, we will attempt to mimic what many review authors

Trends in Education.

Science.gov (United States)

School Planning & Management, 2002

2002-01-01

Several architects, planners, administrators, and contractors answer questions about trends related to school construction, interior design, business, security, and technology. Trends concern funding issues, specialized designs, planning for safety, technological integration, and equity in services. (EV)

Lung Cancer Trends

Science.gov (United States)

... the Biggest Cancer Killer in Both Men and Women” Stay Informed Trends for Other Kinds of Cancer Breast Cervical Colorectal (Colon) Ovarian Prostate Skin Cancer Home Lung Cancer Trends Language: English Español (Spanish) Recommend ...

World trends from 2017

Directory of Open Access Journals (Sweden)

Janković Slobodan

2016-01-01

Full Text Available Issue of prognosis, analyses of future trends is companion to statecraft, political, economic and military planning. How we plan, what does IR says about scientific prognosis. Jankovic starts with this set of issues in order to pass into prognosis itself based on observable world trends. He claims that European Union has entered its climax comparing it foreign policy situation with that of war situation of Third Reich in 1943. Article is divided in five parts. After presenting and criticizing Anglo-American approach in prognosis, he starts with analysis of the world order changes, of EU trends, Middle, Far East and some trends regarding Africa. Author presents macro trends in North - West Pacific, in Israel-Palestine, in Syria, Iraq, in Europe.

Chapter 10. From PSB to PSM

OpenAIRE

Jakubowicz, Karol

2013-01-01

10.1. Introduction There is no shortage of gloom-and-doom forecasts concerning the future of public service broadcasting (PSB), or rather the possibility that it may have no future. Thomass (2007) has noted that PSB is likely to celebrate its hundredth birthday in 2020, but only if it can renew itself by that time. This does not indicate great confidence in PSB’s future. Some of those who formulate such forecasts would indeed like to see an end to PSB. Others feel that PSB should continue but...

[Mental health: an identification of new directions walking in Archie Cochrane footsteps].

Science.gov (United States)

Tansella, Michele

2006-10-01

New borders and promising new directions in scientific fields are often difficult to identify and define. This paper attempts to it so in relation to recent developments and new research evidence in mental health, recognizing that this exercise may be biased by many factors, including: the author's own perspective, professional background and research training and the always present dialectic between the analysis of the past and the attraction of the future. A good starting point is the ground-breaking work by Sir Archibald Cochrane. He recommended to adopt a rigorous and continuous evaluation of clinical practice and protocols, promoting well designed clinical research and the use of scientific methods. This evidence-based approach should also be used in mental health. High quality research, continuous education and good clinical practice, incorporating the results of scientific experiments and observations, represent the approach that ensures an improvement in care provision and patient satisfaction. Currently, mental health care is still too "opinion oriented", due to the over emphasis placed on personal experience and traditional approaches by many psychiatrists. In this paper some of the most promising recent results in psychosocial research, psychopharmacological studies and genetics, as well as in neuroimaging studies, are briefly summarised. From a pragmatic point of view, it is possible to achieve a significant improvement in the quality of mental health care if the following procedure is followed: firstly, to start from solid evidence; secondly, to promote the wide implementation of evidence-based research into every day practice; thirdly, to ensure that administrators and policy makers incorporate the available scientific evidence in the planning and evaluating services and mental health systems of care. The integration between research, education and practice remains the hardest border to cross, yet the achievement of it holds the greatest promise for

Effectiveness and efficacy of nutritional therapy: A systematic review following Cochrane methodology.

Science.gov (United States)

Muscaritoli, Maurizio; Krznarić, Zeljko; Singer, Pierre; Barazzoni, Rocco; Cederholm, Tommy; Golay, Alain; Van Gossum, André; Kennedy, Nicholas; Kreymann, Georg; Laviano, Alessandro; Pavić, Tajana; Puljak, Livia; Sambunjak, Dario; Utrobičić, Ana; Schneider, Stéphane M

2017-08-01

Disease-related malnutrition has deleterious consequences on patients' outcome and healthcare costs. The demonstration of improved outcome by appropriate nutritional management is on occasion difficult. The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed the Nutrition Education Study Group (ESPEN-NESG) to increase recognition of nutritional knowledge and support in health services. To obtain the best available evidence on the potential effects of malnutrition on morbidity, mortality and hospital stay; cost of malnutrition; effect of nutritional treatment on outcome parameters and pharmaco-economics of nutritional therapy, a systematic review of the literature was performed following Cochrane methodology, to answer the following key questions: Q1) Is malnutrition an independent predictive factor for readmission within 30 days from hospital discharge? Q2) Does nutritional therapy reduce the risk of readmission within 30 days from hospital discharge? Q3) Is nutritional therapy cost-effective/does it reduce costs in hospitalized patients? and Q4) Is nutritional therapy cost effective/does it reduce costs in outpatients? For Q1 six of 15 identified observational studies indicated that malnutrition was predictive of re-admissions, whereas the remainder did not. For Q2 nine randomized controlled trials and two meta-analyses gave non-conclusive results whether re-admissions could be reduced by nutritional therapy. Economic benefit and cost-effectiveness of nutritional therapy was consistently reported in 16 identified studies for hospitalized patients (Q3), whereas the heterogeneous and limited corresponding data on out-patients (Q4) indicated cost-benefits in some selected sub-groups. This result of this review supports the use of nutritional therapy to reduce healthcare costs, most evident from large, homogeneous studies. In general, reports are too heterogeneous and overall of limited quality for conclusions on impact of malnutrition and its

Computer architecture technology trends

CERN Document Server

1991-01-01

Please note this is a Short Discount publication. This year's edition of Computer Architecture Technology Trends analyses the trends which are taking place in the architecture of computing systems today. Due to the sheer number of different applications to which computers are being applied, there seems no end to the different adoptions which proliferate. There are, however, some underlying trends which appear. Decision makers should be aware of these trends when specifying architectures, particularly for future applications. This report is fully revised and updated and provides insight in

Lifestyle Factors in Hypertension Drug Research: Systematic Analysis of Articles in a Leading Cochrane Report

Directory of Open Access Journals (Sweden)

Dan E. Wilson

2014-01-01

Full Text Available Established standards for first-line hypertension management include lifestyle modification and behavior change. The degree to which and how lifestyle modification is systematically integrated into studies of first-line drug management for hypertension is of methodological and clinical relevance. This study systematically reviewed the methodology of articles from a recent Cochrane review that had been designed to inform first-line medical treatment of hypertension and was representative of high quality established clinical trials in the field. Source articles (n=34 were systematically reviewed for lifestyle interventions including smoking cessation, diet, weight loss, physical activity and exercise, stress reduction, and moderate alcohol consumption. 54% of articles did not mention lifestyle modification; 46% contained nonspecific descriptions of interventions. We contend that hypertension management research trials (including drug studies need to elucidate the benefits and risks of drug-lifestyle interaction, to support the priority of lifestyle modification, and that lifestyle modification, rather than drugs, is seen by patients and the public as a priority for health professionals. The inclusion of lifestyle modification strategies in research designs for hypertension drug trials could enhance current research, from trial efficacy to clinical outcome effectiveness, and align hypertension best practices of a range of health professionals with evidence-based knowledge translation.

The Effect of Plant Growth Promoting Rhizobacteria (PGPR and Phosphate Solubilizing Microorganism (PSM on Yield and Yield Components of Wheat (cv. N80 under Different Nitrogen and Phosphorous Fertilizers Levels in Greenhouse Condition

Directory of Open Access Journals (Sweden)

S. H Bahari saravi

2013-04-01

Full Text Available In order to evaluate the effect of plant growth promoting rhizobacteria (PGPR and phosphate solubilizing microorganism (PSM on yield and yield components of wheat a pot experiment was conducted at Sari Agricultural Sciences and Natural Resources University during 2009. Experiment was arranged in factorial based on completely randomized design in three replicates. Treatments were included bio-fertilizer in four levels (non-inoculation control, Phosphate Barvare 2 (Pseudomonas fluorescens+Bacillus subtilis, Supernitroplus (Azotobacter brasilense+Azospirillum lipoferum and Nitroxine (Azospirillum + Pseudomona + Bacillus, three levels of chemical nitrogen fertilizer (0, 75 and 150 kg urea/ha and three levels of phosphorus fertilizer (0, 60 and 120 kg super phosphate triple/ha. Results showed that the studied treatments (biofertilizer, nitrogen and phosphate inorganic fertilizers had significant effect on grain number per spike, 1000 grain weight, grain yield, straw yield, biological yield and harvest index. Interaction effect between biofertilizer and chemical fertilizers was significant in terms of grain yield. The maximum grain yield was resulted from simultaneously applying of Nitroxine and 75 kg ha-1 nitrogen fertilizer. By contrast, the highest straw yield was obtained when 150 kg nitrogen fertilizer was used. Grain yield had the maximum correlation with biological yield (r=0.85**. Grain yield positively and significantly correlated with grain number per spike (r=0.73**, 1000 grain weight (r=0.68**, straw yield (r=0.56** and harvest index (r=0.69**. In conclusion biofertilizer inoculations could reduce application of nitrogen and phosphorus chemical fertilizers and increase plant performance.

Niveles de plomo sanguíneo en madres y recién nacidos derechohabientes del Instituto Mexicano del Seguro Social

Directory of Open Access Journals (Sweden)

Navarrete-Espinosa Joel

2000-01-01

Full Text Available OBJETIVO: Establecer la relación entre el nivel de plomo sanguíneo materno (PSM y el de sangre en cordón umbilical (PSC al momento del parto, así como determinar los principales predictores del PSM en derechohabientes del Instituto Mexicano del Seguro Social (IMSS, en el Distrito Federal (D.F.. MATERIAL Y MÉTODOS: Se realizó un estudio transversal en el que se reclutaron voluntarias con embarazo normoevolutivo y se les tomaron muestras de sangre al momento del parto, en cuatro hospitales del IMSS en el D.F., de 1991 a 1993. Se tomó, además, muestra de sangre de cordón umbilical. Los datos fueron analizados mediante regresión lineal simple y múltiple. RESULTADOS: Se estudiaron un total de 1 404 binomios madre-hijo; el promedio de edad de las madres fue de 25 años. La media de PSM fue 10.7 ± 6.5 µg/dl; no se encontraron variaciones significativas por hospital, edad o estado civil. Para el PSC la media fue de 10.4 ± 6.2 µg/dl. Por cada aumento en una unidad logarítmica de PSM, el PSC aumenta 0.62 (p<0.01 unidades logarítmicas. La correlación entre ambos fue de 0.61 (p<0.01. Los principales predictores de PSM fueron el uso de loza vidriada, el consumo de leche y jugo de naranja, estos últimos se asociaron inversamente con el PSM. Un 47% de las madres y 50% de los niños tuvieron valores superiores a 10 µg/dl. En 578 recién nacidos se registraron niveles de plomo superiores a los de la madre. CONCLUSIONES: Se sugiere continuar la línea de investigación para proponer tipos de intervención.

The Agr Quorum Sensing System Represses Persister Formation through Regulation of Phenol Soluble Modulins in Staphylococcus aureus

Directory of Open Access Journals (Sweden)

Tao Xu

2017-11-01

Full Text Available The opportunistic pathogen Staphylococcus aureus has become an increasing threat to public health. While the Agr quorum sensing (QS system is a master regulator of S. aureus virulence, its dysfunction has been frequently reported to promote bacteremia and mortality in clinical infections. Here we show that the Agr system is involved in persister formation in S. aureus. Mutation of either agrCA or agrD but not RNAIII resulted in increased persister formation of stationary phase cultures. RNA-seq analysis showed that in stationary phase AgrCA/AgrD and RNAIII mutants showed consistent up-regulation of virulence associated genes (lip and splE, etc. and down-regulation of metabolism genes (bioA and nanK, etc.. Meanwhile, though knockout of agrCA or agrD strongly repressed expression of phenol soluble modulin encoding genes psmα1-4, psmβ1-2 and phenol soluble modulins (PSM transporter encoding genes in the pmt operon, mutation of RNAIII enhanced expression of the genes. We further found that knockout of psmα1-4 or psmβ1-2 augmented persister formation and that co-overexpression of PSMαs and PSMβs reversed the effects of AgrCA mutation on persister formation. We also detected the effects on persister formation by mutations of metabolism genes (arcA, hutU, narG, nanK, etc. that are potentially regulated by Agr system. It was found that deletion of the ManNAc kinase encoding gene nanK decreased persister formation. Taken together, these results shed new light on the PSM dependent regulatory role of Agr system in persister formation and may have implications for clinical treatment of MRSA persistent infections.

Impact of amphiphilic molecules on the structure and stability of homogeneous sphingomyelin bilayer: Insights from atomistic simulations

Science.gov (United States)

Kumari, Pratibha; Kaur, Supreet; Sharma, Shobha; Kashyap, Hemant K.

2018-04-01

Modulation of lipid membrane properties due to the permeation of amphiphiles is an important biological process pertaining to many applications in the field of pharmaceutics, toxicology, and biotechnology. Sphingolipids are both structural and functional lipids that constitute an important component of mechanically stable and chemically resistant outer leaflets of plasma membranes. Here, we present an atomistic molecular dynamics simulation study to appreciate the concentration-dependent effects of small amphiphilic molecules, such as ethanol, acetone, and dimethyl sulfoxide (DMSO), on the structure and stability of a fully hydrated homogeneous N-palmitoyl-sphingomyelin (PSM) bilayer. The study reveals an increase in the lateral expansion of the bilayer along with disordering of the hydrophobic lipid tails on increasing the concentration of ethanol. At higher concentrations of ethanol, rupturing of the bilayer is quite evident through the analysis of partial electron density profiles and lipid tail order parameters. For ethanol containing systems, permeation of water molecules in the hydrophobic part of the bilayer is allowed through local defects made due to the entry of ethanol molecules via ethanol-ethanol and ethanol-PSM hydrogen bonds. Moreover, the extent of PSM-PSM hydrogen bonding decreases with increasing ethanol concentration. On the other hand, acetone and DMSO exhibit minimal effects on the stability of the PSM bilayer at their lower concentrations, but at higher concentrations they tend to enhance the stability of the bilayer. The simulated potential of mean force (PMF) profiles for the translocation of the three solutes studied reveal that the free-energy of transfer of an ethanol molecule across the PSM lipid head region is lower than that for acetone and DMSO molecules. However, highest free-energy rise in the core hydrophobic part of the bilayer is observed for the DMSO molecule, whereas the ethanol and acetone PMF profiles show a lower barrier in

Normalize the response of EPID in pursuit of linear accelerator dosimetry standardization.

Science.gov (United States)

Cai, Bin; Goddu, S Murty; Yaddanapudi, Sridhar; Caruthers, Douglas; Wen, Jie; Noel, Camille; Mutic, Sasa; Sun, Baozhou

2018-01-01

Normalize the response of electronic portal imaging device (EPID) is the first step toward an EPID-based standardization of Linear Accelerator (linac) dosimetry quality assurance. In this study, we described an approach to generate two-dimensional (2D) pixel sensitivity maps (PSM) for EPIDs response normalization utilizing an alternative beam and dark-field (ABDF) image acquisition technique and large overlapping field irradiations. The automated image acquisition was performed by XML-controlled machine operation and the PSM was generated based on a recursive calculation algorithm for Varian linacs equipped with aS1000 and aS1200 imager panels. Cross-comparisons of normalized beam profiles and 1.5%/1.5 mm 1D Gamma analysis was adopted to quantify the improvement of beam profile matching before and after PSM corrections. PSMs were derived for both photon (6, 10, 15 MV) and electron (6, 20 MeV) beams via proposed method. The PSM-corrected images reproduced a horn-shaped profile for photon beams and a relative uniform profiles for electrons. For dosimetrically matched linacs equipped with aS1000 panels, PSM-corrected images showed increased 1D-Gamma passing rates for all energies, with an average 10.5% improvement for crossline and 37% for inline beam profiles. Similar improvements in the phantom study were observed with a maximum improvement of 32% for 15 MV and 22% for 20 MeV. The PSM value showed no significant change for all energies over a 3-month period. In conclusion, the proposed approach correct EPID response for both aS1000 and aS1200 panels. This strategy enables the possibility to standardize linac dosimetry QA and to benchmark linac performance utilizing EPID as the common detector. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Architecture of the Product State Model Environment

DEFF Research Database (Denmark)

Holm Larsen, Michael; Lynggaard, Hans Jørgen B.

2003-01-01

on thedevelopment activities of the PSM architecture. An example discusses how to handle product relatedinformation on the shop floor in a manufacturing company and focuses on how dynamically updatedproduct data can improve control of production activities. This prototype example of welding a jointbetween two steel...... plates serves as proof of concept for the PSM architecture....

Petroleum supply monthly, May 1999, with data for March 1999

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-05-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary supplies of petroleum products in the US (50 states and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 72 tabs.

Petroleum supply monthly, June 1999, with data for April 1999

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-06-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 figs., 66 tabs.

Petroleum supply monthly, April 1999, with data for February 1999

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-04-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 72 tabs.

Petroleum supply monthly, November 1998, with data for September 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-11-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the Unites States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 72 tabs.

Petroleum supply monthly, December 1997 with data from October 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-12-01

Data presented in the Petroleum Supply Monthly (PSM) describes the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregates, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 figs., 66 tabs.

Petroleum supply monthly, January 1999 with data for November 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-01-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 82 tabs.

Petroleum supply monthly, July 1997 with data from May 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-07-01

Data presented in the Petroleum Supply Monthly (PSM) describes the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 figs., 66 tabs.

Petroleum supply monthly, February 1999, with data for December 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-02-01

Data presented in the Petroleum Supply Monthly (PSM) describes the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 figs., 66 tabs.

Petroleum supply monthly, August 1998, with data for June 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-08-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 fig., 66 tabs.

Petroleum supply monthly: July 1998, with data for May 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-07-01

Data presented in the Petroleum Supply Monthly (PSM) describes the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 figs., 56 tabs.

Petroleum supply monthly, May 1996 with data from March 1996

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-05-01

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the US and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. 16 figs., 66 tabs.

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

Science.gov (United States)

Faggion, Clovis Mariano

2012-09-01

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

Conocimiento y perfil de uso de la biblioteca Cochrane en médicos asistentes a un congreso de Medicina Interna

Directory of Open Access Journals (Sweden)

Luz M. Letelier S.

2017-11-01

Full Text Available Introducción: las Revisiones Sistemáticas (RS son herramientas para practicar Medicina Basada en la Evidencia. La Colaboración Cochrane genera RS, pero el conocimiento y uso de la Biblioteca Cochrane (BC es heterogéneo. Nuestro objetivo fue describir el nivel de conocimiento y el perfil de uso de la BC entre asistentes a una Conferencia Mundial de Medicina Interna (WCIM. Método: estudio transversal vía encuesta electrónica entre asistentes al XXXI WCIM, recabando información demográfica de los participantes; su conocimiento, acceso y usos de la BC. Resultados: 413 asistentes aceptaron participar y 198 (47,9% de 24 países respondieron. 91,4% eran Latinoamericanos, 50,5% eran internistas. El conocimiento de la BC fue del 96,5%. El 76% de quienes respondieron usaban la BC al menos una vez al mes. No encontramos diferencias en la frecuencia de uso según edad o ámbito académico. Las principales razones para utilizar RS-BC fueron: toma de decisiones clínicas (67,6%, actualización (64,2% y docencia (31,8%; 46% consideraron la BC muy útil para sus propósitos. Los 35 años (70% vs 53%, p: 0,017. Quienes consideraron muy útil la BC la utilizaron significativamente más para propósitos docentes (41% vs. 24%, p: 0,019 y toma de decisiones clínicas (79% vs. 58%, p: 0,003 que quienes la declararon como a veces útil o no útil. Hubo también diferencias estadísticamente significativas en la distribución del acceso a la BC según región geográfica (p: 0,001. Conclusiones: encontramos un alto nivel de conocimiento dela BC entre los asistentes a WCIM. Los usuarios describen un uso frecuente para diversos propósitos, considerándola útil para estos.

Trend Analysis of Pahang River Using Non-Parametric Analysis: Mann Kendalls Trend Test

International Nuclear Information System (INIS)

Nur Hishaam Sulaiman; Mohd Khairul Amri Kamarudin; Mohd Khairul Amri Kamarudin; Ahmad Dasuki Mustafa; Muhammad Azizi Amran; Fazureen Azaman; Ismail Zainal Abidin; Norsyuhada Hairoma

2015-01-01

Flood is common in Pahang especially during northeast monsoon season from November to February. Three river cross station: Lubuk Paku, Sg. Yap and Temerloh were selected as area of this study. The stream flow and water level data were gathered from DID record. Data set for this study were analysed by using non-parametric analysis, Mann-Kendall Trend Test. The results that obtained from stream flow and water level analysis indicate that there are positively significant trend for Lubuk Paku (0.001) and Sg. Yap (<0.0001) from 1972-2011 with the p-value < 0.05. Temerloh (0.178) data from 1963-2011 recorded no trend for stream flow parameter but negative trend for water level parameter. Hydrological pattern and trend are extremely affected by outside factors such as north east monsoon season that occurred in South China Sea and affected Pahang during November to March. There are other factors such as development and management of the areas which can be considered as factors affected the data and results. Hydrological Pattern is important to indicate the river trend such as stream flow and water level. It can be used as flood mitigation by local authorities. (author)

Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol.

Science.gov (United States)

O'Brien, Kelly K; Tynan, Anne-Marie; Nixon, Stephanie A; Glazier, Richard H

2016-04-26

People with HIV are living longer with the health-related consequences of HIV, multi-morbidity, and aging. Exercise is a key strategy that may improve or sustain health for people living with HIV. Our aim was to examine the safety and effectiveness of aerobic exercise interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV. We conducted a systematic review using the Cochrane Collaboration protocol. We searched databases up to April 2013. We included randomized controlled trials comparing aerobic exercise with no exercise or another intervention performed at least three times per week for at least four weeks among adults living with HIV. Two reviewers independently determined study eligibility. Data were extracted from studies that met inclusion criteria using standardized forms. We assessed risk of bias using the Cochrane Collaboration's tool for assessing risk of bias. Outcomes were analyzed as continuous and meta-analyses conducted using random effects models with Review Manager (RevMan) computer software. Twenty-four studies met inclusion criteria (n = 936 participants at study completion); the majority of participants were men (73 %) and the majority were taking antiretroviral therapy (19/24 included studies). The exercise intervention included aerobic exercise alone (11 studies) or a combination of aerobic and resistive exercise (13 studies) ranging from 5 to 52 weeks. Fifty-eight meta-analyses were performed. Main results indicated statistically significant improvements in selected outcomes of cardiorespiratory status (maximum oxygen consumption, exercise time), strength (chest press, knee flexion), body composition (lean body mass, percent body fat, leg muscle area), depression symptoms, and quality of life (SF-36 questionnaire) among exercisers compared with non-exercisers. No significant differences in change in CD4 count and viral load were found

Prevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infections Among Transgender Persons Referred to an Italian Center for Total Sex Reassignment Surgery.

Science.gov (United States)

Luzzati, Roberto; Zatta, Marta; Pavan, Nicola; Serafin, Maurizia; Maurel, Cristina; Trombetta, Carlo; Barbone, Fabio

2016-07-01

The burden of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in transgender population is an underestimated issue. We performed a study to evaluate the prevalence of such infections in transgender persons addressed our center for total sex reassignment surgery (SRS). All transgender persons undergoing SRS from 2000 to 2014 were evaluated retrospectively. Participant characteristics and results of HIV, HBV, and HCV testing were collected. Exact Fisher test, Cochran-Armitage tests for trend and correct prevalence ratios were estimated. Among 498 transgender persons, 243 had confirmed serological data. Of them, 25 were female-to-male and 218 male-to-female (MtF) subjects. The prevalence of HIV, HBV and HCV infections was 0%, 4.0%, and 8.0% in female-to-male, and 12.1%, 4.6%, and 3.7% in MtF. Among MtF, younger age and earlier year of SRS were associated with lower HIV prevalence. From the multivariate model, the mutually adjustment prevalence ratios were 1.9 (95% confidence interval [95% CI], 1.2-3.1) for SRS in 2005-2010 and 3.6 (95% CI, 1.3-9.4) in 2010-2014, as compared with SRS in 2000-2004; and 4.7 (95% CI, 2.4-9.4) for South Americans as compared with others. Among the HCV-positive MtF, 57.1% were also HIV-positive. Regarding HBV, the immunity was 38.5% and, after mutual adjustment, the prevalence ratios were 2.1 (95% CI, 1.3-3.4) for South Americans versus others and 2.2 (95% CI, 1.6-3.1) for year of birth ≥ 1980. The prevalence of HBV and HCV infections among our transgender persons overlaps that reported in the general population, but HCV prevalence was much higher in HIV-infected MtF. The high burden of HIV infection among MtF and its recent incremented prevalence points out that social and medical support should be strongly promoted in such population.

Contemporary management of subclavian and axillary artery injuries-A Western Trauma Association multicenter review.

Science.gov (United States)

Waller, Christine J; Cogbill, Thomas H; Kallies, Kara J; Ramirez, Luis D; Cardenas, Justin M; Todd, S Rob; Chapman, Kayla J; Beckman, Marshall A; Sperry, Jason L; Anto, Vincent P; Eriksson, Evert A; Leon, Stuart M; Anand, Rahul J; Pearlstein, Maura; Capano-Wehrle, Lisa; Cothren Burlew, Clay; Fox, Charles J; Cullinane, Daniel C; Roberts, Jennifer C; Harrison, Paul B; Berg, Gina M; Haan, James M; Lightwine, Kelly

2017-12-01

Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. A multicenter, retrospective review of patients with subclavian or axillary artery injuries from January 1, 2004, to December 31, 2014, was completed at 11 participating Western Trauma Association institutions. Statistical analysis included χ, t-tests, and Cochran-Armitage trend tests. A p value less than 0.05 was significant. Two hundred twenty-three patients were included; mean age was 36 years, 84% were men. An increase in computed tomography angiography and decrease in conventional angiography was observed over time (p = 0.018). There were 120 subclavian and 119 axillary artery injuries. Procedure type was associated with injury grade (p < 0.001). Open operations were performed in 135 (61%) patients, including 93% of greater than 50% circumference lacerations and 83% of vessel transections. Endovascular repairs were performed in 38 (17%) patients; most frequently for pseudoaneurysms. Fourteen (6%) patients underwent a hybrid procedure. Use of endovascular versus open procedures did not increase over the duration of the study (p = 0.248). In-hospital mortality rate was 10%. Graft or stent thrombosis occurred in 7% and graft or stent infection occurred in 3% of patients. Mean follow-up was 1.6 ± 2.4 years (n = 150). Limb salvage was achieved in 216 (97%) patients. The management of subclavian and axillary artery injuries still requires a wide variety of open exposures and procedures, especially for the control of active hemorrhage from more than 50% vessel lacerations and transections. Endovascular repairs were used most often for

Bibliometric Analysis of Gender Authorship Trends and Collaboration Dynamics Over 30 Years of Spine 1985 to 2015.

Science.gov (United States)

Brinker, Alexander R; Liao, Jane L; Kraus, Kent R; Young, Jocelyn; Sandelski, Morgan; Mikesell, Carter; Robinson, Daniel; Adjei, Michael; Lunsford, Shatoria D; Fischer, James; Kacena, Melissa A; Whipple, Elizabeth C; Loder, Randall T

2018-07-15

A bibliometric analysis. The aim of this article was to study bibliometric changes over the last 30 years of Spine. These trends are important regarding academic publication productivity. Inflation in authorship number and other bibliometric variables has been described in the scientific literature. The issue of author gender is taking on increasing importance, as efforts are being made to close the gender gap. From 1985 to 2015, 10-year incremental data for several bibliometric variables were collected, including author gender. Standard bivariate statistical analyses were performed. Trends over time were assessed by the Cochran linear trend. A P < 0.05 was considered statistically significant. Inclusion criteria were met for 1566 manuscripts. The majority of the manuscripts were from North America (51.2%), Europe (25.2%), and Asia (20.8%). The number of manuscripts, authors, countries, pages, and references all increased from 1985 to 2015. There was a slight increase in female first authors over time (17.5% to 18.4%, P = 0.048). There was no gender change over time for corresponding authors (14.3% to 14.0%, P = 0.29). There was an 88% increase in the percentage of female first authors having male corresponding authors (P = 0.00004), and a 123% increase in male first authors having female corresponding authors (P = 0.0002). The 14% to 18% of female authors in Spine is higher than the ∼5% female membership of the Scoliosis Research Society and North American Spine Society. Manuscripts in Spine over the past 30 years have shown a significant increase in the number of authors, collaborating institutions and countries, printed pages, references, and number of times each manuscript was cited. There has been a mild increase in female first authorship, but none in corresponding authorship. Increases in female authorship will likely require recruitment of more females into the discipline rather than providing females in the discipline with authorship

Marketing Trends to Watch

Science.gov (United States)

Circle, Alison

2009-01-01

This article identifies 13 cultural trends that libraries can turn into opportunites to reach patrons. These trends include: Twitter, online reputation management, value added content, mobile marketing, and emotional connection.

The Cochrane Corner in the SAMJ: Summaries of Cochrane ...

African Journals Online (AJOL)

decisions is in doubt, but rather that the ethos of evidence-based ... the incorporation of information regarding patient preferences and values.[2]. So what ... Greenhalgh T, Howick J, Maskrey N. Evidence based medicine: A movement in crisis?

Models of Public Service Provision

DEFF Research Database (Denmark)

Andersen, Lotte Bøgh; Kristensen, Nicolai; Pedersen, Lene Holm

2013-01-01

This article extends the framework of Le Grand (2003, 2010) to encompass responsiveness, and the main argument is that the combination of employee motivation, user capacity, and models of public service provision potentially has serious implications for responsiveness across service areas. Although...... research on employee motivation thrives, especially in the public service motivation (PSM) literature, few studies have investigated user capacity empirically, and we know little about the combination of PSM, user capacity and models of service provision. Analyzing four central service areas (day care......, schools, hospitals, and universities), we find variations in both user capacity and PSM. Taking this variation as a point of departure we discuss what implications different combinations of employee motivation, user capacity, and models of public service provision may have for responsiveness....

Childhood amblyopia: current management and new trends

OpenAIRE

Tailor, V.; Bossi, M.; Greenwood, J. A.; Dahlmann-Noor, A.

2016-01-01

INTRODUCTION OR BACKGROUND: With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries. SOURCES OF DATA: Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database). AREAS OF AGREEMENT: Screening and treatment at the age of 4-5 years are cost efficient and clinically effective. Optical treatment (glasses) alone can im...

Only when the societal impact potential is high? A panel study of the relationship between public service motivation and performance

DEFF Research Database (Denmark)

Loon, Nina van; Kjeldsen, Anne Mette; Andersen, Lotte Bøgh

Does the performance of public organizations benefit from high public service motivation (PSM) under all circumstances? This article studies whether the societal impact potential (SIP) – the degree to which the job provides opportunities to contribute to society of the job –moderates the relation......Does the performance of public organizations benefit from high public service motivation (PSM) under all circumstances? This article studies whether the societal impact potential (SIP) – the degree to which the job provides opportunities to contribute to society of the job –moderates...... the relationship between PSM and self-perceived performance, first on the individual level, and second on an organizational level. By shifting to the organizational level we are able to provide a test over time. Using organizational panel data from 2010 and 2012 on approximately 13.000 public employees, we...... (organizational level) or even no relationship (individual level) when SIP is low. This is an important insight for organizations that aim to enhance their performance through PSM as it shows that individual motives only contribute to performance when they are accounted for in the design of the work....

Optimization of exposure procedures for sub-quarter-micron CMOS applications

Science.gov (United States)

Hotta, Shoji; Onozuka, Toshihiko; Fukumoto, Keiko; Shirai, Seiichiro; Okazaki, Shinji

1998-06-01

We investigated various exposure procedures to minimize the Critical Dimension (CD) variation for the patterning of sub- quarter micron gates. To examine dependence of the CD variation on the pattern pitch and defocus conditions, the light intensity profiles of four different mask structures: (1) a binary mask with clear field, (2) a binary mask with dark field, (3) a phase-edge type phase-shifting mask (a phase-edge PSM) with clear field, and (4) a halftone phase- shifting mask (a halftone PSM) were compared, where exposure wavelength was 248 nm and numerical aperture (NA) of KrF stepper was 0.55. For 200-nm gate patterns, dependence of the CD variation on the pattern pitch and defocus conditions was minimized by a phase-edge PSM with clear field. By optimizing the illumination condition for a phase-edge PSM exposure, we obtained the CD variation of 10 nm at the minimum gate pitch of 0.8 micrometer and the defocus condition of plus or minus 0.4 micrometer. Applying the optimized exposure procedure to the device fabrication process, we obtained the total CD variation of plus or minus 27 nm.

Petroleum supply monthly, October 1998, with data for August 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-10-01

Data presented in the PSM describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. A feature article, Accuracy of petroleum supply data, is also included. 72 tabs.

De-trending of turbulence measurements

DEFF Research Database (Denmark)

Hansen, Kurt Schaldemose; Larsen, Gunner Chr.

2006-01-01

contribution to the wind speed turbulence intensity for a number of representative locations. A linear de-trending process has been implemented during indexing of the time-series. The observed de-trended turbulence intensities are reduced 3 – 15 % compared to the raw turbulence intensity. This reduction...... depends primarily on site characteristics and local mean wind speed variations. Reduced turbulence intensity will result in lower design fatigue loads. This aspect of de-trending is discussed by use of a simple heuristic load model. Finally an empirical model for de-trending wind resource data...

Nutritional evaluation of phosphorylated pumpkin seed (Cucurbita moschata) protein concentrate in silver catfish Rhamdia quelen (Quoy and Gaimard, 1824).

Science.gov (United States)

Lovatto, Naglezi de Menezes; Goulart, Fernanda Rodrigues; de Freitas, Silvandro Tonetto; Mombach, Patricia Inês; Loureiro, Bruno Bianch; Bender, Ana Betine Beutinger; Boligon, Aline Augusti; Radünz Neto, João; da Silva, Leila Picolli

2015-12-01

An 8-week feeding trial was conducted to evaluate the effect of replacing fish meal with pumpkin seed meal (PSM) or phosphorylated protein concentrate of pumpkin seed meal (PPCPS) on growth and metabolic responses of silver catfish. Five isonitrogenous and isocaloric diets were formulated. Control diet contained fish meal as the main protein source. The treatment groups contained 25 and 50% of either PSM or PPCPS protein replaced the fishmeal protein. A total of 400 silver catfish, with initial mean weight of 24 ± 0.46 g, were distributed into 20 tanks. For data four orthogonal contrasts were applied: control diet versus PSM diets; control diets versus PPCPS diets; control versus other diets; PSM diets versus PPCPS diets. The results indicated that the fish fed PSM diets had lower weight gain when compared to either control diet or PPCPS. The PPCPS do not affect growth and protein efficiency ratio. Lower albumin contents were found for the control diet fish for the contrasts control diet versus PPCPS diet and control diet versus other diets. The hepatic ALAT enzyme activity was higher in the fish fed the control diet (P < 0.05). The hepatic ALP was most active in fish that received the PPCPS diets, when comparing control diet versus PPCPS diets and control diet versus other diets. The hepatosomatic index was higher for fish fed the PPCPS. Our results indicated that PPCPS presents relevant nutritional quality for fish and can replace the fish meal protein up to 50% without affecting growth, PER and intermediate metabolites in silver catfish.

Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

Energy Technology Data Exchange (ETDEWEB)

Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Grace L., E-mail: glsmith@mdanderson.org [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2016-03-15

Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

International Nuclear Information System (INIS)

Huo, Jinhai; Giordano, Sharon H.; Smith, Benjamin D.; Shaitelman, Simona F.; Smith, Grace L.

2016-01-01

Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

Oral Mycobiome Analysis of HIV-Infected Patients: Identification of Pichia as an Antagonist of Opportunistic Fungi

Science.gov (United States)

Mukherjee, Pranab K.; Chandra, Jyotsna; Retuerto, Mauricio; Sikaroodi, Masoumeh; Brown, Robert E.; Jurevic, Richard; Salata, Robert A.; Lederman, Michael M.; Gillevet, Patrick M.; Ghannoum, Mahmoud A.

2014-01-01

Oral microbiota contribute to health and disease, and their disruption may influence the course of oral diseases. Here, we used pyrosequencing to characterize the oral bacteriome and mycobiome of 12 HIV-infected patients and matched 12 uninfected controls. The number of bacterial and fungal genera in individuals ranged between 8–14 and 1–9, among uninfected and HIV-infected participants, respectively. The core oral bacteriome (COB) comprised 14 genera, of which 13 were common between the two groups. In contrast, the core oral mycobiome (COM) differed between HIV-infected and uninfected individuals, with Candida being the predominant fungus in both groups. Among Candida species, C. albicans was the most common (58% in uninfected and 83% in HIV-infected participants). Furthermore, 15 and 12 bacteria-fungi pairs were correlated significantly within uninfected and HIV-infected groups, respectively. Increase in Candida colonization was associated with a concomitant decrease in the abundance of Pichia, suggesting antagonism. We found that Pichia spent medium (PSM) inhibited growth of Candida, Aspergillus and Fusarium. Moreover, Pichia cells and PSM inhibited Candida biofilms (P = .002 and .02, respectively, compared to untreated controls). The mechanism by which Pichia inhibited Candida involved nutrient limitation, and modulation of growth and virulence factors. Finally, in an experimental murine model of oral candidiasis, we demonstrated that mice treated with PSM exhibited significantly lower infection score (P = .011) and fungal burden (P = .04) compared to untreated mice. Moreover, tongues of PSM-treated mice had few hyphae and intact epithelium, while vehicle- and nystatin-treated mice exhibited extensive fungal invasion of tissue with epithelial disruption. These results showed that PSM was efficacious against oral candidiasis in vitro and in vivo. The inhibitory activity of PSM was associated with secretory protein/s. Our findings provide the

SU-E-T-775: Use of Electronic Portal Imaging Device (EPID) for Quality Assurance (QA) of Electron Beams On Varian Truebeam System

Energy Technology Data Exchange (ETDEWEB)

Cai, B; Yaddanapudi, S; Sun, B; Li, H; Noel, C; Mutic, S; Goddu, S [Department of Radiation Oncology, Washington University in St Louis, St. Louis, MO (United States)

2015-06-15

Purpose: In a previous study we have demonstrated the feasibility of using EPID to QA electron beam parameters on a single Varian TrueBeam LINAC. This study aims to provide further investigation on (1) reproducibility of using EPID to detect electron beam energy changes on multiple machines and (2) evaluation of appropriate calibration methods to compare results from different EPIDs. Methods: Ad-hoc mode electron beam images were acquired in developer mode with XML code. Electron beam data were collected on a total of six machines from four institutions. A custom-designed double-wedge phantom was placed on the EPID detector. Two calibration methods - Pixel Sensitivity Map (PSM) and Large Source-to-Imager Distance Flood Field (LSID-FF) - were used. To test the sensitivity of EPID in detecting energy drifts, Bending Magnet Current (BMC) was detuned to invoke energy changes corresponding to ∼±1.5 mm change in R50% of PDD on two machines from two institutions. Percent depth ionization (PDI) curves were then analyzed and compared with the respective baseline images using LSID-FF calibration. For reproducibility testing, open field EPID images and images with a standard testing phantom were collected on multiple machines. Images with and without PSM correction for same energies on different machines were overlaid and compared. Results: Two pixel shifts were observed in PDI curve when energy changes exceeded the TG142 tolerance. PSM showed the potential to correct the differences in pixel response of different imagers. With PSM correction, the histogram of images differences obtained from different machines showed narrower distributions than those images without PSM correction. Conclusion: EPID is sensitive for electron energy changes and the results are reproducible on different machines. When overlaying images from different machines, PSM showed the ability to partially eliminate the intrinsic variation of various imagers. Research Funding from Varian Medical Systems

Automated analysis of flow cytometric data for measuring neutrophil CD64 expression using a multi-instrument compatible probability state model.

Science.gov (United States)

Wong, Linda; Hill, Beth L; Hunsberger, Benjamin C; Bagwell, C Bruce; Curtis, Adam D; Davis, Bruce H

2015-01-01

Leuko64™ (Trillium Diagnostics) is a flow cytometric assay that measures neutrophil CD64 expression and serves as an in vitro indicator of infection/sepsis or the presence of a systemic acute inflammatory response. Leuko64 assay currently utilizes QuantiCALC, a semiautomated software that employs cluster algorithms to define cell populations. The software reduces subjective gating decisions, resulting in interanalyst variability of state modeling (PSM). Four hundred and fifty-seven human blood samples were processed using the Leuko64 assay. Samples were analyzed on four different flow cytometer models: BD FACSCanto II, BD FACScan, BC Gallios/Navios, and BC FC500. A probability state model was designed to identify calibration beads and three leukocyte subpopulations based on differences in intensity levels of several parameters. PSM automatically calculates CD64 index values for each cell population using equations programmed into the model. GemStone software uses PSM that requires no operator intervention, thus totally automating data analysis and internal quality control flagging. Expert analysis with the predicate method (QuantiCALC) was performed. Interanalyst precision was evaluated for both methods of data analysis. PSM with GemStone correlates well with the expert manual analysis, r(2) = 0.99675 for the neutrophil CD64 index values with no intermethod bias detected. The average interanalyst imprecision for the QuantiCALC method was 1.06% (range 0.00-7.94%), which was reduced to 0.00% with the GemStone PSM. The operator-to-operator agreement in GemStone was a perfect correlation, r(2) = 1.000. Automated quantification of CD64 index values produced results that strongly correlate with expert analysis using a standard gate-based data analysis method. PSM successfully evaluated flow cytometric data generated by multiple instruments across multiple lots of the Leuko64 kit in all 457 cases. The probability-based method provides greater objectivity, higher

Trends of Sustainable Residential Architecture

OpenAIRE

Narvydas, A

2014-01-01

The article is based on Master’s research conducted during Scottish Housing Expo 2010. The aim of the research was to determine the prevailing trends in sustainable residential architecture. Each trend can be described by features detected during visual and technical observation of project data. Based on that architects may predict possible problems related to a specific trend.

Which Trend is your Friend?

DEFF Research Database (Denmark)

Levine, Ari; Heje Pedersen, Lasse

2016-01-01

Managed futures funds and commodity trading advisers (CTAs) use heuristics or statistical measures often called “filters” to trade on price trends. Two key statistical measures of trends are “time-series momentum” and “moving-average crossovers.” We show, empirically and theoretically, that these......Managed futures funds and commodity trading advisers (CTAs) use heuristics or statistical measures often called “filters” to trade on price trends. Two key statistical measures of trends are “time-series momentum” and “moving-average crossovers.” We show, empirically and theoretically......, that these trend indicators are closely related. In fact, they are equivalent representations in their most general forms. They also capture many other types of filters, such as the Hodrick–Prescott (HP) filter, the Kalman filter, and all other linear filters. We show how these filters can be represented through...

De-trending of turbulence measurements

DEFF Research Database (Denmark)

Hansen, Kurt Schaldemose; Larsen, Gunner Chr.

2007-01-01

based on time series statistics only. The performance of the proposed de-trending algorithm is assessed using huge number of time series recorded at different types of terrain and orography. The strategy is the following: Based on the available time series information a conventional (linear) time series...... de-trending is performed and subsequently compared with the prediction from the proposed algorithm. The de-trended turbulence intensities are reduced in the range of 3 – 15 % compared to the raw turbulence intensity. The performed analysis shows that the proposed model, based on statistical...... this requires access to the basic time-series. However, including a suitable modelling of the mean wind speed time variation, it is possible to estimate an approximate (linear) trend correction based on statistical data only. This paper presents such an algorithm for de-trending of turbulence standard deviation...

Evaluating characteristics of PROSPERO records as predictors of eventual publication of non-Cochrane systematic reviews: a meta-epidemiological study protocol.

Science.gov (United States)

Ruano, Juan; Gómez-García, Francisco; Gay-Mimbrera, Jesús; Aguilar-Luque, Macarena; Fernández-Rueda, José Luis; Fernández-Chaichio, Jesús; Alcalde-Mellado, Patricia; Carmona-Fernandez, Pedro J; Sanz-Cabanillas, Juan Luis; Viguera-Guerra, Isabel; Franco-García, Francisco; Cárdenas-Aranzana, Manuel; Romero, José Luis Hernández; Gonzalez-Padilla, Marcelino; Isla-Tejera, Beatriz; Garcia-Nieto, Antonio Velez

2018-03-09

Epidemiology and the reporting characteristics of systematic reviews (SRs) and meta-analyses (MAs) are well known. However, no study has analyzed the influence of protocol features on the probability that a study's results will be finally reported, thereby indirectly assessing the reporting bias of International Prospective Register of Systematic Reviews (PROSPERO) registration records. The objective of this study is to explore which factors are associated with a higher probability that results derived from a non-Cochrane PROSPERO registration record for a systematic review will be finally reported as an original article in a scientific journal. The PROSPERO repository will be web scraped to automatically and iteratively obtain all completed non-Cochrane registration records stored from February 2011 to December 2017. Downloaded records will be screened, and those with less than 90% fulfilled or are duplicated (i.e., those sharing titles and reviewers) will be excluded. Manual and human-supervised automatic methods will be used for data extraction, depending on the data source (fields of PROSPERO registration records, bibliometric databases, etc.). Records will be classified into published, discontinued, and abandoned review subgroups. All articles derived from published reviews will be obtained through multiple parallel searches using the full protocol "title" and/or "list reviewers" in MEDLINE/PubMed databases and Google Scholar. Reviewer, author, article, and journal metadata will be obtained using different sources. R and Python programming and analysis languages will be used to describe the datasets; perform text mining, machine learning, and deep learning analyses; and visualize the data. We will report the study according to the recommendations for meta-epidemiological studies adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for SRs and MAs. This meta-epidemiological study will explore, for the first time

CALS and the Product State Model - Methodology and Supporting Schools and Paradigms

DEFF Research Database (Denmark)

Larsen, Michael Holm

1998-01-01

incorporates relevant information about each stage of the production process.The paper will describe the research object, the model object and discuss a part of the methodology in developing a Product State Model. The project is primarily technological, however, organisational and human aspects......This paper address the preliminary considerations in a research project, initiated February 1997, regarding Continuous Acquisition and Life-cycle Support (CALS) which is a part of the activities in CALS Center Denmark. The CALS concept is presented focusing on the Product State Model (PSM). The PSM...... will be developed upon, will be discussed. Also, the parameters for evaluating the PSM will be considered. In establishing the theoretical body of knowledge with respect to CALS, an identification of schools and paradigms within the research area of applying information technology in a manufacturing environment...

Ion generation and CPC detection efficiency studies in sub 3-nm size range

Energy Technology Data Exchange (ETDEWEB)

Kangasluoma, J.; Junninen, H.; Sipilae, M.; Kulmala, M.; Petaejae, T. [Department of Physics, P.O. Box 64, 00014, University of Helsinki, Helsinki (Finland); Lehtipalo, K. [Department of Physics, P.O. Box 64, 00014, University of Helsinki, Helsinki (Finland); Airmodus Ltd., Finland, Gustaf Haellstroemin katu 2 A, 00560 Helsinki (Finland); Mikkilae, J.; Vanhanen, J. [Airmodus Ltd., Finland, Gustaf Haellstroemin katu 2 A, 00560 Helsinki (Finland); Attoui, M. [University Paris Est Creteil, University Paris-Diderot, LISA, UMR CNRS 7583 (France); Worsnop, D. [Department of Physics, P.O. Box 64, 00014, University of Helsinki, Helsinki (Finland) and Aerodyne Research Inc., Billerica, MA (United States)

2013-05-24

We studied the chemical composition of commonly used condensation particle counter calibration ions with a mass spectrometer and found that in our calibration setup the negatively charged ammonium sulphate, sodium chloride and tungsten oxide are the least contaminated whereas silver on both positive and negative and the three mentioned earlier in positive mode are contaminated with organics. We report cut-off diameters for Airmodus Particle Size Magnifier (PSM) 1.1, 1.3, 1.4, 1.6 and 1.6-1.8 nm for negative sodium chloride, ammonium sulphate, tungsten oxide, silver and positive organics, respectively. To study the effect of sample relative humidity on detection efficiency of the PSM we used different humidities in the differential mobility analyzer sheath flow and found that with increasing relative humidity also the detection efficiency of the PSM increases.

Ion generation and CPC detection efficiency studies in sub 3-nm size range

International Nuclear Information System (INIS)

Kangasluoma, J.; Junninen, H.; Sipilä, M.; Kulmala, M.; Petäjä, T.; Lehtipalo, K.; Mikkilä, J.; Vanhanen, J.; Attoui, M.; Worsnop, D.

2013-01-01

We studied the chemical composition of commonly used condensation particle counter calibration ions with a mass spectrometer and found that in our calibration setup the negatively charged ammonium sulphate, sodium chloride and tungsten oxide are the least contaminated whereas silver on both positive and negative and the three mentioned earlier in positive mode are contaminated with organics. We report cut-off diameters for Airmodus Particle Size Magnifier (PSM) 1.1, 1.3, 1.4, 1.6 and 1.6-1.8 nm for negative sodium chloride, ammonium sulphate, tungsten oxide, silver and positive organics, respectively. To study the effect of sample relative humidity on detection efficiency of the PSM we used different humidities in the differential mobility analyzer sheath flow and found that with increasing relative humidity also the detection efficiency of the PSM increases.

Cochrane Commentary: Probiotics For Prevention of Acute Upper Respiratory Infection.

Science.gov (United States)

Quick, Melissa

2015-01-01

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, who are at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyze 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI [at least one episode: odds ratio (OR): 0.53; 95% CI = 0.37-0.76, P school absence (OR: 0.10; 95% CI = 0.02-0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio: 0

Trends in der IT-Sicherheit

Science.gov (United States)

Eckert, Claudia

Ich möchte Ihnen einen Überblick geben über Trends, Challenges, offene Fragestellungen sowie Lösungsansätze aus dem Bereich der IT-Sicherheit. Meine Vorredner haben mir schon eine wunderbare Basis dafür geschaffen, indem sie wichtige Trends im Bereich IT bereits angesprochen haben. Deshalb werde ich auf diese Trends, nämlich das Internet of Things and Services nur noch einmal kurz eingehen, um daran dann die IT-Sicherheitsthemen, die sich aus diesen IT-Trends ergeben, zu skizzieren und anschließend Lösungen vorstellen, die insbesondere im Forschungsumfeld entwickelt werden, aber schon reif sind, auch in die unternehmerische Praxis übernommen zu werden.

Alignment of Product Models and Product State Models - Integration of the Product Lifecycle Phases

DEFF Research Database (Denmark)

Larsen, Michael Holm; Kirkby, Lars Phillip; Vesterager, Johan

1999-01-01

The purpose of this paper is to discuss the integration of the Product Model (PM) and the Product State Model (PCM). Focus is on information exchange from the PSM to the PM within the manufacturing of a single ship. The paper distinguishes between information and knowledge integration. The paper ...... provides some overall strategies for integrating PM and PSM. The context of this discussion is a development project at Odense Steel Shipyard....

The Acquisition of Functional Planning- and Programming Knowledge: Diagnosis, Modeling, and User-Adapted Help

OpenAIRE

Möbus, Claus; Schröder, Olaf

1993-01-01

The topic of our project has been to empirically investigate and to model processes of the acquisition, utilization, and optimization of knowledge while working with the ABSYNT Problem Solving Monitor (PSM ). The ABSYNT PSM is designed to support the acquisition of basic functional programming concepts by supplying learners with individualized, adaptive online help and proposals. ABSYNT ("Abstract Syntax Trees") is a functional visual programming language developed in the project. The ABSYNT ...

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.

Science.gov (United States)

Geneen, Louise J; Moore, R Andrew; Clarke, Clare; Martin, Denis; Colvin, Lesley A; Smith, Blair H

2017-04-24

Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%.For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning.Physical activity and exercise programmes are increasingly being promoted and offered in various healthcare systems, and for a variety of chronic pain conditions. It is therefore important at this stage to establish the efficacy and safety of these programmes, and furthermore to address the critical factors that determine their success or failure. To provide an overview of Cochrane Reviews of adults with chronic pain to determine (1) the effectiveness of different physical activity and exercise interventions in reducing pain severity and its impact on function, quality of life, and healthcare use; and (2) the evidence for any adverse effects or harm associated with physical activity and exercise interventions. We searched theCochrane Database of Systematic Reviews (CDSR) on the Cochrane Library (CDSR 2016, Issue 1) for systematic reviews of randomised controlled trials (RCTs), after which we tracked any included reviews for updates, and tracked protocols in case of full review publication until an arbitrary cut-off date of 21 March 2016 (CDSR 2016, Issue 3). We assessed the methodological quality of the reviews using the AMSTAR tool, and also planned to analyse data for each painful condition based on quality of the evidence.We extracted data for (1) self-reported pain severity, (2) physical function (objectively or subjectively measured), (3) psychological function, (4) quality of

Global fertility and population trends.

Science.gov (United States)

Bongaarts, John

2015-01-01

Over the past several decades, the world and most countries have undergone unprecedented demographic change. The most obvious example of this change is the rise in human numbers, and there are also important trends in fertility, family structure, mortality, migration, urbanization, and population aging. This paper summarizes past trends and projections in fertility and population. After reaching 2.5 billion in 1950, the world population grew rapidly to 7.2 billion in 2013 and the projections expect this total to be 10.9 billion by 2100. World regions differ widely in their demographic trends, with rapid population growth and high fertility continuing in the poorest countries, particularly in sub-Saharan Africa, while population decline, population aging, and very low fertility are now a key concern in many developed countries. These trends have important implications for human welfare and are of interest to policy makers. The conclusion comments briefly on policy options to address these adverse trends. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Immunotherapy for cancer

Science.gov (United States)

... 2017. Accessed February 15, 2018. Pardoll D. Cancer immunology. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan ... D.A.M. Editorial team. Related MedlinePlus Health Topics Cancer Immunotherapy Browse the Encyclopedia A.D.A. ...

Wage Sorting Trends

DEFF Research Database (Denmark)

Bagger, Jesper; Vejlin, Rune Majlund; Sørensen, Kenneth Lykke

Using a population-wide Danish Matched Employer-Employee panel from 1980-2006, we document a strong trend towards more positive assortative wage sorting. The correlation between worker and firm fixed effects estimated from a log wage regression increases from -0.07 in 1981 to .14 in 2001. The non......Using a population-wide Danish Matched Employer-Employee panel from 1980-2006, we document a strong trend towards more positive assortative wage sorting. The correlation between worker and firm fixed effects estimated from a log wage regression increases from -0.07 in 1981 to .14 in 2001....... The nonstationary wage sorting pattern is not due to compositional changes in the labor market, primarily occurs among high wage workers, and comprises 41 percent of the increase in the standard deviation of log real wages between 1980 and 2006. We show that the wage sorting trend is associated with worker...

Spatial-temporal trend for mother-to-child transmission of HIV up to infancy and during pre-Option B+ in western Kenya, 2007-13.

Science.gov (United States)

Waruru, Anthony; Achia, Thomas N O; Muttai, Hellen; Ng'ang'a, Lucy; Zielinski-Gutierrez, Emily; Ochanda, Boniface; Katana, Abraham; Young, Peter W; Tobias, James L; Juma, Peter; De Cock, Kevin M; Tylleskär, Thorkild

2018-01-01

Using spatial-temporal analyses to understand coverage and trends in elimination of mother-to-child transmission of HIV (e-MTCT) efforts may be helpful in ensuring timely services are delivered to the right place. We present spatial-temporal analysis of seven years of HIV early infant diagnosis (EID) data collected from 12 districts in western Kenya from January 2007 to November 2013, during pre-Option B+ use. We included in the analysis infants up to one year old. We performed trend analysis using extended Cochran-Mantel-Haenszel stratified test and logistic regression models to examine trends and associations of infant HIV status at first diagnosis with: early diagnosis (ever having breastfed, use of single dose nevirapine, and maternal antiretroviral therapy status. We examined these covariates and fitted spatial and spatial-temporal semiparametric Poisson regression models to explain HIV-infection rates using R-integrated nested Laplace approximation package. We calculated new infections per 100,000 live births and used Quantum GIS to map fitted MTCT estimates for each district in Nyanza region. Median age was two months, interquartile range 1.5-5.8 months. Unadjusted pooled positive rate was 11.8% in the seven-years period and declined from 19.7% in 2007 to 7.0% in 2013, p best in explaining geographical variation in MTCT. Improved EID uptake and reduced MTCT rates are indicators of progress towards e-MTCT. Cojoined analysis of time and covariates in a spatial context provides a robust approach for explaining differences in programmatic impact over time. During this pre-Option B+ period, the prevention of mother to child transmission program in this region has not achieved e-MTCT target of ≤50 infections per 100,000 live births. Geographical disparities in program achievements may signify gaps in spatial distribution of e-MTCT efforts and could indicate areas needing further resources and interventions.

Multiple long-term trends and trend reversals dominate environmental conditions in a man-made freshwater reservoir.

Science.gov (United States)

Znachor, Petr; Nedoma, Jiří; Hejzlar, Josef; Seďa, Jaromír; Kopáček, Jiří; Boukal, David; Mrkvička, Tomáš

2018-05-15

Man-made reservoirs are common across the world and provide a wide range of ecological services. Environmental conditions in riverine reservoirs are affected by the changing climate, catchment-wide processes and manipulations with the water level, and water abstraction from the reservoir. Long-term trends of environmental conditions in reservoirs thus reflect a wider range of drivers in comparison to lakes, which makes the understanding of reservoir dynamics more challenging. We analysed a 32-year time series of 36 environmental variables characterising weather, land use in the catchment, reservoir hydrochemistry, hydrology and light availability in the small, canyon-shaped Římov Reservoir in the Czech Republic to detect underlying trends, trend reversals and regime shifts. To do so, we fitted linear and piecewise linear regression and a regime shift model to the time series of mean annual values of each variable and to principal components produced by Principal Component Analysis. Models were weighted and ranked using Akaike information criterion and the model selection approach. Most environmental variables exhibited temporal changes that included time-varying trends and trend reversals. For instance, dissolved organic carbon showed a linear increasing trend while nitrate concentration or conductivity exemplified trend reversal. All trend reversals and cessations of temporal trends in reservoir hydrochemistry (except total phosphorus concentrations) occurred in the late 1980s and during 1990s as a consequence of dramatic socioeconomic changes. After a series of heavy rains in the late 1990s, an administrative decision to increase the flood-retention volume of the reservoir resulted in a significant regime shift in reservoir hydraulic conditions in 1999. Our analyses also highlight the utility of the model selection framework, based on relatively simple extensions of linear regression, to describe temporal trends in reservoir characteristics. This approach can

Procurement and Supply Management System for MDR-TB in Nigeria: Are the Early Warning Targets for Drug Stock Outs and Over Stock of Drugs Being Achieved?

Science.gov (United States)

Jatau, Bolajoko; Avong, Yohanna; Ogundahunsi, Olumide; Shah, Safieh; Tayler Smith, Katherine; Van den Bergh, Rafael; Zachariah, Rony; van Griensven, Johan; Ekong, Ernest; Dakum, Patrick

2015-01-01

The World Health Organisation (WHO) introduced the twelve early warning indicators for monitoring and evaluating drug Procurement and Supply management (PSM) systems, intended to prevent drug stock-outs and overstocking. Nigeria--one of the high Multi Drug Resistant Tuberculosis (MDR-TB) burden countries, scaled-up treatment in 2012 with the concurrent implementation of a PSM system. We evaluated how well this system functioned using the WHO indicators, including all seven MDR-TB treatment centres in the country that were functional throughout 2013. The quantity of MDR-TB drugs ordered for 2013 matched the annual forecast and all central orders placed during the year were delivered in full and on time. Drug consumption was 81%-106% of the quantity allocated for routine consumption. Timely submission of complete inventory reports ranged from 86-100%, late submissions being 5-15 days late. Forty to 71% of treatment centres placed a drug order when stock was below the minimum level of three months. The proportion of drug orders received at the treatment centres in full and on time ranged from 29-80%, late orders being 1-19 days late. The PSM was found to be performing well in terms of forecasting and procurement of MDR-TB drugs, but there were shortcomings in drug distribution, reporting at treatment centre level and in drug order placements. Despite these gaps, there were no stock outs. These findings indicate that where it matters most, namely ensuring that no drug stock outs affect patient management, the PSM system is effective. Addressing the observed shortcomings will help to strengthen the existing PSM system in anticipation of a growing MDR-TB case burden in the country.

Toxin Mediates Sepsis Caused by Methicillin-Resistant Staphylococcus epidermidis.

Directory of Open Access Journals (Sweden)

Li Qin

2017-02-01

Full Text Available Bacterial sepsis is a major killer in hospitalized patients. Coagulase-negative staphylococci (CNS with the leading species Staphylococcus epidermidis are the most frequent causes of nosocomial sepsis, with most infectious isolates being methicillin-resistant. However, which bacterial factors underlie the pathogenesis of CNS sepsis is unknown. While it has been commonly believed that invariant structures on the surface of CNS trigger sepsis by causing an over-reaction of the immune system, we show here that sepsis caused by methicillin-resistant S. epidermidis is to a large extent mediated by the methicillin resistance island-encoded peptide toxin, PSM-mec. PSM-mec contributed to bacterial survival in whole human blood and resistance to neutrophil-mediated killing, and caused significantly increased mortality and cytokine expression in a mouse sepsis model. Furthermore, we show that the PSM-mec peptide itself, rather than the regulatory RNA in which its gene is embedded, is responsible for the observed virulence phenotype. This finding is of particular importance given the contrasting roles of the psm-mec locus that have been reported in S. aureus strains, inasmuch as our findings suggest that the psm-mec locus may exert effects in the background of S. aureus strains that differ from its original role in the CNS environment due to originally "unintended" interferences. Notably, while toxins have never been clearly implied in CNS infections, our tissue culture and mouse infection model data indicate that an important type of infection caused by the predominant CNS species is mediated to a large extent by a toxin. These findings suggest that CNS infections may be amenable to virulence-targeted drug development approaches.

Googling trends in conservation biology.

Science.gov (United States)

Proulx, Raphaël; Massicotte, Philippe; Pépino, Marc

2014-02-01

Web-crawling approaches, that is, automated programs data mining the internet to obtain information about a particular process, have recently been proposed for monitoring early signs of ecosystem degradation or for establishing crop calendars. However, lack of a clear conceptual and methodological framework has prevented the development of such approaches within the field of conservation biology. Our objective was to illustrate how Google Trends, a freely accessible web-crawling engine, can be used to track changes in timing of biological processes, spatial distribution of invasive species, and level of public awareness about key conservation issues. Google Trends returns the number of internet searches that were made for a keyword in a given region of the world over a defined period. Using data retrieved online for 13 countries, we exemplify how Google Trends can be used to study the timing of biological processes, such as the seasonal recurrence of pollen release or mosquito outbreaks across a latitudinal gradient. We mapped the spatial extent of results from Google Trends for 5 invasive species in the United States and found geographic patterns in invasions that are consistent with their coarse-grained distribution at state levels. From 2004 through 2012, Google Trends showed that the level of public interest and awareness about conservation issues related to ecosystem services, biodiversity, and climate change increased, decreased, and followed both trends, respectively. Finally, to further the development of research approaches at the interface of conservation biology, collective knowledge, and environmental management, we developed an algorithm that allows the rapid retrieval of Google Trends data. © 2013 Society for Conservation Biology.

PSM and Media Personalisation – a Conflict?

DEFF Research Database (Denmark)

Sørensen, Jannick Kirk

2008-01-01

PSBs experience currently the challenge from personalised social webservices which let their users customise web pages. BBC’s re-launched front page is one response to this, this paper examines another widget-based project, namely the Danish PSB ‘DR’s ‘MitDR’ [MyDR]. Through in-depth research...... interviews during the design process of ‘MitDR’, tensions between the concept of PSB and the concept of personalisation are identified. The findings from the ‘MitDR’ project are analysed as a balance between getting attention and insisting on intention with Herbert Simon’s concept of attention economy......, and with a proposed concept of ‘narrative economy’. Furthermore it is discussed whether PSBs have customers and whether the management method of Customer Relation Management is relevant in relation to PSB....

Trend Monitoring and Forecasting

Science.gov (United States)

2015-03-11

including breaking news, meme , and commemorative day, on the context patterns. Table 2 shows the example pattern of classifying context pattern feature...used the following rule to find the ‘ meme ’. If the trending topic contains ‘#’ AND ‘subject+verb’, then trending topic is ‘ Meme ’. Table 2 Context

Synthesis of plastic scintillation microspheres: Alpha/beta discrimination

International Nuclear Information System (INIS)

Santiago, L.M.; Bagán, H.; Tarancón, A.; Garcia, J.F.

2014-01-01

Plastic scintillation microspheres (PSm) have been developed as an alternative for liquid scintillation cocktails due to their ability to avoid the mixed waste, besides other strengths in which the possibility for alpha/beta discrimination is included. The aim of this work was to evaluate the capability of PSm containing two combinations of fluorescence solutes (PPO/POPOP and pT/Bis-MSB) and variable amounts of a second organic solvent (naphthalene) to enhance the alpha/beta discrimination. Two commercial detectors with different Pulse Shape Discrimination performances (Quantulus and Triathler) were used to evaluate the alpha/beta discrimination. An optimal discrimination of alpha/beta particles was reached, with very low misclassification values (2% for beta particles and 0.5% for alpha particles), when PSm containing PPO/POPOP and between 0.6 and 2.0 g of naphthalene were evaluated using Triathler and the appropriate programme for data processing. - Highlights: • Plastic scintillation microspheres for α/β discrimination have been synthesised. • The energy transfer process in PSm with different compositions has been investigated. • The α/β discrimination capabilities of two commercial detectors have been evaluated. • 2% and 0.5% of misclassifications for β and α radionuclides have been achieved respectively

Performance Analysis of a Burst Transmission Mechanism Using Microsleep Operation for Green IEEE 802.11 WLANs

Directory of Open Access Journals (Sweden)

Raul Palacios-Trujillo

2017-07-01

Full Text Available This paper evaluates the performance of a burst transmission mechanism using microsleep operation to support high energy efficiency in IEEE 802.11 Wireless Local Area Networks (WLANs. This mechanism is an implementation of the IEEE 802.11ac Transmission Opportunity Power Save Mode (TXOP PSM. A device using the TXOP PSM-based mechanism can switch to a low-power sleep state for the time that another device transmits a burst of data frames to a third one. This operation is called microsleep and its feasibility strongly depends on the time and energy consumption that a device incurs in the transitions from and to the sleep state. This paper accounts for the impact of these transitions in the derivation of an analytical model to calculate the energy efficiency of the TXOP PSM-based mechanism under network saturation. Results obtained show that the impact of the transition requirements on the feasibility of microsleep operation can be significant depending on the selected system parameters, although it can be reduced by using burst transmissions. When microsleep operation is feasible, the TXOP PSM-based mechanism can improve the energy efficiency of other legacy mechanisms by up to 424% under high traffic loads.

Public Service Motivation and Paternalism

DEFF Research Database (Denmark)

Holm Pedersen, Lene; Qvistgaard, Lars

holds a potential to improve public service provision (Belle, 2013, Andersen et al., 2014), it also has dark sides (Van Loon et al., 2015, forthcoming). The aim of this paper is to analyze and discuss how one type of public service motivated individuals (paternalistic knights) and constitute a problem...... of democratic accountability. The setting of this discussion is unusual for the PSM literature, and takes PSM into the analysis and discussion of motivation and paternalism in trade unions. This setting is relevant and interesting as the election of representatives is based on elections, and hence trade unions...... variables are two dimensions of the PSM construct; namely self-sacrifice and commitment to the public interest, whereas the central independent variable is paternalistic orientation. All three variables are measured with survey constructs in a cross sectional survey design. The survey is made among...

Highly Sensitive and Selective Sensing of Free Bilirubin Using Metal-Organic Frameworks-Based Energy Transfer Process.

Science.gov (United States)

Du, Yaran; Li, Xiqian; Lv, Xueju; Jia, Qiong

2017-09-13

Free bilirubin, a key biomarker for jaundice, was detected with a newly designed fluorescent postsynthetically modified metal organic framework (MOF) (UIO-66-PSM) sensor. UiO-66-PSM was prepared based on the aldimine condensation reaction of UiO-66-NH 2 with 2,3,4-trihydroxybenzaldehyde. The fluorescence of UIO-66-PSM could be effectively quenched by free bilirubin via a fluorescent resonant energy transfer process, thus achieving its recognition of free bilirubin. It was the first attempt to design a MOF-based fluorescent probe for sensing free bilirubin. The probe exhibited fast response time, low detection limit, wide linear range, and high selectivity toward free bilirubin. The sensing system enabled the monitor of free bilirubin in real human serum. Hence, the reported free bilirubin sensing platform has potential applications for clinical diagnosis of jaundice.

Automating Trend Analysis for Spacecraft Constellations

Science.gov (United States)

Davis, George; Cooter, Miranda; Updike, Clark; Carey, Everett; Mackey, Jennifer; Rykowski, Timothy; Powers, Edward I. (Technical Monitor)

2001-01-01

Spacecraft trend analysis is a vital mission operations function performed by satellite controllers and engineers, who perform detailed analyses of engineering telemetry data to diagnose subsystem faults and to detect trends that may potentially lead to degraded subsystem performance or failure in the future. It is this latter function that is of greatest importance, for careful trending can often predict or detect events that may lead to a spacecraft's entry into safe-hold. Early prediction and detection of such events could result in the avoidance of, or rapid return to service from, spacecraft safing, which not only results in reduced recovery costs but also in a higher overall level of service for the satellite system. Contemporary spacecraft trending activities are manually intensive and are primarily performed diagnostically after a fault occurs, rather than proactively to predict its occurrence. They also tend to rely on information systems and software that are oudated when compared to current technologies. When coupled with the fact that flight operations teams often have limited resources, proactive trending opportunities are limited, and detailed trend analysis is often reserved for critical responses to safe holds or other on-orbit events such as maneuvers. While the contemporary trend analysis approach has sufficed for current single-spacecraft operations, it will be unfeasible for NASA's planned and proposed space science constellations. Missions such as the Dynamics, Reconnection and Configuration Observatory (DRACO), for example, are planning to launch as many as 100 'nanospacecraft' to form a homogenous constellation. A simple extrapolation of resources and manpower based on single-spacecraft operations suggests that trending for such a large spacecraft fleet will be unmanageable, unwieldy, and cost-prohibitive. It is therefore imperative that an approach to automating the spacecraft trend analysis function be studied, developed, and applied to

Injection therapy for subacute and chronic low back pain: an updated Cochrane review.

Science.gov (United States)

Staal, J Bart; de Bie, Rob A; de Vet, Henrica C W; Hildebrandt, Jan; Nelemans, Patty

2009-01-01

A systematic review of randomized controlled trials (RCTs). To determine if injection therapy is more effective than placebo or other treatments for patients with subacute or chronic low back pain. The effectiveness of injection therapy for low back pain is still debatable. Heterogeneity of target tissue, pharmacological agent, and dosage, generally found in RCTs, point to the need for clinically valid comparisons in a literature synthesis. We updated the search of the earlier systematic review and searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases up to March 2007 for relevant trials reported in English, French, German, Dutch, and Nordic languages. We also screened references from trials identified. RCTs on the effects of injection therapy involving epidural, facet, or local sites for subacute or chronic low back pain were included. Studies that compared the effects of intradiscal injections, prolotherapy, or ozone therapy with other treatments were excluded unless injection therapy with another pharmaceutical agent (no placebo treatment) was part of one of the treatment arms. Studies about injections in sacroiliac joints and studies evaluating the effects of epidural steroids for radicular pain were also excluded. Eighteen trials (1179 participants) were included in this review. The injection sites varied from epidural sites and facet joints (i.e. intra-articular injections, peri-articular injections and nerve blocks) to local sites (i.e. tender-and trigger points). The drugs that were studied consisted of corticosteroids, local anesthetics, and a variety of other drugs. The methodologic quality of the trials was limited with 10 of 18 trials rated as having a high methodologic quality. Statistical pooling was not possible because of clinical heterogeneity in the trials. Overall, the results indicated that there is no strong evidence for or against the use of any type of injection therapy. There is insufficient evidence to

Public Service Motivation og økonomiske incitamenter: substitutter eller fortrængning?

OpenAIRE

Jacobsen, Christian Bøtcher

2011-01-01

Motivation is probably one of the most important determinants for organizational performance, because it stimulates effort and effective behaviors among people in the organization. But what type of motivation should public managers rely on? The PSM literature has argued that public service motivation is the most important type of motivation in the delivery of public service, because it substitutes for egoistic motivation. Organizations whose members have high levels of PSM are therefore expec...

Trends in food choice and nutrition

DEFF Research Database (Denmark)

Grunert, Klaus G

2012-01-01

'Trends' in the way we eat are discussed in this chapter. Three potential trends are taken as points of departure, namely health concerns, convenience, and process characteristics. Some of the evidence provided may not necessarily be evidence of a trend itself, but can be regarded as indicators o...

Type 2 Diabetes Mellitus: A Review of Current Trends

Directory of Open Access Journals (Sweden)

Abdulfatai B. Olokoba

2012-07-01

Full Text Available Type 2 diabetes mellitus (DM is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO and American Diabetes Association (ADA criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.

NEW TRENDS IN MANAGEMENT

Directory of Open Access Journals (Sweden)

Micu Alexandra

2014-07-01

Full Text Available Over the last years, management have been facing a series of profound changes in trends coming and going, one being more productive than other or causing more damage when applied improperly. The paper focuses on the last trends in management that have evolved in the last years, trends that have been marked by a Darwinian business environment and made more unforgiving since the financial crisis and the innovations in technology, social media and management philosophy. The paper will present and describe the most important new trends in management that enabled select organisations to remain competitive and overcome the multiple difficulties caused by the ever-changing economy based on a qualitative research. From the “outside innovation” that is considered always to be the key in overcoming the obstacles facing an organization, to the new buzzword “design”, that is said to ensure the organization long-term competitive advantage, the paper will analyse new trends and also will be describing the impact they have on the welfare of the organization. The research has also shown that managers tend to put a greater accent on searching for innovation rather than efficiency in order to ensure a continuous progress in the organization and to maintain business sustainability. The paper will not be comparing the efficiency of these different philosophies, or the results they generated, as time will still be the ultimate judge.

Signal trend identification with fuzzy methods

International Nuclear Information System (INIS)

Reifman, J.; Tsoukalas, L. H.; Wang, X.; Wei, T. Y. C.

1999-01-01

A fuzzy-logic-based methodology for on-line signal trend identification is introduced. Although signal trend identification is complicated by the presence of noise, fuzzy logic can help capture important features of on-line signals and classify incoming power plant signals into increasing, decreasing and steady-state trend categories. In order to verify the methodology, a code named PROTREN is developed and tested using plant data. The results indicate that the code is capable of detecting transients accurately, identifying trends reliably, and not misinterpreting a steady-state signal as a transient one

Analysis of gravity data using trend surfaces

Science.gov (United States)

Asimopolos, Natalia-Silvia; Asimopolos, Laurentiu

2013-04-01

In this paper we have developed algorithms and related software programs for calculating of trend surfaces of higher order. These methods of analysis of trends, like mobile media applications are filtration systems for geophysical data in surface. In particular we presented few case studies for gravity data and gravity maps. Analysis with polynomial trend surfaces contributes to the recognition, isolation and measurement of trends that can be represented by surfaces or hyper-surfaces (in several sizes), thus achieving a separation in regional variations and local variations. This separation is achieved by adjusting the trend function at different values. Trend surfaces using the regression analysis satisfy the criterion of least squares. The difference between the surface of trend and the observed value in a certain point is the residual value. Residual sum of squares of these values should be minimal as the criterion of least squares. The trend surface is considered as regional or large-scale and the residual value will be regarded as local or small-scale component. Removing the regional trend has the effect of highlighting local components represented by residual values. Surface analysis and hyper-surfaces principles are applied to the surface trend and any number of dimensions. For hyper-surfaces we can work with polynomial functions with four or more variables (three variables of space and other variables for interest parameters) that have great importance in some applications. In the paper we presented the mathematical developments about generalized trend surfaces and case studies about gravimetric data. The trend surfaces have the great advantage that the effect of regional anomalies can be expressed as analytic functions. These tendency surfaces allows subsequent mathematical processing and interesting generalizations, with great advantage to work with polynomial functions compared with the original discrete data. For gravity data we estimate the depth of

Factors influencing the adolescent pregnancy rate in the Greater Giyani Municipality, Limpopo Province – South Africa

Directory of Open Access Journals (Sweden)

Lenny Mushwana

2015-01-01

Full Text Available A quantitative, descriptive and explorative survey was conducted to determine factors that influence adolescent pregnancy rate among teenage girls (n = 147 attending four high schools in the Greater Giyani Municipality in South Africa. Data was collected using a validated questionnaire which had a reliability of 0.65. Response frequency distributions, two-way frequency tables, Chi-square tests and Cochran–Armitage Trend Tests were used to determine the effect with the demographic characteristics of participants. Participants reported that health services were not conveniently available for them. Their relationship with nurses was poor (p < 0.05 as reported by 73% of participants with regard to maintenance of confidentiality. Participants reported key psychosocial variables such as inadequate sexual knowledge (61%, changing attitudes towards sex (58.9% and peer pressure (56.3% as contributory to high pregnancy rate. Recommendations were made to improve school health services, reproductive education in school curricula focussing on reproductive health, sexuality and guidance for future research.

TREND MECHANISMS IN CONTEMPORARY FASHION

DEFF Research Database (Denmark)

Mackinney-Valentin, Maria

2013-01-01

Explores a spatial approach to trend mechanisms that is argued to be more contemporary than the traditional temporal appraoch.......Explores a spatial approach to trend mechanisms that is argued to be more contemporary than the traditional temporal appraoch....

Comparison of Medicaid spending in schizoaffective patients treated with once monthly paliperidone palmitate or oral atypical antipsychotics.

Science.gov (United States)

Xiao, Yongling; Muser, Erik; Fu, Dong-Jing; Lafeuille, Marie-Hélène; Pilon, Dominic; Emond, Bruno; Wu, Allen; Duh, Mei Sheng; Lefebvre, Patrick

2016-01-01

Compared to oral atypical antipsychotics (OAAs), long-acting injectable antipsychotics require less frequent administration, and thus may improve adherence and reduce risk of relapse in schizoaffective disorder (SAD) patients. To evaluate the impact of once monthly paliperidone palmitate (PP) versus OAAs on healthcare resource utilization, Medicaid spending, and hospital readmission among SAD patients. Using FL, IA, KS, MS, MO, and NJ Medicaid data (January 2009-December 2013), adults with ≥2 SAD diagnoses initiated on PP or OAA (index date) were identified. Baseline characteristics and outcomes were assessed during the 12month pre- and post-index periods, respectively. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to reduce confounding and compare the estimated treatment effect for PP versus OAA. A total of 10,778 OAA-treated patients and 876 PP-treated patients were selected. Compared to OAAs, PP was associated with significantly lower medical costs (PSM: mean monthly cost difference [MMCD] = -$383, p < 0.001; IPTW: MMCD = -$403, p = 0.016), which offset the higher pharmacy costs associated with PP (PSM: MMCD = $270, p < 0.001; IPTW: MMCD = $350, p < 0.001) and resulted in similar total healthcare cost (PSM: MMCD = -$113, p = 0.414; IPTW: MMCD = -$53, p = 0.697) for PP versus OAA. Reduced risk of hospitalization (PSM: incidence rate ratio [IRR] = 0.85, p = 0.128; IPTW: IRR = 0.96, p = 0.004) and fewer hospitalization days (PSM: IRR = 0.74, p = 0.008; IPTW: IRR = 0.85, p < 0.001) were observed in PP versus OAA patients. Among hospitalized patients, PP was associated with a lower risk of 30 day hospital readmission compared to OAA (IPTW: odds ratio = 0.89, p = 0.041). Limitations The Medicaid data may not be representative of the nation or other states, and includes pre-rebate pharmacy costs (potentially over-estimated). Also

Stratospheric Temperature Trends Observed by TIMED/SABER

Science.gov (United States)

Xian, T.; Tan, R.

2017-12-01

Trends in the stratospheric temperature are studied based on the temperature profile observation from the Sounding of the Atmosphere using Broadband Emission Radiometry (SABER). The spatially trends are evaluated in different time scales ranging from decadal to monthly resolved. The results indicate a signature of BDC acceleration. There are strong warming trends (up to 9 K/decade) in the middle to upper stratosphere in the high latitude spring, summer, and autumn seasons, accompanied by strong cooling trends in the lower stratosphere. Besides, strong warming trends occurs through the whole stratosphere over the Southern Hemisphere, which confirms Antarctic ozone layer healing since 2000. In addition, the results demonstrate a significant warming trends in the middle of tropical stratosphere, which becomes strongest during June-July-August.

On-line signal trend identification

International Nuclear Information System (INIS)

Tambouratzis, T.; Antonopoulos-Domis, M.

2004-01-01

An artificial neural network, based on the self-organizing map, is proposed for on-line signal trend identification. Trends are categorized at each incoming signal as steady-state, increasing and decreasing, while they are further classified according to characteristics such signal shape and rate of change. Tests with model-generated signals illustrate the ability of the self-organizing map to accurately and reliably perform on-line trend identification in terms of both detection and classification. The proposed methodology has been found robust to the presence of white noise

Lumbar Supports for Prevention and Treatment of Low Back Pain: A Systematic Review Within the Framework of the Cochrane Back Review Group

DEFF Research Database (Denmark)

Jellema, Petra; van Tulder, Maurits W; van Poppel, Mireille N M

2001-01-01

Study Design : A systematic review of randomized and nonrandomized controlled trials. Summary of Background Data : Lumbar supports are used in the treatment of low back pain, but also to prevent the onset (primary prevention) or recurrences of a low back pain episode (secondary prevention......). Objectives: To assess the effects of lumbar sup-ports for prevention and treatment of nonspecific low back pain. Methods: The Medline, Cinahl, and Current Contents databases; the Cochrane Controlled Trials Register up to September 1999; and the Embase database up to September 1998 were all searched...... are not effective for primary prevention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, whereas it is still unclear whether lumbar...

Skin autofluorescence is a predictor of cardiovascular disease in chronic kidney disease patients.

Science.gov (United States)

Furuya, Fumihiko; Shimura, Hiroki; Takahashi, Kazuya; Akiyama, Daiichiro; Motosugi, Ai; Ikegishi, Yukinobu; Haraguchi, Kazutaka; Kobayashi, Tetsuro

2015-02-01

Accelerated formation and tissue accumulation of advanced glycation end products (AGEs), reflecting cumulative glycemic and oxidative stress, occurs in age-related and chronic diseases like diabetes mellitus (DM) and renal failure, and contributes to vascular damage. Skin autofluorescence (AFR), a noninvasive measurement method, reflects tissue accumulation of AGEs. AFR has been reported to be an independent predictor of mortality in Caucasian hemodialysis patients. We assessed the relationship between levels of AFR and the prevalence of cardiovascular disease (CVD), and clarified the prognostic usefulness of skin AFR levels in Asian (non-Caucasian) hemodialysis (HD) patients. AFR was measured with an autofluorescence reader in 64 HD patients. Overall and cardiovascular mortality was monitored prospectively during the 3-year follow-up. During follow-up, CVD events occurred in 21 patients. The deaths of 10 HD patients were associated with CVD. Multivariate logistic regression analyses showed that initial AFR was an independent risk factor for de novo CVD in HD patients with or without diabetes. When patients were classified on the basis of AFR tertiles, Cochran-Armitage analysis demonstrated that the highest tertile of AFR level showed an increased odds ratio for the prevalence of CVD. These findings suggest that AFR levels can be used to detect the prevalence of CVD in HD patients with or without diabetes. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

Fuzzy forecasting based on two-factors second-order fuzzy-trend logical relationship groups and the probabilities of trends of fuzzy logical relationships.

Science.gov (United States)

Chen, Shyi-Ming; Chen, Shen-Wen

2015-03-01

In this paper, we present a new method for fuzzy forecasting based on two-factors second-order fuzzy-trend logical relationship groups and the probabilities of trends of fuzzy-trend logical relationships. Firstly, the proposed method fuzzifies the historical training data of the main factor and the secondary factor into fuzzy sets, respectively, to form two-factors second-order fuzzy logical relationships. Then, it groups the obtained two-factors second-order fuzzy logical relationships into two-factors second-order fuzzy-trend logical relationship groups. Then, it calculates the probability of the "down-trend," the probability of the "equal-trend" and the probability of the "up-trend" of the two-factors second-order fuzzy-trend logical relationships in each two-factors second-order fuzzy-trend logical relationship group, respectively. Finally, it performs the forecasting based on the probabilities of the down-trend, the equal-trend, and the up-trend of the two-factors second-order fuzzy-trend logical relationships in each two-factors second-order fuzzy-trend logical relationship group. We also apply the proposed method to forecast the Taiwan Stock Exchange Capitalization Weighted Stock Index (TAIEX) and the NTD/USD exchange rates. The experimental results show that the proposed method outperforms the existing methods.

Interior Design Trends in Libraries.

Science.gov (United States)

Sager, Don, Ed.

2000-01-01

Four contributing authors discuss perspectives on current trends in library interior design. Articles include: "Trends in Library Furnishings: A Manufacturer's Perspective" (Andrea Johnson); "Libraries, Architecture, and Light: The Architect's Perspective" (Rick McCarthy); "The Library Administrator's Perspective" (Chadwick Raymond); and "The…

Automatic alternative phase-shift mask CAD layout tool for gate shrinkage of embedded DRAM in logic below 0.18 μm

Science.gov (United States)

Ohnuma, Hidetoshi; Kawahira, Hiroichi

1998-09-01

An automatic alternative phase shift mask (PSM) pattern layout tool has been newly developed. This tool is dedicated for embedded DRAM in logic device to shrink gate line width with improving line width controllability in lithography process with a design rule below 0.18 micrometers by the KrF excimer laser exposure. The tool can crete Levenson type PSM used being coupled with a binary mask adopting a double exposure method for positive photo resist. By using graphs, this tool automatically creates alternative PSM patterns. Moreover, it does not give any phase conflicts. By adopting it to actual embedded DRAM in logic cells, we have provided 0.16 micrometers gate resist patterns at both random logic and DRAM areas. The patterns were fabricated using two masks with the double exposure method. Gate line width has been well controlled under a practical exposure-focus window.

Does nerve-sparing radical prostatectomy increase the risk of positive surgical margins and biochemical progression?

Directory of Open Access Journals (Sweden)

Alkhateeb Sultan

2010-01-01

Full Text Available Background: Since the introduction of nerve-sparing radical prostatectomy (NSRP, there have been concerns about the increased risks of positive surgical margins (PSM and biochemical progression (BP. We examined the relationship of NSRP with PSM and BP using a large, mature dataset. Materials and Methods: Patients who underwent RP for clinically localized prostate cancer at our center between 1997 and 2008 were identified. Patients who received neoadjuvant therapy were excluded. We examined the relation of NSRP to the rate of PSM and BP in univariate and multivariate analyses adjusting for clinical and pathological variables including age, pretreatment prostate-specific antigen (PSA levels and doubling time, and pathological stage and grade. Results: In total, 856 patients were included, 70.9% underwent NSRP and 29.1% had non-NSRP. PSM rates were 13.5% in the NSRP group compared to 17.7% in non-NSRP (P=0.11. In a multivariate analysis, non-NSRP was preformed in patients with a higher pathological stage (HR 1.95, 95% CI 1.25-3.04, P=0.003 and a higher baseline PSA level (HR 1.04, 95% CI 1.01-1.08, P=0.005. With a median follow-up of 41 months, BP-free survival was 88% for non-NSRP compared to 92% for the NSRP group (log rank P=0.018; this difference was not significant in a multivariate Cox regression analysis (HR 0.54, 95% CI 0.28-1.06, P=0.09. Conclusion: When used in properly selected patients, NSRP does not seem to increase the risk of PSM and disease progression. The most effective way of resolving this issue is through a randomized clinical trial; however, such a trial is not feasible.

Petroleum supply monthly, March 1994

Energy Technology Data Exchange (ETDEWEB)

1994-03-30

Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics. The tables and figures in the Summary Statistics section of the PSM present a time series of selected petroleum data on a US level. Most time series include preliminary estimates for one month based on the Weekly Petroleum Supply Reporting System; statistics based on the most recent data from the Monthly Petroleum Supply Reporting System (MPSRS); and statistics published in prior issues of the PSM and PSA. The Detailed Statistics tables of the PSM present statistics for the most current month available as well as year-to-date. In most cases, the statistics are presented for several geographic areas -- the United States (50 States and the District of Columbia), five PAD Districts, and 12 Refining Districts. At the US and PAD District level, the total volume and the daily rate of activities are presented. The statistics are developed from monthly survey forms submitted by respondents to the EIA and from data provided from other sources.

What Is Lean Management in Health Care? Development of an Operational Definition for a Cochrane Systematic Review.

Science.gov (United States)

Rotter, Thomas; Plishka, Christopher; Lawal, Adegboyega; Harrison, Liz; Sari, Nazmi; Goodridge, Donna; Flynn, Rachel; Chan, James; Fiander, Michelle; Poksinska, Bonnie; Willoughby, Keith; Kinsman, Leigh

2018-01-01

Industrial improvement approaches such as Lean management are increasingly being adopted in health care. Synthesis is necessary to ensure these approaches are evidence based and requires operationalization of concepts to ensure all relevant studies are included. This article outlines the process utilized to develop an operational definition of Lean in health care. The literature search, screening, data extraction, and data synthesis processes followed the recommendations outlined by the Cochrane Collaboration. Development of the operational definition utilized the methods prescribed by Kinsman et al. and Wieland et al. This involved extracting characteristics of Lean, synthesizing similar components to establish an operational definition, applying this definition, and updating the definition to address shortcomings. We identified two defining characteristics of Lean health-care management: (1) Lean philosophy, consisting of Lean principles and continuous improvement, and (2) Lean activities, which include Lean assessment activities and Lean improvement activities. The resulting operational definition requires that an organization or subunit of an organization had integrated Lean philosophy into the organization's mandate, guidelines, or policies and utilized at least one Lean assessment activity or Lean improvement activity. This operational definition of Lean management in health care will act as an objective screening criterion for our systematic review. To our knowledge, this is the first evidence-based operational definition of Lean management in health care.

Trends of solar ultraviolet irradiance at Barrow, Alaska, and the effect of measurement uncertainties on trend detection

Directory of Open Access Journals (Sweden)

G. Bernhard

2011-12-01

Full Text Available Spectral ultraviolet (UV irradiance has been observed near Barrow, Alaska (71° N, 157° W between 1991 and 2011 with an SUV-100 spectroradiometer. The instrument was historically part of the US National Science Foundation's UV Monitoring Network and is now a component of NSF's Arctic Observing Network. From these measurements, trends in monthly average irradiance and their uncertainties were calculated. The analysis focuses on two quantities, the UV Index (which is affected by atmospheric ozone concentrations and irradiance at 345 nm (which is virtually insensitive to ozone. Uncertainties of trend estimates depend on variations in the data due to (1 natural variability, (2 systematic and random errors of the measurements, and (3 uncertainties caused by gaps in the time series. Using radiative transfer model calculations, systematic errors of the measurements were detected and corrected. Different correction schemes were tested to quantify the sensitivity of the trend estimates on the treatment of systematic errors. Depending on the correction method, estimates of decadal trends changed between 1.5% and 2.9%. Uncertainties in the trend estimates caused by error sources (2 and (3 were set into relation with the overall uncertainty of the trend determinations. Results show that these error sources are only relevant for February, March, and April when natural variability is low due to high surface albedo. This method of addressing measurement uncertainties in time series analysis is also applicable to other geophysical parameters. Trend estimates varied between −14% and +5% per decade and were significant (95.45% confidence level only for the month of October. Depending on the correction method, October trends varied between −11.4% and −13.7% for irradiance at 345 nm and between −11.7% and −14.1% for the UV Index. These large trends are consistent with trends in short-wave (0.3–3.0 μm solar irradiance measured with pyranometers at NOAA

Congruence between patient characteristics and interventions may partly explain medication adherence intervention effectiveness: an analysis of 190 randomized controlled trials from a Cochrane systematic review.

Science.gov (United States)

Allemann, Samuel S; Nieuwlaat, Robby; Navarro, Tamara; Haynes, Brian; Hersberger, Kurt E; Arnet, Isabelle

2017-11-01

Due to the negative outcomes of medication nonadherence, interventions to improve adherence have been the focus of countless studies. The congruence between adherence-related patient characteristics and interventions may partly explain the variability of effectiveness in medication adherence studies. In their latest update of a Cochrane review reporting inconsistent effects of adherence interventions, the authors offered access to their database for subanalysis. We aimed to use this database to assess congruence between adherence-related patient characteristics and interventions and its association with intervention effects. We developed a congruence score consisting of six features related to inclusion criteria, patient characteristics at baseline, and intervention design. Two independent raters extracted and scored items from the 190 studies available in the Cochrane database. We correlated overall congruence score and individual features with intervention effects regarding adherence and clinical outcomes using Kruskal-Wallis rank sum test and Fisher's exact test. Interrater reliability for newly extracted data was almost perfect with a Cohen's Kappa of 0.92 [95% confidence interval (CI) = 0.89-0.94; P congruence score nor any other individual feature (i.e., "determinants of nonadherence as inclusion criteria," "tailoring of interventions to the inclusion criteria," "reasons for nonadherence assessed at baseline," "adjustment of intervention to individual patient needs," and "theory-based interventions") was significantly associated with intervention effects. The presence of only six studies that included nonadherent patients and the interdependency of this feature with the remaining five might preclude a conclusive assessment of congruence between patient characteristics and adherence interventions. In order to obtain clinical benefits from effective adherence interventions, we encourage researchers to focus on the inclusion of nonadherent patients. Copyright

Selected Trends of the Cybercrime

Directory of Open Access Journals (Sweden)

Josef Požár

2015-12-01

Full Text Available The contribution paid particular attention to trends of the cybercrime in future period dedicated to combating negative phenomena in the context of cyberspace. The structure of article concern of definition of cybercrime, its legal classification especially choosing trends of cybercrime in future period.

Business trend analysis by simulation

NARCIS (Netherlands)

Schonenberg, H.; Jian, J.; Sidorova, N.; Aalst, van der W.M.P.; Pernici, B.

2010-01-01

Business processes are constantly affected by the environment in which they execute. The environment can change due to seasonal and financial trends. For organisations it is crucial to understand their processes and to be able to estimate the effects of these trends on the processes. Business

Regional Trends in Electromobility - Regional Study North America

OpenAIRE

Turrentine, Tom; Garas, Dhalia

2015-01-01

The subproject “Regional Trends in Electro mobility” aims at identifying and analyzing major trends in the field of electro mobility. The trend analysis will monitor research effort and upcoming technologies, policies, products and market developments in different focus regions around the world continuously to enable a systematic analysis of global trends. The regional trend analysis for electro mobility is a major keystone for the project success and therefore cooperation with...

Billing Trends

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Billing Trends. Internet access: Bandwidth becoming analogous to electric power. Only maximum capacity (load) is fixed; Charges based on usage (units). Leased line bandwidth: Billing analogous to phone calls. But bandwidth is variable.

Trends in picture communication

OpenAIRE

Speidel, Joachim

1993-01-01

In the past years significant progress was made with digital transmission of audiovisual services and most interesting trends are visible for the future. Such applications encompass interactive services, like videoconferencing, ISDN-videophone, storage of moving video and audio in computers or on CD, e.g. for multimedia applications. For distribution services, there is an unbroken trend from TV to HDTV. Strong emphasis is on compressed digital video even for transmission to the home.

Trends in Business Investment

OpenAIRE

Lydon, Reamonn; Scally, John

2014-01-01

This article examines trends in business investment in Ireland. Consistent with the international evidence on investment cycles, we show that business investment in Ireland exhibits large cyclical movements around a long-run trend relative to GDP. Changes in business investment broadly coincide with the overall business cycle, although swings in investment tend to be far greater, with extended periods of both over- and under-investment relative to GDP. The sharp fall in business investment si...

TREND: a program using cumulative sum methods to detect long-term trends in data

International Nuclear Information System (INIS)

Cranston, R.J.; Dunbar, R.M.; Jarvis, R.G.

1976-01-01

TREND is a computer program, in FORTRAN, to investigate data for long-term trends that are masked by short-term statistical fluctuations. To do this, it calculates and plots the cumulative sum of deviations from a chosen mean. As a further aid to diagnosis, the procedure can be repeated with a summation of the cumulative sum itself. (author)

Trend assessment: applications for hydrology and climate research

Science.gov (United States)

Kallache, M.; Rust, H. W.; Kropp, J.

2005-02-01

The assessment of trends in climatology and hydrology still is a matter of debate. Capturing typical properties of time series, like trends, is highly relevant for the discussion of potential impacts of global warming or flood occurrences. It provides indicators for the separation of anthropogenic signals and natural forcing factors by distinguishing between deterministic trends and stochastic variability. In this contribution river run-off data from gauges in Southern Germany are analysed regarding their trend behaviour by combining a deterministic trend component and a stochastic model part in a semi-parametric approach. In this way the trade-off between trend and autocorrelation structure can be considered explicitly. A test for a significant trend is introduced via three steps: First, a stochastic fractional ARIMA model, which is able to reproduce short-term as well as long-term correlations, is fitted to the empirical data. In a second step, wavelet analysis is used to separate the variability of small and large time-scales assuming that the trend component is part of the latter. Finally, a comparison of the overall variability to that restricted to small scales results in a test for a trend. The extraction of the large-scale behaviour by wavelet analysis provides a clue concerning the shape of the trend.

Trends in Global Gender Inequality

Science.gov (United States)

Dorius, Shawn F.; Firebaugh, Glenn

2010-01-01

This study investigates trends in gender inequality throughout the world. Using data encompassing a large majority of the world's population, we examine trends in recent decades for key indicators of gender inequality in education, mortality, political representation and economic activity. We find that gender inequality is declining in virtually…

Trends in gender differences in accidents mortality: Relationships to changing gender roles and other societal trends

Directory of Open Access Journals (Sweden)

Inga Earle

2005-11-01

Full Text Available This study tests five hypotheses concerning trends in gender differences in accidents mortality and accident-related behavior, using data for the US, UK, France, Italy, and Japan, 1950-98. As predicted by the Convergence Hypothesis, gender differences have decreased for amount of driving, motor vehicle accidents mortality, and occupational accidents mortality. However, for many types of accidents mortality, gender differences were stable or increased; these trends often resulted from the differential impact on male and female mortality of general societal trends such as increased illicit drug use or improved health care. Similarly, trends in gender differences in accident-related behavior have shown substantial variation and appear to have been influenced by multiple factors, including gender differences in rates of adoption of different types of innovations.

Trend patterns in global sea surface temperature

DEFF Research Database (Denmark)

Barbosa, S.M.; Andersen, Ole Baltazar

2009-01-01

Isolating long-term trend in sea surface temperature (SST) from El Nino southern oscillation (ENSO) variability is fundamental for climate studies. In the present study, trend-empirical orthogonal function (EOF) analysis, a robust space-time method for extracting trend patterns, is applied to iso...

Trends in mortality decrease and economic growth

NARCIS (Netherlands)

Niu, G.; Melenberg, B.

2014-01-01

The vast literature on extrapolative stochastic mortality models focuses mainly on the extrapolation of past mortality trends and summarizes the trends by one or more latent factors. However, the interpretation of these trends is typically not very clear. On the other hand, explanation methods are

Modern trends in contemporary chemistry

International Nuclear Information System (INIS)

Javed, H.; Pervez, H.; Qadeer, R.

1993-01-01

This publication contains a collection of papers presented at symposium on M odern Trends in Contemporary Chemistry , that was held in Islamabad, Pakistan, March 6-8, 1990. The symposium was divided into five sections for presentation of about 55 scientific and technical papers and 6 review papers. The contents of these papers were of good quality in the widespread concern in new trends of chemistry. The six reviews papers covered fields of ortho metallation reactions, evaluation of heterogeneous electron transfer rate contents, macro reticular ion-exchange resins, spectrochemical analytical techniques, liquid crystal-high technology materials for practical applications and trends in advanced ceramics. (A.B.)

Worldwide trends in dietary sugars intake.

OpenAIRE

Wittekind, Anna; Walton, Janette

2014-01-01

Estimating trends in dietary intake data is integral to informing national nutrition policy and monitoring progress towards dietary guidelines. Dietary intake of sugars is a controversial public health issue and guidance in relation to recommended intakes is particularly inconsistent. Published data relating to trends in sugars intake are relatively sparse. The purpose of the present review was to collate and review data from national nutrition surveys to examine changes and trends in dietary...

Trends in Classroom Observation Scores

Science.gov (United States)

Casabianca, Jodi M.; Lockwood, J. R.; McCaffrey, Daniel F.

2015-01-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from…

World trends from 2017

OpenAIRE

Janković Slobodan

2016-01-01

Issue of prognosis, analyses of future trends is companion to statecraft, political, economic and military planning. How we plan, what does IR says about scientific prognosis. Jankovic starts with this set of issues in order to pass into prognosis itself based on observable world trends. He claims that European Union has entered its climax comparing it foreign policy situation with that of war situation of Third Reich in 1943. Article is divided in five parts. After presenting and criticizing...

Cytology exam of urine

Science.gov (United States)

... In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 23rd ed. St Louis, MO: Elsevier; 2017:chap 28. Smith A, Balar AV, Milowsky MI, Chen RC. Bladder cancer. In: Niederhuber JE, Armitage JE, Doroshow JH, Kastan ...

Large-angle coherent/Compton scattering method for measurement in vitro of trabecular bone mineral concentration

International Nuclear Information System (INIS)

Gigante, G.E.; Sciuti, S.

1985-01-01

In this paper, experiments and related theoretical deductions on coherent/Compton scattering of 59.5-keV Am241 gamma line by bonelike materials are described. In particular, the authors demonstrate that a photon scattering mineralometer (PSM) can attain the best working conditions when it operates in a backscattering geometry mode. In fact, the large scattering angle they chose, theta = 135 degrees, allowed them to assemble a very compact source-detector device. Further, the relative sensitivity at 135 degrees turns out to be congruent to 1.7 and congruent to 6 times bigger than at 90 degrees and 45 degrees, respectively. The performances of the theta = 135 degrees PSM were experimentally investigated; i.e., in a measuring time of 10(3) s, a congruent to 5% statistical precision for bonelike materials, such as K 2 HPO 4 -water solutions, was obtained. The large-angle PSM device seems to be very promising for trabecular bone mineral density measurements in vivo in peripheral anatomic sites

Trends in Energy. 'The consumer decides'; Trends in Energy. 'De consument bepaalt'

Energy Technology Data Exchange (ETDEWEB)

Brzezowsky-Ruys, Y.; Van der Zalm, M.; Van Zutphen, M. [eds.

2012-03-15

A report is given of the Capgemini organised congress 'Trends in Energy 2011' which has the Dutch subtitle 'De consument bepaalt' (The consumer decides'. The focus of the articles, interviews, debates and presentations is on the role of the consumer in the supply of and demand for energy. Parts of the report are in Dutch and English [Dutch] Dit rapport bestaat uit een verslag van het congres 'Trends in Energy 2011. De consument bepaalt' en een aantal artikelen met achtergrondinformatie over onder meer de rol van de consument in vraag en aanbod van energie.

FASHION TREND FOR A SILHOUETTE: BALENCIAGA CASE

OpenAIRE

ERTÜRK, Nilay; özüdoğru, şakir

2014-01-01

Fashion, in broad and accepted definition, is any temporary preference or a temporary new thing in any area of human life, which prevails for a certain period of time. The issue of how fashionable products would look like in a particular season is discussed under the concept of fashion trends. The main purpose of this study is to discuss the concept of fashion trends and the studies on predictions in fashion trends, to conduct a sample trend survey for a silhouette and observe whether or not ...

The World Health Organization's Health Promoting Schools framework: a Cochrane systematic review and meta-analysis.

Science.gov (United States)

Langford, Rebecca; Bonell, Christopher; Jones, Hayley; Pouliou, Theodora; Murphy, Simon; Waters, Elizabeth; Komro, Kelli; Gibbs, Lisa; Magnus, Daniel; Campbell, Rona

2015-02-12

Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization's Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The effectiveness of this approach has not yet been rigorously reviewed. We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We included cluster randomised controlled trials. Participants were children and young people aged four to 18 years attending schools/colleges. HPS interventions had to include the following three elements: input into the curriculum; changes to the school's ethos or environment; and engagement with families and/or local communities. Two reviewers identified relevant trials, extracted data and assessed risk of bias. We grouped studies according to the health topic(s) targeted. Where data permitted, we performed random-effects meta-analyses. We identified 67 eligible trials tackling a range of health issues. Few studies included any academic/attendance outcomes. We found positive average intervention effects for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small. On average across studies, we found little evidence of effectiveness for zBMI (BMI, standardized for age and gender), and no evidence for fat intake, alcohol use, drug use, mental health, violence and bullying others. It was not possible to meta-analyse data on other health outcomes due to lack of data. Methodological limitations were identified including reliance on self-reported data, lack of long-term follow-up, and high attrition rates. This Cochrane review has found the WHO HPS framework is effective at improving some aspects of student health. The effects are small but potentially important at a population level.

Mediterranean Ocean Colour Chlorophyll Trends.

Science.gov (United States)

Colella, Simone; Falcini, Federico; Rinaldi, Eleonora; Sammartino, Michela; Santoleri, Rosalia

2016-01-01

In being at the base of the marine food web, phytoplankton is particularly important for marine ecosystem functioning (e.g., biodiversity). Strong anthropization, over-exploitation of natural resources, and climate change affect the natural amount of phytoplankton and, therefore, represent a continuous threat to the biodiversity in marine waters. In particular, a concerning risks for coastal waters is the increase in nutrient inputs of terrestrial/anthropogenic origin that can lead to undesirable modifications of phytoplankton concentration (i.e., eutrophication). Monitoring chlorophyll (Chl) concentration, which is a proxy of phytoplankton biomass, is an efficient tool for recording and understanding the response of the marine ecosystem to human pressures and thus for detecting eutrophication. Here, we compute Chl trends over the Mediterranean Sea by using satellite data, also highlighting the fact that remote sensing may represent an efficient and reliable solution to synoptically control the "good environmental status" (i.e., the Marine Directive to achieve Good Environmental Status of EU marine waters by 2020) and to assess the application of international regulations and environmental directives. Our methodology includes the use of an ad hoc regional (i.e., Mediterranean) algorithm for Chl concentration retrieval, also accounting for the difference between offshore (i.e., Case I) and coastal (i.e., Case II) waters. We apply the Mann-Kendall test and the Sens's method for trend estimation to the Chl concentration de-seasonalized monthly time series, as obtained from the X-11 technique. We also provide a preliminary analysis of some particular trends by evaluating their associated inter-annual variability. The high spatial resolution of our approach allows a clear identification of intense trends in those coastal waters that are affected by river outflows. We do not attempt to attribute the observed trends to specific anthropogenic events. However, the trends

Mediterranean Ocean Colour Chlorophyll Trends.

Directory of Open Access Journals (Sweden)

Simone Colella

Full Text Available In being at the base of the marine food web, phytoplankton is particularly important for marine ecosystem functioning (e.g., biodiversity. Strong anthropization, over-exploitation of natural resources, and climate change affect the natural amount of phytoplankton and, therefore, represent a continuous threat to the biodiversity in marine waters. In particular, a concerning risks for coastal waters is the increase in nutrient inputs of terrestrial/anthropogenic origin that can lead to undesirable modifications of phytoplankton concentration (i.e., eutrophication. Monitoring chlorophyll (Chl concentration, which is a proxy of phytoplankton biomass, is an efficient tool for recording and understanding the response of the marine ecosystem to human pressures and thus for detecting eutrophication. Here, we compute Chl trends over the Mediterranean Sea by using satellite data, also highlighting the fact that remote sensing may represent an efficient and reliable solution to synoptically control the "good environmental status" (i.e., the Marine Directive to achieve Good Environmental Status of EU marine waters by 2020 and to assess the application of international regulations and environmental directives. Our methodology includes the use of an ad hoc regional (i.e., Mediterranean algorithm for Chl concentration retrieval, also accounting for the difference between offshore (i.e., Case I and coastal (i.e., Case II waters. We apply the Mann-Kendall test and the Sens's method for trend estimation to the Chl concentration de-seasonalized monthly time series, as obtained from the X-11 technique. We also provide a preliminary analysis of some particular trends by evaluating their associated inter-annual variability. The high spatial resolution of our approach allows a clear identification of intense trends in those coastal waters that are affected by river outflows. We do not attempt to attribute the observed trends to specific anthropogenic events. However

Sea level trends in Southeast Asian seas

Science.gov (United States)

Strassburg, M. W.; Hamlington, B. D.; Leben, R. R.; Manurung, P.; Lumban Gaol, J.; Nababan, B.; Vignudelli, S.; Kim, K.-Y.

2015-05-01

Southeast Asian seas span the largest archipelago in the global ocean and provide a complex oceanic pathway connecting the Pacific and Indian oceans. The Southeast Asian sea regional sea level trends are some of the highest observed in the modern satellite altimeter record that now spans almost 2 decades. Initial comparisons of global sea level reconstructions find that 17-year sea level trends over the past 60 years exhibit good agreement with decadal variability associated with the Pacific Decadal Oscillation and related fluctuations of trade winds in the region. The Southeast Asian sea region exhibits sea level trends that vary dramatically over the studied time period. This historical variation suggests that the strong regional sea level trends observed during the modern satellite altimeter record will abate as trade winds fluctuate on decadal and longer timescales. Furthermore, after removing the contribution of the Pacific Decadal Oscillation (PDO) to sea level trends in the past 20 years, the rate of sea level rise is greatly reduced in the Southeast Asian sea region. As a result of the influence of the PDO, the Southeast Asian sea regional sea level trends during the 2010s and 2020s are likely to be less than the global mean sea level (GMSL) trend if the observed oscillations in wind forcing and sea level persist. Nevertheless, long-term sea level trends in the Southeast Asian seas will continue to be affected by GMSL rise occurring now and in the future.

REALISASI ISI KEPUTUSAN PESAMUAN AGUNG III MUDP BALI NO. 01/KEP/PSM-3 MDP BALI/X/2010 TERKAIT DENGAN ANAK PEREMPUAN TERMASUK BERHAK MEWARIS (STUDI KASUS DI KABUPATEN BULELENG

Directory of Open Access Journals (Sweden)

Ketut Sudiatmaka

2016-08-01

perubahan awig-awig yang telah dimiliki dan berlaku. Dalam aplikasi putusan Pesamuan Agung III MUDP Bali, mendapat respon negarif dari anak laki-laki yang kurang memahami asas komunalitas di antara anak laki-laki maupun perempuan, tetapi jika dilihat pemberi waris dalam bentuk paweweh tampaknya anak laki-laki pun tidak keberatan. Tanggapan positif masyarakat Buleleng menghormati hak perempuan Bali dalam bidang kehidupan sosial dan ekonomi dengan kebijaksanaan memberikan kesempatan sebagai pewaris di dalam keluarga. Kata Kunci: Decision Tree, Diskriminasi Perlakuan, Hukum Adat, Kebijakan, Keputusan, Kontradiktif , Mewaris, Perempuan Bali. Abstract The background of this research is the study of the legal status of women Bali weak in terms of inheritance, because according to the Customary Law Bali rightful heir only male offspring and the families of men and male foster child. Women in the Indigenous people of Bali are still suffering discrimination in terms of provision law. In general, this study aims to (1 to determine the form of policy making in the traditional decision-making process regarding inheritance in Buleleng district; (2 to determine the actual contents of Bali Province MUDP decision No.01/Kep/PSM-3/ MDP BALI/X/2010, October 15, 2010 on Bali receives 1/2 of the women's inheritance rights purusa after the deduction of 30% for inheritance and conservation purposes. (3 To know the views and acceptance of women in Buleleng against the great implementasion pesamuan III MUDP Bali; (4 to determine the effect of fixing SK MUDP Bali Province No.01/ Kep/PSM-3/MDP BALI/X/2010, and the holding capacity for indigenous peoples in Buleleng regency. This study will be conducted over two years, ie from 2015 to 2016. The output of the study described as follows: (1 the outcome of the first: the design and development of a policy on customary provisions that guarantee the rights of women in law, and Textbook , (2 the outcome of II: scientific articles in journals accredited

Trends in communications satellites

CERN Document Server

Curtin, Denis J

1979-01-01

Trends in Communications Satellites offers a comprehensive look at trends and advances in satellite communications, including experimental ones such as NASA satellites and those jointly developed by France and Germany. The economic aspects of communications satellites are also examined. This book consists of 16 chapters and begins with a discussion on the fundamentals of electrical communications and their application to space communications, including spacecraft, earth stations, and orbit and wavelength utilization. The next section demonstrates how successful commercial satellite communicati

Trends in neurology fellowship training

Institute of Scientific and Technical Information of China (English)

Jordan S.A. Williams; Trent S. Hodgson; Fernando D. Goldenberg; Rimas V. Lukas

2017-01-01

Aim:Aneed for Neurologists exists in the USA.The majority of Neurology residency graduates go on to additional subspecialty training. Methods: Data from the Accreditation Council for Graduate Medical Education from 2001-2014 and the United Council for Neurologic Subspecialties from was analyzed for trends in the number of Neurology subspecialty training programs and their composition. Results: There has been an overall trend of growth in the number of accredited Neurology subspecialty training programs and fellows. These trends vary between specific subspecialties. Conclusion: The authors provide an overview of the contemporary state of Neurology subspecialty training in the USA. A clearer understanding of subspecialty training allows for anticipation of workforce surpluses and deficits.

Food Trends.

Science.gov (United States)

Schwenk, Nancy E.

1991-01-01

An overall perspective on trends in food consumption is presented. Nutrition awareness is at an all-time high; consumption is influenced by changes in disposable income, availability of convenience foods, smaller household size, and an increasing proportion of ethnic minorities in the population. (18 references) (LB)

Greater sage-grouse population trends across Wyoming

Science.gov (United States)

Edmunds, David; Aldridge, Cameron L.; O'Donnell, Michael; Monroe, Adrian

2018-01-01

The scale at which analyses are performed can have an effect on model results and often one scale does not accurately describe the ecological phenomena of interest (e.g., population trends) for wide-ranging species: yet, most ecological studies are performed at a single, arbitrary scale. To best determine local and regional trends for greater sage-grouse (Centrocercus urophasianus) in Wyoming, USA, we modeled density-independent and -dependent population growth across multiple spatial scales relevant to management and conservation (Core Areas [habitat encompassing approximately 83% of the sage-grouse population on ∼24% of surface area in Wyoming], local Working Groups [7 regional areas for which groups of local experts are tasked with implementing Wyoming's statewide sage-grouse conservation plan at the local level], Core Area status (Core Area vs. Non-Core Area) by Working Groups, and Core Areas by Working Groups). Our goal was to determine the influence of fine-scale population trends (Core Areas) on larger-scale populations (Working Group Areas). We modeled the natural log of change in population size ( peak M lek counts) by time to calculate the finite rate of population growth (λ) for each population of interest from 1993 to 2015. We found that in general when Core Area status (Core Area vs. Non-Core Area) was investigated by Working Group Area, the 2 populations trended similarly and agreed with the overall trend of the Working Group Area. However, at the finer scale where Core Areas were analyzed separately, Core Areas within the same Working Group Area often trended differently and a few large Core Areas could influence the overall Working Group Area trend and mask trends occurring in smaller Core Areas. Relatively close fine-scale populations of sage-grouse can trend differently, indicating that large-scale trends may not accurately depict what is occurring across the landscape (e.g., local effects of gas and oil fields may be masked by increasing

Trend analyses with river sediment rating curves

Science.gov (United States)

Warrick, Jonathan A.

2015-01-01

Sediment rating curves, which are fitted relationships between river discharge (Q) and suspended-sediment concentration (C), are commonly used to assess patterns and trends in river water quality. In many of these studies it is assumed that rating curves have a power-law form (i.e., C = aQb, where a and b are fitted parameters). Two fundamental questions about the utility of these techniques are assessed in this paper: (i) How well to the parameters, a and b, characterize trends in the data? (ii) Are trends in rating curves diagnostic of changes to river water or sediment discharge? As noted in previous research, the offset parameter, a, is not an independent variable for most rivers, but rather strongly dependent on b and Q. Here it is shown that a is a poor metric for trends in the vertical offset of a rating curve, and a new parameter, â, as determined by the discharge-normalized power function [C = â (Q/QGM)b], where QGM is the geometric mean of the Q values sampled, provides a better characterization of trends. However, these techniques must be applied carefully, because curvature in the relationship between log(Q) and log(C), which exists for many rivers, can produce false trends in â and b. Also, it is shown that trends in â and b are not uniquely diagnostic of river water or sediment supply conditions. For example, an increase in â can be caused by an increase in sediment supply, a decrease in water supply, or a combination of these conditions. Large changes in water and sediment supplies can occur without any change in the parameters, â and b. Thus, trend analyses using sediment rating curves must include additional assessments of the time-dependent rates and trends of river water, sediment concentrations, and sediment discharge.

Time Trends in School Well-Being Among Adolescents in Oslo: Can Trends be Explained by Social Relationships?

OpenAIRE

Wilhelmsen, Tiril

2017-01-01

Even though well-being in the domain of school is important for mental health, time trend research of this topic is limited. In particular, there is a lack of research investigating differences between ethnic minority and majority students, and there is a lack of literature empirically exploring possible explanations for the time trends in school well-being. The aims of this study were to investigate time trends in school well-being among adolescents in Oslo, explore moderations by gender and...

Spatial correlation in precipitation trends in the Brazilian Amazon

Science.gov (United States)

Buarque, Diogo Costa; Clarke, Robin T.; Mendes, Carlos Andre Bulhoes

2010-06-01

A geostatistical analysis of variables derived from Amazon daily precipitation records (trends in annual precipitation totals, trends in annual maximum precipitation accumulated over 1-5 days, trend in length of dry spell, trend in number of wet days per year) gave results that are consistent with those previously reported. Averaged over the Brazilian Amazon region as a whole, trends in annual maximum precipitations were slightly negative, the trend in the length of dry spell was slightly positive, and the trend in the number of wet days in the year was slightly negative. For trends in annual maximum precipitation accumulated over 1-5 days, spatial correlation between trends was found to extend up to a distance equivalent to at least half a degree of latitude or longitude, with some evidence of anisotropic correlation. Time trends in annual precipitation were found to be spatially correlated up to at least ten degrees of separation, in both W-E and S-N directions. Anisotropic spatial correlation was strongly evident in time trends in length of dry spell with much stronger evidence of spatial correlation in the W-E direction, extending up to at least five degrees of separation, than in the S-N. Because the time trends analyzed are shown to be spatially correlated, it is argued that methods at present widely used to test the statistical significance of climate trends over time lead to erroneous conclusions if spatial correlation is ignored, because records from different sites are assumed to be statistically independent.

TRENDS IN CROATIAN HOTEL INDUSTRY

Directory of Open Access Journals (Sweden)

Jasmina GRZINIC

2008-01-01

Full Text Available Tourism and hotel business is becoming one of the leading industries of theworld. Therefore, an increased attention needs to be paid to the study oftrends in tourism because they determine the trends in hotel industry. Thepurpose of the paper is to point out the importance of hotel industry as one ofthe most important elements of development in tourist economies. The paperaims at introducing the newest trends in modern hotel industry and offering areview of the recent trends of demand and the directions of hotel industrydevelopment. The importance of hotel industry on both micro and macro, i.e.global level is increasing. Besides a series of theoretical representations andconclusions, this paper brings some concrete data and examples frompractice in hotel management.

Emerging trends in nuclear energy

International Nuclear Information System (INIS)

Weinberg, A.M.

1984-01-01

Nuclear energy is faltering in many places - especially in the USA: should it be written off. The author sees underlying trends that justify a more optimistic view of nuclear energy's future - the continuing tendency for the electricity intensity of economic activity to rise while the total energy intensity falls; a consistently favourable price trend for electricity compared with energy prices generally - a trend that may become more favourable if his judgment that nuclear plants will turn out to be very long-lived is borne out by events; the substitution of electricity-based processes in industry for older processes; and the development of ultra-safe reactors which will remove once and for all the fears of accidents such as the one that occurred at Three Mile Island. (author)

Trends in computer hardware and software.

Science.gov (United States)

Frankenfeld, F M

1993-04-01

Previously identified and current trends in the development of computer systems and in the use of computers for health care applications are reviewed. Trends identified in a 1982 article were increasing miniaturization and archival ability, increasing software costs, increasing software independence, user empowerment through new software technologies, shorter computer-system life cycles, and more rapid development and support of pharmaceutical services. Most of these trends continue today. Current trends in hardware and software include the increasing use of reduced instruction-set computing, migration to the UNIX operating system, the development of large software libraries, microprocessor-based smart terminals that allow remote validation of data, speech synthesis and recognition, application generators, fourth-generation languages, computer-aided software engineering, object-oriented technologies, and artificial intelligence. Current trends specific to pharmacy and hospitals are the withdrawal of vendors of hospital information systems from the pharmacy market, improved linkage of information systems within hospitals, and increased regulation by government. The computer industry and its products continue to undergo dynamic change. Software development continues to lag behind hardware, and its high cost is offsetting the savings provided by hardware.

Dismantling technologies trends

International Nuclear Information System (INIS)

Devaux, P.

2009-01-01

In this work dismantling technologies trends realized by the CEA are reviewed. There following technologies are presented: Data acquisition from facilities; Scenario studies; Remote handling and carriers; Dismantling techniques; Decontamination.

Oceanographic Station Data and temperature profiles from bottle and XBT casts from the COCHRANE and other platforms as part of the International Decade of Ocean Exploration / Controlled Ecosystem Pollution Experiment (IDOE/CEPEX) from 1973-10-28 to 1975-01-29 (NODC Accession 7500529)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Oceanographic Station Data and temperature profiles were collected from bottle and XBT casts from the COCHRANE and other platforms from 28 October 1973 to 29 January...

Post spinal meningitis and asepsis.

Science.gov (United States)

Videira, Rogerio L R; Ruiz-Neto, P P; Brandao Neto, M

2002-07-01

Post spinal meningitis (PSM) is a complication still currently being reported. After two PSM cases in our hospital an epidemiological study was initiated, which included a survey of techniques for asepsis that are applied in our department. Cases defined as PSM comprised meningitis within a week after spinal anesthesia. Anesthesia records, anesthesia complication files and the records of the Hospital Commission for Infection Control from 1997 to 2000 were reviewed. Asepsis techniques applied were surveyed by a questionnaire answered by all our department's anesthesiologists. The equipment and procedures for spinal anesthesia were listed. Current anesthesia textbooks were reviewed for recommendations regarding asepsis techniques in conjunction with spinal anesthesia. Three cases of PSM were identified following 38,128 spinal anesthesias whereas none was observed in 12,822 patients subjected to other types of regional or general anesthesia (P>0.05). Culture of cerebrospinal fluid yielded Streptococcus in two patients and was negative in the other patient. The asepsis technique applied by the anesthesiologists varied considerably. The literature review showed that aspects on asepsis for spinal anesthesia are poorly covered. The incidence of meningitis was similar in patients subjected to spinal anesthesia and in those subjected to other anesthetic techniques. Asepsis techniques were found to differ considerably among our staff members, reflecting the lack of well-defined published standards for this procedure. We recommend that asepsis for spinal anesthesia should not be less rigorous than for surgical asepsis.

Microbial Phosphorus Solubilization and Its Potential for Use in Sustainable Agriculture

Directory of Open Access Journals (Sweden)

Elizabeth T. Alori

2017-06-01

Full Text Available The use of excess conventional Phosphorus (P fertilizers to improve agricultural productivity, in order to meet constantly increasing global food demand, potentially causes surface and ground water pollution, waterway eutrophication, soil fertility depletion, and accumulation of toxic elements such as high concentration of selenium (Se, arsenic (As in the soil. Quite a number of soil microorganisms are capable of solubilizing/mineralizing insoluble soil phosphate to release soluble P and making it available to plants. These microorganisms improve the growth and yield of a wide variety of crops. Thus, inoculating seeds/crops/soil with Phosphate Solubilizing Microorganisms (PSM is a promising strategy to improve world food production without causing any environmental hazard. Despite their great significance in soil fertility improvement, phosphorus-solubilizing microorganisms have yet to replace conventional chemical fertilizers in commercial agriculture. A better understanding of recent developments in PSM functional diversity, colonizing ability, mode of actions and judicious application should facilitate their use as reliable components of sustainable agricultural systems. In this review, we discussed various soil microorganisms that have the ability to solubilize phosphorus and hence have the potential to be used as bio fertilizers. The mechanisms of inorganic phosphate solubilization by PSM and the mechanisms of organic phosphorus mineralization are highlighted together with some factors that determine the success of this technology. Finally we provide some indications that the use of PSM will promote sustainable agriculture and conclude that this technology is ready for commercial exploitation in various regions worldwide.

Delayed radical prostatectomy for intermediate-risk prostate cancer is associated with biochemical recurrence: possible implications for active surveillance from the SEARCH database.

Science.gov (United States)

Abern, Michael R; Aronson, William J; Terris, Martha K; Kane, Christopher J; Presti, Joseph C; Amling, Christopher L; Freedland, Stephen J

2013-03-01

Active surveillance (AS) is increasingly accepted as appropriate management for low-risk prostate cancer (PC) patients. It is unknown whether delaying radical prostatectomy (RP) is associated with increased risk of biochemical recurrence (BCR) for men with intermediate-risk PC. We performed a retrospective analysis of 1,561 low and intermediate-risk men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database treated with RP between 1988 and 2011. Patients were stratified by interval between diagnosis and RP (≤ 3, 3-6, 6-9, or >9 months) and by risk using the D'Amico classification. Cox proportional hazard models were used to analyze BCR. Logistic regression was used to analyze positive surgical margins (PSM), extracapsular extension (ECE), and pathologic upgrading. Overall, 813 (52%) men were low-risk, and 748 (48%) intermediate-risk. Median follow-up among men without recurrence was 52.9 months, during which 437 men (38.9%) recurred. For low-risk men, RP delays were unrelated to BCR, ECE, PSM, or upgrading (all P > 0.05). For intermediate-risk men, however, delays >9 months were significantly related to BCR (HR: 2.10, P = 0.01) and PSM (OR: 4.08, P 9 months were associated with BCR in subsets of intermediate-risk men with biopsy Gleason score ≤ 3 + 4 (HR: 2.51, P 9 months predicted greater BCR and PSM risk. If confirmed in future studies, this suggests delayed RP for intermediate-risk PC may compromise outcomes. Copyright © 2012 Wiley Periodicals, Inc.

Intermittent Catheterization: The Devil Is in the Details.

Science.gov (United States)

Christison, Kathleen; Walter, Matthias; Wyndaele, Jean-Jacques J M; Kennelly, Michael; Kessler, Thomas M; Noonan, Vanessa K; Fallah, Nader; Krassioukov, Andrei V

2018-02-01

During the last few years, the international community debated urinary tract infection and re-use of catheters when managing neurogenic lower urinary tract dysfunction (NLUTD) among individuals with spinal cord injury (SCI). In this respect, the 2014 Cochrane review by Prieto and colleagues, "Intermittent catheterisation for long-term bladder management," became one of the leading documents that captured the minds and attention of clinicians around the world. Although numerous countries had switched to single-use catheters for management of NLUTD following SCI, the opinion that was expressed in the 2014 Cochrane review had a strong influence on healthcare providers and agencies to recommend re-use of catheters. However, many clinicians have expressed concern regarding the conclusions in the 2014 Cochrane review by Prieto and colleagues. We therefore conducted an independent appraisal of the data and analyses presented in the review. Our appraisal identified crucial discrepancies of data extraction and analyses within the review. In appraisal to that of Prieto and colleagues' review, our analysis revealed a trend to favor single over multiple use of catheters. After addressing our concerns to Cochrane's acting Editor-in-Chief, the most recent version of the 2014 Cochrane review was withdrawn from publication.

Water-quality trends in the nation’s rivers and streams, 1972–2012—Data preparation, statistical methods, and trend results

Science.gov (United States)

Oelsner, Gretchen P.; Sprague, Lori A.; Murphy, Jennifer C.; Zuellig, Robert E.; Johnson, Henry M.; Ryberg, Karen R.; Falcone, James A.; Stets, Edward G.; Vecchia, Aldo V.; Riskin, Melissa L.; De Cicco, Laura A.; Mills, Taylor J.; Farmer, William H.

2017-04-04

Since passage of the Clean Water Act in 1972, Federal, State, and local governments have invested billions of dollars to reduce pollution entering rivers and streams. To understand the return on these investments and to effectively manage and protect the Nation’s water resources in the future, we need to know how and why water quality has been changing over time. As part of the National Water-Quality Assessment Project, of the U.S. Geological Survey’s National Water-Quality Program, data from the U.S. Geological Survey, along with multiple other Federal, State, Tribal, regional, and local agencies, have been used to support the most comprehensive assessment conducted to date of surface-water-quality trends in the United States. This report documents the methods used to determine trends in water quality and ecology because these methods are vital to ensuring the quality of the results. Specific objectives are to document (1) the data compilation and processing steps used to identify river and stream sites throughout the Nation suitable for water-quality, pesticide, and ecology trend analysis, (2) the statistical methods used to determine trends in target parameters, (3) considerations for water-quality, pesticide, and ecology data and streamflow data when modeling trends, (4) sensitivity analyses for selecting data and interpreting trend results with the Weighted Regressions on Time, Discharge, and Season method, and (5) the final trend results at each site. The scope of this study includes trends in water-quality concentrations and loads (nutrient, sediment, major ion, salinity, and carbon), pesticide concentrations and loads, and metrics for aquatic ecology (fish, invertebrates, and algae) for four time periods: (1) 1972–2012, (2) 1982–2012, (3) 1992–2012, and (4) 2002–12. In total, nearly 12,000 trends in concentration, load, and ecology metrics were evaluated in this study; there were 11,893 combinations of sites, parameters, and trend periods. The

Relation between trends in late middle age mortality and trends in old age mortality--is there evidence for mortality selection?

NARCIS (Netherlands)

Janssen, F.; Peeters, A.; Mackenbach, J. P.; Kunst, A. E.

2005-01-01

STUDY OBJECTIVE: To test whether mortality selection was a dominant factor in determining trends in old age mortality, by empirically studying the existence of a negative correlation between trends in late middle age mortality and trends in old age mortality among the same cohorts. DESIGN AND

Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses.

Science.gov (United States)

Flemming, Kate; Booth, Andrew; Hannes, Karin; Cargo, Margaret; Noyes, Jane

2018-05-01

To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group. Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching. Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses. Copyright © 2017 Elsevier Inc. All rights reserved.

[Internal migration trends and regional dynamics].

Science.gov (United States)

Trabelsi, M

1992-01-01

This study concerns aspects of regional development in Tunisia. It specifically considers how economic factors affect income differentials among regions, and ways in which these in turn influence trends in internal migration. The effect of these trends on urbanization is also explored.

Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study.

Science.gov (United States)

Atwoli, Lukoye; Platt, Jonathan M; Basu, Archana; Williams, David R; Stein, Dan J; Koenen, Karestan C

2016-07-07

This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important. Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions. After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06-2.07) for arthritis and 2.07 (95 % CI: 1.57-2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions

Study Design Rigor in Animal-Experimental Research Published in Anesthesia Journals.

Science.gov (United States)

Hoerauf, Janine M; Moss, Angela F; Fernandez-Bustamante, Ana; Bartels, Karsten

2018-01-01

Lack of reproducibility of preclinical studies has been identified as an impediment for translation of basic mechanistic research into effective clinical therapies. Indeed, the National Institutes of Health has revised its grant application process to require more rigorous study design, including sample size calculations, blinding procedures, and randomization steps. We hypothesized that the reporting of such metrics of study design rigor has increased over time for animal-experimental research published in anesthesia journals. PubMed was searched for animal-experimental studies published in 2005, 2010, and 2015 in primarily English-language anesthesia journals. A total of 1466 publications were graded on the performance of sample size estimation, randomization, and blinding. Cochran-Armitage test was used to assess linear trends over time for the primary outcome of whether or not a metric was reported. Interrater agreement for each of the 3 metrics (power, randomization, and blinding) was assessed using the weighted κ coefficient in a 10% random sample of articles rerated by a second investigator blinded to the ratings of the first investigator. A total of 1466 manuscripts were analyzed. Reporting for all 3 metrics of experimental design rigor increased over time (2005 to 2010 to 2015): for power analysis, from 5% (27/516), to 12% (59/485), to 17% (77/465); for randomization, from 41% (213/516), to 50% (243/485), to 54% (253/465); and for blinding, from 26% (135/516), to 38% (186/485), to 47% (217/465). The weighted κ coefficients and 98.3% confidence interval indicate almost perfect agreement between the 2 raters beyond that which occurs by chance alone (power, 0.93 [0.85, 1.0], randomization, 0.91 [0.85, 0.98], and blinding, 0.90 [0.84, 0.96]). Our hypothesis that reported metrics of rigor in animal-experimental studies in anesthesia journals have increased during the past decade was confirmed. More consistent reporting, or explicit justification for absence

Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making

Directory of Open Access Journals (Sweden)

Burkle Christopher M

2012-11-01

Full Text Available Abstract Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs. In addition, physician views regarding legal risk, patients’ ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate. Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41% would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17% would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52% considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage

Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making.

Science.gov (United States)

Burkle, Christopher M; Mueller, Paul S; Swetz, Keith M; Hook, C Christopher; Keegan, Mark T

2012-11-21

Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians' decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients' ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents' perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient's AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to "pass away in peace." Few (17%) would forgo an AD following a family's request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities

'Fat mass and obesity associated' gene (FTO: No significant association of variant rs9939609 with weight loss in a lifestyle intervention and lipid metabolism markers in German obese children and adolescents

Directory of Open Access Journals (Sweden)

Müller Timo D

2008-09-01

Full Text Available Abstract Background We have previously identified strong association of six single nucleotide polymorphisms (SNPs in FTO (fat mass and obesity associated gene to early onset extreme obesity within the first genome wide association study (GWA for this phenotype. The aim of this study was to investigate whether the obesity risk allele of one of these SNPs (rs9939609 is associated with weight loss in a lifestyle intervention program. Additionally, we tested for association of rs9939609 alleles with fasting blood parameters indicative of glucose and lipid metabolism. Methods We initially analysed rs9939609 in a case-control study comprising 519 German overweight and obese children and adolescents and 178 normal weight adults. In 207 of the obese individuals who took part in the outpatient obesity intervention program 'Obeldicks' we further analysed whether carrier status of the obesity risk A-allele of rs9939609 has a differential influence on weight loss after the intervention program. Additionally, we investigated in 480 of the overweight and obese patients whether rs9939609 is associated with fasting blood levels of glucose, triglycerides and HDL and LDL-cholesterol. Genotyping was performed using allele specific polymerase chain reaction (ARMS-PCR. For the association study (case-control approach, the Cochran-Armitage trend test was applied. Blood parameters were analysed using commercially available test kits and the log10-transformed blood parameters and changes in BMI-standard deviation scores (BMI-SDS were analysed by linear regression with sex and age as covariates under an additive mode of inheritance with the rs9939609 A-allele as risk allele. Results We confirmed the association of the risk A-allele of rs9939609 with overweight and early onset obesity (one sided p = 0.036. However, we observed no association of rs9939609 alleles with weight loss or fasting levels of blood glucose, triglycerides and cholesterol. Conclusion We confirmed

Factors that could explain the increasing prevalence of type 2 diabetes among adults in a Canadian province: a critical review and analysis

Directory of Open Access Journals (Sweden)

Véronique Thibault

2016-11-01

Full Text Available Abstract Background The prevalence of diabetes has increased since the last decade in New Brunswick. Identifying factors contributing to the increase in diabetes prevalence will help inform an action plan to manage the condition. The objective was to describe factors that could explain the increasing prevalence of type 2 diabetes in New Brunswick since 2001. Methods A critical literature review was conducted to identify factors potentially responsible for an increase in prevalence of diabetes. Data from various sources were obtained to draw a repeated cross-sectional (2001–2014 description of these factors concurrently with changes in the prevalence of type 2 diabetes in New Brunswick. Linear regressions, Poisson regressions and Cochran Armitage analysis were used to describe relationships between these factors and time. Results Factors identified in the review were summarized in five categories: individual-level risk factors, environmental risk factors, evolution of the disease, detection effect and global changes. The prevalence of type 2 diabetes has increased by 120% between 2001 and 2014. The prevalence of obesity, hypertension, prediabetes, alcohol consumption, immigration and urbanization increased during the study period and the consumption of fruits and vegetables decreased which could represent potential factors of the increasing prevalence of type 2 diabetes. Physical activity, smoking, socioeconomic status and education did not present trends that could explain the increasing prevalence of type 2 diabetes. During the study period, the mortality rate and the conversion rate from prediabetes to diabetes decreased and the incidence rate increased. Suggestion of a detection effect was also present as the number of people tested increased while the HbA1c and the age at detection decreased. Period and birth cohort effect were also noted through a rise in the prevalence of type 2 diabetes across all age groups, but greater increases were

Elimination of water pathogens with solar radiation using an automated sequential batch CPC reactor

CSIR Research Space (South Africa)

Polo-López, MI

2011-11-01

Full Text Available Ireland BT37 0QB, United Kingdom f Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin 2, Ireland ? Corresponding author. Tel.: +34 950 387957; fax: +34 950 365015. E-mail addresses: mpolo@psa.es (M.I. Polo...-L?pez), pilar.fernandez@psa.es (P. Fern?ndez-Ib?nez), euniceubombajaswa@yahoo.com (E. Ubomba-Jaswa), christian.navntoft@solarmate.com.ar (C.Navntoft), irene.garcia@psa.es (I. Garc?a-Fern?ndez), psm.dunlop@ulster.ac.uk (P.S.M. Dunlop), j.byrne@ulster.ac.uk (J...

How does public service motivation among teachers affect student performance in schools?

DEFF Research Database (Denmark)

Andersen, Lotte Bøgh; Heinesen, Eskil; HolmPedersen, Lene

2014-01-01

using an objective outcome measure (the students' academic performance in their final examinations). Combining survey data and administrative register data in a multilevel data set, we are able to control very robustly for the specific characteristics of the students (n = 5,631), the schools (n = 85......The literature expects public service motivation (PSM) to affect performance, but most of the existing studies of this relationship use subjective performance data and focus on output rather than outcome. This article investigates the association between PSM and the performance of Danish teachers...

Public Values and Public Service Motivation

DEFF Research Database (Denmark)

Andersen, Lotte Bøgh; Beck Jørgensen, Torben; Kjeldsen, Anne Mette

2013-01-01

The literatures on public values (PV) and public service motivation (PSM) both address whether public service delivery is driven by something more than self-interest. They have developed separately, although they can benefit from insights developed by the other, and this article discusses...... conceptual and empirical relationships between them. Based on a survey of 501 public managers, we find that PSM and PV are associated empirically, but not in a manner allowing total integration. The conceptual discussion reveals how the two concepts cannot be totally separated, as values can be motivating...