WorldWideScience

Sample records for significant systematic effects

  1. Systematic reviews of anesthesiologic interventions reported as statistically significant

    DEFF Research Database (Denmark)

    Imberger, Georgina; Gluud, Christian; Boylan, John

    2015-01-01

    statistically significant meta-analyses of anesthesiologic interventions, we used TSA to estimate power and imprecision in the context of sparse data and repeated updates. METHODS: We conducted a search to identify all systematic reviews with meta-analyses that investigated an intervention that may......: From 11,870 titles, we found 682 systematic reviews that investigated anesthesiologic interventions. In the 50 sampled meta-analyses, the median number of trials included was 8 (interquartile range [IQR], 5-14), the median number of participants was 964 (IQR, 523-1736), and the median number...

  2. Systematic significance of anatomical characterization in some euphorbiaceous species

    International Nuclear Information System (INIS)

    Zahra, N.B.; Shinwari, Z.K.

    2014-01-01

    The study was aimed to explore the systematic potential of anatomical characters for identification and delimitation among Euphorbia species. Eight species of leafy spurges of genus Euphorbia L. (Euphorbiaceae) were evaluated for variations in micro morphological characters of foliar epidermal anatomy. While anatomical observations are of importance in the assessments and appraisals, use of these characters as an effective tool in interpreting phyletic evaluations and systematic delineations has its limitations too. The epidermal cell wall in majority of species was wavy to undulate on both adaxial and abaxial surfaces. The observations made in this study indicate that there is not a single type of stomata which appears as characteristic of the genus Euphorbia. Also their distribution whether epistomatic or hypostomatic is not a genus-characteristic. The trichomes found were simple, unicellular or multicellular, uniseriate. Present investigation revealed the utility of both qualitative and quantitative characters in systematic studies; also the potential influence in the delimitation of species cannot be ignored. Our results show that the micro-morphology of anatomical characters play an important role in definition of taxa at species and sectional levels. (author)

  3. Thresholds for statistical and clinical significance in systematic reviews with meta-analytic methods

    DEFF Research Database (Denmark)

    Jakobsen, Janus Christian; Wetterslev, Jorn; Winkel, Per

    2014-01-01

    BACKGROUND: Thresholds for statistical significance when assessing meta-analysis results are being insufficiently demonstrated by traditional 95% confidence intervals and P-values. Assessment of intervention effects in systematic reviews with meta-analysis deserves greater rigour. METHODS......: Methodologies for assessing statistical and clinical significance of intervention effects in systematic reviews were considered. Balancing simplicity and comprehensiveness, an operational procedure was developed, based mainly on The Cochrane Collaboration methodology and the Grading of Recommendations...... Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS: We propose an eight-step procedure for better validation of meta-analytic results in systematic reviews (1) Obtain the 95% confidence intervals and the P-values from both fixed-effect and random-effects meta-analyses and report the most...

  4. Enamel differentiations in Myoxid incisors and their systematic significance

    Directory of Open Access Journals (Sweden)

    Wighart Koenigswald

    1995-05-01

    Full Text Available Abstract Based on enamel microstructure of lower incisors, extant and fossil myoxids can be arranged into three groups. In the first group, Hunter-Schreger bands retain the plesiomorphic state, a transverse orientation. An oblique orientation is found in the second, and in the third group a longitudinal orientation is achieved. This additional morphological character should enter into phylogenetic and systematic discussions. This modification of the schmelzmuster is so far exclusively found in myoxids. Even if parallel evolution within myoxids cannot be excluded, a reversal of the direction of differentiation is most unlikely. Riassunto Differenziazione dello smalto negli incisivi dei Mioxidi e suo significato sistematico - I Mioxidi esistenti e fossili possono essere riuniti in tre gruppi in base alla microstruttura dello smalto degli incisivi inferiori. Nel primo gruppo, le bande Hunter-Schreger mantengono lo stato plesiomorfico, ovvero un orientamento trasversale. L'orientamento è obliquo nel secondo gruppo e longitudinale nel terzo. Questo ulteriore carattere morfologico dovrebbe essere incluso nelle discussioni di sistematica e filogenesi. Questa modificazione del tipo di smalto è stata finora riscontrata solo nei Mioxidi. Anche se non è possibile escludere una evoluzione parallela tra i Mioxidi, una inversione nella direzione di differenziamento è piu improbabile.

  5. Systematic Significance of Leaf Epidermal Features in Holcoglossum (Orchidaceae)

    OpenAIRE

    Fan, Jie; He, Runli; Zhang, Yinbo; Jin, Xiaohua

    2014-01-01

    Determining the generic delimitations within Aeridinae has been a significant issue in the taxonomy of Orchidaceae, and Holcoglossum is a typical case. We investigated the phylogenetic utility of the morphological traits of leaf epidermis in the taxonomy of Holcoglossum s.l. by using light and scanning electron microscopy to analyze 38 samples representing 12 species of Holcoglossum, with five species from five closely related genera, such as Ascocentrum, Luisia, Papilionanthe, Rhynchostylis ...

  6. Systematic significance of leaf epidermal features in holcoglossum (orchidaceae).

    Science.gov (United States)

    Fan, Jie; He, Runli; Zhang, Yinbo; Jin, Xiaohua

    2014-01-01

    Determining the generic delimitations within Aeridinae has been a significant issue in the taxonomy of Orchidaceae, and Holcoglossum is a typical case. We investigated the phylogenetic utility of the morphological traits of leaf epidermis in the taxonomy of Holcoglossum s.l. by using light and scanning electron microscopy to analyze 38 samples representing 12 species of Holcoglossum, with five species from five closely related genera, such as Ascocentrum, Luisia, Papilionanthe, Rhynchostylis and Vanda. Our results indicated that Holcoglossum can be distinguished from the related genera based on cuticular wax characteristics, and the inclusion of Holcoglossum himalaicum in Holcoglossum is supported by the epidermis characteristics found by LM and SEM. The percentage of the tetracytic, brachyparacytic, and laterocytic stomata types as well as the stomata index and certain combinations of special wax types support infrageneric clades and phylogenetic relationships that have been inferred from molecular data. Laterocytic and polarcytic stomata are perhaps ecological adaptations to the strong winds and ample rains in the alpine region of the Hengduanshan Mountains.

  7. Systematic significance of leaf epidermal features in holcoglossum (orchidaceae.

    Directory of Open Access Journals (Sweden)

    Jie Fan

    Full Text Available Determining the generic delimitations within Aeridinae has been a significant issue in the taxonomy of Orchidaceae, and Holcoglossum is a typical case. We investigated the phylogenetic utility of the morphological traits of leaf epidermis in the taxonomy of Holcoglossum s.l. by using light and scanning electron microscopy to analyze 38 samples representing 12 species of Holcoglossum, with five species from five closely related genera, such as Ascocentrum, Luisia, Papilionanthe, Rhynchostylis and Vanda. Our results indicated that Holcoglossum can be distinguished from the related genera based on cuticular wax characteristics, and the inclusion of Holcoglossum himalaicum in Holcoglossum is supported by the epidermis characteristics found by LM and SEM. The percentage of the tetracytic, brachyparacytic, and laterocytic stomata types as well as the stomata index and certain combinations of special wax types support infrageneric clades and phylogenetic relationships that have been inferred from molecular data. Laterocytic and polarcytic stomata are perhaps ecological adaptations to the strong winds and ample rains in the alpine region of the Hengduanshan Mountains.

  8. Formal conditions for the significance-effect

    DEFF Research Database (Denmark)

    Thellefsen, Torkild Leo; Sørensen, Bent; Thellefsen, Martin

    2006-01-01

    The significance-effect is the right effect of meaning caused upon an interpreting mind. The right effect is understood as the right interpretation of an intended meaning caused by a sign communicated by an utterer. In the article, which is inspired by Charles S. Peirce's doctrine of signs, his s...... semeiotics and his theory of communication, we account for the formal conditions that have to be present for the release of the significance-effect....

  9. Prognostic significance of detection of microscopic peritoneal disease in colorectal cancer: a systematic review.

    LENUS (Irish Health Repository)

    Mohan, Helen M

    2013-06-01

    Free intraperitoneal tumour cells are an independent indicator of poor prognosis, and are encorporated in current staging systems in upper gastrointestinal cancers, but not colorectal cancer. This systematic review aimed to evaluate the role and prognostic significance of positive peritoneal lavage in colorectal cancer.

  10. Prognostic significance of neurological signs in high-risk infants : a systematic review

    NARCIS (Netherlands)

    Hamer, Elisa G.; Hadders-Algra, Mijna

    The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for developmental problems such as cerebral palsy (CP). A literature search was performed using the databases PubMed, Embase, Web of

  11. Prognostic significance of neurological signs in high-risk infants - a systematic review

    NARCIS (Netherlands)

    Hamer, E.G.; Hadders-Algra, M.

    2016-01-01

    The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for developmental problems such as cerebral palsy (CP). A literature search was performed using the databases PubMed, Embase, Web of

  12. A systematic review on diagnostic accuracy of CT-based detection of significant coronary artery disease

    International Nuclear Information System (INIS)

    Janne d'Othee, Bertrand; Siebert, Uwe; Cury, Ricardo; Jadvar, Hossein; Dunn, Edward J.; Hoffmann, Udo

    2008-01-01

    Objectives: Systematic review of diagnostic accuracy of contrast enhanced coronary computed tomography (CE-CCT). Background: Noninvasive detection of coronary artery stenosis (CAS) by CE-CCT as an alternative to catheter-based coronary angiography (CCA) may improve patient management. Methods: Forty-one articles published between 1997 and 2006 were included that evaluated native coronary arteries for significant stenosis and used CE-CCT as diagnostic test and CCA as reference standard. Study group characteristics, study methodology and diagnostic outcomes were extracted. Pooled summary sensitivity and specificity of CE-CCT were calculated using a random effects model (1) for all coronary segments, (2) assessable segments, and (3) per patient. Results: The 41 studies totaled 2515 patients (75% males; mean age: 59 years, CAS prevalence: 59%). Analysis of all coronary segments yielded a sensitivity of 95% (80%, 89%, 86%, 98% for electron beam CT, 4/8-slice, 16-slice and 64-slice MDCT, respectively) for a specificity of 85% (77%, 84%, 95%, 91%). Analysis limited to segments deemed assessable by CT showed sensitivity of 96% (86%, 85%, 98%, 97%) for a specificity of 95% (90%, 96%, 96%, 96%). Per patient, sensitivity was 99% (90%, 97%, 99%, 98%) and specificity was 76% (59%, 81%, 83%, 92%). Heterogeneity was quantitatively important but not explainable by patient group characteristics or study methodology. Conclusions: Current diagnostic accuracy of CE-CCT is high. Advances in CT technology have resulted in increases in diagnostic accuracy and proportion of assessable coronary segments. However, per patient, accuracy may be lower and CT may have more limited clinical utility in populations at high risk for CAD

  13. The Significance of Effective Leadership in Organisations

    Institute of Scientific and Technical Information of China (English)

    王丽闻

    2017-01-01

    This essay will study leadership by critically analysing several key theories; it will begin with the concept of leadership to facility an understanding of the subject. Initially, the description of leadership in organisations will be explored to present the development of leadership, and simultaneously identify the purpose of effective leadership. Subse-quently, the demand for good leaders in current business environment will be discussed in order to identify the importance of effective lead-ership. Finally, an empirical case will be discussed to reveal how well the key theories help leaders to address various issues in organisations.

  14. Modelling vocal anatomy's significant effect on speech

    NARCIS (Netherlands)

    de Boer, B.

    2010-01-01

    This paper investigates the effect of larynx position on the articulatory abilities of a humanlike vocal tract. Previous work has investigated models that were built to resemble the anatomy of existing species or fossil ancestors. This has led to conflicting conclusions about the relation between

  15. Significance assessment of the external control effects of lecturers

    Directory of Open Access Journals (Sweden)

    Kurbatova Margarita, V.

    2015-06-01

    Full Text Available The state policy regarding higher education has changed in the last decade. These changes were part of the efficiency programs of the public sector. Governments of different countries ruined previously existing system of higher education state regulation and attempted to build the quasi-market structure in the higher education industry. Such transformations served as timely and progressive reforms in the recent studies of the economics of education. Substitution of bureaucratic management mechanisms and modern competition managerial tools are articulated. Economic and institutional and sociological studies on the effects of the introduction of quasi-markets and managerial tools in higher education governance oppose to orthodox market approach. They drew attention to the fact that evaluation methods and improve the effectiveness of organizations and employees that are typical of the private sector often produce results that differ from those in the public sector. To assess the consequences of the introduction of managerial tools of external control activities of university lecturers used a methodology based on the allocation of the individual structural components (effects and building on their basis of a multi-level hierarchical model in the research. Each component of the model (single effect is characterized by a degree of significance (importance and the degree of severity. The results of the systematization and assessment of the significance of the effects of external control activity of lecturers of Russian universities implemented in conditions of quasi-market mechanisms of the higher education system are highlighted in the paper.

  16. Systematic comparative and sensitivity analyses of additive and outranking techniques for supporting impact significance assessments

    International Nuclear Information System (INIS)

    Cloquell-Ballester, Vicente-Agustin; Monterde-Diaz, Rafael; Cloquell-Ballester, Victor-Andres; Santamarina-Siurana, Maria-Cristina

    2007-01-01

    Assessing the significance of environmental impacts is one of the most important and all together difficult processes of Environmental Impact Assessment. This is largely due to the multicriteria nature of the problem. To date, decision techniques used in the process suffer from two drawbacks, namely the problem of compensation and the problem of identification of the 'exact boundary' between sub-ranges. This article discusses these issues and proposes a methodology for determining the significance of environmental impacts based on comparative and sensitivity analyses using the Electre TRI technique. An application of the methodology for the environmental assessment of a Power Plant project within the Valencian Region (Spain) is presented, and its performance evaluated. It is concluded that contrary to other techniques, Electre TRI automatically identifies those cases where allocation of significance categories is most difficult and, when combined with sensitivity analysis, offers greatest robustness in the face of variation in weights of the significance attributes. Likewise, this research demonstrates the efficacy of systematic comparison between Electre TRI and sum-based techniques, in the solution of assignment problems. The proposed methodology can therefore be regarded as a successful aid to the decision-maker, who will ultimately take the final decision

  17. The MRI features of placental adhesion disorder and their diagnostic significance: systematic review

    International Nuclear Information System (INIS)

    Rahaim, N.S.A.; Whitby, E.H.

    2015-01-01

    Aim: To identify the most frequently used MRI features in the diagnosis of placenta adhesion disorder (PAD) in the antenatal period and their significance. Materials and methods: The online databases Medline via PubMed and Ovid, Google Scholar, and Scopus were searched using the keywords and subject headings MRI*, magnetic resonance imaging*, prenatal diagnosis and placenta accreta*, morbidly adherent placenta* or placenta. Cases where MRI was carried out at/after 20 weeks gestation with detailed information available in relation to criteria and sequences used were included in the review. Exclusion criteria were case report study and studies that used intravenous contrast agents. Information regards sensitivity and specificity for each feature was taken, or calculated where possible, from the papers. Any new features were identified. The overall contribution of each feature to the diagnostic process was noted. Results: Six hundred and fourteen potentially relevant articles were identified of which only 11 met the inclusion criteria. The commonest MRI criteria used were T2 dark intraplacental bands, heterogeneity of placenta, abnormal uterine bulging, and disruption of the uteroplacental zone. A newly described criterion is disorganised vasculature of placenta. MRI sensitivity and specificity varied between 75–100% and 65–100% respectively. Conclusion: MRI diagnosis of PAD relies on unstandardised criteria of diagnosis that enable systematic image interpretation of invasion status in all studies and enable the reproducibility. However, it is still has a high diagnostic accuracy and frequently aids in surgical planning, emphasising its value in supporting ultrasound. Most studies are of a small sample size. Additional multicentre studies are recommended to enhance the generalisability of the findings and asses the value of the newly described criteria

  18. Assessing harmful effects in systematic Reviews

    Directory of Open Access Journals (Sweden)

    Woolacott Nerys F

    2004-07-01

    Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

  19. 15 CFR 971.602 - Significant adverse environmental effects.

    Science.gov (United States)

    2010-01-01

    ... Environmental Effects § 971.602 Significant adverse environmental effects. (a) Determination of significant adverse environmental effects. The Administrator will determine the potential for or the occurrence of any significant adverse environmental effect or impact (for the purposes of sections 103(a)(2)(D), 105(a)(4), 106...

  20. Food Classification Systems Based on Food Processing: Significance and Implications for Policies and Actions: A Systematic Literature Review and Assessment.

    Science.gov (United States)

    Moubarac, Jean-Claude; Parra, Diana C; Cannon, Geoffrey; Monteiro, Carlos A

    2014-06-01

    This paper is the first to make a systematic review and assessment of the literature that attempts methodically to incorporate food processing into classification of diets. The review identified 1276 papers, of which 110 were screened and 21 studied, derived from five classification systems. This paper analyses and assesses the five systems, one of which has been devised and developed by a research team that includes co-authors of this paper. The quality of the five systems is assessed and scored according to how specific, coherent, clear, comprehensive and workable they are. Their relevance to food, nutrition and health, and their use in various settings, is described. The paper shows that the significance of industrial food processing in shaping global food systems and supplies and thus dietary patterns worldwide, and its role in the pandemic of overweight and obesity, remains overlooked and underestimated. Once food processing is systematically incorporated into food classifications, they will be more useful in assessing and monitoring dietary patterns. Food classification systems that emphasize industrial food processing, and that define and distinguish relevant different types of processing, will improve understanding of how to prevent and control overweight, obesity and related chronic non-communicable diseases, and also malnutrition. They will also be a firmer basis for rational policies and effective actions designed to protect and improve public health at all levels from global to local.

  1. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Colorectal Liver Metastasis: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Tang, Haowen; Li, Bingmin; Zhang, Aiqun; Lu, Wenping; Xiang, Canhong; Dong, Jiahong

    2016-01-01

    Inflammation is deemed to play critical roles in tumor progression and metastasis, and an increased neutrophil-lymphocyte ratio (NLR) has been reported to correlate with poor survivals in various malignancies. However, association between NLR elevation and survival outcome in patients with colorectal liver metastasis (CRLM) remains controversial. The aim of this study was to investigate the prognostic significance of elevated NLR in CRLM. The meta-analysis was conducted in adherence to the MOOSE guidelines. PubMed, Embase, Cochrane Library, Web of Science and the Chinese SinoMed were systematically searched to identify eligible studies from the initiation of the databases to May, 2016. Overall survival (OS) and recurrence free survival (RFS) were pooled by using hazard ratio (HR) with corresponding 95% confidence interval (CI). Correlation between NLR values and clinicopathological features was synthesized by using odds ratio (OR) with corresponding 95% CI. A total of 1685 patients from 8 studies (9 cohorts) were analyzed, consisting 347 (20.59%) in high pretreatment NLR value group and 1338 (79.41%) in low pretreatment NLR value one. The results demonstrated that elevated pretreatment NLR was significantly related to poor OS (HR 2.17, 95% CI 1.82-2.58) and RFS (HR 1.96, 95% CI 1.64-2.35) in patients with CRLM. The result of this systematic review and meta-analysis indicated that an elevated pretreatment NLR was closely correlated with poor long-term survival (OS and RFS) in CRLM patients. NLR can be routinely monitored and serve as a useful and cost-effective marker with strong prognostic significance in patients with CRLM.

  2. The systematic description of cacao clones and its significance for taxonomy and plant breeding

    NARCIS (Netherlands)

    Engels, J.M.M.

    1986-01-01

    The value of germplasm collections depends to a large extent on the data accompanying the individual accessions. In order to facilitate the selection of the most useful characters for the systematic description of a cacao germplasm collection methods were developed to measure and to compare

  3. An outline of the systematic-dialectical method: scientific and political significance

    NARCIS (Netherlands)

    Reuten, G.; Moseley, F.; Smith, T.

    2014-01-01

    The method of systematic-dialectics (SD) is reconstructed with a focus on what institutions and processes are necessary - rather than contingent - for the capitalist system. This allows for the detection of strengths and weaknesses in the actual structure of the system. Weaknesses should be

  4. A systematic review on screening for Fabry disease: prevalence of individuals with genetic variants of unknown significance

    NARCIS (Netherlands)

    van der Tol, L.; Smid, B. E.; Poorthuis, B. J. H. M.; Biegstraaten, M.; Deprez, R. H. Lekanne; Linthorst, G. E.; Hollak, C. E. M.

    2014-01-01

    Screening for Fabry disease (FD) reveals a high prevalence of individuals with α-galactosidase A (GLA) genetic variants of unknown significance (GVUS). These individuals often do not express characteristic features of FD. A systematic review on FD screening studies was performed to interpret the

  5. Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review.

    Science.gov (United States)

    Khamis, Sam; Carmeli, Eli

    2017-09-01

    Controversy still exists as to the clinical significance of leg length discrepancy (LLD) in spite of the fact that further evidence has been emerging regarding the relationship between several clinical conditions and LLD. The objectives of our study were to review the available research with regard to LLD as a cause of clinically significant gait deviations, to determine if there is a relationship between the magnitude of LLD and the presence of gait deviations and to identify the most common gait deviations associated with LLD. In line with the PRISMA guidelines, a literature search was carried out throughout the Medline, CINAHL and EMBASE databases. Twelve articles met the predetermined inclusion criteria and were included in the review. Quality assessment using the Methodological Index for Non-Randomized Studies (MINORS) scale was completed for all included studies. Two main methodologies were found in 4 studies evaluating gait asymmetry in patients or healthy participants with anatomic LLD and 8 studies evaluating gait deviations while simulating LLD by employing artificial lifts of 1-5cm on healthy subjects. A significant relationship was found between anatomic LLD and gait deviation. Evidence suggests that gait deviations may occur with discrepancies of >1cm, with greater impact seen as the discrepancy increases. Compensatory strategies were found to occur in both the shorter and longer limb, throughout the lower limb. As the discrepancy increases, more compensatory strategies occur. Sagittal plane deviations seem to be the most effective deviations, although, frontal plane compensations also occur in the pelvis, hip and foot. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. A systematic approach to assessing the clinical significance of genetic variants.

    Science.gov (United States)

    Duzkale, H; Shen, J; McLaughlin, H; Alfares, A; Kelly, M A; Pugh, T J; Funke, B H; Rehm, H L; Lebo, M S

    2013-11-01

    Molecular genetic testing informs diagnosis, prognosis, and risk assessment for patients and their family members. Recent advances in low-cost, high-throughput DNA sequencing and computing technologies have enabled the rapid expansion of genetic test content, resulting in dramatically increased numbers of DNA variants identified per test. To address this challenge, our laboratory has developed a systematic approach to thorough and efficient assessments of variants for pathogenicity determination. We first search for existing data in publications and databases including internal, collaborative and public resources. We then perform full evidence-based assessments through statistical analyses of observations in the general population and disease cohorts, evaluation of experimental data from in vivo or in vitro studies, and computational predictions of potential impacts of each variant. Finally, we weigh all evidence to reach an overall conclusion on the potential for each variant to be disease causing. In this report, we highlight the principles of variant assessment, address the caveats and pitfalls, and provide examples to illustrate the process. By sharing our experience and providing a framework for variant assessment, including access to a freely available customizable tool, we hope to help move towards standardized and consistent approaches to variant assessment. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Clinically significant drug–drug interactions involving opioid analgesics used for pain treatment in patients with cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Kotlinska-Lemieszek A

    2015-09-01

    Full Text Available Aleksandra Kotlinska-Lemieszek,1 Pål Klepstad,2,3,6 Dagny Faksvåg Haugen2,4,5 1Palliative Medicine Chair and Department, University Hospital of the Lord’s Transfiguration, Karol Marcinkowski University of Medical Sciences, Poznan, Poland; 2European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology,Trondheim, Norway; 3Department of Anaesthesiology and Intensive Care Medicine, St Olavs Hospital, Trondheim, Norway; 4Regional Centre of Excellence for Palliative Care, Haukeland University Hospital, Bergen, Norway; 5Department of Clinical Medicine K1, University of Bergen, Bergen, Norway; 6Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway Background: Opioids are the most frequently used drugs to treat pain in cancer patients. In some patients, however, opioids can cause adverse effects and drug–drug interactions. No advice concerning the combination of opioids and other drugs is given in the current European guidelines. Objective: To identify studies that report clinically significant drug–drug interactions involving opioids used for pain treatment in adult cancer patients. Design and data sources: Systematic review with searches in Embase, MEDLINE, and Cochrane Central Register of Controlled Trials from the start of the databases (Embase from 1980 through January 2014. In addition, reference lists of relevant full-text papers were hand-searched. Results: Of 901 retrieved papers, 112 were considered as potentially eligible. After full-text reading, 17 were included in the final analysis, together with 15 papers identified through hand-searching of reference lists. All of the 32 included publications were case reports or case series. Clinical manifestations of drug–drug interactions involving opioids were grouped as follows: 1 sedation and respiratory depression, 2 other central nervous system symptoms, 3 impairment of pain

  8. Effectiveness of Structured Psychodrama and Systematic Desensitization in Reducing Test Anxiety.

    Science.gov (United States)

    Kipper, David A.; Giladi, Daniel

    1978-01-01

    Students with examination anxiety took part in study of effectiveness of two kinds of treatment, structured psychodrama and systematic desensitization, in reducing test anxiety. Results showed that subjects in both treatment groups significantly reduced test-anxiety scores. Structured psychodrama is as effective as systematic desensitization in…

  9. Candida parapsilosis is a Significant Neonatal Pathogen: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Pammi, Mohan; Holland, Linda; Butler, Geraldine; Gacser, Attila; Bliss, Joseph M.

    2013-01-01

    Background Candida is the third most common cause of late-onset neonatal sepsis in infants born at Candida infections. C. parapsilosis rates were similar in studies performed before the year 2000, 33.53 % [95% CI, 30.06, 37.40] (28 studies), to those after 2000, 27.00% [95% CI, 8.25, 88.37] (8 studies). The mortality due to neonatal Candida parapsilosis infections was 10.02% [95% CI, 7.66, 13.12]. Geographical variations in C. parapsilosis infections included a low incidence in Europe and higher incidence in North America and Australia. Biofilm formation was a significant virulence determinant and predominant risk factors for C. parapsilosis infections were prematurity, prior colonization and catheterization. Amphotericin B remains the antifungal drug of choice and combination therapy with caspofungin or other echinocandins may be considered in resistant cases. Conclusion C. parapsilosis is a significant neonatal pathogen, comprises a third of all Candida infections and is associated with 10% mortality. Availability of tools for genetic manipulation of this organism will identify virulence determinants and organism characteristics that may explain predilection for preterm neonates. Strategies to prevent horizontal transmission in the neonatal unit are paramount in decreasing infection rates. PMID:23340551

  10. Exploring cosmic origins with CORE: Mitigation of systematic effects

    Science.gov (United States)

    Natoli, P.; Ashdown, M.; Banerji, R.; Borrill, J.; Buzzelli, A.; de Gasperis, G.; Delabrouille, J.; Hivon, E.; Molinari, D.; Patanchon, G.; Polastri, L.; Tomasi, M.; Bouchet, F. R.; Henrot-Versillé, S.; Hoang, D. T.; Keskitalo, R.; Kiiveri, K.; Kisner, T.; Lindholm, V.; McCarthy, D.; Piacentini, F.; Perdereau, O.; Polenta, G.; Tristram, M.; Achucarro, A.; Ade, P.; Allison, R.; Baccigalupi, C.; Ballardini, M.; Banday, A. J.; Bartlett, J.; Bartolo, N.; Basak, S.; Baumann, D.; Bersanelli, M.; Bonaldi, A.; Bonato, M.; Boulanger, F.; Brinckmann, T.; Bucher, M.; Burigana, C.; Cai, Z.-Y.; Calvo, M.; Carvalho, C.-S.; Castellano, M. G.; Challinor, A.; Chluba, J.; Clesse, S.; Colantoni, I.; Coppolecchia, A.; Crook, M.; D'Alessandro, G.; de Bernardis, P.; De Zotti, G.; Di Valentino, E.; Diego, J.-M.; Errard, J.; Feeney, S.; Fernandez-Cobos, R.; Finelli, F.; Forastieri, F.; Galli, S.; Genova-Santos, R.; Gerbino, M.; González-Nuevo, J.; Grandis, S.; Greenslade, J.; Gruppuso, A.; Hagstotz, S.; Hanany, S.; Handley, W.; Hernandez-Monteagudo, C.; Hervías-Caimapo, C.; Hills, M.; Keihänen, E.; Kitching, T.; Kunz, M.; Kurki-Suonio, H.; Lamagna, L.; Lasenby, A.; Lattanzi, M.; Lesgourgues, J.; Lewis, A.; Liguori, M.; López-Caniego, M.; Luzzi, G.; Maffei, B.; Mandolesi, N.; Martinez-González, E.; Martins, C. J. A. P.; Masi, S.; Matarrese, S.; Melchiorri, A.; Melin, J.-B.; Migliaccio, M.; Monfardini, A.; Negrello, M.; Notari, A.; Pagano, L.; Paiella, A.; Paoletti, D.; Piat, M.; Pisano, G.; Pollo, A.; Poulin, V.; Quartin, M.; Remazeilles, M.; Roman, M.; Rossi, G.; Rubino-Martin, J.-A.; Salvati, L.; Signorelli, G.; Tartari, A.; Tramonte, D.; Trappe, N.; Trombetti, T.; Tucker, C.; Valiviita, J.; Van de Weijgaert, R.; van Tent, B.; Vennin, V.; Vielva, P.; Vittorio, N.; Wallis, C.; Young, K.; Zannoni, M.

    2018-04-01

    We present an analysis of the main systematic effects that could impact the measurement of CMB polarization with the proposed CORE space mission. We employ timeline-to-map simulations to verify that the CORE instrumental set-up and scanning strategy allow us to measure sky polarization to a level of accuracy adequate to the mission science goals. We also show how the CORE observations can be processed to mitigate the level of contamination by potentially worrying systematics, including intensity-to-polarization leakage due to bandpass mismatch, asymmetric main beams, pointing errors and correlated noise. We use analysis techniques that are well validated on data from current missions such as Planck to demonstrate how the residual contamination of the measurements by these effects can be brought to a level low enough not to hamper the scientific capability of the mission, nor significantly increase the overall error budget. We also present a prototype of the CORE photometric calibration pipeline, based on that used for Planck, and discuss its robustness to systematics, showing how CORE can achieve its calibration requirements. While a fine-grained assessment of the impact of systematics requires a level of knowledge of the system that can only be achieved in a future study phase, the analysis presented here strongly suggests that the main areas of concern for the CORE mission can be addressed using existing knowledge, techniques and algorithms.

  11. A systematic experimental investigation of significant parameters affecting model tire hydroplaning

    Science.gov (United States)

    Wray, G. A.; Ehrlich, I. R.

    1973-01-01

    The results of a comprehensive parametric study of model and small pneumatic tires operating on a wet surface are presented. Hydroplaning inception (spin down) and rolling restoration (spin up) are discussed. Conclusions indicate that hydroplaning inception occurs at a speed significantly higher than the rolling restoration speed. Hydroplaning speed increases considerably with tread depth, surface roughness and tire inflation pressure of footprint pressure, and only moderately with increased load. Water film thickness affects spin down speed only slightly. Spin down speed varies inversely as approximately the one-sixth power of film thickness. Empirical equations relating tire inflation pressure, normal load, tire diameter and water film thickness have been generated for various tire tread and surface configurations.

  12. Statistical Significance and Effect Size: Two Sides of a Coin.

    Science.gov (United States)

    Fan, Xitao

    This paper suggests that statistical significance testing and effect size are two sides of the same coin; they complement each other, but do not substitute for one another. Good research practice requires that both should be taken into consideration to make sound quantitative decisions. A Monte Carlo simulation experiment was conducted, and a…

  13. Reporting effect sizes as a supplement to statistical significance ...

    African Journals Online (AJOL)

    The purpose of the article is to review the statistical significance reporting practices in reading instruction studies and to provide guidelines for when to calculate and report effect sizes in educational research. A review of six readily accessible (online) and accredited journals publishing research on reading instruction ...

  14. Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews.

    Science.gov (United States)

    Golder, Su; Loke, Yoon K; Zorzela, Liliane

    2014-06-01

    Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. To compare search methods in systematic reviews of adverse effects with other reviews. The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials (RCTs). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE. However, reviews of adverse effects are more likely to include a range of study designs (not just RCTs) and search beyond MEDLINE. © 2014 Crown Copyright.

  15. Thalidomide has a significant effect in patients with thalassemia intermedia.

    Science.gov (United States)

    Li, YunShuan; Ren, Quan; Zhou, Yali; Li, Pingping; Lin, Wanhua; Yin, Xiaolin

    2018-01-01

    To investigate the effect of thalidomide in patients with thalassemia intermedia. We observed the effect of thalidomide in seven patients with thalassemia intermedia requiring blood transfusion. Four of the patients were transfusion-independent, and three patients were transfusion-dependent. For the four transfusion-independent patients, hemoglobin concentration increased significantly (≥2 g/dl) in three and moderately (1-2 g/dl) in one. After 3 months of treatment, hemoglobin concentration increased 3.2 ± 1.2 g/dl compared to pretreatment. Among the three transfusion-dependent patients, transfusion was terminated after one month of treatment in one patient and decreased >50% in the other two patients, accompanied by an increase in the average hemoglobin concentration. Thalidomide had a significant effect in patients with thalassemia intermedia. Further studies of a larger scale and more rigorous design are warranted.

  16. Significance of autobiographical episodes and spacing effects in incidental memory.

    Science.gov (United States)

    Toyota, Hiroshi

    2013-10-01

    Participants were presented with target words on two occasions, and were asked each time to generate a memory of a past episode associated with the targets. Participants were also instructed to rate the importance (significance elaboration) or pleasantness of the pisode (pleasantness elaboration) in an orienting task, followed by an unexpect d recall test. Significance elaboration led to better recall than pleasantness elaboration, but only in the spaced presentation. The spaced presentation led to better tree recall than massed presentation with significance elaboration, but the difference between the two types of presentation was not observed with pleasantness elaboration. These results suggest that the significance of an episode is more critical than the pleasantness of an episode in determining the effectiveness of autobiographical elaboration in facilitating recall.

  17. SARS: systematic review of treatment effects.

    Directory of Open Access Journals (Sweden)

    Lauren J Stockman

    2006-09-01

    Full Text Available BACKGROUND: The SARS outbreak of 2002-2003 presented clinicians with a new, life-threatening disease for which they had no experience in treating and no research on the effectiveness of treatment options. The World Health Organization (WHO expert panel on SARS treatment requested a systematic review and comprehensive summary of treatments used for SARS-infected patients in order to guide future treatment and identify priorities for research. METHODS AND FINDINGS: In response to the WHO request we conducted a systematic review of the published literature on ribavirin, corticosteroids, lopinavir and ritonavir (LPV/r, type I interferon (IFN, intravenous immunoglobulin (IVIG, and SARS convalescent plasma from both in vitro studies and in SARS patients. We also searched for clinical trial evidence of treatment for acute respiratory distress syndrome. Sources of data were the literature databases MEDLINE, EMBASE, BIOSIS, and the Cochrane Central Register of Controlled Trials (CENTRAL up to February 2005. Data from publications were extracted and evidence within studies was classified using predefined criteria. In total, 54 SARS treatment studies, 15 in vitro studies, and three acute respiratory distress syndrome studies met our inclusion criteria. Within in vitro studies, ribavirin, lopinavir, and type I IFN showed inhibition of SARS-CoV in tissue culture. In SARS-infected patient reports on ribavirin, 26 studies were classified as inconclusive, and four showed possible harm. Seven studies of convalescent plasma or IVIG, three of IFN type I, and two of LPV/r were inconclusive. In 29 studies of steroid use, 25 were inconclusive and four were classified as causing possible harm. CONCLUSIONS: Despite an extensive literature reporting on SARS treatments, it was not possible to determine whether treatments benefited patients during the SARS outbreak. Some may have been harmful. Clinical trials should be designed to validate a standard protocol for dosage

  18. Higgs effective field theories. Systematics and applications

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Claudius G.

    2016-07-28

    Researchers of the Large Hadron Collider (LHC) at the European Organization for Nuclear Research (CERN) announced on July 4th, 2012, the observation of a new particle. The properties of the particle agree, within the relatively large experimental uncertainties, with the properties of the long-sought Higgs boson. Particle physicists around the globe are now wondering, ''Is it the Standard Model Higgs that we observe; or is it another particle with similar properties?'' We employ effective field theories (EFTs) for a general, model-independent description of the particle. We use a few, minimal assumptions - Standard Model (SM) particle content and a separation of scales to the new physics - which are supported by current experimental results. By construction, effective field theories describe a physical system only at a certain energy scale, in our case at the electroweak-scale v. Effects of new physics from a higher energy-scale, Λ, are described by modified interactions of the light particles. In this thesis, ''Higgs Effective Field Theories - Systematics and Applications'', we discuss effective field theories for the Higgs particle, which is not necessarily the Higgs of the Standard Model. In particular, we focus on a systematic and consistent expansion of the EFT. The systematics depends on the dynamics of the new physics. We distinguish two different consistent expansions. EFTs that describe decoupling new-physics effects and EFTs that describe non-decoupling new-physics effects. We briefly discuss the first case, the SM-EFT. The focus of this thesis, however, is on the non-decoupling EFTs. We argue that the loop expansion is the consistent expansion in the second case. We introduce the concept of chiral dimensions, equivalent to the loop expansion. Using the chiral dimensions, we expand the electroweak chiral Lagrangian up to next-to-leading order, O(f{sup 2}/Λ{sup 2})=O(1/16π{sup 2}). Further, we discuss how different

  19. Evaluating significance in linear mixed-effects models in R.

    Science.gov (United States)

    Luke, Steven G

    2017-08-01

    Mixed-effects models are being used ever more frequently in the analysis of experimental data. However, in the lme4 package in R the standards for evaluating significance of fixed effects in these models (i.e., obtaining p-values) are somewhat vague. There are good reasons for this, but as researchers who are using these models are required in many cases to report p-values, some method for evaluating the significance of the model output is needed. This paper reports the results of simulations showing that the two most common methods for evaluating significance, using likelihood ratio tests and applying the z distribution to the Wald t values from the model output (t-as-z), are somewhat anti-conservative, especially for smaller sample sizes. Other methods for evaluating significance, including parametric bootstrapping and the Kenward-Roger and Satterthwaite approximations for degrees of freedom, were also evaluated. The results of these simulations suggest that Type 1 error rates are closest to .05 when models are fitted using REML and p-values are derived using the Kenward-Roger or Satterthwaite approximations, as these approximations both produced acceptable Type 1 error rates even for smaller samples.

  20. Moderating Effects of Trust on Environmentally Significant Behavior in Korea

    Directory of Open Access Journals (Sweden)

    Seong-Gin Moon

    2017-03-01

    Full Text Available To treat environmental problems and to seek sustainable development, voluntary and cooperative efforts, which is really against the traditional mentality with the emphasis on the individual competitive optimization, became the key to maintain the sustainability of complex social and ecological systems. To understand the cooperative and voluntary individual’s environmentally significant behavior (ESB, this paper focuses on the role of trust, and assesses the effect of trust on the relationship between existing factors and ESB. A structural equation model (SEM is constructed to estimate the moderating effects of trust on ESB in Korea. We found that people with a negative view on strict environmental regulations do not exhibit ESB and thus nudge policies could be much more effective than the forceful measure. It is noteworthy that public private partnership, as a kind of optimal trust, should be more promoted in the environmental protection policies.

  1. Prognostic significance of lymphovascular invasion in radical cystectomy on patients with bladder cancer: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Hwanik Kim

    Full Text Available PURPOSE: The objective of the present study was to conduct a systematic review and meta-analysis of published literature to appraise the prognostic value of lymphovascular invasion (LVI in radical cystectomy specimens. MATERIALS AND METHODS: Following the PRISMA statement, PubMed, Cochrane Library, and SCOPUS database were searched from the respective dates of inception until June 2013. RESULTS: A total of 21 articles met the eligibility criteria for this systematic review, which included a total of 12,527 patients ranging from 57 to 4,257 per study. LVI was detected in 34.6% in radical cystectomy specimens. LVI was associated with higher pathological T stage and tumor grade, as well as lymph node metastasis. The pooled hazard ratio (HR was statistically significant for recurrence-free survival (pooled HR, 1.61; 95% confidence interval [CI], 1.26-2.06, cancer-specific survival (pooled HR, 1.67; 95% CI, 1.38-2.01, and overall survival (pooled HR, 1.67; 95% CI, 1.38-2.01, despite the heterogeneity among included studies. On sensitivity analysis, the pooled HRs and 95% CIs were not significantly altered when any one study was omitted. The funnel plot for overall survival demonstrated a certain degree of asymmetry, which showed slight publication bias. CONCLUSIONS: This meta-analysis indicates that LVI is significantly associated with poor outcome in patients with bladder cancer who underwent radical cystectomy. Adequately designed prospective studies are required to provide the precise prognostic significance of LVI in bladder cancer.

  2. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Wells Cherie

    2013-01-01

    Full Text Available Abstract Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back

  3. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

    Science.gov (United States)

    2013-01-01

    Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small

  4. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.

    Science.gov (United States)

    Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Hill, Bridget; Bialocerkowski, Andrea

    2013-01-19

    Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological

  5. Effectiveness of Reablement: A Systematic Review.

    Science.gov (United States)

    Tessier, Annie; Beaulieu, Marie-Dominique; Mcginn, Carrie Anna; Latulippe, Renée

    2016-05-01

    The ageing of the population and the increasing need for long-term care services are global issues. Some countries have adapted homecare programs by introducing an intervention called reablement, which is aimed at optimizing independence. The effectiveness of reablement, as well as its different service models, was examined. A systematic literature review was conducted using MEDLINE, CINAHL, PsycINFO and EBM Reviews to search from 2001 to 2014. Core characteristics and facilitators of reablement implementation were identified from international experiences. Ten studies comprising a total of 14,742 participants (including four randomized trials, most of excellent or good quality) showed a positive impact of reablement, especially on health-related quality of life and service utilization. The implementation of reablement was studied in three regions, and all observed a reduction in healthcare service utilization. Considering its effectiveness and positive impact observed in several countries, the implementation of reablement is a promising avenue to be pursued by policy makers. Copyright © 2016 Longwoods Publishing.

  6. Acute alerting effects of light: A systematic literature review.

    Science.gov (United States)

    Souman, Jan L; Tinga, Angelica M; Te Pas, Susan F; van Ee, Raymond; Vlaskamp, Björn N S

    2018-01-30

    Periodic, well timed exposure to light is important for our health and wellbeing. Light, in particular in the blue part of the spectrum, is thought to affect alertness both indirectly, by modifying circadian rhythms, and directly, giving rise to acute effects. We performed a systematic review of empirical studies on direct, acute effects of light on alertness to evaluate the reliability of these effects. In total, we identified 68 studies in which either light intensity, spectral distribution, or both were manipulated, and evaluated the effects on behavioral measures of alertness, either subjectively or measured in reaction time performance tasks. The results show that increasing the intensity of polychromatic white light has been found to increase subjective ratings of alertness in a majority of studies, though a substantial proportion of studies failed to find significant effects, possibly due to small sample sizes or high baseline light intensities. The effect of the color temperature of white light on subjective alertness is less clear. Some studies found increased alertness with higher color temperatures, but other studies reported no detrimental effects of filtering out the short wavelengths from the spectrum. Similarly, studies that used monochromatic light exposure showed no systematic pattern for the effects of blue light compared to longer wavelengths. Far fewer studies investigated the effects of light intensity or spectrum on alertness as measured with reaction time tasks and of those, very few reported significant effects. In general, the small sample sizes used in studies on acute alerting effects of light make it difficult to draw definitive conclusions and better powered studies are needed, especially studies that allow for the construction of dose-response curves. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Significantly enhanced memory effect in metallic glass by multistep training

    Science.gov (United States)

    Li, M. X.; Luo, P.; Sun, Y. T.; Wen, P.; Bai, H. Y.; Liu, Y. H.; Wang, W. H.

    2017-11-01

    The state of metastable equilibrium glass can carry an imprint of the past and exhibit memory effect. As a hallmark of glassy dynamics, memory effect can affect glassy behavior as it evolves further upon time. Even though the physical picture of the memory effect has been well studied, it is unclear whether a glass can recall as many pieces of information as possible, and if so, how the glass will accordingly behave. We report that by fractionizing temperature interval, inserting multistep aging protocols, and optimizing the time of each temperature step, i.e., by imposing a multistep "training" on a prototypical P d40N i10C u30P20 metallic glass, the memory of the trained glass can be significantly strengthened, marked by a pronounced augment in potential energy. These findings provide a new guide for regulating the energy state of glass by enhancing the nonequilibrium behaviors of the memory effect and offer an opportunity to develop a clearer physical picture of glassy dynamics.

  8. Immunological Effects of Probiotics and their Significance to Human Health

    Science.gov (United States)

    Gill, Harsharn S.; Grover, Sunita; Batish, Virender K.; Gill, Preet

    Probiotics are defined as live microorganisms which when administered in adequate amounts confer a health benefit upon the host (FAO/WHO, 2001). Lactic acid bacteria, particularly Lactobacillus and Bifidobacterium species are commonly used as probiotics. Other less commonly used probiotics include the yeast Sacchromyces cerevisiae and some non-pathogenic Escherichia coli and Bacillus species. Studies over the past 20 years have demonstrated that probiotic intake is able to confer a range of health benefits including modulation of the immune system, protection against gastrointestinal and respiratory tract infections, lowering of blood cholesterol levels, attenuation of overt immuno-inflammatory disorders (such as inflammatory bowel disease, allergies) and anti-cancer effects. However, the strongest clinical evidence for probiotics relates to their effectiveness in improving gut health and modulating (via stimulation or regulation) the host immune system. This chapter provides an overview of the current status of our knowledge regarding the immunostimulatory and immunoregulatory effects of probiotics on the immune system and their significance to human health.

  9. Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews.

    Science.gov (United States)

    Azar, Farbod Ebadifard; Azami-Aghdash, Saber; Pournaghi-Azar, Fatemeh; Mazdaki, Alireza; Rezapour, Aziz; Ebrahimi, Parvin; Yousefzadeh, Negar

    2017-06-19

    Due to extensive literature in the field of lung cancer and their heterogeneous results, the aim of this study was to systematically review of systematic reviews studies which reviewed the cost-effectiveness of various lung cancer screening and treatment methods. In this systematic review of systematic reviews study, required data were collected searching the following key words which selected from Mesh: "lung cancer", "lung oncology", "lung Carcinoma", "lung neoplasm", "lung tumors", "cost- effectiveness", "systematic review" and "Meta-analysis". The following databases were searched: PubMed, Cochrane Library electronic databases, Google Scholar, and Scopus. Two reviewers (RA and A-AS) evaluated the articles according to the checklist of "assessment of multiple systematic reviews" (AMSTAR) tool. Overall, information of 110 papers was discussed in eight systematic reviews. Authors focused on cost-effectiveness of lung cancer treatments in five systematic reviews. Targeted therapy options (bevacizumab, Erlotinib and Crizotinib) show an acceptable cost-effectiveness. Results of three studies failed to show cost-effectiveness of screening methods. None of the studies had used the meta-analysis method. The Quality of Health Economic Studies (QHES) tool and Drummond checklist were mostly used in assessing the quality of articles. Most perspective was related to the Payer (64 times) and the lowest was related to Social (11times). Most cases referred to Incremental analysis (82%) and also the lowest point of referral was related to Discounting (in 49% of the cases). The average quality score of included studies was calculated 9.2% from 11. Targeted therapy can be an option for the treatment of lung cancer. Evaluation of the cost-effectiveness of computerized tomographic colonography (CTC) in lung cancer screening is recommended. The perspective of the community should be more taken into consideration in studies of cost-effectiveness. Paying more attention to the topic of

  10. There Is a Significant Discrepancy Between "Big Data" Database and Original Research Publications on Hip Arthroscopy Outcomes: A Systematic Review.

    Science.gov (United States)

    Sochacki, Kyle R; Jack, Robert A; Safran, Marc R; Nho, Shane J; Harris, Joshua D

    2018-06-01

    The purpose of this study was to compare (1) major complication, (2) revision, and (3) conversion to arthroplasty rates following hip arthroscopy between database studies and original research peer-reviewed publications. A systematic review was performed using PRISMA guidelines. PubMed, SCOPUS, SportDiscus, and Cochrane Central Register of Controlled Trials were searched for studies that investigated major complication (dislocation, femoral neck fracture, avascular necrosis, fluid extravasation, septic arthritis, death), revision, and hip arthroplasty conversion rates following hip arthroscopy. Major complication, revision, and conversion to hip arthroplasty rates were compared between original research (single- or multicenter therapeutic studies) and database (insurance database using ICD-9/10 and/or current procedural terminology coding terminology) publishing studies. Two hundred seven studies (201 original research publications [15,780 subjects; 54% female] and 6 database studies [20,825 subjects; 60% female]) were analyzed (mean age, 38.2 ± 11.6 years old; mean follow-up, 2.7 ± 2.9 years). The database studies had a significantly higher age (40.6 + 2.8 vs 35.4 ± 11.6), body mass index (27.4 ± 5.6 vs 24.9 ± 3.1), percentage of females (60.1% vs 53.8%), and longer follow-up (3.1 ± 1.6 vs 2.7 ± 3.0) compared with original research (P database studies (P = .029; relative risk [RR], 1.3). There was a significantly higher rate of femoral neck fracture (0.24% vs 0.03%; P database studies. Reoperations occurred at a significantly higher rate in the database studies (11.1% vs 7.3%; P database studies (8.0% vs 3.7%; P Database studies report significantly increased major complication, revision, and conversion to hip arthroplasty rates compared with original research investigations of hip arthroscopy outcomes. Level IV, systematic review of Level I-IV studies. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights

  11. Prognostic significance of neutrophil-to-lymphocyte ratio in biliary tract cancers: a systematic review and meta-analysis.

    Science.gov (United States)

    Tang, Haowen; Lu, Wenping; Li, Bingmin; Li, Chonghui; Xu, Yinzhe; Dong, Jiahong

    2017-05-30

    Inflammation was considered to perform crucial roles in the development and metastasis of malignancies. A heightened neutrophil-lymphocyte ratio has been described to be associated with detrimental survivals in different malignancies. Debate remains over the impact of heightened neutrophil-lymphocyte ratio on survivals in biliary tract cancer. The review evaluated the prognostic value of neutrophil-lymphocyte ratio in biliary tract cancer. MEDLINE, the Cochrane Library, EMBASE, and the Chinese SinoMed were systematically searched for relevant articles. Associations between neutrophil-lymphocyte ratio and long-term outcomes were expressed as the hazard ratios and 95% confidence intervals. The odds ratio was utilized to assess the association between neutrophil-lymphocyte ratio and clinicopathological parameters. Fourteen studies consisting of 3217 patients were analyzed: 1278 (39.73%) in the high pretreatment neutrophil-lymphocyte ratio group and 1939 (60.27%) in the low pretreatment neutrophil-lymphocyte ratio one. The results proved that heightened pretreatment neutrophil-lymphocyte ratio was significantly associated with detrimental overall survival and relapse free survival for biliary tract cancer patients. In addition, elevated neutrophil-lymphocyte ratio was positively correlated with higher carbohydrate antigen 19-9 levels, advanced TNM staging and greater lymph node involvement. This meta-analysis marked that an increased pretreatment neutrophil-lymphocyte ratio was significantly linked with detrimental long-term outcomes and clinicopathological parameters for patients with biliary tract cancer.

  12. Effectiveness of Music Therapy in Alzheimer Patients: Systematic Review

    Directory of Open Access Journals (Sweden)

    Neslihan Lok

    Full Text Available The incidence of Alzheimers disease increases with advancing age. This increase cause significant economic and emotional burden on family and national health care system which makes Alzheimers disease a national issue to be considered. Music therapy could be an alternative treatment approach in Alzheimer's disease. Especially in the second stage of Alzheimers disease, growth and expansion of amyloid plaques results in anger and aggression among patients. Calming effects of music might be beneficial in management of patients during this period. This study is a systematic review of researches conducted to determine the effects of music therapy in Alzheimer's diseases. In sum results have supported possible positive effects of music therapy on Alzheimer patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(3.000: 266-274

  13. Is valve choice a significant determinant of paravalular leak post-transcatheter aortic valve implantation? A systematic review and meta-analysis.

    Science.gov (United States)

    O'Sullivan, Katie E; Gough, Aideen; Segurado, Ricardo; Barry, Mitchel; Sugrue, Declan; Hurley, John

    2014-05-01

    Paravalvular regurgitation (PVR) following transcatheter aortic valve implantation (TAVI) is associated with poor survival. The two main valve delivery systems used to date differ significantly in both structure and deployment technique. The primary objective of this study was to perform a systematic review and meta-analysis of studies identifying PVR in patients post-TAVI using Medtronic CoreValve (MCV) and Edward Sapien (ES) valves in order to identify whether a significant difference exists between valve types. The secondary objective was to identify additional factors predisposing to PVR to provide an overview of the other associated considerations. A systematic review and meta-analysis of the current literature to identify PVR rate in patients with MCV and ES valves was performed. We also sought to examine other factors predisposing to PVR. A total of 5910 patients were identified from 9 studies. PVR rates for MCV and ES were analysed. MCV was associated with a higher PVR rate of 15.75% [95% confidence interval (CI) 12.48-19.32] compared with ES 3.93% [95% CI 1.05-8.38]. We separately reviewed predisposing factors associated with PVR. A formal comparison of the MCV and ES valve leakage rates by mixed-effects meta-regression with a fixed-effect moderator variable for valve type (MCV or ES) suggested a statistically significant difference in leakage rate between the two valve types (P = 0.0002). Unfavourable anatomical and pathological factors as well as valve choice have an impact on rates of PVR. Additionally, certain anatomical features dictate valve choice. A direct comparison of all the predisposing factors at this time is not possible and will require prospective multivariate analysis. There is, however, a significant difference in the PVR rates between valves based on the published observational data available to date. The ES valve associated with a lower incidence of PVR overall; therefore, we conclude that valve choice is indeed a significant

  14. Prevalence and clinical significance of incidental F18-FDG breast uptake. A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Bertagna, F.; Giubbini, R.; Treglia, G.; Giovanella, L.; Orlando, E.; Dognini, L.; Sadeghi, R.

    2014-01-01

    This review aims to analyse the published data on the prevalence and clinical significance of breast incidental F18-FDG uptake detected by PET or PET/CT (BIU). A comprehensive computer literature search of the Pub-Med/MEDLINE, Scopus and Embase databases for studies on BIU published through July 2013 was performed. Pooled prevalence and malignancy risk of BIU were calculated. The literature search revealed 42 articles, and 17 were selected. One study was excluded because of data overlap but four additional studies were found screening the references. Finally, 20 articles were included in the systematic review and 13 were eligible for a meta-analysis. The pooled prevalence of BIU on all scans was 0.4% (95% CI 0.23-0.61%), the pooled prevalence on scans on female patients only was 0.82% (95% CI 0.51-1.2%), the pooled risk of malignancy of BIU when further analysed was 48% (95% CI 38-58%) and the pooled risk of malignancy of BIU with histological examination was 60% (95% CI 53-66%). The most frequent malignant lesion detected was infiltrating ductal carcinoma. Despite being rare, the identification of BIU frequently signals the presence of an unsuspected subclinical lesion, which differs from the indicated reason for which the patient was initially scanned, and the risk of malignancy is very high. (author)

  15. The Significance of an Excess in a Counting Experiment: Assessing the Impact of Systematic Uncertainties and the Case with a Gaussian Background

    Science.gov (United States)

    Vianello, Giacomo

    2018-05-01

    Several experiments in high-energy physics and astrophysics can be treated as on/off measurements, where an observation potentially containing a new source or effect (“on” measurement) is contrasted with a background-only observation free of the effect (“off” measurement). In counting experiments, the significance of the new source or effect can be estimated with a widely used formula from Li & Ma, which assumes that both measurements are Poisson random variables. In this paper we study three other cases: (i) the ideal case where the background measurement has no uncertainty, which can be used to study the maximum sensitivity that an instrument can achieve, (ii) the case where the background estimate b in the off measurement has an additional systematic uncertainty, and (iii) the case where b is a Gaussian random variable instead of a Poisson random variable. The latter case applies when b comes from a model fitted on archival or ancillary data, or from the interpolation of a function fitted on data surrounding the candidate new source/effect. Practitioners typically use a formula that is only valid when b is large and when its uncertainty is very small, while we derive a general formula that can be applied in all regimes. We also develop simple methods that can be used to assess how much an estimate of significance is sensitive to systematic uncertainties on the efficiency or on the background. Examples of applications include the detection of short gamma-ray bursts and of new X-ray or γ-ray sources. All the techniques presented in this paper are made available in a Python code that is ready to use.

  16. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Kumar S

    2013-09-01

    Full Text Available Saravana Kumar,1 Kate Beaton,1 Tricia Hughes2 1International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; 2Australian Association of Massage Therapists, Adelaide, South Australia, Australia Introduction: The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. Methods: A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Results: Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an

  17. Is the prognostic significance of O6-methylguanine- DNA methyltransferase promoter methylation equally important in glioblastomas of patients from different continents? A systematic review with meta-analysis.

    Science.gov (United States)

    Meng, Wei; Jiang, Yangyang; Ma, Jie

    2017-01-01

    O6-methylguanine-DNA methyltransferase (MGMT) is an independent predictor of therapeutic response and potential prognosis in patients with glioblastoma multiforme (GBM). However, its significance of clinical prognosis in different continents still needs to be explored. To explore the effects of MGMT promoter methylation on both progression-free survival (PFS) and overall survival (OS) among GBM patients from different continents, a systematic review of published studies was conducted. A total of 5103 patients from 53 studies were involved in the systematic review and the total percentage of MGMT promoter methylation was 45.53%. Of these studies, 16 studies performed univariate analyses and 17 performed multivariate analyses of MGMT promoter methylation on PFS. The pooled hazard ratio (HR) estimated for PFS was 0.55 (95% CI 0.50, 0.60) by univariate analysis and 0.43 (95% CI 0.38, 0.48) by multivariate analysis. The effect of MGMT promoter methylation on OS was explored in 30 studies by univariate analysis and in 30 studies by multivariate analysis. The combined HR was 0.48 (95% CI 0.44, 0.52) and 0.42 (95% CI 0.38, 0.45), respectively. In each subgroup divided by areas, the prognostic significance still remained highly significant. The proportion of methylation in each group was in inverse proportion to the corresponding HR in the univariate and multivariate analyses of PFS. However, from the perspective of OS, compared with data from Europe and the US, higher methylation rates in Asia did not bring better returns.

  18. A systematic review of the therapeutic effects of Reiki.

    Science.gov (United States)

    vanderVaart, Sondra; Gijsen, Violette M G J; de Wildt, Saskia N; Koren, Gideon

    2009-11-01

    Reiki is an ancient form of Japanese healing. While this healing method is widely used for a variety of psychologic and physical symptoms, evidence of its effectiveness is scarce and conflicting. The purpose of this systematic review was to try to evaluate whether Reiki produces a significant treatment effect. Studies were identified using an electronic search of Medline, EMBASE, Cochrane Library, and Google Scholar. Quality of reporting was evaluated using a modified CONSORT Criteria for Herbal Interventions, while methodological quality was assessed using the Jadad Quality score. Two (2) researchers selected articles based on the following features: placebo or other adequate control, clinical investigation on humans, intervention using a Reiki practitioner, and published in English. They independently extracted data on study design, inclusion criteria, type of control, sample size, result, and nature of outcome measures. The modified CONSORT Criteria indicated that all 12 trials meeting the inclusion criteria were lacking in at least one of the three key areas of randomization, blinding, and accountability of all patients, indicating a low quality of reporting. Nine (9) of the 12 trials detected a significant therapeutic effect of the Reiki intervention; however, using the Jadad Quality score, 11 of the 12 studies ranked "poor." The serious methodological and reporting limitations of limited existing Reiki studies preclude a definitive conclusion on its effectiveness. High-quality randomized controlled trials are needed to address the effectiveness of Reiki over placebo.

  19. Significance of radiation-induced bystander effects in radiation therapy

    International Nuclear Information System (INIS)

    Suzuki, Masao

    2014-01-01

    Since 1994, a Phase I/II clinical study and radiotherapy have carried out using carbon-ion beams produced with the Heavy Ion Medical Accelerator in Chiba (HIMAC) at National Institute of Radiological Sciences. Now we constructed the new treatment facility for the advanced carbon-ion therapy at HIMAC applying a 3D fast spot scanning system with pencil beams. In the field of fundamental biological studies for high-LET heavy ions, there are some reports regarding bystander effects after exposure to alpha particles derived from 238 Pu or He-ion microbeams. However, only limited sets of studies have examined bystander effects after exposure to different ion species heavier than helium, such as carbon ions. We have been investigating bystander cellular responses in both normal human and human tumor cells irradiated with the HIMAC carbon ions. Bystander cell-killing effect was observed in the cells harboring wild-type P53 gene, but not in the P53-mutated cells. Moreover, observed bystander effect was suppressed by treating with a specific inhibitor of gap-junction mediated cell-cell communication. There is clear evidence that the carbon-ion irradiation enables the enhanced cell killing in cells with wild-type P53 gene via gap-junction mediated bystander effect. (author)

  20. Systematic reviews of adverse effects: framework for a structured approach

    Directory of Open Access Journals (Sweden)

    Herxheimer Andrew

    2007-07-01

    Full Text Available Abstract Background As every healthcare intervention carries some risk of harm, clinical decision making needs to be supported by a systematic assessment of the balance of benefit to harm. A systematic review that considers only the favourable outcomes of an intervention, without also assessing the adverse effects, can mislead by introducing a bias favouring the intervention. Much of the current guidance on systematic reviews is directed towards the evaluation of effectiveness; but this differs in important ways from the methods used in assessing the safety and tolerability of an intervention. A detailed discussion of why, how and when to include adverse effects in a systematic review, is required. Methods This discussion paper, which presupposes a basic knowledge of systematic review methodology, was developed by consensus among experienced reviewers, members of the Adverse Effects Subgroup of The Cochrane Collaboration, and supplemented by a consultation of content experts in reviews methodology, as well as those working in drug safety. Results A logical framework for making decisions in reviews that incorporate adverse effects is provided. We explore situations where a comprehensive investigation of adverse effects is warranted and suggest strategies to identify practicable and clinically useful outcomes. The advantages and disadvantages of including observational and experimental study designs are reviewed. The consequences of including separate studies for intended and unintended effects are explained. Detailed advice is given on designing electronic searches for studies with adverse effects data. Reviewers of adverse effects are given general guidance on the assessment of study bias, data collection, analysis, presentation and the interpretation of harms in a systematic review. Conclusion Readers need to be able to recognize how strategic choices made in the review process determine what harms are found, and how the findings may affect

  1. Parent socialization effects in different cultures: significance of directive parenting.

    Science.gov (United States)

    Sorkhabi, Nadia

    2012-06-01

    In this article, the controversy of divergent findings in research on parental socialization effects in different cultures is addressed. Three explanations intended to address divergent findings of socialization effects in different cultures, as advanced by researchers who emphasize cultural differences, are discussed. These include cultural differences in socialization values and goals of parents, parental emotional and cognitive characteristics associated with parenting styles, and adolescents' interpretations or evaluations of their parents' parenting styles. The empirical evidence for and against each of these arguments is examined and an alternative paradigm for understanding and empirical study of developmental outcomes associated with parenting styles in different cultures is suggested. Baumrind's directive parenting style is presented as an alternative to the authoritarian parenting style in understanding the positive developmental effects associated with "strict" parenting in cultures said to have a collectivist orientation. Directions for research on the three explanations are mentioned.

  2. Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects.

    Science.gov (United States)

    Pollock, Alex; Campbell, Pauline; Struthers, Caroline; Synnot, Anneliese; Nunn, Jack; Hill, Sophie; Goodare, Heather; Watts, Chris; Morley, Richard

    2017-01-01

    Researchers are expected to actively involve stakeholders (including patients, the public, health professionals, and others) in their research. Although researchers increasingly recognise that this is good practice, there is limited practical guidance about how to involve stakeholders. Systematic reviews are a research method in which international literature is brought together, using carefully designed and rigorous methods to answer a specified question about healthcare. We want to investigate how researchers have involved stakeholders in systematic reviews, and how involvement has potentially affected the quality and impact of reviews. We plan to bring this information together by searching and reviewing the literature for reports of stakeholder involvement in systematic reviews. This paper describes in detail the methods that we plan to use to do this. After carrying out comprehensive searches for literature, we will: 1. Provide an overview of identified reports, describing key information such as types of stakeholders involved, and how. 2. Pick out reports of involvement which include detailed descriptions of how researchers involved people in a systematic review and summarise the methods they used. We will consider who was involved, how people were recruited, and how the involvement was organised and managed. 3. Bring together any reports which have explored the effect, or impact, of involving stakeholders in a systematic review. We will assess the quality of these reports, and summarise their findings. Once completed, our review will be used to produce training resources aimed at helping researchers to improve ways of involving stakeholders in systematic reviews. Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence

  3. Metastatic breast cancer - age has a significant effect on survival ...

    African Journals Online (AJOL)

    The data on 217 elderly (aged ≥ 65 years) and 209 middleaged postmenopausal patients with metastatic breast cancer treated in the Department of Medical Oncology, University of Pretoria, from 1976 to 1985 were analysed to determine the effect of age on survival. When considered as a group, the elderly have a more ...

  4. Significance of radiation effects in solid radioactive waste

    International Nuclear Information System (INIS)

    Permar, P.H.; McDonell, W.R.

    1980-01-01

    Proposed NRC criteria for disposal of high-level nuclear waste require development of waste packages to contain radionuclide for at least 1000 years, and design of repositories to prevent radionuclide release at an annual rate greater than 1 part in 100,000 of the total activity. The high-level wastes that are now temporarily stored as aqueous salts, sludges, and calcines must be converted to high-integrity solid forms that resist deterioration from radiation and other effects of long-term storage. Spent fuel may be encapsulated for similar long-term storage. Candidate waste forms beside the spent fuel elements themselves, include borosilicate and related glasses, mineral-like crystalline ceramics, concrete formulations, and metal-matrix glass or ceramic composites. these waste forms will sustain damage produced by beta-gamma radiation up to 10 12 rads, by alpha radiation up to 10 19 particles/g, by internal helium generation greater than about 0.1 atom percent, and by the atom transmutations accompanying radioactive decay. Current data indicate that under these conditions the glass forms suffer only minor volume changes, stored energy deposition, and leachability effects. The crystalline ceramics appear susceptible to the potentially more severe alterations accompanying metamictization and natural analogs of candidate materials are being examined to establish their suitability as waste forms. Helium concentrations in the waste forms are generally below thresholds for severe damage in either glass or crystalline ceramics at low temperatures, but microstructural effects are not well characterized. Transmutation effects remain to be established

  5. The significance of domino effect in chemical accidents

    OpenAIRE

    Hemmatian, Behrouz; Abdolhamidzadeh, B; Darbra Roman, Rosa Maria; Casal Fàbrega, Joaquim

    2014-01-01

    A historical survey was performed on 330 accidents involving domino effect, occurred in process/storage plants and in the transportation of hazardous materials; only accidents occurred after 1st-January-1961 have been considered. The main features – geographical location, type of accident, materials involved, origin and causes, consequences, domino sequences – were analyzed, with special consideration to the situation in the developing countries and compared to those from other previous surve...

  6. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews.

    Science.gov (United States)

    Kumar, Saravana; Beaton, Kate; Hughes, Tricia

    2013-09-04

    The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as

  7. Adverse effects of anticoagulation treatment: clinically significant upper gastrointestinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2006-12-01

    Full Text Available Background: Over the last years, the use of oral anticoagulant treatment has increased dramatically, principally for the prevention of venous thrombosis and thrombembolic events. This treatment is demanding, especially among the elderly with concommitant diseases and different medication. Aim of the study to evaluate the rate of serious complications, clinically significant hemorrhage from upper gastointestinal tract in patients treated with oral antiocoagulants in a prospective cohort study.Patients and methods: Included were patients admitted to our institution between January 1, 1994 and December 31, 2003 due to gastrointestinal hemorrhage. Emergency endoscopy and laboratory testing was performed in all patients.Results: 6416 patients were investigated: 2452 women (38.2 % and 3964 men (61.8 %, mean age 59.1 years, SD 17.2. Among our patients, 55 % were aged over 60 years. In 86.4 % of patients the source of bleeding was confirmed in the upper gastrointestinal tract. In the last week prior to bleeding, 20.4 % (1309/6416 of all patients were regularly taking nonsteroidal anti-inflammatory drugs, anticoagulant therapy or antiplatelet agents in single daily doses at least. 6.3 % of patients (82/1309 with abundant hemorrhage from upper gastrointestinal tract were using oral anticoagulant therapy and had INR > 5 at admission, 25.6 % of them had INR > 10. The mortality of patients using oral anticoagulants and INR > 5 was 17.1 %.Conclusions: Upper gastrointestinal hemorrhage is a serious complication of different medications, particularly in elderly patients. Safe use of anticoagulant therapy is based on careful selection of patients and correct intake of the prescribed drugs.

  8. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Yue, Hu; Shan, Liu; Bin, Lv

    2018-02-19

    Despite extensive research on the criteria for the assessment of gastric cancer risk using the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis/Intestinal-Metaplasia Assessment (OLGIM) systems, no comprehensive overview or systematic summary on their use is currently available. To perform a systematic review and meta-analysis to assess the efficacy of the OLGA and OLGIM staging systems in evaluating gastric cancer risk. We searched various databases, including PubMed, EMBASE, Medline, and Cochrane's library, for articles published before March 2017 on the association between OLGA/OLGIM stages and risk of gastric cancer. Statistical analysis was performed using RevMan 5.30 and Stata 14.0, with the odds ratio, risk ratio, and 95% confidence interval as the effect measures. A meta-analysis of six case-control studies and two cohort studies, comprising 2700 subjects, was performed. The meta-analysis of prospective case-control studies demonstrated a significant association between the OLGA/OLGIM stages III/IV and gastric cancer. The Newcastle-Ottawa Scale (NOS) score reflected heterogeneity in the case-control studies on OLGA. Subgroup analysis of high-quality (NOS score ≥ 5) studies showed an association between OLGA stage III/IV and increased risk of gastric cancer; the association was also high in the remaining study with low NOS score. The association between higher stages of gastritis defined by OLGA and risk of gastric cancer was significant. This correlation implies that close and frequent monitoring of such high-risk patients is necessary to facilitate timely diagnosis of gastric cancer.

  9. Significance, Nature, and Direction of the Association Between Child Sexual Abuse and Conduct Disorder: A Systematic Review.

    Science.gov (United States)

    Maniglio, Roberto

    2015-07-01

    To elucidate the significance, nature, and direction of the potential relationship between child sexual abuse and conduct disorder, all the pertinent studies were reviewed. Ten databases were searched. Blind assessments of study eligibility and quality were performed by two independent researchers. Thirty-six studies including 185,358 participants and meeting minimum quality criteria that were enough to ensure objectivity and to not invalidate results were analyzed. Across the majority of studies, conduct disorder was significantly and directly related to child sexual abuse, especially repeated sexual molestation and abuse involving penetration, even after controlling for various sociodemographic, family, and clinical variables. The association between child sexual abuse and conduct disorder was not confounded by other risk factors, such as gender, socioeconomic status, school achievement, substance problems, physical abuse, parental antisocial behavior or substance problems, parent-child relationships, and family disruption, conflict, or violence. Evidence for a significant interactive effect between child sexual abuse and monoamine oxidase A gene on conduct disorder was scant. Early sexual abuse might predispose to the subsequent onset of conduct disorder which, in turn, may lead to further sexual victimization through association with sexually abusive peers or involvement in dangerous situations or sexual survival strategies. © The Author(s) 2014.

  10. Health effects of employment: a systematic review of prospective studies

    NARCIS (Netherlands)

    van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I.

    2014-01-01

    The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked.

  11. Is individualized medicine more cost-effective? A systematic review.

    Science.gov (United States)

    Hatz, Maximilian H M; Schremser, Katharina; Rogowski, Wolf H

    2014-05-01

    Individualized medicine (IM) is a rapidly evolving field that is associated with both visions of more effective care at lower costs and fears of highly priced, low-value interventions. It is unclear which view is supported by the current evidence. Our objective was to systematically review the health economic evidence related to IM and to derive general statements on its cost-effectiveness. A literature search of MEDLINE database for English- and German-language studies was conducted. Cost-effectiveness and cost-utility studies for technologies meeting the MEDLINE medical subject headings (MeSH) definition of IM (genetically targeted interventions) were reviewed. This was followed by a standardized extraction of general study characteristics and cost-effectiveness results. Most of the 84 studies included in the synthesis were from the USA (n = 43, 51 %), cost-utility studies (n = 66, 79 %), and published since 2005 (n = 60, 71 %). The results ranged from dominant to dominated. The median value (cost-utility studies) was calculated to be rounded $US22,000 per quality-adjusted life year (QALY) gained (adjusted to $US, year 2008 values), which is equal to the rounded median cost-effectiveness in the peer-reviewed English-language literature according to a recent review. Many studies reported more than one strategy of IM with highly varying cost-effectiveness ratios. Generally, results differed according to test type, and tests for disease prognosis or screening appeared to be more favorable than tests to stratify patients by response or by risk of adverse effects. However, these results were not significant. Different definitions of IM could have been used. Quality assessment of the studies was restricted to analyzing transparency. IM neither seems to display superior cost-effectiveness than other types of medical interventions nor to be economically inferior. Instead, rather than 'whether' healthcare was individualized, the question of 'how' it was individualized was

  12. Improving the Comprehension of Students with Significant Developmental Disabilities: Systematic Instruction on the Steps for Completing and Using a Graphic Organizer

    Science.gov (United States)

    Britt, Alexander P.

    2015-01-01

    A single-subject, multiple-baseline across participants design was used to examine the functional relation between systematic instruction and the ability to complete a graphic organizer and recall facts about informational texts by students with significant development disabilities. Four high school students enrolled in an adapted academic program…

  13. IEP Documentation for Effective Systematic Facilitation

    Science.gov (United States)

    Eng, Peng-Sim

    2015-01-01

    This paper discusses how the process for IEP documentation was used in a training program for a group of young inexperienced teachers and teaching aides to effectively address the educational needs of children with diverse disabilities. Teachers at Kianh Centre in Vietnam received explicit instructions for writing effective functional individual…

  14. Effectiveness of screening preschool children for amblyopia: a systematic review

    Directory of Open Access Journals (Sweden)

    Lange Stefan

    2009-07-01

    Full Text Available Abstract Background Amblyopia and amblyogenic factors like strabismus and refractive errors are the most common vision disorders in children. Although different studies suggest that preschool vision screening is associated with a reduced prevalence rate of amblyopia, the value of these programmes is the subject of a continuing scientific and health policy discussion. Therefore, this systematic review focuses on the question of whether screening for amblyopia in children up to the age of six years leads to better vision outcomes. Methods Ten bibliographic databases were searched for randomised controlled trials, non-randomised controlled trials and cohort studies with no limitations to a specific year of publication and language. The searches were supplemented by handsearching the bibliographies of included studies and reviews to identify articles not captured through our main search strategy. Results Five studies met the inclusion criteria. Of these, three studies suggested that screening is associated with an absolute reduction in the prevalence of amblyopia between 0.9% and 1.6% (relative reduction: between 45% and 62%. However, the studies showed weaknesses, limiting the validity and reliability of their findings. The main limitation was that studies with significant results considered only a proportion of the originally recruited children in their analysis. On the other hand, retrospective sample size calculation indicated that the power based on the cohort size was not sufficient to detect small changes between the groups. Outcome parameters such as quality of life or adverse effects of screening have not been adequately investigated in the literature currently available. Conclusion Population based preschool vision screening programmes cannot be sufficiently assessed by the literature currently available. However, it is most likely that the present systematic review contains the most detailed description of the main limitations in current

  15. [A systematic review of the effectiveness of workplace safety interventions].

    Science.gov (United States)

    Baldasseroni, A; Olimpi, Nadia; Bonaccorsi, G

    2009-01-01

    The authors carried out a systematic review of the effectiveness of workplace safety interventions, as a part of a wider project funded by CCM, Centre for Disease Control. Several electronic bibliographic databases were checked, using a standardized string selection. The string contained the following four items: the intervention; job features; type of injury; efficacy/effectiveness. Of the various databases consulted, Web of Science was the most efficient. Overall 5531 articles were selected. After reading the title and abstract, 4695 were excluded and eventually 35 systematic reviews were selected, which synthesized 769 original articles. The main topics of the selected systematic reviews were: certain sectors (building industry, agriculture, health care); personal protective equipment; work organization and prevention management at plant level; evaluation of prevention policies by national and regional authorities. A clear need for multiple bibliographical data-base search emerged at the end of this study.

  16. Effectiveness of alcohol media literacy programmes: a systematic literature review.

    Science.gov (United States)

    Gordon, Chloe S; Hindmarsh, Chloe S; Jones, Sandra C; Kervin, Lisa

    2015-06-01

    Alcohol media literacy is an emerging field that aims to address the link between exposure to alcohol advertising and subsequent expectancies and behaviours for children and adolescents. The design, rigour and results of alcohol media literacy programmes vary considerably, resulting in a number of unanswered questions about effectiveness. To provide insight into some of these questions, a systematic literature review of alcohol media literacy studies was conducted. The review was guided by the following research question: What considerations are needed to develop an effective school-based alcohol media literacy programme? On the basis of a critical synthesis of 10 interventions (published in the period 1997 to May 2014), our findings provide a comprehensive understanding of the descriptive, methodological and outcome characteristics of this small body of significant research. The review provides considerations for future alcohol media literacy programmes, including the need for an interactive pedagogical approach within the naturalistic school setting, implementation fidelity and a holistic approach to programme evaluation, a means for maintaining relevance, consideration of gender differences, relevance for an international audience and use of follow-up and longitudinal data. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Effects of health insurance on labour supply: A systematic review

    NARCIS (Netherlands)

    Quynh, Nga Le Thi; Groot, Wim; Tomini, Sonila M.; Tomini, Florian

    2017-01-01

    This study provides a systematic review of empirical evidence on the labour supply effects of health insurance. The outcomes in the 63 studies reviewed include labour supply in terms of hours worked and the probability of employment, self-employment and the level of economic formalisation. One of

  18. Systematic effects in LOD from SLR observations

    Science.gov (United States)

    Bloßfeld, Mathis; Gerstl, Michael; Hugentobler, Urs; Angermann, Detlef; Müller, Horst

    2014-09-01

    Beside the estimation of station coordinates and the Earth’s gravity field, laser ranging observations to near-Earth satellites can be used to determine the rotation of the Earth. One parameter of this rotation is ΔLOD (excess Length Of Day) which describes the excess revolution time of the Earth w.r.t. 86,400 s. Due to correlations among the different parameter groups, it is difficult to obtain reliable estimates for all parameters. In the official ΔLOD products of the International Earth Rotation and Reference Systems Service (IERS), the ΔLOD information determined from laser ranging observations is excluded from the processing. In this paper, we study the existing correlations between ΔLOD, the orbital node Ω, the even zonal gravity field coefficients, cross-track empirical accelerations and relativistic accelerations caused by the Lense-Thirring and deSitter effect in detail using first order Gaussian perturbation equations. We found discrepancies due to different a priories by using different gravity field models of up to 1.0 ms for polar orbits at an altitude of 500 km and up to 40.0 ms, if the gravity field coefficients are estimated using only observations to LAGEOS 1. If observations to LAGEOS 2 are included, reliable ΔLOD estimates can be achieved. Nevertheless, an impact of the a priori gravity field even on the multi-satellite ΔLOD estimates can be clearly identified. Furthermore, we investigate the effect of empirical cross-track accelerations and the effect of relativistic accelerations of near-Earth satellites on ΔLOD. A total effect of 0.0088 ms is caused by not modeled Lense-Thirring and deSitter terms. The partial derivatives of these accelerations w.r.t. the position and velocity of the satellite cause very small variations (0.1 μs) on ΔLOD.

  19. Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association.

    Science.gov (United States)

    Shimada, Hideaki; Noie, Tamaki; Ohashi, Manabu; Oba, Koji; Takahashi, Yutaka

    2014-01-01

    The aim of this review was to evaluate the clinical significance of serum tumor markers, particularly CEA, CA19-9, and CA72-4, in patients with gastric cancer. A systematic literature search was performed using PubMed/MEDLINE with the keywords "gastric cancer" and "tumor marker," to select 4,925 relevant reports published before the end of November 2012. A total of 187 publications contained data for CEA and CA19-9, and 19 publications contained data related to all three tumor markers. The positive rates were 21.1 % for CEA, 27.8 % for CA19-9, and 30.0 % for CA72-4. These three markers were significantly associated with tumor stage and patient survival. Serum markers are not useful for early cancer, but they are useful for detecting recurrence and distant metastasis, predicting patient survival, and monitoring after surgery. Tumor marker monitoring may be useful for patients after surgery because the positive conversion of tumor markers usually occurs 2-3 months before imaging abnormalities. Among other tumor markers, alpha-fetoprotein (AFP) is useful for detecting and predicting liver metastases. Moreover, CA125 and sialyl Tn antigens (STN) are useful for detecting peritoneal metastases. Although no prospective trial has yet been completed to evaluate the clinical significance of these serum markers, this literature survey suggests that combinations of CEA, CA19-9, and CA72-4 are the most effective ways for staging before surgery or chemotherapy. In particular, monitoring tumor markers that were elevated before surgery or chemotherapy could be useful for detection of recurrence or evaluation of the response.

  20. Micromorphological studies on seeds of orobanche species from the iberian peninsula and the balearic islands, and their systematic significance.

    Science.gov (United States)

    Plaza, L; Fernández, I; Juan, R; Pastor, J; Pujadas, A

    2004-07-01

    Previous research has made clear the intrinsic taxonomic difficulties in identifying species in the genus Orobanche. The aim of this study, therefore, was to investigate the systematic utility of seed characteristics. Light and scanning electron microscopy was used to examine the seeds of 33 taxa of Orobanche from the Iberian Peninsula and the Balearic Islands. Characters such as size, shape and ornamentation of the seeds were not found to be very useful in differentiation of taxa; however, other characters of the epidermal seed coat cells proved to be very helpful in this respect. Ornamentation of the periclinal walls could be used to discriminate four morphological types. Other features related to the anticlinal walls of the cells, such as thickness, presence/absence of a narrow trough, or relative depth, all contributed to the characterization of a large number of species. The usefulness of micromorphological studies on seeds of Orobanche in relation to differentiating taxa is demonstrated, and a key is provided to distinguish species or groups of species.

  1. Side effects are incompletely reported among systematic reviews in gastroenterology.

    Science.gov (United States)

    Mahady, Suzanne E; Schlub, Timothy; Bero, Lisa; Moher, David; Tovey, David; George, Jacob; Craig, Jonathan C

    2015-02-01

    Systematic reviews are an integral component of evidence-based health care. However, little is known on how well they report the potential harms of interventions. We assessed the reporting of harms in recently published systematic reviews of interventions relevant to clinical gastroenterology. We identified all systematic reviews of randomized trials of gastroenterology interventions published from 2008 to 2012 in highly cited gastroenterology and general medical journals. We adapted the Consolidated Standards of Reporting Trials guidelines for harms and assessed qualitative and quantitative parameters of harms reporting. Regression analyses determined predictors of more comprehensive harms reporting. In total, 78 systematic reviews were identified, with 72 published in gastroenterology journals and six in general medical journals. Overall, one in three systematic reviews (26/78, 33%) did not refer to harms of the intervention anywhere in the article. Less than half of the studies included adverse events as an outcome measure, and data on absolute rates of adverse events were only provided in 28%. Most (65%) did not include any figures or tables on adverse event; however, all included these on efficacy outcomes (mean, 3 and range, 1-7). Regression analyses indicated that the use of reporting guidelines was significantly associated with better harms reporting (P = 0.04). The reporting of harms in gastroenterology systematic reviews is largely inadequate and highly asymmetrical compared with the reporting of benefits. We suggest that review authors routinely assess both efficacy and harms outcomes of an intervention and that reporting guidelines specifically targeting harms reporting be developed. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  2. A laboratory exercise on systematic effects in gamma ray spectrometry

    International Nuclear Information System (INIS)

    Henrik Ramebaeck

    2015-01-01

    A laboratory exercise for calculation of true coincidence summing correction factors as well as calculating the effect of deviations between sample and standard source (filling height) was developed. This laboratory exercise was held in a masters course in nuclear chemistry the first time during fall 2013. The aim of the exercise was to high-light the importance of correcting for biases due to different systematic effects in gamma spectrometric measurements. (author)

  3. Effectiveness of regionalization of trauma care services: a systematic review.

    Science.gov (United States)

    Vali, Y; Rashidian, A; Jalili, M; Omidvari, A H; Jeddian, A

    2017-05-01

    Improving trauma systems in various forms has always been an important aspect of health policy. While several papers have reported the implementation of a structured trauma system of care, research evidence on the effectiveness of such regionalization for improvement in trauma outcome is limited. Systematic review. Medline, EMbase, EconLit and Health Management Information Consortium were searched, using sensitive search terms, for interventional studies that reported a trauma regionalization system as their intervention, and compared important outcomes such as mortality and preventable deaths. At least two authors assessed eligibility for inclusion and risk of bias, and extracted data from the included studies. As meta-analysis was not possible for all studies, two controlled before-after studies were included in the meta-analysis, and a narrative analysis was conducted for the other studies. After title and abstract sifting, 66 papers were retrieved. After reading the full texts, a total of 24 studies from the USA, UK, Canada, Australia, and the Netherlands were included in this review. In spite of variation in study specifications, most were before-after studies with a high risk of bias. Although a reduction in mortality was shown in most studies, only two studies were eligible for meta-analysis, and the results showed a significant reduction in mortality after implementation of an organized trauma system (odds ratio 0.840, 95% confidence interval 0.756-0.924; P = 0.00). Correlation was found between a regionalized network of trauma care and a reduction in trauma-related mortality, based on studies that did not exclude the effects of other concurrent changes on observed reductions. It is recommended that more studies with robust research designs should be conducted in a more diverse range of countries to assess the effectiveness of regionalization. Despite this limitation, the present findings support the regionalization of trauma care services. Copyright

  4. Clinical significance of tumor necrosis factor-α inhibitors in the treatment of sciatica: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Yun Fu; Chen, Ping You; Chang, Wei; Zhu, Fi Qi; Xu, Li Li; Wang, Song Lin; Chang, Li Ying; Luo, Jie; Liu, Guang Jian

    2014-01-01

    Currently, no satisfactory treatment is available for sciatica caused by herniated discs and/or spinal stenosis. The objective of this study is to assess the value of tumor necrosis factor (TNF)-α inhibitors in the treatment of sciatica. Without language restrictions, we searched PubMed, OVID, EMBASE, the Web of Science, the Clinical Trials Registers, the Cochrane Central Register of Controlled Trials and the China Academic Library and Information System. We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria. Nine prospective randomized controlled trials (RCTs) and two before-after controlled trials involving 531 patients met our inclusion criteria and were included in this study. Our systematic assessment and meta-analysis demonstrated that in terms of the natural course of the disease, compared with the control condition, TNF-α inhibitors neither significantly relieved lower back and leg pain (both p > 0.05) nor enhanced the proportion of patients who felt overall satisfaction (global perceived effect (satisfaction)) or were able to return to work (return to work) (combined endpoint; p > 0.05) at the short-term, medium-term and long-term follow-ups. In addition, compared with the control condition, TNF-α inhibitors could reduce the risk ratio (RR) of discectomy or radicular block (combined endpoint; RR = 0.51, 95% CI 0.26 to 1.00, p = 0.049) at medium-term follow-up, but did not decrease RR at the short-term (RR = 0.64, 95% CI 0.17 to 2.40, p = 0.508) and long-term follow-ups (RR = 0.64, 95% CI 0.40 to 1.03, p = 0.065). The currently available evidence demonstrated that other than reducing the RR of discectomy or radicular block (combined endpoint) at medium-term follow-up, TNF-α inhibitors showed limited clinical value in the treatment of sciatica caused by herniated discs and/or spinal stenosis.

  5. Clinical significance of tumor necrosis factor-α inhibitors in the treatment of sciatica: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yun Fu Wang

    Full Text Available Currently, no satisfactory treatment is available for sciatica caused by herniated discs and/or spinal stenosis. The objective of this study is to assess the value of tumor necrosis factor (TNF-α inhibitors in the treatment of sciatica.Without language restrictions, we searched PubMed, OVID, EMBASE, the Web of Science, the Clinical Trials Registers, the Cochrane Central Register of Controlled Trials and the China Academic Library and Information System. We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria.Nine prospective randomized controlled trials (RCTs and two before-after controlled trials involving 531 patients met our inclusion criteria and were included in this study. Our systematic assessment and meta-analysis demonstrated that in terms of the natural course of the disease, compared with the control condition, TNF-α inhibitors neither significantly relieved lower back and leg pain (both p > 0.05 nor enhanced the proportion of patients who felt overall satisfaction (global perceived effect (satisfaction or were able to return to work (return to work (combined endpoint; p > 0.05 at the short-term, medium-term and long-term follow-ups. In addition, compared with the control condition, TNF-α inhibitors could reduce the risk ratio (RR of discectomy or radicular block (combined endpoint; RR = 0.51, 95% CI 0.26 to 1.00, p = 0.049 at medium-term follow-up, but did not decrease RR at the short-term (RR = 0.64, 95% CI 0.17 to 2.40, p = 0.508 and long-term follow-ups (RR = 0.64, 95% CI 0.40 to 1.03, p = 0.065.The currently available evidence demonstrated that other than reducing the RR of discectomy or radicular block (combined endpoint at medium-term follow-up, TNF-α inhibitors showed limited clinical value in the treatment of sciatica caused by herniated discs and/or spinal stenosis.

  6. Treatment effects for dysphagia in Parkinson's disease: a systematic review.

    Science.gov (United States)

    van Hooren, M R A; Baijens, L W J; Voskuilen, S; Oosterloo, M; Kremer, B

    2014-08-01

    Dysphagia remains a common problem in Parkinson's disease (PD). Previous systematic reviews on therapy effects for oropharyngeal dysphagia in PD have shown a lack of evidence. In the past 5 years several placebo or sham-controlled trials with varying results have been published. The aim of this systematic literature review is to summarize and qualitatively analyze the published studies on this matter. Studies published up to December 2013 were found via a systematic comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Twelve studies were included and qualitatively analyzed using critical appraisal items. The review includes rehabilitative (exercises, electrical stimulation, bolus modification etc.) and pharmacologic treatment. Some well-designed controlled trials were included. However, none of the included studies fulfilled all criteria for external and internal validity. A meta-analysis was not carried out as most of the studies were not of sufficient quality to warrant doing so. Expiratory Muscle Strength Training (EMST) and Video-Assisted Swallowing Therapy (VAST) may be effective dysphagia treatments solely or in addition to dopaminergic therapy for PD. However, these preliminary results warrant further investigation concerning their clinical applicability, and further research should be based on randomized sham-controlled trials to determine the effectiveness and long-term effects of different therapies for dysphagia in PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Systematic measurements of the Bohr-Weisskopf effect at ISOLDE

    CERN Multimedia

    Nojiri, Y; Matsuki, S; Ragnarsson, I; Neugart, R; Redi, O; Stroke, H H; Duong, H T; Marescaux, D; Pinard, J; Juncar, P; Ekstrom, C; Pellarin, M; Vialle, J-L; Inamura, T

    2002-01-01

    The " Bohr-Weisskopf " effect, or " hyperfine structure (hfs) anomaly ", which results from the effect of the distribution of nuclear magnetization on the electro-nuclear interaction, will be measured systematically at the PS Booster ISOLDE, first for a long chain of radioactive cesium isotopes, analogously to previous isotope shift and hfs studies. In addition to the direct measurement of magnetic moment values, the results are expected to provide independent data for testing nuclear wavefunctions, these will be of importance for interpreting systematic parity non-conservation experiments, complementary to the single isotope study which requires a high precision knowledge of the electron wavefunction. Substantial progress in these calculations has been achieved recently. Precision measurements of the hfs splittings and nuclear magnetic moments are required, with sensitivity adequate for the radioactive isotopes produced. A triple resonance atomic beam magnetic resonance apparatus with optical pumping state s...

  8. Systematic Measurements of the Bohr-Weisskopf Effect at ISOLDE

    CERN Multimedia

    2002-01-01

    Nuclear electric and magnetic structure properties are measurable by high-resolution atomic spectroscopy through isotope shifts and the Bohr-Weisskopf effect (hyperfine structure anomalies). \\\\ \\\\ The greatest value of these measurements is when made systematically over a large number of isotopes. This has been done in the case of isotopes shifts most extensively by the experiment at ISOLDE. To date the magnetic distribution studies are few and isolated. Here we propose to intitiate a program at ISOLDE to measure hfs anomalies systematically. The experiments, requiring high-precision data on magnetic dipole constants as well as on nuclear g-factors, will be done by atomic-beam magnetic resonance with the use of laser excitation for polarization of the beam and a sixpole magnet acting as an analyser. \\\\ \\\\ The heavy alkali elements are the most promising candidates for hfs anomaly studies because of the large effect expected, the high production yields at ISOLDE and most importantly, the interesting variations...

  9. Is valve choice a significant determinant of paravalular leak post-transcatheter aortic valve implantation? A systematic review and meta-analysis.

    LENUS (Irish Health Repository)

    O'Sullivan, Katie E

    2013-11-01

    Paravalvular regurgitation (PVR) following transcatheter aortic valve implantation (TAVI) is associated with poor survival. The two main valve delivery systems used to date differ significantly in both structure and deployment technique. The primary objective of this study was to perform a systematic review and meta-analysis of studies identifying PVR in patients post-TAVI using Medtronic CoreValve (MCV) and Edward Sapien (ES) valves in order to identify whether a significant difference exists between valve types. The secondary objective was to identify additional factors predisposing to PVR to provide an overview of the other associated considerations.

  10. Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review.

    Science.gov (United States)

    Westgaard, R H; Winkel, J

    2011-01-01

    This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable

  11. Effectiveness of antibiotics given before admission in reducing mortality from meningococcal disease: systematic review.

    NARCIS (Netherlands)

    Hahné, Susan J M; Charlett, André; Purcell, Bernadette; Samuelsson, Susanne; Camaroni, Ivonne; Ehrhard, Ingrid; Heuberger, Sigrid; Santamaria, Maria; Stuart, James M

    2006-01-01

    OBJECTIVE: To review the evidence for effectiveness of treatment with antibiotics before admission in reducing case fatality from meningococcal disease. DESIGN: Systematic review. DATA SOURCES: Cochrane register of trials and systematic reviews, database of abstracts of reviews of effectiveness,

  12. Comparative Effectiveness of Dental Anatomy Carving Pedagogy: A Systematic Review.

    Science.gov (United States)

    de Azevedo, Renato de A; da Rosa, Wellington Luiz de O; da Silva, Adriana F; Correa, Marcos B; Torriani, Marcos A; Lund, Rafael G

    2015-08-01

    The aim of this study was to review the effectiveness of methods used for teaching dental anatomy carving to dental students in operative dentistry as evaluated in published studies. This systematic review is described in accordance with the PRISMA statement. Two independent reviewers performed a systematic literature search of research published from January 1945 until May 2014. Seven databases were screened: MedLine (PubMed), Lilacs, IBECS, Web of Science, Scopus, SciELO, and The Cochrane Library. After removing duplicates, only studies using dental carving to assess the practical knowledge of anatomy were selected. The tabulated data were organized by title of article, names of authors, number of students assessed, assessment method, material used, groups tested, main results, and conclusions. The methodology quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Initially, 2,258 studies were identified in all databases. Five articles met the eligibility criteria and were included in this review. According to these studies, the geometric method, teaching step-by-step along with the teacher, and adjuvant methods such as the use of tutors and teaching through digital media with DVDs proved to be effective in improving learning. There is no standard technique that is widely accepted for the teaching of dental carving, nor is there an appropriately validated method of evaluation to verify whether the teaching methods used are effective for the acquisition of skills and expertise in dental anatomy by students.

  13. Improving the uptake of systematic reviews: a systematic review of intervention effectiveness and relevance.

    LENUS (Irish Health Repository)

    Wallace, John

    2014-01-01

    Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved.

  14. Community effectiveness of copepods for dengue vector control: systematic review.

    Science.gov (United States)

    Lazaro, A; Han, W W; Manrique-Saide, P; George, L; Velayudhan, R; Toledo, J; Runge Ranzinger, S; Horstick, O

    2015-06-01

    Vector control remains the only available method for primary prevention of dengue. Several interventions exist for dengue vector control, with limited evidence of their efficacy and community effectiveness. This systematic review compiles and analyses the existing global evidence for community effectiveness of copepods for dengue vector control. The systematic review follows the PRISMA statement, searching six relevant databases. Applying all inclusion and exclusion criteria, 11 articles were included. There is evidence that cyclopoid copepods (Mesocyclops spp.) could potentially be an effective vector control option, as shown in five community effectiveness studies in Vietnam. This includes long-term effectiveness for larval and adult control of Ae. aegypti, as well as dengue incidence. However, this success has so far not been replicated elsewhere (six studies, three community effectiveness studies--Costa Rica, Mexico and USA, and three studies analysing both efficacy and community effectiveness--Honduras, Laos and USA), probably due to community participation, environmental and/or biological factors. Judging by the quality of existing studies, there is a lack of good study design, data quality and appropriate statistics. There is limited evidence for the use of cyclopoid copepods as a single intervention. There are very few studies, and more are needed in other communities and environments. Clear best practice guidelines for the methodology of entomological studies should be developed. © 2015 John Wiley & Sons Ltd.

  15. The effect of financial ratios on systematic risk index

    Directory of Open Access Journals (Sweden)

    Ali Faez

    2013-11-01

    Full Text Available This paper investigates the relationship between financial ratios and indicator of systemic risk in the Tehran Stock Exchange. The study selects 73 manufacturing companies of the Tehran Stock Exchange market over the period 2003-2010. The study first calculates the independent variables in the form of financial ratios and then the ratios affecting the systematic risk index are extracted using entropy method. The output of this stage is the introduction of five influential financial indicators as the independent variables of the study. Using t-test and Pearson correlation coefficient the rate of independent variables effect on the systematic risk index is evaluated and finally, using stepwise regression method, the effect of independent variables on the dependent variable is examined. According to results of our survey, the correlation coefficient of such indices as “the ratio of stock price to the profit of each share”, “Current ratio”, “each share profit ratio” and “the stockholders rights return ratio” have respectively the highest correlation with the systematic risk index.

  16. Adverse effects of iodine thyroid blocking: A systematic review

    International Nuclear Information System (INIS)

    Spallek, L.; Krille, L.; Reiners, C.; Schneider, R.; Yamashita, S.; Zeeb, H.

    2008-01-01

    131 I, when released in a radiological or nuclear accident as happened recently in Fukushima (Japan)), may cause thyroid cancer as a long-term consequence. Iodine thyroid blocking (ITB) is known to reduce the risk of developing thyroid cancer. Potential adverse effects of ITB have not been systematically investigated so far. This article summarises the results of a review on adverse effects of ITB based on a systematic literature search in scientific medical databases. A meta-analysis was not performed as identified studies displayed major heterogeneity. The search resulted in 14 articles relevant to the topic, reporting mostly on surveys, ecological and intervention studies. Only one study from Poland focused on effects (both desired and adverse) of an ITB intervention following the Chernobyl accident. All other studies reported on iodine administration in a different context. Overall, the studies did not reveal severe adverse reactions to potassium iodide in the general public. Since ITB is a protective measure only applied in very specific circumstances, scientifically sound studies of adverse effects are scarce and consequently the evidence base is weak. The assessment of adverse effects of ITB relies on indirect evidence from related areas. This study may contribute to ongoing developments in pharmaco-epidemiology aiming to better quantify adverse effects of medications and health care interventions including ITB. All rights reserved. (authors)

  17. Prognostic and clinicopathological significance of serum interleukin-6 expression in colorectal cancer: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wang Z

    2015-12-01

    Full Text Available Zhen Wang,1 Pin Wu,1,2 Dang Wu,1 Zhigang Zhang,3 Guoming Hu,1 Shuai Zhao,1 Yucheng Lai,1 Jian Huang1,41Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Key Laboratory of Molecular Biology in Medical Sciences, China National Ministry of Education, 2Department of Thoracic Surgery, 3Department of Gynecology, 4Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of ChinaPurpose: Interleukin-6 (IL-6 plays an important role in human colorectal cancer (CRC development. However, the exact clinical and prognostic significance of IL-6 in CRC is still unclear. Here, we conducted this meta-analysis to explore this issue in detail.Methods: A meta-analysis was performed to clarify the association between serum IL-6 expression and clinical outcomes in articles published up to June 2015. Weighted mean difference (WMD and its corresponding 95% confidence interval (CI were used to assess the association between serum IL-6 expression and the clinicopathological characteristics of CRC. Hazard ratio (HR with 95% CI was used to quantify the predictive value of IL-6 on CRC prognosis.Results: Fourteen studies comprising 1,245 patients were included. Analysis of these data showed that serum IL-6 expression was highly correlated with poor 5-year overall survival (OS rate (HR =0.43, 95% CI: 0.31–0.59, P=0.755. Simultaneously, we also found that serum IL-6 expression was associated with certain clinical parameters of CRC, such as tumor invasion (T category: T0–T2, T3–T4 (WMD =3.15, 95% CI: 1.92–4.39, P=0.816, distant metastasis (M category: M0, M1 (WMD =4.69, 95% CI: 3.33–6.06, P=0.377, and tumor stage (I–II, III–IV (WMD =2.65, 95% CI: 1.09–4.21, P=0.066.Conclusion: A high serum IL-6 expression is associated with adverse OS in CRC. The IL-6 expression can be an important supplement in establishing prognostic score

  18. Effects of inbreeding and other systematic effects on fertility of Black Forest Draught horses in Germany.

    Science.gov (United States)

    Müller-Unterberg, Maarit; Wallmann, Sandra; Distl, Ottmar

    2017-10-18

    The Black Forest Draught horse (BFDH) is an endangered German coldblood breed with its origin in the area of the Black Forest in South Germany. In this retrospective study, the influence of the inbreeding coefficient on foaling rates was investigated using records from ten breeding seasons. Due to the small population size of BFDH, the level of inbreeding is increasing and may have an effect on foaling rates.The data of the present study included all coverings reported for 1024 BFDH mares in the years 2001-2009. These mares were covered by 32 BFDH stallions from the State Stud Marbach. Data from 4534 estrus cycles was used to calculate per cycle foaling rate (CFR). Pedigree data contained all studbook data up to the foundation of the breed as early as 1836. The level of inbreeding of the mare, stallion and expected foal along with other systematic effects on CFR were analysed using a generalized linear mixed model approach. Stallion was employed as a random effect. Systematic fixed effects were month of mating, mating type, age of the mare and stallion, reproductive status of the mare and stallion line of the mare. Inbreeding coefficients of the stallion, mare and expected foal were modelled as linear covariates. The average CFR was 40.9%. The mean inbreeding coefficients of the mares, stallions and expected foals were 7.46, 7.70 and 9.66%. Mating type, age of the mare, reproductive status of the mare and stallion line of the mare had a significant effect. The results showed that the mating type, stallion line of the mare, sire, age and reproductive status of the mare exerted the largest influences on CFR in BFDH. Inbreeding coefficients of the stallion, mare and expected foal were not significantly related with CFR.

  19. Temperature and pressure effects on 40Ar-39Ar systematics

    International Nuclear Information System (INIS)

    Ozima, M.; Kaneoka, I.; Yanagisawa, M.

    1979-01-01

    The effects of thermal and compressional treatment on 40 Ar- 39 Ar systematics have been investigated on three artificially heated biotite samples (heated for 1 hour at 700 0 C and 860 0 C in air and 700 0 C in vacuum respectively) and uniaxially compressed granite (p=1400 bar) and basalt samples (p=1660 bar). The 40 Ar- 39 Ar results for the disturbed samples are compared with those for undisturbed samples. Except for the vacuum-heating case, the effects of the disturbances may be interpreted as the combined effect of a partial loss of radiogenic 40 Ar from the sample and an incorporation of air Ar into the sample. Common diagnostic effects are (1) reduction of the total fusion age, (2) distortion of the age spectrum and, if the degree of the partial Ar loss is small (3) approximate preservation of the isochron age, and (4) reduction of the intercept value ( 40 Ar/ 36 Ar) in the isochron plot. The features observed in the age spectra of artificially disturbed samples are rather common in geologically disturbed samples, suggesting that the artificial disturbances simulate the effects of geological disturbances on 40 Ar- 39 Ar systematics. (Auth.)

  20. Effects of Vocal Function Exercises: A Systematic Review.

    Science.gov (United States)

    Angadi, Vrushali; Croake, Daniel; Stemple, Joseph

    2017-11-03

    The purpose of the present review was to systematically analyze the evidence for the effectiveness of vocal function exercises (VFEs) in improving voice production. A systematic literature search was performed by two independent reviewers using PubMed and EBSCOHost to access relevant databases and to locate outcome studies that used VFEs as an intervention. Articles that met inclusion criteria were appraised based on the American Speech-Language and Hearing Association's levels of evidence. Effect sizes for outcomes were calculated using Hedge's g. Voice outcomes were categorized according to the five domains of voice assessment: visual perceptual analysis, acoustic analysis, aerodynamic analysis, auditory-perceptual analysis, and patient self-report measures. Twenty-one articles were included for the final appraisal. All studies demonstrated positive effects of VFEs as demonstrated by effect sizes across selected voice parameters. Effect sizes across parameters ranged from -0.59 to 1.55. None of the included studies reported adverse voice outcomes as a result of VFEs. Outcome studies demonstrate that VFEs are efficacious in enhancing vocal function in individuals with normal and disordered voices, presbylaryngeus, and professional voice users. The available research suggests moderate to strong evidence to support the use of VFEs for a variety of voice disorders. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Effects of Ramadan fasting on blood pressure in hypertensive patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Maryam Alinezhad-Namaghi

    2016-03-01

    Full Text Available Ramadan is a holy month for Muslims and fasting in this month is the rule for any healthy matured person. Nutritional and behavioral changes occurred during Ramadan fasting may lead to several physiological change, such as blood pressure (2. Studies evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients, are scarce and reported inadequate results. In this paper a systematic review was performed to accumulate the results of published literature designed to evaluate blood pressure changes in hypertensive patients due to Ramadan fasting. All prospective, English studies which evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients and measured systolic and diastolic blood pressure twice at least ( before Ramadan and during last week of Ramadan or after Ramadan fasting were included in systematic review . Five studies reported the effect of Ramadan fasting on blood pressure in hypertensive patients in full text. Although significant reduction in systolic blood pressure during Ramadan fasting were seen in 3 studies (3-5, other 3 studies reported no significant difference between systolic blood pressure before and after Ramadan fasting (6, 7. Among 6 studies that reviewed in this paper, 4 studies reported no significant changes in diastolic blood pressure (4, 6, 7. While 2 other studies reported significant reduction in systolic blood pressure after Ramadan fasting (3, 5. This systematic review suggested that Ramadan fasting can be safe in treated essential hypertensive patients with continuation of previous medications. Also it can improve systolic and diastolic blood pressures.

  2. Systematic identification of proteins that elicit drug side effects

    DEFF Research Database (Denmark)

    Kuhn, Michael; Al Banchaabouchi, Mumna; Campillos, Monica

    2013-01-01

    Side effect similarities of drugs have recently been employed to predict new drug targets, and networks of side effects and targets have been used to better understand the mechanism of action of drugs. Here, we report a large-scale analysis to systematically predict and characterize proteins...... that cause drug side effects. We integrated phenotypic data obtained during clinical trials with known drug-target relations to identify overrepresented protein-side effect combinations. Using independent data, we confirm that most of these overrepresentations point to proteins which, when perturbed, cause......) is responsible for hyperesthesia in mice, which, in turn, can be prevented by a drug that selectively inhibits HTR7. Taken together, we show that a large fraction of complex drug side effects are mediated by individual proteins and create a reference for such relations....

  3. Effects of therapy for dysphagia in Parkinson's disease: systematic review.

    Science.gov (United States)

    Baijens, Laura W J; Speyer, Renée

    2009-03-01

    This systematic review explores the effects of dysphagia treatment for Parkinson's disease. The review includes rehabilitative, surgical, pharmacologic, and other treatments. Only oropharyngeal dysphagia is selected for this literature search, excluding dysphagia due to esophageal or gastric disorders. The effects of deep brain stimulation on dysphagia are not included. In general, the literature concerning dysphagia treatment in Parkinson's disease is rather limited. Most effect studies show diverse methodologic problems. Multiple case studies and trials are identified by searching biomedical literature databases PubMed and Embase, and by hand-searching reference lists. The conclusions of most studies cannot be compared with one another because of heterogeneous therapy methods and outcome measures. Further research based on randomized controlled trials to determine the effectiveness of different therapies for dysphagia in Parkinson's disease is required.

  4. Arthroscopic Debridement for Primary Degenerative Osteoarthritis of the Elbow Leads to Significant Improvement in Range of Motion and Clinical Outcomes: A Systematic Review.

    Science.gov (United States)

    Sochacki, Kyle R; Jack, Robert A; Hirase, Takashi; McCulloch, Patrick C; Lintner, David M; Liberman, Shari R; Harris, Joshua D

    2017-12-01

    The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates. A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. Systematic review of level IV studies. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Effects of Fermented Dairy Products on Skin: A Systematic Review.

    Science.gov (United States)

    Vaughn, Alexandra R; Sivamani, Raja K

    2015-07-01

    Fermented dairy products, such as yogurt, have been proposed as a natural source of probiotics to promote intestinal health. Growing evidence shows that modulation of the gastrointestinal tract microbiota can modulate skin disease as well. This systematic review was conducted to examine the evidence for the use of ingested fermented dairy products to modulate skin health and function. We also sought to review the effects of the topical application of dairy products. The PubMed and Embase databases were systematically searched for clinical studies involving humans only that examined the relationship between fermented dairy products and skin health. A total of 312 articles were found and a total of 4 studies met inclusion criteria. Three studies evaluated the effects of ingestion, while one evaluated the effects of topical application. All studies noted improvement with the use of fermented dairy. Overall, there is early and limited evidence that fermented dairy products, used both topically and orally, may provide benefits for skin health. However, existing studies are limited and further studies will be important to better assess efficacy and the mechanisms involved.

  6. The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review

    Science.gov (United States)

    Ngai, Shirley Pui-Ching; He, Wanjia; Chow, Jason Ka-Wing; Tsang, Hector Wing-Hong

    2017-01-01

    Background. Depression is one of the greatest health concerns affecting 350 million people globally. Aromatherapy is a popular CAM intervention chosen by people with depression. Due to the growing popularity of aromatherapy for alleviating depressive symptoms, in-depth evaluation of the evidence-based clinical efficacy of aromatherapy is urgently needed. Purpose. This systematic review aims to provide an analysis of the clinical evidence on the efficacy of aromatherapy for depressive symptoms on any type of patients. Methods. A systematic database search was carried out using predefined search terms in 5 databases: AMED, CINHAL, CCRCT, MEDLINE, and PsycINFO. Outcome measures included scales measuring depressive symptoms levels. Results. Twelve randomized controlled trials were included and two administration methods for the aromatherapy intervention including inhaled aromatherapy (5 studies) and massage aromatherapy (7 studies) were identified. Seven studies showed improvement in depressive symptoms. Limitations. The quality of half of the studies included is low, and the administration protocols among the studies varied considerably. Different assessment tools were also employed among the studies. Conclusions. Aromatherapy showed potential to be used as an effective therapeutic option for the relief of depressive symptoms in a wide variety of subjects. Particularly, aromatherapy massage showed to have more beneficial effects than inhalation aromatherapy. PMID:28133489

  7. Immediate effect of exercise on achilles tendon properties: systematic review.

    Science.gov (United States)

    Obst, Steven J; Barrett, Rod S; Newsham-West, Richard

    2013-08-01

    Understanding the mechanical and morphological adaptation of the Achilles tendon (AT) in response to acute exercise could have important implications for athletic performance, injury prevention, and rehabilitation. The purpose of this study was to conduct a systematic review and critical evaluation of the literature to determine the immediate effect of a single bout of exercise on the mechanical and morphological properties of the AT in vivo. Five electronic research databases were systematically searched for intervention-based studies reporting mechanical and morphological properties of the AT after a single bout of exercise. Searches revealed 3292 possible articles; 21 met the inclusion criteria. There is evidence that maximal isometric contractions and prolonged static stretching (>5 min) of the triceps surae complex cause an immediate decrease in AT stiffness, whereas prolonged running and hopping have minimal effect. Limited but consistent evidence exists, indicating that AT hysteresis is reduced after prolonged static stretching. Consistent evidence supports a reduction in free AT diameter (anterior-posterior) after dynamic ankle exercise, and this change appears most pronounced in the healthy tendon and after eccentric exercise. The mechanical and morphological properties of the AT in vivo are affected by acute exercise in a mode- and dose-dependent manner. Transient changes in AT stiffness, hysteresis, and diameter after unaccustomed exercise modes and doses may expose the tendon to increased risk of strain injury and impact on the mechanical function of the triceps surae muscle-tendon unit.

  8. The effects of organic nitrates on osteoporosis: a systematic review.

    Science.gov (United States)

    Jamal, S A; Reid, L S; Hamilton, C J

    2013-03-01

    Current treatments for osteoporosis are limited by lack of effect on cortical bone, side effects, and, in some cases, cost. Organic nitrates, which act as nitric oxide donors, may be a potential alternative. This systematic review summarizes the clinical data that reports on the effects of organic nitrates and bone. Organic nitrates, which act as nitric oxide donors, are novel agents that have several advantages over the currently available treatments for osteoporosis. This systematic review summarizes the clinical data that reports on the effects of organic nitrates on bone. We searched Medline (1966 to November 2012), EMBASE (1980 to November 2012), and the Cochrane Central Register of Controlled Trials (Issue 11, 2012). Keywords included nitrates, osteoporosis, bone mineral density (BMD), and fractures. We identified 200 citations. Of these, a total of 29 were retrieved for more detailed evaluation and we excluded 19 manuscripts: 15 because they did not present original data and four because they did not provide data on the intervention or outcome of interest. As such, we included ten studies in literature review. Of these ten studies two were observational cohort studies reporting nitrate use was associated with increased BMD; two were case control studies reporting that use of nitrates were associated with lower risk of hip fracture; two were randomized controlled trials (RCT) comparing alendronate to organic nitrates for treatment of postmenopausal women and demonstrating that both agents increased lumbar spine BMD. The two largest RCT with the longest follow-up, both of which compared effects of organic nitrates to placebo on BMD in women without osteoporosis, reported conflicting results. Headaches were the most common adverse event among women taking nitrates. No studies have reported on fracture efficacy. Further research is needed before recommending organic nitrates for the treatment of postmenopausal osteoporosis.

  9. Effects of contracture on gait kinematics: A systematic review.

    Science.gov (United States)

    Attias, Michael; Chevalley, Odile; Bonnefoy-Mazure, Alice; De Coulon, Geraldo; Cheze, Laurence; Armand, Stéphane

    2016-03-01

    Contractures of a major joint in the lower limbs may impair human walking in addition to other daily living activities. A contracture is defined as the inability of a joint to perform the full range of motion and excessive resistance during passive mobilization of the joint. Few studies have reported methods describing how to evaluate contractures. Understanding the association among all of these studies seems essential to improve patient management. Therefore, we conducted a systematic review on this topic to elucidate the influence of contractures on gait kinematics. An electronic search in the literature will be conducted. Studies were screened by title and abstract and full texts were evaluated secondarily for definitive inclusion. The quality of the included studies was assessed independently by the two review authors with the Modified Quality Assessment Checklist. The included studies were separated into three categories: pathological contracture versus healthy controls (descriptive), simulated contracture versus healthy controls (experimental), and pre- and post-kinematics after surgical muscle lengthening (surgery). From a total of 4402 references, 112 original articles were selected, and 28 studies were identified in this systematic review. No significant difference between raters was observed on the total score of the Modified Quality Assessment Checklist. Contractures influence walking depending on the location (muscle) and the contracture level (muscle-tendon length). After giving a definition of contracture, this review identified some contracture alterations, such as plantarflexion, knee flexion and hip flexion contractures, with a kinematic description and presented possible different compensations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Systematic improvement of parton showers with effective theory

    International Nuclear Information System (INIS)

    Baumgart, Matthew; Marcantonini, Claudio; Stewart, Iain W.

    2011-01-01

    We carry out a systematic classification and computation of next-to-leading order kinematic power corrections to the fully differential cross section in the parton shower. To do this we devise a map between ingredients in a parton shower and operators in a traditional effective field theory framework using a chain of soft-collinear effective theories. Our approach overcomes several difficulties including avoiding double counting and distinguishing approximations that are coordinate choices from true power corrections. Branching corrections can be classified as hard-scattering, that occur near the top of the shower, and jet-structure, that can occur at any point inside it. Hard-scattering corrections include matrix elements with additional hard partons, as well as power suppressed contributions to the branching for the leading jet. Jet-structure corrections require simultaneous consideration of potential 1→2 and 1→3 branchings. The interference structure induced by collinear terms with subleading powers remains localized in the shower.

  11. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

    Directory of Open Access Journals (Sweden)

    Luke Perraton

    2009-11-01

    Full Text Available Luke Perraton, Zuzana Machotka, Saravana KumarInternational Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaAim: Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS. The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials.Method: A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery were analyzed.Results: Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery.Conclusions: Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%–80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes.Keywords: hydrotherapy, fibromyalgia syndrome, exercise, effective, components

  12. Antimicrobial effect of essential oils: a systematic review

    Directory of Open Access Journals (Sweden)

    E Sadeghi

    2015-08-01

    Full Text Available Regarding the harmful effects of chemical foods preservatives on human body, it is crucial to find out safe antimicrobials among essential oils and herbs. This study aimed to address the effects of different essential oils on various bacterial species through a systematic review. A wide range of published papers in national and international data bases have been searched for the relevant articles. For this reason, the keywords used in searching were: "essential oils in food", "antimicrobial effect" and "vegetable oils". Among 462 retrieved articles, 76 papers were selected for further reviewing based on their title and abstracts. Based on results, the antimicrobial effects of different essential oils on pathogenic and spoilage organisms were compared. Moreover, the most effective as well as the least effective essential oils on microbial growth were identified. It was concluded that essential oils are more effective on gram positive bacteria rather than gram negatives. Besides, it was evident that some essential oils negatively affected the useful organisms such as lactobacilli.

  13. Is Video-Based Education an Effective Method in Surgical Education? A Systematic Review.

    Science.gov (United States)

    Ahmet, Akgul; Gamze, Kus; Rustem, Mustafaoglu; Sezen, Karaborklu Argut

    2018-02-12

    Visual signs draw more attention during the learning process. Video is one of the most effective tool including a lot of visual cues. This systematic review set out to explore the influence of video in surgical education. We reviewed the current evidence for the video-based surgical education methods, discuss the advantages and disadvantages on the teaching of technical and nontechnical surgical skills. This systematic review was conducted according to the guidelines defined in the preferred reporting items for systematic reviews and meta-analyses statement. The electronic databases: the Cochrane Library, Medline (PubMED), and ProQuest were searched from their inception to the 30 January 2016. The Medical Subject Headings (MeSH) terms and keywords used were "video," "education," and "surgery." We analyzed all full-texts, randomised and nonrandomised clinical trials and observational studies including video-based education methods about any surgery. "Education" means a medical resident's or student's training and teaching process; not patients' education. We did not impose restrictions about language or publication date. A total of nine articles which met inclusion criteria were included. These trials enrolled 507 participants and the total number of participants per trial ranged from 10 to 172. Nearly all of the studies reviewed report significant knowledge gain from video-based education techniques. The findings of this systematic review provide fair to good quality studies to demonstrate significant gains in knowledge compared with traditional teaching. Additional video to simulator exercise or 3D animations has beneficial effects on training time, learning duration, acquisition of surgical skills, and trainee's satisfaction. Video-based education has potential for use in surgical education as trainees face significant barriers in their practice. This method is effective according to the recent literature. Video should be used in addition to standard techniques

  14. A Systematic Overview of Radiation Therapy Effects in Rectal Cancer

    International Nuclear Information System (INIS)

    Glimelius, Bengt; Groenberg, Henrik; Jaerhult, Johannes; Wallgren, Arne; Cavallin-Staahl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for rectal cancer is based on data from 42 randomized trials and 3 meta-analyses. Moreover, data from 36 prospective studies, 7 retrospective studies and 17 other articles were used. A total of 131 scientific articles are included, involving 25,351 patients. The results were compared with those of a similar overview from 1996 including 15,042 patients. The conclusions reached can be summarized thus: The results after rectal cancer surgery have improved during the past decade. It is likely that local failure rates after 5 years of follow-up at hospitals adopting the TME-concept (TME=total mesorectal excision) have decreased from about 28% to 10-15%. Preoperative radiotherapy at biological effective doses above 30 Gy decreases the relative risk of a local failure by more than half (50-70%). Postoperative radiotherapy decreases the risk by 30-40% at doses that generally are higher than those used preoperatively. There is strong evidence that preoperative radiotherapy is more effective than postoperative. There is moderate evidence that preoperative radiotherapy significantly decreases the local failure rate (from 8% to 2% after 2 years) also with TME. There is strong evidence that preoperative radiotherapy improves survival (by about 10%). There is no evidence that postoperative radiotherapy improves survival. There is some indication that survival is prolonged when postoperative radiotherapy is combined with concomitant chemotherapy. Preoperative radiotherapy at adequate doses can be given with low acute toxicity. Higher, and unacceptable acute toxicity has been seen in some preoperative radiotherapy trials using suboptimal techniques. Postoperative radiotherapy can also be

  15. The effect of early postnatal discharge from hospital for women and infants: a systematic review protocol.

    Science.gov (United States)

    Jones, Eleanor; Taylor, Beck; MacArthur, Christine; Pritchett, Ruth; Cummins, Carole

    2016-02-08

    The length of postnatal hospital stay has declined over the last 40 years. There is little evidence to support a policy of early discharge following birth, and there is some concern about whether early discharge of mothers and babies is safe. The Cochrane review on the effects of early discharge from hospital only included randomised controlled trials (RCTs) which are problematic in this area, and a systematic review including other study designs is required. The aim of this broader systematic review is to determine possible effects of a policy of early postnatal discharge on important maternal and infant health-related outcomes. A systematic search of published literature will be conducted for randomised controlled trials, non-randomised controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series studies (ITS) that report on the effect of a policy of early postnatal discharge from hospital. Databases including Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and Science Citation Index will be searched for relevant material. Reference lists of articles will also be searched in addition to searches to identify grey literature. Screening of identified articles and data extraction will be conducted in duplicate and independently. Methodological quality of the included studies will be assessed using the Effective Practice and Organisation of Care (EPOC) criteria for risk of bias tool. Discrepancies will be resolved by consensus or by consulting a third author. Meta-analysis using a random effects model will be used to combine data. Where significant heterogeneity is present, data will be combined in a narrative synthesis. The findings will be reported according to the preferred reporting items for systematic reviews (PRISMA) statement. Information on the effects of early postnatal discharge from hospital will be important for policy makers and clinicians providing maternity care. This review will also identify any gaps in the current

  16. The effects on student health of interventions modifying the school environment: systematic review.

    Science.gov (United States)

    Bonell, C; Wells, H; Harden, A; Jamal, F; Fletcher, A; Thomas, J; Campbell, R; Petticrew, M; Whitehead, M; Murphy, S; Moore, L

    2013-08-01

    Owing to the limited effectiveness of traditional health education curricula in schools, there is increasing interest in interventions aiming to promote young people's health by modifying the school environment. Existing systematic reviews cannot determine whether environmental intervention is effective because they examine interventions combining environmental modifications and traditional health education. This gap is significant because school-environment interventions are complex to implement and may be sidelined in underfunded and attainment-focused school systems without evidence to support such an approach. This systematic review examined the effectiveness of school-environment interventions without health-education components on student health and inequalities. This was a systematic review of experimental/quasi-experimental studies of school-environment interventions. Sixteen databases were searched, eliciting 62 329 references which were screened, with included studies quality assessed, data extracted and narratively synthesised. Sixteen reports of 10 studies were included, all from the USA and the UK. Five evaluations of interventions aiming to develop a stronger sense of community and/or improve relationships between staff and students suggested potential benefits particularly regarding violence and aggression. Two trials of interventions enabling students to advocate for changes in school catering and physical activity reported benefits for physical activity but not diet. Three evaluations of improvements to school playgrounds offered weak evidence of effects on physical activity. School environment interventions show the potential to improve young people's health particularly regarding violence, aggression and physical activity. Further trials are required to provide a stronger and more generalisable evidence base.

  17. Financial effects of health information technology: a systematic review.

    Science.gov (United States)

    Low, Alexander F H; Phillips, Andrew B; Ancker, Jessica S; Patel, Ashwin R; Kern, Lisa M; Kaushal, Rainu

    2013-11-01

    Health information technology (HIT) is widely viewed as an important lever with which to improve the quality and efficiency of the healthcare system. However, there has long been debate about its financial effects. To characterize the existing data on the financial effects of HIT and to consider the implications for the effect of HIT on healthcare spending. Systematic literature review. We identified articles by (1) searching PubMed using the intersection of terms related to HIT applications and terms related to financial or economic effect; and (2) reviewing the reference lists of the included articles as well as additional policy articles and literature reviews. A total of 57 articles met our inclusion criteria, including 43 articles (75%) reporting financial benefits to a stakeholder associated with HIT. These included 26 articles (46%) reporting cost savings, 6 articles (11%) reporting revenue gains, and 11 articles (19%) reporting a mixture of cost savings and revenue gains. Among articles with experimental study designs, 22 of 34 (65%) reported financial benefits; and among articles explicitly measuring costs and benefits, 19 of 21 (90%) reported financial benefits. The most prevalent mechanisms were savings on administrative goods and/or personnel, savings on pharmaceuticals, and revenue gains through improved billing. Overall there is a dearth of articles on this topic, especially ones with strong study designs and financial analyses. HIT can have financial benefits, but more research is required, especially on HIT's effects under emerging delivery and payment reform efforts.

  18. The effects of probiotics in lactose intolerance: A systematic review.

    Science.gov (United States)

    Oak, Sophia J; Jha, Rajesh

    2018-02-09

    Over 60 percent of the human population has a reduced ability to digest lactose due to low levels of lactase enzyme activity. Probiotics are live bacteria or yeast that supplements the gastrointestinal flora. Studies have shown that probiotics exhibit various health beneficial properties such as improvement of intestinal health, enhancement of the immune responses, and reduction of serum cholesterol. Accumulating evidence has shown that probiotic bacteria in fermented and unfermented milk products can be used to alleviate the clinical symptoms of lactose intolerance (LI). In this systematic review, the effectiveness of probiotics in the treatment of LI was evaluated using 15 randomized double-blind studies. Eight probiotic strains with the greatest number of proven benefits were studied. Results showed varying degrees of efficacy but an overall positive relationship between probiotics and lactose intolerance.

  19. The Nab Spectrometer, Precision Field Mapping, and Associated Systematic Effects

    Science.gov (United States)

    Fry, Jason; Nab Collaboration

    2017-09-01

    The Nab experiment will make precision measurements of a, the e- ν correlation parameter, and b, the Fierz interference term, in neutron beta decay, aiming to deliver an independent determination of the ratio λ =GA /GV to sensitively test CKM unitarity. Nab utilizes a novel, long asymmetric spectrometer to measure the proton TOF and electron energy. We extract a from the slope of the measured TOF distribution for different electron energies. A reliable relation of the measured proton TOF to a requires detailed knowledge of the effective proton pathlength, which in turn imposes further requirements on the precision of the magnetic fields in the Nab spectrometer. The Nab spectrometer, magnetometry, and associated systematics will be discussed.

  20. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review.

    Science.gov (United States)

    Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

    2009-11-30

    Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials. A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery) were analyzed. Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery. Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%-80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes.

  1. Effective recruitment strategies in primary care research: a systematic review.

    Science.gov (United States)

    Ngune, Irene; Jiwa, Moyez; Dadich, Ann; Lotriet, Jaco; Sriram, Deepa

    2012-01-01

    Patient recruitment in primary care research is often a protracted and frustrating process, affecting project timeframes, budget and the dissemination of research findings. Yet, clear guidance on patient recruitment strategies in primary care research is limited. This paper addresses this issue through a systematic review. Articles were sourced from five academic databases - AustHealth, CINAHL, the Cochrane Methodology Group, EMBASE and PubMed/Medline; grey literature was also sourced from an academic library and the Primary Healthcare Research & Information Service (PHCRIS) website. Two reviewers independently screened the articles using the following criteria: (1) published in English, (2) reported empirical research, (3) focused on interventions designed to increase patient recruitment in primary care settings, and (4) reported patient recruitment in primary care settings. Sixty-six articles met the inclusion criteria. Of these, 23 specifically focused on recruitment strategies and included randomised trials (n = 7), systematic reviews (n = 8) and qualitative studies (n = 8). Of the remaining articles, 30 evaluated recruitment strategies, while 13 addressed the value of recruitment strategies using descriptive statistics and/or qualitative data. Among the 66 articles, primary care chiefly included general practice (n = 30); nursing and allied health services, multiple settings, as well as other community settings (n = 30); and pharmacy (n = 6). Effective recruitment strategies included the involvement of a discipline champion, simple patient eligibility criteria, patient incentives and organisational strategies that reduce practitioner workload. The most effective recruitment in primary care research requires practitioner involvement. The active participation of primary care practitioners in both the design and conduct of research helps to identify strategies that are congruent with the context in which patient care is delivered. This is reported to be the

  2. Effectiveness of internet-based affect induction procedures: A systematic review and meta-analysis.

    Science.gov (United States)

    Ferrer, Rebecca A; Grenen, Emily G; Taber, Jennifer M

    2015-12-01

    Procedures used to induce affect in a laboratory are effective and well-validated. Given recent methodological and technological advances in Internet research, it is important to determine whether affect can be effectively induced using Internet methodology. We conducted a meta-analysis and systematic review of prior research that has used Internet-based affect induction procedures, and examined potential moderators of the effectiveness of affect induction procedures. Twenty-six studies were included in final analyses, with 89 independent effect sizes. Affect induction procedures effectively induced general positive affect, general negative affect, fear, disgust, anger, sadness, and guilt, but did not significantly induce happiness. Contamination of other nontarget affect did not appear to be a major concern. Video inductions resulted in greater effect sizes. Overall, results indicate that affect can be effectively induced in Internet studies, suggesting an important venue for the acceleration of affective science. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  3. Topology of Large-Scale Structures of Galaxies in two Dimensions—Systematic Effects

    Science.gov (United States)

    Appleby, Stephen; Park, Changbom; Hong, Sungwook E.; Kim, Juhan

    2017-02-01

    We study the two-dimensional topology of galactic distribution when projected onto two-dimensional spherical shells. Using the latest Horizon Run 4 simulation data, we construct the genus of the two-dimensional field and consider how this statistic is affected by late-time nonlinear effects—principally gravitational collapse and redshift space distortion (RSD). We also consider systematic and numerical artifacts, such as shot noise, galaxy bias, and finite pixel effects. We model the systematics using a Hermite polynomial expansion and perform a comprehensive analysis of known effects on the two-dimensional genus, with a view toward using the statistic for cosmological parameter estimation. We find that the finite pixel effect is dominated by an amplitude drop and can be made less than 1% by adopting pixels smaller than 1/3 of the angular smoothing length. Nonlinear gravitational evolution introduces time-dependent coefficients of the zeroth, first, and second Hermite polynomials, but the genus amplitude changes by less than 1% between z = 1 and z = 0 for smoothing scales {R}{{G}}> 9 {Mpc}/{{h}}. Non-zero terms are measured up to third order in the Hermite polynomial expansion when studying RSD. Differences in the shapes of the genus curves in real and redshift space are small when we adopt thick redshift shells, but the amplitude change remains a significant ˜ { O }(10 % ) effect. The combined effects of galaxy biasing and shot noise produce systematic effects up to the second Hermite polynomial. It is shown that, when sampling, the use of galaxy mass cuts significantly reduces the effect of shot noise relative to random sampling.

  4. Effect of Exergames on Depression: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

    2016-01-01

    Depression is a major public health concern in current society. In recent years many studies began to investigate the potential benefits of exergames on depression. The current study aimed to provide a systematic review to synthesize the existing studies and discover the overall effect size of exergames on treating depression. A comprehensive literature search was conducted among major bibliographic databases in computer technology, psychology, and medical science. Key study characteristics of participants, interventions, and experiment were extracted in the systematic review. Both studies using independent groups and matched groups were included in meta-analysis. Overall effect size of Hedges' g was calculated, followed by subgroup analyses. Nine studies included in the review, while eight studies applying exergames of Nintendo's Wii or Wii Fit. A random effects meta-analysis on eight studies resulted an overall significant effect size of g = 0.21. Demographic factors, depression severity, number of session, and game type were found to be significant moderators for the effectiveness. The study has not only supported the positive effect of exergames on alleviating depression, but also provided many theoretical and practical implications for health professionals and police makers. More rigorous experimental controlled studies are needed in this new research field.

  5. Effects of acupuncture on rheumatoid arthritis: a systematic review ...

    African Journals Online (AJOL)

    The meta-analysis indicated that a significant benefit of acupuncture compared with non-acupuncture on improving the symptoms of RA (pooled RR = 1.19, 95% CI 1.08–1.31, Z = 3.47, P = 0.001). In the subgroup analysis, 9 RCTs showed significant effects of acupuncture for response rate compared with western medicine ...

  6. Effective axial-vector strength and β-decay systematics

    Science.gov (United States)

    Delion, D. S.; Suhonen, J.

    2014-09-01

    We use the weak axial-vector coupling strength g_{\\text{A}} as a key parameter to reproduce simultaneously the available data for both the Gamow-Teller \\beta^- and \\beta^+/\\text{EC} decay rates in nine triplets of isobars with mass numbers A=70,78,100,104,106,110,116,128,130 . We use the proton-neutron quasiparticle random-phase approximation (pnQRPA) with schematic dipole interaction containing particle-particle and particle-hole parts with mass-dependent strengths. Our analysis points to a strongly quenched effective value g_{\\text{A}}\\approx 0.3 , with a relative error of 28%. We then perform a systematic computation of 218 experimentally known \\beta^- and \\beta^+/\\text{EC} decays with quite a remarkable success. The presently extracted value of g_{\\text{A}} should be taken as an effective one, specific for a given nuclear theory framework. Present studies suggest that the effective g_{\\text{A}} is suitable for the description of decay transitions to 1^+ states at moderate excitation, below the Gamow-Teller giant resonance region.

  7. Effects of martial arts on health status: a systematic review.

    Science.gov (United States)

    Bu, Bin; Haijun, Han; Yong, Liu; Chaohui, Zhang; Xiaoyuan, Yang; Singh, Maria Fiatarone

    2010-11-01

    To systematically summarize the evidence for the effects of martial arts on health and fitness, to show the strengths of different types of martial arts, and to get a more complete picture of the impacts of martial arts on health, and also to provide a basis for future research on martial arts as an exercise prescription in exercise therapy. We searched for "martial arts"health" and "random" in eight databases (n= 5432). Randomized controlled trials and controlled clinical trials on the health effects of martial arts were included in the study. The final analysis included 28 papers (one general martial arts, one kung fu, sixteen tai chi, six judo, three karate, and one taekwondo). Among the disciplines of martial arts, tai chi was the most well-studied, followed by judo, karate, and taekwondo. Research topics varied widely, and included health, injuries, competition, morals and psychology, and herbal medicine. Most found positive effects on health. Tai chi is no-contact, low-impact, soft body and mindfulness exercise, which has been widely adopted by elderly people and proven to be a beneficial health promotion exercise. Research on judo, karate, and taekwondo mainly focused on improvements to athletes' competitive abilities, rather than on health effects. We did not find any published randomized controlled trials or controlled clinical trials on aikido, kendo, sumo, kyudo, qi gong, or other disciplines. Since martial arts are widely practiced, their effects on physiology, morphology, immunology, and neurology should be further studied in order to help people to select the best discipline or style to accomplish their purposes. This necessitates categorizing and classifying the disciplines and styles according to their effects on different body systems and levels of contact, as well as standardizing evaluation criteria for martial arts. Martial arts as an exercise prescription can then move from an experience-based to an evidence-based treatment. © 2010 Blackwell

  8. Should we expect financial globalization to have significant effects on business cycles?

    OpenAIRE

    Iversen, Jens

    2009-01-01

    Empirical research suggests that financial globalization has insignificant effects on business cycles. Based on standard theoretical models it might be conjectured that the effects should be significant. I show that this conjecture is wrong. Theoretical effects of financial globalization can be determined to any level of precision by expanding the underlying artificial samples. In contrast, in the data the effects are imprecisely estimated because of short samples. I show that if the conclusi...

  9. 77 FR 24722 - Draft Guidance for Industry: Assessing the Effects of Significant Manufacturing Process Changes...

    Science.gov (United States)

    2012-04-25

    ...] Draft Guidance for Industry: Assessing the Effects of Significant Manufacturing Process Changes... Manufacturing Process Changes, Including Emerging Technologies, on the Safety and Regulatory Status of Food... determining whether changes in manufacturing process, including the intentional reduction in particle size to...

  10. Effect of exercise on the quality of life in type 2 diabetes mellitus: a systematic review.

    Science.gov (United States)

    Cai, Hong; Li, Guichen; Zhang, Ping; Xu, Duo; Chen, Li

    2017-03-01

    Diabetic patients tend to have a poor quality of life. A sedentary lifestyle is considered to be a modifiable risk factor for type 2 diabetes and an independent predictor of poor quality of life. Exercise is a key treatment for people living with diabetes. The purpose of this study was to conduct a systematic review to assess the effect of exercise on the quality of life of people with type 2 diabetes. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Embase, Cochrane Library, CINAHL and three Chinese databases were searched for studies published until January 2016. The review included all clinical trials that evaluated the effect of exercise on quality of life compared with that of usual care for people with type 2 diabetes. Two reviewers independently assessed the quality of all the included studies, by using the Downs and Black Quality Index (QI). Thirty studies met inclusion criteria, with 2785 participants. We divided the exercise into four modes: aerobic, resistance, a combination of aerobic and resistance and yoga. Aerobic exercise showed a significant effect between groups. Resistance and combined exercise showed mixed results. Yoga also showed good intervention effects on quality of life. The effect of aerobic exercise on the quality of life in people with type 2 diabetes was safe and effective. Then, most of the studies on aerobic exercise were of good methodological quality. The effects of resistance exercise and combined exercise on the quality of life in people with type 2 diabetes were mixed, and the effect of yoga on quality of life still need more research.

  11. Effectiveness of UK provider financial incentives on quality of care: a systematic review.

    Science.gov (United States)

    Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias

    2017-11-01

    Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

  12. Is Pilocarpine Effective in Preventing Radiation-Induced Xerostomia? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Yang, Wei-fa; Liao, Gui-qing; Hakim, Samer G; Ouyang, Dai-qiao; Ringash, Jolie; Su, Yu-xiong

    2016-03-01

    To evaluate the efficacy of concomitant administration of pilocarpine on radiation-induced xerostomia in patients with head and neck cancers. The PubMed, Web of Science, Cochrane Library, and ClinicalTrials were searched to identify randomized, controlled trials studying the effect of concomitant administration of pilocarpine for radiation-induced xerostomia. Included trials were systematically reviewed, and quantifiable outcomes were pooled for meta-analysis. Outcomes of interest included salivary flow, clinician-rated xerostomia grade, patient-reported xerostomia scoring, quality of life, and adverse effects. Six prospective, randomized, controlled trials in 8 articles were included in this systematic review. The total number of patients was 369 in the pilocarpine group and 367 in the control group. Concomitant administration of pilocarpine during radiation could increase the unstimulated salivary flow rate in a period of 3 to 6 months after treatment, and also reduce the clinician-rated xerostomia grade. Patient-reported xerostomia was not significantly impacted by pilocarpine in the initial 3 months but was superior at 6 months. No significant difference of stimulated salivary flow rate could be confirmed between the 2 arms. Adverse effects of pilocarpine were mild and tolerable. The concomitant administration of pilocarpine during radiation increases unstimulated salivary flow rate and reduces clinician-rated xerostomia grade after radiation. It also relieves patients' xerostomia at 6 months and possibly at 12 months. However, pilocarpine has no effect on stimulated salivary flow rate. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Road safety effects of porous asphalt: a systematic review of evaluation studies

    DEFF Research Database (Denmark)

    Elvik, R.; Greibe, Poul

    2005-01-01

    of eighteen estimates of the effect of porous asphalt on accident rates. No clear effect on road safety of porous asphalt was found. All summary estimates of effect indicated very small changes in accident rates and very few were statistically significant at conventional levels. Studies that have evaluated...... of these changes in risk factors on accident occurrence cannot be predicted. On the whole, the research that has been reported so far regarding road safety effects of porous asphalt is inconclusive. The studies are not of high quality and the findings are inconsistent.......This paper presents a systematic review of studies that have evaluated the effects on road safety of porous asphalt. Porous asphalt is widely used on motorways in Europe, mainly in order to reduce traffic noise and increase road capacity. A meta-analysis was made of six studies, containing a total...

  14. The Threat Effect of Active Labor Market Programs: A Systematic Review

    DEFF Research Database (Denmark)

    Filges, Trine; Hansen, Anne Toft

    2017-01-01

    This paper is a systematic review of the threat effect of active labor market programs for unemployed individuals. The threat effect is the induced change in the hazard rate of leaving unemployment prior to program participation. Studies included in the review all estimated a threat effect...... a hazard rate of 1.27 for the pooled estimate. It has thus been concluded that active labor market programs constitute a significant threat effect......., with the participants in all cases being unemployed individuals in receipt of benefit of some kind during their tenure of unemployment. Seven of these studies have been included in a meta-analysis: The meta-analysis, which has been carried out using a random effects model to account for heterogeneity, indicated...

  15. A Systematic Overview of Radiation Therapy Effects in Oesophageal Cancer

    International Nuclear Information System (INIS)

    Ask, Anders; Albertsson, Maria; Jaerhult, Johannes; Cavallin-Staahl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for oesophageal cancer is based on data from 42 randomized trials and 2 meta-analyses. A total of 44 scientific articles are included, involving 5,772 patients. The conclusions reached can be summarized as follows: There is fairly strong evidence that preoperative radiotherapy does not improve the survival in patients with potentially resectable oesophageal cancer. There is moderate evidence that preoperative chemo-radiotherapy has no beneficial impact on the survival of patients with potentially resectable oesophageal cancer. There is no scientific evidence that postoperative radiotherapy improves survival in patients with resectable oesophageal cancer. The documentation is, however, poor, consisting of only three randomized trials. There is fairly strong evidence that concomitant (but not sequential) chemo-radiotherapy gives significantly better survival rate than radiotherapy alone in inoperable oesophageal cancer. The results of the reported clinical trials are, however, conflicting, and no solid conclusion can be drawn. Hyperfractionated radiotherapy has been compared with conventionally fractionated radiotherapy in two randomized studies with conflicting results and no firm conclusion can be drawn

  16. The Effects of Systematic Training for Effective Parenting on Parental Attitudes.

    Science.gov (United States)

    Nystul, Michael S.

    1982-01-01

    The Attitude toward the Freedom of Children Scale and the revised Parent Attitude Research Instrument were administered to 28 Australian mothers. Half of the mothers attended a nine-week course in Systematic Training for Effective Parenting (STEP), while the remaining half acted as the control group. A one-way analysis of variance evaluated the…

  17. Effectiveness of teaching quality improvement to clinicians: a systematic review.

    Science.gov (United States)

    Boonyasai, Romsai T; Windish, Donna M; Chakraborti, Chayan; Feldman, Leonard S; Rubin, Haya R; Bass, Eric B

    2007-09-05

    Accreditation requirements mandate teaching quality improvement (QI) concepts to medical trainees, yet little is known about the effectiveness of teaching QI. To perform a systematic review of the effectiveness of published QI curricula for clinicians and to determine whether teaching methods influence the effectiveness of such curricula. The electronic literature databases of MEDLINE, EMBASE, CINAHL, and ERIC were searched for English-language articles published between January 1, 1980, and April 30, 2007. Experts in the field of QI were queried about relevant studies. Two independent reviewers selected studies for inclusion if the curriculum taught QI principles to clinicians and the evaluation used a comparative study design. Information about the features of each curriculum, its use of 9 principles of adult learning, and the type of educational and clinical outcomes were extracted. The relationship between the outcomes and the number of educational principles used was assessed. Of 39 studies that met eligibility criteria, 31 described team-based projects; 37 combined didactic instruction with experiential learning. The median number of adult learning principles used was 7 (range, 2-8). Evaluations included 22 controlled trials (8 randomized and 14 nonrandomized) and 17 pre/post or time series studies. Fourteen studies described educational outcomes (attitudes, knowledge, or skills or behaviors) and 28 studies described clinical process or patient outcomes. Nine of the 10 studies that evaluated knowledge reported only positive effects but only 2 of these described a validated assessment tool. The 6 assessments of attitudes found mixed results. Four of the 6 studies on skill or behavior outcomes reported only positive effects. Eight of the 28 studies of clinical outcomes reported only beneficial effects. Controlled studies were more likely than other studies to report mixed or null effects. Only 4 studies evaluated both educational and clinical outcomes

  18. Statins as anti-arrhythmics: a systematic review part II: effects on risk of ventricular arrhythmias.

    Science.gov (United States)

    Abuissa, Hussam; O'Keefe, James H; Bybee, Kevin A

    2009-10-01

    Recent studies have demonstrated that statins may possess anti-arrhythmic properties in addition to their lipid-lowering effects. Studies which reported the association of statins with the incidence of ventricular arrhythmias were identified through a systematic review of the published literature. Statins have been associated with a significant reductions in ventricular arrhythmia in cardiomyopathy patients with an implantable cardioverter defibrillator, although randomized trials have not been completed. Published data suggests that statins may possess anti-arrhythmic properties that reduce the propensity for ventricular arrhythmias. Most of this data is observational; more randomized, placebo-controlled trials are needed.

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

    Science.gov (United States)

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

    2009-01-01

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

  20. Is Pilates an effective rehabilitation tool? A systematic review.

    Science.gov (United States)

    Byrnes, Keira; Wu, Ping-Jung; Whillier, Stephney

    2018-01-01

    Pilates is a system of exercise focusing upon controlled movement, stretching and breathing. Pilates is popular today not only for physical fitness but also for rehabilitation programs. This paper is a review of the literature on the effectiveness of Pilates as a rehabilitation tool in a wide range of conditions in an adult population. A systematic literature review was carried out according to the PRISMA guidelines. Electronic databases were searched for cohort studies or randomised controlled trials (RCTs), and inclusion and exclusion criteria were applied. The final RCTs were assessed using the PEDro and CONSORT 2010 checklists. Twenty-three studies, published between 2005 and 2016, met the inclusion criteria. These papers assessed the efficacy of Pilates in the rehabilitation of low back pain, ankylosing spondylitis, multiple sclerosis, post-menopausal osteoporosis, non-structural scoliosis, hypertension and chronic neck pain. Nineteen papers found Pilates to be more effective than the control or comparator group at improving outcomes including pain and disability levels. When assessed using the CONSORT and PEDro scales, the quality of the papers varied, with more falling toward the upper end of the scale. The majority of the clinical trials in the last five years into the use of Pilates as a rehabilitation tool have found it to be effective in achieving desired outcomes, particularly in the area of reducing pain and disability. It indicates the need for further research in these many areas, and especially into the benefits of particular Pilates exercises in the rehabilitation of specific conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Effectiveness of nursing management information systems: a systematic review.

    Science.gov (United States)

    Choi, Mona; Yang, You Lee; Lee, Sun-Mi

    2014-10-01

    The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag(*) and admin(*), and nurs(*) were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs.

  2. Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews.

    Science.gov (United States)

    Kitsiou, Spyros; Paré, Guy; Jaana, Mirou; Gerber, Ben

    2017-01-01

    Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes. The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers. A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR. Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect. Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.

  3. The effectiveness of workplace dietary modification interventions: a systematic review.

    Science.gov (United States)

    Geaney, F; Kelly, C; Greiner, B A; Harrington, J M; Perry, I J; Beirne, P

    2013-11-01

    To evaluate the effectiveness of workplace dietary modification interventions alone or in combination with nutrition education on employees' dietary behaviour, health status, self-efficacy, perceived health, determinants of food choice, nutrition knowledge, co-worker support, job satisfaction, economic cost and food-purchasing patterns. Data sources included PubMed, Medline, Embase, Psych Info., Web of Knowledge and Cochrane Library (November 2011). This review was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies were randomised controlled trials and controlled studies. Interventions were implemented for at least three months. Cochrane Collaboration's risk of bias tool measured potential biases. Heterogeneity precluded meta-analysis. Results were presented in a narrative summary. Six studies conducted in Brazil, the USA, Netherlands and Belgium met the inclusion criteria. Four studies reported small increases in fruit and vegetable consumption (≤half serving/day). These studies involved workplace dietary modifications and three incorporated nutrition education. Other outcomes reported included health status, co-worker support, job satisfaction, perceived health, self-efficacy and food-purchasing patterns. All studies had methodological limitations that weakened confidence in the results. Limited evidence suggests that workplace dietary modification interventions alone and in combination with nutrition education increase fruit and vegetable intakes. These interventions should be developed with recommended guidelines, workplace characteristics, long-term follow-up and objective outcomes for diet, health and cost. © 2013.

  4. A Systematic Overview of Radiation Therapy Effects in Ovarian Cancer

    International Nuclear Information System (INIS)

    Einhorn, Nina; Trope, Claes; Ridderheim, Mona; Boman, Karin; Sorbe, Bengt; Cavallin-Staahl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for ovarian cancer is based on data from six randomized trials. Moreover, data from one prospective study and three retrospective studies were used. In total, 10 scientific articles are included, involving 1,282 patients. The results were compared with those of a similar overview from 1996 including 15,042 patients. The conclusions reached can be summarized in the following points: There is no scientific documentation supporting adjuvant radiotherapy for early-stage, low-risk patients. No studies have been reported where adjuvant radiotherapy has been compared with no adjuvant therapy in early-stage, high-risk patients. Adjuvant radiotherapy, either whole abdominal irradiation or intraperitoneal P32, has been compared with adjuvant chemotherapy in early-stage, high-risk patients. There is no scientific evidence to show that there is a difference in efficacy. There is some evidence to suggest that adjuvant radiotherapy after radical surgery leads to an increase in disease-free survival rate for patients with advanced-stage ovarian cancer. There is little documentation on long-term side effects (second malignancy) after adjuvant radiotherapy and no conclusions can be drawn

  5. The effect of bipolar electrocoagulation during ovarian cystectomy on ovarian reserve: a systematic review.

    Science.gov (United States)

    Pergialiotis, Vasilios; Prodromidou, Anastasia; Frountzas, Maximos; Bitos, Konstantinos; Perrea, Despina; Doumouchtsis, Stergios K

    2015-11-01

    The aim of the present systematic review was to study the effect of bipolar electrocoagulation during ovarian cystectomy on ovarian reserve. We searched Medline (1966-2015), Scopus (2004-2015), ClinicalTrials.gov (2008-2015), and Cochrane Central Register (CENTRAL) databases along with reference lists of electronically retrieved studies. The levels of antimullerian hormone (AMH) and antral follicle count (AFC) at 1, 3, 6, and 12 months following the excision of the benign ovarian cyst were defined as primary outcomes. Eight studies were finally included in our systematic review, which recruited 545 women. A metaanalysis was precluded because of significant heterogeneity in the methodological characteristics of the included studies. Data from the included studies suggest that the use of bipolar coagulation compared with ovarian sutures seems to result in significantly lower AMH and AFC during the first 3 months following the excision of the ovarian cyst. Two studies reported that this effect seems to persist at 6 and 12 months postoperatively. Bipolar electrodiathermy seems to be accompanied by increased damage to ovarian reserve, which is indicated by the lower levels of AMH and AFC. However, definitive results are precluded because of the significant heterogeneity of included studies and the potential bias. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Effects of organisational-level interventions at work on employees’ health: a systematic review

    Science.gov (United States)

    2014-01-01

    Background Organisational-level workplace interventions are thought to produce more sustainable effects on the health of employees than interventions targeting individual behaviours. However, scientific evidence from intervention studies does not fully support this notion. It is therefore important to explore conditions of positive health effects by systematically reviewing available studies. We set out to evaluate the effectiveness of 39 health-related intervention studies targeting a variety of working conditions. Methods Systematic review. Organisational-level workplace interventions aiming at improving employees’ health were identified in electronic databases and manual searches. The appraisal of studies was adapted from the Cochrane Back Review Group guidelines. To improve comparability of the widely varying studies we classified the interventions according to the main approaches towards modifying working conditions. Based on this classification we applied a logistic regression model to estimate significant intervention effects. Results 39 intervention studies published between 1993 and 2012 were included. In terms of methodology the majority of interventions were of medium quality, and four studies only had a high level of evidence. About half of the studies (19) reported significant effects. There was a marginally significant probability of reporting effects among interventions targeting several organisational-level modifications simultaneously (Odds ratio (OR) 2.71; 95% CI 0.94-11.12), compared to those targeting one dimension only. Conclusions Despite the heterogeneity of the 39 organisational-level workplace interventions underlying this review, we were able to compare their effects by applying broad classification categories. Success rates were higher among more comprehensive interventions tackling material, organisational and work-time related conditions simultaneously. To increase the number of successful organisational-level interventions in the

  7. Effects of organisational-level interventions at work on employees' health: a systematic review.

    Science.gov (United States)

    Montano, Diego; Hoven, Hanno; Siegrist, Johannes

    2014-02-08

    Organisational-level workplace interventions are thought to produce more sustainable effects on the health of employees than interventions targeting individual behaviours. However, scientific evidence from intervention studies does not fully support this notion. It is therefore important to explore conditions of positive health effects by systematically reviewing available studies. We set out to evaluate the effectiveness of 39 health-related intervention studies targeting a variety of working conditions. Systematic review. Organisational-level workplace interventions aiming at improving employees' health were identified in electronic databases and manual searches. The appraisal of studies was adapted from the Cochrane Back Review Group guidelines. To improve comparability of the widely varying studies we classified the interventions according to the main approaches towards modifying working conditions. Based on this classification we applied a logistic regression model to estimate significant intervention effects. 39 intervention studies published between 1993 and 2012 were included. In terms of methodology the majority of interventions were of medium quality, and four studies only had a high level of evidence. About half of the studies (19) reported significant effects. There was a marginally significant probability of reporting effects among interventions targeting several organisational-level modifications simultaneously (Odds ratio (OR) 2.71; 95% CI 0.94-11.12), compared to those targeting one dimension only. Despite the heterogeneity of the 39 organisational-level workplace interventions underlying this review, we were able to compare their effects by applying broad classification categories. Success rates were higher among more comprehensive interventions tackling material, organisational and work-time related conditions simultaneously. To increase the number of successful organisational-level interventions in the future, commonly reported obstacles against

  8. The effect of electronic monitoring feedback on medication adherence and clinical outcomes: A systematic review.

    Science.gov (United States)

    van Heuckelum, Milou; van den Ende, Cornelia H M; Houterman, Anne E J; Heemskerk, Charlotte P M; van Dulmen, Sandra; van den Bemt, Bart J F

    2017-01-01

    This study aims to assess the efficacy of Electronic Monitoring Feedback (EMF) as an intervention to improve medication adherence (i.e. dose- or full adherence) and clinical outcomes in adult patients. A systematic search was performed in Medline, EMBASE, PsycINFO and Web of Science and reported according to the PRISMA guidelines. Randomised controlled trials (RCTs) comparing EMF with usual care were identified to systematically summarise the evidence for use of EMF in improving medication adherence and clinical outcomes. The GRADE approach was used to assess the quality of the body of evidence. Of 9,993 initially-identified studies, ten studies (four of high-quality and six of low-quality) were included. The sample size of the studies included varied from 18 to 205 patients. Four of the six studies (66.7%) reported a significant positive effect of EMF on mean dose adherence levels, whereas a significant positive effect of EMF on mean full adherence levels was found in all of the included studies (100%, five out of five of the studies included). A significant positive effect of EMF on clinical outcomes was reported in one of the seven studies included. The overall effect of EMF on mean dose- and full adherence was positive and the overall effect of EMF on clinical outcomes was inconclusive. Considering the positive effect of EMF on medication adherence, EMF might be a promising intervention to enhance medication adherence. However, the effect of EMF on clinical outcomes was inconclusive. Prior to implementing EMF in clinical practice, future research with high-quality studies (e.g. adequate sample sizes, follow-up periods and no interfering co-interventions) is required to examine the (long-term) efficacy of EMF.

  9. Effectiveness of workplace weight management interventions: a systematic review

    Science.gov (United States)

    Background: A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral and incentive based components. Main outcomes were defined as change in weight-related measures. Methods: Key w...

  10. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses.

    Science.gov (United States)

    Lewis, Ruth A; Williams, Nefyn H; Sutton, Alex J; Burton, Kim; Din, Nafees Ud; Matar, Hosam E; Hendry, Maggie; Phillips, Ceri J; Nafees, Sadia; Fitzsimmons, Deborah; Rickard, Ian; Wilkinson, Clare

    2015-06-01

    There are numerous treatment approaches for sciatica. Previous systematic reviews have not compared all these strategies together. To compare the clinical effectiveness of different treatment strategies for sciatica simultaneously. Systematic review and network meta-analysis. We searched 28 electronic databases and online trial registries, along with bibliographies of previous reviews for comparative studies evaluating any intervention to treat sciatica in adults, with outcome data on global effect or pain intensity. Network meta-analysis methods were used to simultaneously compare all treatment strategies and allow indirect comparisons of treatments between studies. The study was funded by the UK National Institute for Health Research Health Technology Assessment program; there are no potential conflict of interests. We identified 122 relevant studies; 90 were randomized controlled trials (RCTs) or quasi-RCTs. Interventions were grouped into 21 treatment strategies. Internal and external validity of included studies was very low. For overall recovery as the outcome, compared with inactive control or conventional care, there was a statistically significant improvement following disc surgery, epidural injections, nonopioid analgesia, manipulation, and acupuncture. Traction, percutaneous discectomy, and exercise therapy were significantly inferior to epidural injections or surgery. For pain as the outcome, epidural injections and biological agents were significantly better than inactive control, but similar findings for disc surgery were not statistically significant. Biological agents were significantly better for pain reduction than bed rest, nonopioids, and opioids. Opioids, education/advice alone, bed rest, and percutaneous discectomy were inferior to most other treatment strategies; although these findings represented large effects, they were statistically equivocal. For the first time, many different treatment strategies for sciatica have been compared in the

  11. Effects of glyphosate exposure on sperm concentration in rodents: A systematic review and meta-analysis.

    Science.gov (United States)

    Cai, Wenyan; Ji, Ying; Song, Xianping; Guo, Haoran; Han, Lei; Zhang, Feng; Liu, Xin; Zhang, Hengdong; Zhu, Baoli; Xu, Ming

    2017-10-01

    Correlation between exposure to glyphosate and sperm concentrations is important in reproductive toxicity risk assessment for male reproductive functions. Many studies have focused on reproductive toxicity on glyphosate, however, results are still controversial. We conducted a systematic review of epidemiological studies on the association between glyphosate exposure and sperm concentrations of rodents. The aim of this study is to explore the potential adverse effects of glyphosate on reproductive function of male rodents. Systematic and comprehensive literature search was performed in MEDLINE, TOXLINE, Embase, WANFANG and CNKI databases with different combinations of glyphosate exposure and sperm concentration. 8 studies were eventually identified and random-effect model was conducted. Heterogeneity among study results was calculated via chi-square tests. Ten independent experimental datasets from these eight studies were acquired to synthesize the random-effect model. A decrease in sperm concentrations was found with mean difference of sperm concentrations(MDsperm)=-2.774×10 6 /sperm/g/testis(95%CI=-0.969 to -4.579) in random-effect model after glyphosate exposure. There was also a significant decrease after fitting the random-effect model: MDsperm=-1.632×10 6 /sperm/g/testis (95%CI=-0.662 to -2.601). The results of meta-analysis support the hypothesis that glyphosate exposure decreased sperm concentration in rodents. Therefore, we conclude that glyphosate is toxic to male rodent's reproductive system. Copyright © 2017. Published by Elsevier B.V.

  12. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment.

    Science.gov (United States)

    Jonsson, T; Christrup, L L; Højsted, J; Villesen, H H; Albjerg, T H; Ravn-Nielsen, L V; Sjøgren, P

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment. We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics. patients treated with either opioids and/or adjuvant analgesics were asked to report their symptoms spontaneously, followed by a 41-item investigator-developed symptom checklist. A control group also filled in the checklist. a total of 62 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (9.9 ± 5.9) were significantly higher than those reported by the controls (3.2 ± 3.9) (Pside effects due to analgesics was: (1) Dry mouth (42%); (2) Sweating (34%); (3) Weight gain (29%); (4) Memory deficits (24%); (5) Fatigue (19%); and (6) Concentration deficits (19%). the number of symptoms reported using systematic assessment was eightfold higher than those reported voluntarily. Fatigue, cognitive dysfunction, dry mouth, sweating and weight gain were the most frequently reported. The patients reported the side effects of their analgesics to contribute substantially to the reported symptoms. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

  13. Effectiveness, Medication Patterns, and Adverse Events of Traditional Chinese Herbal Patches for Osteoarthritis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Xuezong Wang

    2014-01-01

    Full Text Available Objective. The aim of this study is to systematically evaluate the evidence whether traditional Chinese herbal patches (TCHPs for osteoarthritis (OA are effective and safe and analyze their medication patterns. Methods. A systematic literature search was performed using all the possible Medical Subject Headings (MeSH and keywords from January 1979 to July 2013. Both randomized controlled trials (RCTs and observational studies were included. Estimated effects were analyzed using mean difference (MD or relative risk (RR with 95% confidence intervals (CI and meta-analysis. Results. 86 kinds of TCHPs were identified. RCTs and controlled clinical trials (CCTs which were mostly of low quality favored TCHPs for local pain and dysfunction relief. TCHPs, compared with diclofenac ointment, had significant effects on global effectiveness rate (RR = 0.50; 95% CI (0.29, 0.87. Components of formulae were mainly based on the compounds “Xiao Huo Luo Dan” (Minor collateral-freeing pill and “Du Huo Ji Sheng Tang” (Angelicae Pubescentis and Loranthi decoction. Ten kinds of adverse events (AEs, mainly consisting of itching and/or local skin rashes, were identified after 3-4 weeks of follow-up. Conclusions. TCHPs have certain evidence in improving global effectiveness rate for OA; however, more rigorous studies are warranted to support their use.

  14. A systematic review of the effects of Iranian pharmaceutical plant extracts on Giardia lamblia

    Directory of Open Access Journals (Sweden)

    Hajar Ziaei Hezarjaribi

    2015-12-01

    Full Text Available This study aimed to provide a systematic review regarding anti-Giardia effect of different Iranian plant extracts used in vivo and in vitro on cysts and trophozoites. Many reports indicated that most of plant extracts used as anti-Giardia were obtained from Liliaceae, Apiaceae, Asteraceae, and Myrtaceae. These extracts included different fractions such as aqueous, alcoholic and chloroform extracts as well as Soxhlet extraction of juice or essence. The findings of this review showed that hydroalcoholic extract of asafoetida, Chenopodium botrys, and chloroformic extract of feverfew (Tanacetum parthenium have the maximum effect (100% efficacy on in vitro application against Giardia. However, the highest in vivo effect of 100% therapeutic significance was recorded for the extract of Allium sativum at 80 mg/mL concentration. Given the plant species richness of Iran in terms of herbal medicines with fewer side effects, it can be a good alternative to chemical drugs used to treat giardiasis.

  15. Effective implementation of research into practice: an overview of systematic reviews of the health literature

    OpenAIRE

    Boaz, Annette; Baeza, Juan; Fraser, Alec

    2011-01-01

    Abstract Background The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing...

  16. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

    OpenAIRE

    Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

    2009-01-01

    Luke Perraton, Zuzana Machotka, Saravana KumarInternational Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaAim: Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials.Method: A systematic review of randomized controlled trials was conducted. Onl...

  17. Effects of systematic mental intervention on mental health, personality and coping style in recruits

    Directory of Open Access Journals (Sweden)

    Zhen-zhen WANG

    2013-02-01

    Full Text Available Objective  To observe the effects of systematic mental intervention, with combined centralized teaching, group interview and individual consulting, on mental health, personality and coping style in recruits, and explore an optimal intervention model for recruits' mental health. Methods  Two thousand and sixteen recruits in one unit were involved in the present study, among them 1064 were allocated to study group, and the remaining 952 to control group. Recruits in study group received centralized teaching with battalion as a unit, and received group interview in squad or platoon as a unit, and meanwhile individual interview was conducted. Symptoms Checklist-90 (SCL-90, Eysenck Personality Questionnaire (EPQ and Simplified Coping Style Questionnaire (SCSQ were filled one month after they were enlisted in the army and 3 days before the training ended. Recruits in control group undertook the same tests mentioned above only 3 days before the training ended. Results  The total score and factor scores except hostility in SCL-90 test were significantly lower after than before systematic mental intervention (P0.05. The total score and factor scores except paranoia in SCL-90 test were significantly lower in study group than in control group after intervention (P0.05, the score of active coping was significantly higher (P<0.001, and of negative coping was significantly lower (P<0.001 after than before intervention. The ratio of the score over 2 and above declined obviously (P<0.05 in neurosis, SCL-90 abnormality, SCL-90 total scores, number of positive items, somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid, and psychotic factor after than before intervention in recruits. Conclusion  Systematic mental intervention, which consisted of combined centralized teaching, group interview and individual consulting, may promote the mental health, personality and coping style in recruits.

  18. The caries-preventive effect of chlorhexidine varnish in children and adolescents: a systematic review.

    LENUS (Irish Health Repository)

    James, Patrice

    2010-01-01

    Our purpose was to systematically review the literature on the effectiveness of chlorhexidine varnish for preventing dental caries in children and adolescents and to determine its effectiveness compared to fluoride varnish.

  19. Prognostic significances of overexpression MYC and/or BCL2 in R-CHOP-treated diffuse large B-cell lymphoma: A Systematic review and meta-analysis.

    Science.gov (United States)

    Li, Lu; Li, Yanyan; Que, Ximei; Gao, Xue; Gao, Qian; Yu, Mingxing; Ma, Kaili; Xi, Yanfeng; Wang, Tong

    2018-04-19

    Numerous studies have investigated the prognostic values of MYC and/or BCL2 protein overexpression in diffuse large B-cell lymphoma (DLBCL). However, the results still demonstrate discrepancies among different studies. We aimed to do a systematic review and meta-analysis on the relationships between overexpression MYC and/or BCL2 and DLBCLs treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). This study followed the guidelines of PRISMA and Cochrane handbook. The hazard ratios (HRs) for overall survival (OS) were pooled to estimate the main effect size. Twenty studies recruited a total of 5576 patients were available for this meta-analysis. The results showed that MYC (HR = 1.96, 95%CI (confidence interval) = 1.69-2.27)without heterogeneity(I 2  = 17.2%, P = 0.280), BCL2 (HR = 1.65, 95%CI = 1.43-1.89, I 2  = 20.7%, P = 0.234) protein overexpression, and co-overexpression (HR = 2.58, 95%CI = 2.19-3.04, I 2  = 17.2%, P = 0.275) had a poor prognosis in R-CHOP treated DLBCL patients, respectively. The current analysis indicated that MYC and/or BCL2 protein overexpression, and particularly co-overexpression was related to short overall survival in R-CHOP treated DLBCL patients, showing that application of the two new biomarkers can help to better stratify DLBCL patients and guide targeted treatment.

  20. The Effectiveness of Dance Interventions to Improve Older Adults' Health: A Systematic Literature Review.

    Science.gov (United States)

    Hwang, Phoebe Woei-Ni; Braun, Kathryn L

    2015-01-01

    Physical inactivity is commonly observed among individuals aged ≥ 60 y. Identified barriers to sedentary older adults beginning activity include low self-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture. Dancing has the potential to be an attractive physical activity that can be adjusted to fit a target population's age, physical limitations, and culture. This review examined the benefits to physical health of dance interventions among older adults. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search using the PubMed database was conducted. Eighteen studies met the inclusion and exclusion criteria and were analyzed for type of intervention, the study's design, participants' demographics, and outcomes, including attrition. The 18 articles reported on studies conducted in North America, South America, Europe, and Asia. Of the styles of dancing, 6 studies used ballroom, 5 used contemporary, 4 used cultural, 1 used pop, and 2 used jazz. Two studies targeted older adults with pre-existing medical conditions. The average age of participants ranged from 52-87 y. Researchers used a variety of measures to assess effectiveness: (1) 3 of 5 (60%) that used measures to assess flexibility showed significant positive results; (2) 23 of 28 (82%) that used measures of muscular strength and endurance showed significant positive changes; (3) 8 of 9 (89%) that used measures of balance showed significant positive changes; (4) 8 of 10 (80%) that used measures of cognitive ability showed significant positive changes; and (5) the one that measured cardiovascular endurance showed significant positive changes. Only 6 studies reported participation, and they found low attrition. The findings suggest that dance, regardless of its style, can significantly improve muscular strength and endurance, balance, and other aspects of functional fitness in older adults. Future

  1. Effects of serum phosphorus on vascular calcification in a healthy, adult population: A systematic review.

    Science.gov (United States)

    Sheridan, Kristin; Logomarsino, John V

    2017-09-01

    Cardiovascular disease has been associated with elevated serum phosphorus levels, which have been associated with cardiovascular mortality. This is commonly seen in the chronic kidney disease (CKD) population where studies have shown that high phosphorus levels cause coronary artery calcification. Although studies have independently associated vascular stiffness and serum phosphorus in those with and without CKD, there are fewer data in individuals without CKD. Therefore, the aim of this systematic review was to analyze whether serum phosphorus levels are associated with cardiovascular calcification in healthy individuals. A systematic review of the literature that was conducted revealed 10 articles, all cross-sectional studies, that met eligibility criteria. These criteria were peer-reviewed studies on a healthy, adult population written in the English language. Studies lacking data on serum phosphorus and measured to assess its association with vascular calcification were excluded. Studies on subjects with CKD, other chronic diseases, or on children were also excluded. Of the 10 studies located, 8 indicated an association between serum phosphorus and vascular calcification. One study did not indicate an association. One study indicated a statistically significant association between serum phosphorus and vascular calcification prevalence, but not incidence. Studies were limited since no randomized controlled trials were available. This systematic review generates gaps in research. Due to considerable amounts of phosphorus additives in the food supply, there may be a connection to dietary phosphorus and vascular calcification. Additionally, phosphorus binders may assist in the prevention of vascular calcification but have not been studied in a healthy population. Further study on both dietary phosphorus restriction and phosphorus binders is needed. While 8 out of 10 cross-sectional studies found an association in this systematic review, the topic of vascular

  2. No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Kjaergaard, Krista D; Jensen, Jens D

    2014-01-01

    Agents blocking the renin-angiotensin-aldosterone system are frequently used in patients with end-stage renal disease, but whether they exert beneficial cardiovascular effects is unclear. Here the long-term effects of the angiotensin II receptor blocker, irbesartan, were studied in hemodialysis......, and residual renal function. Brachial blood pressure decreased significantly in both groups, but there was no significant difference between placebo and irbesartan. Use of additional antihypertensive medication, ultrafiltration volume, and dialysis dosage were not different. Intermediate cardiovascular end...... points such as central aortic blood pressure, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal brain natriuretic prohormone, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic blood pressure during...

  3. Is hydroxychloroquine effective in treating primary Sjogren's syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Shi-Qin; Zhang, Li-Wei; Wei, Pan; Hua, Hong

    2017-05-12

    To systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren's syndrome (pSS). Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospective or prospective studies published in English that reported the effect of HCQ on pSS. The subjective symptoms (sicca symptoms, fatigue and pain) and the objective indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main outcome measures. A meta-analysis and descriptive study on the efficacy and safety of HCQ were conducted. The estimate of the effect of HCQ treatment was expressed as a proportion together with 95% confidence interval, and plotted on a forest plot. Four trials with totals of 215 SS patients, including two randomized controlled trials, one double blind crossover trial and one retrospective open-label study, were analyzed in this review. For dry mouth and dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The efficacy of HCQ in treating pain associated with pSS was superior to that of the placebo. There was no significant difference between HCQ-treated groups and controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte sedimentation rate compare with placebo. A descriptive safety assessment showed that gastrointestinal adverse effects were the most common adverse effects associated with HCQ. This systematic review showed that there is no significant difference between HCQ and placebo in the treatment of dry mouth and dry eye in pSS. Well-designed, randomized, controlled trials are needed to provide higher-quality evidence to confirm our findings, and future studies should focus on some other index or extraglandular measures, such as cutaneous manifestations, to further explore the therapeutic effect of HCQ in

  4. Systematic effects in radon mitigation by sump/pump remediation

    International Nuclear Information System (INIS)

    Groves-Kirkby, C.J.; Denman, A.R.; Groves-Kirkby, C.J.; Woolridge, A.C.; Woolridge, A.C.; Phillips, P.S.; Crockett, R.G.M.; Tornberg, R.

    2006-01-01

    Sump/Pump remediation is widely used in the United Kingdom to mitigate indoor radon gas levels in residential properties. To quantify the effectiveness of this technology, a study was made of radon concentration data from a set of 173 homes situated in radon Affected Areas in and around Northamptonshire, U.K., re-mediated using conventional sump/pump technology. This approach is characterised by a high incidence of satisfactory mitigation outcomes, with more than 75% of the sample exhibiting mitigation factors (defined as the ratio of radon concentrations following and prior to remediation) of 0.2 or better. There is evidence of a systematic trend, where houses with higher initial radon concentrations have higher mitigation factors, suggesting that the total indoor radon concentration within a dwelling can be represented by two components, one susceptible to mitigation by sump/pump remediation, the other remaining essentially unaffected by these remediation strategies. The first component can be identified with ground-radon emanating from the subsoil and bedrock geologies, percolating through the foundations of the dwelling as a component of the soil-gas, potentially capable of being attenuated by sump/pump or radon-barrier remediation. The second contribution is attributed to radon emanating from materials used in the construction of the dwelling, principally concrete and gypsum plaster-board, with a further small contribution from the natural background level, and is essentially unaffected by ground-level remediation strategies. Modelling of such a two-component radon dependency using realistic ground-radon attenuation factors in conjunction with typical structural-radon levels yields behaviour in good agreement with the observed inverse-power dependence of mitigation factor on initial radon concentration. (authors)

  5. Ramadan Fasting Exerts Immunomodulatory Effects: Insights from a Systematic Review

    Science.gov (United States)

    Adawi, Mohammad; Watad, Abdulla; Brown, Stav; Aazza, Khadija; Aazza, Hicham; Zouhir, Mohamed; Sharif, Kassem; Ghanayem, Khaled; Farah, Raymond; Mahagna, Hussein; Fiordoro, Stefano; Sukkar, Samir Giuseppe; Bragazzi, Nicola Luigi; Mahroum, Naim

    2017-01-01

    Ramadan is the ninth month of the Islamic lunar calendar and is observed by Muslims as a month of fasting. All Muslim adults are expected to fast; nevertheless certain subgroups, including sick, frail subjects, and pregnant women, among others, are exempted. Ramadan fasting has been shown to impact on body systems in different manners. The influence of Ramadan fasting on immune system regulation remains elusive; however, immune system changes, such as the modulation of body response to various infectious, stressful, and other harmful events, are of great interest during fasting. In this paper, we performed an extensive systematic literature review of different scholarly databases (ISI/Web of Science, Scopus, PubMed,/MEDLINE, Google Scholar, Directory of Open Access Journals, EbscoHOST, Scirus, Science Direct, the Cochrane Library, and ProQuest), using the following key words: “fasting,” “Ramadan,” “Islam,” and “immunity.” Conclusions drawn from these findings included: (1) Ramadan fasting has been shown to only mildly influence the immune system and the alterations induced are transient, returning to basal pre-Ramadan status shortly afterward. (2) Ramadan fasting during the second trimester of pregnancy was shown to be safe and did not result in negative fetal outcomes, or maternal oxidative status alterations. (3) In cardiac patients, Ramadan fasting can have beneficial effects including lipid profile improvement and alleviation of oxidative stress. (4) In asthmatic patients as well as in patients with human immunodeficiency virus/acquired immunodeficiency syndrome and autoimmune disorders, fasting was safe. (5) In psychiatric patients, such as those suffering from schizophrenia, fasting could increase immunologic markers. (6) Fasting Muslim athletes who maintain intensive training schedule during Ramadan showed fluctuations of immunologic markers. PMID:29230208

  6. Ramadan Fasting Exerts Immunomodulatory Effects: Insights from a Systematic Review

    Directory of Open Access Journals (Sweden)

    Mohammad Adawi

    2017-11-01

    Full Text Available Ramadan is the ninth month of the Islamic lunar calendar and is observed by Muslims as a month of fasting. All Muslim adults are expected to fast; nevertheless certain subgroups, including sick, frail subjects, and pregnant women, among others, are exempted. Ramadan fasting has been shown to impact on body systems in different manners. The influence of Ramadan fasting on immune system regulation remains elusive; however, immune system changes, such as the modulation of body response to various infectious, stressful, and other harmful events, are of great interest during fasting. In this paper, we performed an extensive systematic literature review of different scholarly databases (ISI/Web of Science, Scopus, PubMed,/MEDLINE, Google Scholar, Directory of Open Access Journals, EbscoHOST, Scirus, Science Direct, the Cochrane Library, and ProQuest, using the following key words: “fasting,” “Ramadan,” “Islam,” and “immunity.” Conclusions drawn from these findings included: (1 Ramadan fasting has been shown to only mildly influence the immune system and the alterations induced are transient, returning to basal pre-Ramadan status shortly afterward. (2 Ramadan fasting during the second trimester of pregnancy was shown to be safe and did not result in negative fetal outcomes, or maternal oxidative status alterations. (3 In cardiac patients, Ramadan fasting can have beneficial effects including lipid profile improvement and alleviation of oxidative stress. (4 In asthmatic patients as well as in patients with human immunodeficiency virus/acquired immunodeficiency syndrome and autoimmune disorders, fasting was safe. (5 In psychiatric patients, such as those suffering from schizophrenia, fasting could increase immunologic markers. (6 Fasting Muslim athletes who maintain intensive training schedule during Ramadan showed fluctuations of immunologic markers.

  7. Ramadan Fasting Exerts Immunomodulatory Effects: Insights from a Systematic Review.

    Science.gov (United States)

    Adawi, Mohammad; Watad, Abdulla; Brown, Stav; Aazza, Khadija; Aazza, Hicham; Zouhir, Mohamed; Sharif, Kassem; Ghanayem, Khaled; Farah, Raymond; Mahagna, Hussein; Fiordoro, Stefano; Sukkar, Samir Giuseppe; Bragazzi, Nicola Luigi; Mahroum, Naim

    2017-01-01

    Ramadan is the ninth month of the Islamic lunar calendar and is observed by Muslims as a month of fasting. All Muslim adults are expected to fast; nevertheless certain subgroups, including sick, frail subjects, and pregnant women, among others, are exempted. Ramadan fasting has been shown to impact on body systems in different manners. The influence of Ramadan fasting on immune system regulation remains elusive; however, immune system changes, such as the modulation of body response to various infectious, stressful, and other harmful events, are of great interest during fasting. In this paper, we performed an extensive systematic literature review of different scholarly databases (ISI/Web of Science, Scopus, PubMed,/MEDLINE, Google Scholar, Directory of Open Access Journals, EbscoHOST, Scirus, Science Direct, the Cochrane Library, and ProQuest), using the following key words: "fasting," "Ramadan," "Islam," and "immunity." Conclusions drawn from these findings included: (1) Ramadan fasting has been shown to only mildly influence the immune system and the alterations induced are transient, returning to basal pre-Ramadan status shortly afterward. (2) Ramadan fasting during the second trimester of pregnancy was shown to be safe and did not result in negative fetal outcomes, or maternal oxidative status alterations. (3) In cardiac patients, Ramadan fasting can have beneficial effects including lipid profile improvement and alleviation of oxidative stress. (4) In asthmatic patients as well as in patients with human immunodeficiency virus/acquired immunodeficiency syndrome and autoimmune disorders, fasting was safe. (5) In psychiatric patients, such as those suffering from schizophrenia, fasting could increase immunologic markers. (6) Fasting Muslim athletes who maintain intensive training schedule during Ramadan showed fluctuations of immunologic markers.

  8. Interventions to significantly improve service uptake and retention of HIV-positive pregnant women and HIV-exposed infants along the prevention of mother-to-child transmission continuum of care: systematic review.

    Science.gov (United States)

    Vrazo, Alexandra C; Firth, Jacqueline; Amzel, Anouk; Sedillo, Rebecca; Ryan, Julia; Phelps, B Ryan

    2018-02-01

    Despite the success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programmes, low uptake of services and poor retention pose a formidable challenge to achieving the elimination of vertical HIV transmission in low- and middle-income countries. This systematic review summarises interventions that demonstrate statistically significant improvements in service uptake and retention of HIV-positive pregnant and breastfeeding women and their infants along the PMTCT cascade. Databases were systematically searched for peer-reviewed studies. Outcomes of interest included uptake of services, such as antiretroviral therapy (ART) such as initiation, early infant diagnostic testing, and retention of HIV-positive pregnant and breastfeeding women and their infants. Interventions that led to statistically significant outcomes were included and mapped to the PMTCT cascade. An eight-item assessment tool assessed study rigour. CRD42017063816. Of 686 citations reviewed, 11 articles met inclusion criteria. Ten studies detailed maternal outcomes and seven studies detailed infant outcomes in PMTCT programmes. Interventions to increase access to antenatal care (ANC) and ART services (n = 4) and those using lay cadres (n = 3) were most common. Other interventions included quality improvement (n = 2), mHealth (n = 1), and counselling (n = 1). One study described interventions in an Option B+ programme. Limitations included lack of HIV testing and counselling and viral load monitoring outcomes, small sample size, geographical location, and non-randomized assignment and selection of participants. Interventions including ANC/ART integration, family-centred approaches, and the use of lay healthcare providers are demonstrably effective in increasing service uptake and retention of HIV-positive mothers and their infants in PMTCT programmes. Future studies should include control groups and assess whether interventions developed in the context of earlier 'Options' are

  9. Effects of racing games on risky driving behaviour, and the significance of personality and physiological data.

    Science.gov (United States)

    Deng, Mingming; Chan, Alan H S; Wu, Feng; Wang, Jun

    2015-08-01

    Racing games have emerged as top-selling products in the video and computer game industry. The effect of playing racing games on the inclination of gamers to take risks has been investigated. Two experiments were conducted. In experiment 1, the impact of personality traits on the effects of playing racing games on risk-taking inclination was examined. The Vienna Test System, which includes the Eysenck Personality Profile Test and the Vienna Risk-Taking Test, was used to measure risk-taking inclination and risk-taking while driving. Experiment 2 was designed and conducted to analyse the effects of different intensity levels of car racing games on risk-taking inclination, and to study the relationship between physiological data and risk-taking inclination. Physiological data on skin conductance, heart rate and blood pressure were measured with the NeuroDyne System. Participants playing a racing game were more inclined to take risks in critical road traffic situations than those playing a neutral game. The adventurousness dimension of the Eysenck Personality Profile Test correlated significantly positively with risk-taking inclination. More importantly, the effect of the intensity level of a racing game on risk-taking inclination was significant. The higher the intensity level of the racing game, the higher the risk-taking inclination while driving. The effect of intensity level of the racing game on skin conductance was significantly positive. Skin conductance correlated significantly positively with risk-taking inclination. The effect of playing racing games on risk-taking inclination is linked to personality and physiological data. Some recommendations are proposed as a result of this study for racing game management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Ruixue Huang

    2016-08-01

    Full Text Available It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder = −0.30, 95% CI (−0.51–−0.09, p = 0.005 in the subjects. Probiotics had an effect on both the healthy population (MD = −0.25, 95% CI (−0.47–−0.03, p = 0.03 and patients with major depressive disorder (MDD (MD = −0.73, 95% CI (−1.37–−0.09, p = 0.03. Probiotics had an effect on the population aged under 60 (MD = −0.43, 95% CI (−0.72–−0.13, p = 0.005, while it had no effect on people aged over 65 (MD = −0.18, 95% CI (−0.47–0.11, p = 0.22. This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.

  11. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Huang, Ruixue; Wang, Ke; Hu, Jianan

    2016-08-06

    It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder) = -0.30, 95% CI (-0.51--0.09), p = 0.005) in the subjects. Probiotics had an effect on both the healthy population (MD = -0.25, 95% CI (-0.47--0.03), p = 0.03) and patients with major depressive disorder (MDD) (MD = -0.73, 95% CI (-1.37--0.09), p = 0.03). Probiotics had an effect on the population aged under 60 (MD = -0.43, 95% CI (-0.72--0.13), p = 0.005), while it had no effect on people aged over 65 (MD = -0.18, 95% CI (-0.47-0.11), p = 0.22). This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.

  12. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

    Science.gov (United States)

    Rando-Matos, Yolanda; Pons-Vigués, Mariona; López, María José; Córdoba, Rodrigo; Ballve-Moreno, José Luis; Puigdomènech-Puig, Elisa; Benito-López, Vega Estíbaliz; Arias-Agudelo, Olga Lucía; López-Grau, Mercè; Guardia-Riera, Anna; Trujillo, José Manuel; Martin-Cantera, Carlos

    2017-01-01

    The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36%) than for asthma (5-31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.

  13. The effect of additional physiotherapy to hospital inpatients outside of regular business hours: a systematic review.

    Science.gov (United States)

    Brusco, Natasha K; Paratz, Jennifer

    2006-12-01

    Provision of out of regular business hours (OBH) physiotherapy to hospital inpatients is widespread in the hospital setting. This systematic review evaluated the effect of additional OBH physiotherapy services on patient length of stay (LOS), pulmonary complications, discharge destination, discharge mobility status, quality of life, cost saving, adverse events, and mortality compared with physiotherapy only within regular business hours. A literature search was completed on databases with citation tracking using key words. Two reviewers completed data extraction and quality assessment independently by using modified scales for historical cohorts and case control studies as well as the PEDro scale for randomized controlled trials and quasi-randomised controlled trials. This search identified nine articles of low to medium quality. Four reported a significant reduction in LOS associated with additional OBH physiotherapy, with two articles reporting overall significance and two reporting only for specific subgroups. Two studies reported significant reduction in pulmonary complications for two different patient groups in an intensive care unit (ICU) with additional OBH physiotherapy. Three studies accounted for discharge destination and/or discharge mobility status with no significant difference reported. Quality of life, adverse events, and mortality were not reported in any studies. Cost savings were considered in three studies, with two reporting a cost saving. This systematic review was unable to conclude that the provision of additional OBH physiotherapy made significant improvement to patient outcomes for all subgroups of inpatients. One study in critical care reported that overnight physiotherapy decreased LOS and reduced pulmonary complications of patients in the ICU. However, the studies in the area of orthopaedics, neurology, postcardiac surgery, and rheumatology, which all considered additional daytime weekend physiotherapy intervention, did not provide

  14. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yolanda Rando-Matos

    Full Text Available The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose among all populations.Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1 original scientific studies about smokefree legislation, 2 Data before and after legislation were collected, and 3 Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment.A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers. Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months. Four (50% of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36% than for asthma (5-31%. Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46% of the studies.Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms and, to a lesser degree, rates of hospitalization for

  15. The effects of sleep loss on young drivers' performance: A systematic review.

    Directory of Open Access Journals (Sweden)

    Shamsi Shekari Soleimanloo

    Full Text Available Young drivers (18-24 years are over-represented in sleep-related crashes (comprising one in five fatal crashes in developed countries primarily due to decreased sleep opportunity, lower tolerance for sleep loss, and ongoing maturation of brain areas associated with driving-related decision making. Impaired driving performance is the proximal reason for most car crashes. There is still a limited body of evidence examining the effects of sleep loss on young drivers' performance, with discrepancies in the methodologies used, and in the definition of outcomes. This study aimed to identify the direction and magnitude of the effects of sleep loss on young drivers' performance, and to appraise the quality of current evidence via a systematic review. Based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA approach, 16 eligible studies were selected for review, and their findings summarised. Next, critical elements of these studies were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE guidelines augmented to rate those elements. Using those criteria, the quality of individual papers was calculated and the overall body of evidence for each driving outcome were assigned a quality ranking (from 'very low' to 'high-quality'. Two metrics, the standard deviation of lateral position and number of line crossings, were commonly reported outcomes (although in an overall 'low-quality' body of evidence, with significant impairments after sleep loss identified in 50% of studies. While speed-related outcomes and crash events (also with very low- quality evidence both increased under chronic sleep loss, discrepant findings were reported under conditions of acute total sleep deprivation. It is crucial to obtain more reliable data about the effects of sleep loss on young drivers' performance by using higher quality experimental designs, adopting common protocols, and the use of consistent

  16. Measuring and modelling the effects of systematic non-adherence to mass drug administration

    Directory of Open Access Journals (Sweden)

    Louise Dyson

    2017-03-01

    Full Text Available It is well understood that the success or failure of a mass drug administration campaign critically depends on the level of coverage achieved. To that end coverage levels are often closely scrutinised during campaigns and the response to underperforming campaigns is to attempt to improve coverage. Modelling work has indicated, however, that the quality of the coverage achieved may also have a significant impact on the outcome. If the coverage achieved is likely to miss similar people every round then this can have a serious detrimental effect on the campaign outcome. We begin by reviewing the current modelling descriptions of this effect and introduce a new modelling framework that can be used to simulate a given level of systematic non-adherence. We formalise the likelihood that people may miss several rounds of treatment using the correlation in the attendance of different rounds. Using two very simplified models of the infection of helminths and non-helminths, respectively, we demonstrate that the modelling description used and the correlation included between treatment rounds can have a profound effect on the time to elimination of disease in a population. It is therefore clear that more detailed coverage data is required to accurately predict the time to disease elimination. We review published coverage data in which individuals are asked how many previous rounds they have attended, and show how this information may be used to assess the level of systematic non-adherence. We note that while the coverages in the data found range from 40.5% to 95.5%, still the correlations found lie in a fairly narrow range (between 0.2806 and 0.5351. This indicates that the level of systematic non-adherence may be similar even in data from different years, countries, diseases and administered drugs.

  17. Clinical Effectiveness of Aloe Vera in the Management of Oral Mucosal Diseases- A Systematic Review

    Science.gov (United States)

    Nair, Gopakumar Ramachandran; Naidu, Giridhar Seetharam; Jain, Supreet; Makkad, Ramanpal Singh; Jha, Abhishek

    2016-01-01

    Introduction Aloe vera is well known for its medicinal properties which lead to its application in treating various diseases. Its use in treating oral lesions has not been much documented in literature. Aim Although, systematic reviews on aloe vera and its extracts have been done earlier, but in relation to oral diseases this is the first systematic review. The aim of the present systematic review was to compile evidence based studies on the effectiveness of Aloe vera in treatment of various oral diseases. Materials and Methods Computerized literature searches were performed to identify all published articles in the subject. The following databases were used: PUBMED [MEDLINE], SCOPUS, COCHRANE DATABASE, EMBASE and SCIENCE DIRECT using specific keywords. The search was limited to articles published in English or with an English Abstract. All articles (or abstracts if available as abstracts) were read in full. Data were extracted in a predefined fashion. Assessment was done using Jadad score. Results Fifteen studies satisfied the inclusion criteria. Population of sample study ranged from 20 patients to 110 patients with clinically diagnosed oral mucosal lesions. Out of 15 studies, five were on patients with oral lichen planus, two on patients with oral submucous fibrosis, other studies were carried on patients with burning mouth syndrome, radiation induced mucositis, candida associated denture stomatitis, xerostomic patients and four were on minor recurrent apthous stomatitis. Most studies showed statistically significant result demonstrating the effectiveness of Aloe vera in treatment of oral diseases. Conclusion Although there are promising results but in future, more controlled clinical trials are required to prove the effectiveness of Aloe vera for management of oral diseases. PMID:27656587

  18. Effects of Turmeric (Curcuma longa) on Skin Health: A Systematic Review of the Clinical Evidence.

    Science.gov (United States)

    Vaughn, Alexandra R; Branum, Amy; Sivamani, Raja K

    2016-08-01

    Turmeric (Curcuma longa), a commonly used spice throughout the world, has been shown to exhibit antiinflammatory, antimicrobial, antioxidant, and anti-neoplastic properties. Growing evidence shows that an active component of turmeric, curcumin, may be used medically to treat a variety of dermatologic diseases. This systematic review was conducted to examine the evidence for the use of both topical and ingested turmeric/curcumin to modulate skin health and function. The PubMed and Embase databases were systematically searched for clinical studies involving humans that examined the relationship between products containing turmeric, curcumin, and skin health. A total of 234 articles were uncovered, and a total of 18 studies met inclusion criteria. Nine studies evaluated the effects of ingestion, eight studies evaluated the effects of topical, and one study evaluated the effects of both ingested and topical application of turmeric/curcumin. Skin conditions examined include acne, alopecia, atopic dermatitis, facial photoaging, oral lichen planus, pruritus, psoriasis, radiodermatitis, and vitiligo. Ten studies noted statistically significant improvement in skin disease severity in the turmeric/curcumin treatment groups compared with control groups. Overall, there is early evidence that turmeric/curcumin products and supplements, both oral and topical, may provide therapeutic benefits for skin health. However, currently published studies are limited and further studies will be essential to better evaluate efficacy and the mechanisms involved. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Research Pearls: The Significance of Statistics and Perils of Pooling. Part 3: Pearls and Pitfalls of Meta-analyses and Systematic Reviews.

    Science.gov (United States)

    Harris, Joshua D; Brand, Jefferson C; Cote, Mark P; Dhawan, Aman

    2017-08-01

    Within the health care environment, there has been a recent and appropriate trend towards emphasizing the value of care provision. Reduced cost and higher quality improve the value of care. Quality is a challenging, heterogeneous, variably defined concept. At the core of quality is the patient's outcome, quantified by a vast assortment of subjective and objective outcome measures. There has been a recent evolution towards evidence-based medicine in health care, clearly elucidating the role of high-quality evidence across groups of patients and studies. Synthetic studies, such as systematic reviews and meta-analyses, are at the top of the evidence-based medicine hierarchy. Thus, these investigations may be the best potential source of guiding diagnostic, therapeutic, prognostic, and economic medical decision making. Systematic reviews critically appraise and synthesize the best available evidence to provide a conclusion statement (a "take-home point") in response to a specific answerable clinical question. A meta-analysis uses statistical methods to quantitatively combine data from single studies. Meta-analyses should be performed with high methodological quality homogenous studies (Level I or II) or evidence randomized studies, to minimize confounding variable bias. When it is known that the literature is inadequate or a recent systematic review has already been performed with a demonstration of insufficient data, then a new systematic review does not add anything meaningful to the literature. PROSPERO registration and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines assist authors in the design and conduct of systematic reviews and should always be used. Complete transparency of the conduct of the review permits reproducibility and improves fidelity of the conclusions. Pooling of data from overly dissimilar investigations should be avoided. This particularly applies to Level IV evidence, that is, noncomparative investigations

  20. The effectiveness of public health interventions to reduce the health impact of climate change: a systematic review of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Maha Bouzid

    Full Text Available BACKGROUND: Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases. METHODS AND FINDINGS: For each disease, we performed a systematic search with no restriction on date or language of publication on Medline, Web of Knowledge, Cochrane CENTRAL and SCOPUS up to December 2010 to identify systematic reviews of public health interventions. We retrieved some 3176 records of which 85 full papers were assessed and 33 included in the review. The included papers investigated the effect of public health interventions on various outcome measures. All interventions were GRADE assessed to determine the strength of evidence. In addition we developed a systematic review quality score. The interventions included environmental interventions to control vectors, chemoprophylaxis, immunization, household and community water treatment, greening cities and community advice. For most reviews, GRADE showed low quality of evidence because of poor study design and high heterogeneity. Also for some key areas such as floods, droughts and other weather extremes, there are no adequate systematic reviews of potential public health interventions. CONCLUSION: In conclusion, we found the evidence base to be mostly weak for environmental interventions that could have the most value in a warmer world. Nevertheless, such interventions should not be dismissed. Future research on public health interventions for climate change adaptation needs to be concerned about quality in study design and should address the gap for floods, droughts and other extreme weather events that pose a risk to health.

  1. The effectiveness of public health interventions to reduce the health impact of climate change: a systematic review of systematic reviews.

    Science.gov (United States)

    Bouzid, Maha; Hooper, Lee; Hunter, Paul R

    2013-01-01

    Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases. For each disease, we performed a systematic search with no restriction on date or language of publication on Medline, Web of Knowledge, Cochrane CENTRAL and SCOPUS up to December 2010 to identify systematic reviews of public health interventions. We retrieved some 3176 records of which 85 full papers were assessed and 33 included in the review. The included papers investigated the effect of public health interventions on various outcome measures. All interventions were GRADE assessed to determine the strength of evidence. In addition we developed a systematic review quality score. The interventions included environmental interventions to control vectors, chemoprophylaxis, immunization, household and community water treatment, greening cities and community advice. For most reviews, GRADE showed low quality of evidence because of poor study design and high heterogeneity. Also for some key areas such as floods, droughts and other weather extremes, there are no adequate systematic reviews of potential public health interventions. In conclusion, we found the evidence base to be mostly weak for environmental interventions that could have the most value in a warmer world. Nevertheless, such interventions should not be dismissed. Future research on public health interventions for climate change adaptation needs to be concerned about quality in study design and should address the gap for floods, droughts and other extreme weather events that pose a risk to health.

  2. Peer review of health research funding proposals: A systematic map and systematic review of innovations for effectiveness and efficiency.

    Science.gov (United States)

    Shepherd, Jonathan; Frampton, Geoff K; Pickett, Karen; Wyatt, Jeremy C

    2018-01-01

    To investigate methods and processes for timely, efficient and good quality peer review of research funding proposals in health. A two-stage evidence synthesis: (1) a systematic map to describe the key characteristics of the evidence base, followed by (2) a systematic review of the studies stakeholders prioritised as relevant from the map on the effectiveness and efficiency of peer review 'innovations'. Standard processes included literature searching, duplicate inclusion criteria screening, study keyword coding, data extraction, critical appraisal and study synthesis. A total of 83 studies from 15 countries were included in the systematic map. The evidence base is diverse, investigating many aspects of the systems for, and processes of, peer review. The systematic review included eight studies from Australia, Canada, and the USA, evaluating a broad range of peer review innovations. These studies showed that simplifying the process by shortening proposal forms, using smaller reviewer panels, or expediting processes can speed up the review process and reduce costs, but this might come at the expense of peer review quality, a key aspect that has not been assessed. Virtual peer review using videoconferencing or teleconferencing appears promising for reducing costs by avoiding the need for reviewers to travel, but again any consequences for quality have not been adequately assessed. There is increasing international research activity into the peer review of health research funding. The studies reviewed had methodological limitations and variable generalisability to research funders. Given these limitations it is not currently possible to recommend immediate implementation of these innovations. However, many appear promising based on existing evidence, and could be adapted as necessary by funders and evaluated. Where feasible, experimental evaluation, including randomised controlled trials, should be conducted, evaluating impact on effectiveness, efficiency and quality.

  3. Peer review of health research funding proposals: A systematic map and systematic review of innovations for effectiveness and efficiency

    Science.gov (United States)

    Frampton, Geoff K.; Pickett, Karen; Wyatt, Jeremy C.

    2018-01-01

    Objective To investigate methods and processes for timely, efficient and good quality peer review of research funding proposals in health. Methods A two-stage evidence synthesis: (1) a systematic map to describe the key characteristics of the evidence base, followed by (2) a systematic review of the studies stakeholders prioritised as relevant from the map on the effectiveness and efficiency of peer review ‘innovations’. Standard processes included literature searching, duplicate inclusion criteria screening, study keyword coding, data extraction, critical appraisal and study synthesis. Results A total of 83 studies from 15 countries were included in the systematic map. The evidence base is diverse, investigating many aspects of the systems for, and processes of, peer review. The systematic review included eight studies from Australia, Canada, and the USA, evaluating a broad range of peer review innovations. These studies showed that simplifying the process by shortening proposal forms, using smaller reviewer panels, or expediting processes can speed up the review process and reduce costs, but this might come at the expense of peer review quality, a key aspect that has not been assessed. Virtual peer review using videoconferencing or teleconferencing appears promising for reducing costs by avoiding the need for reviewers to travel, but again any consequences for quality have not been adequately assessed. Conclusions There is increasing international research activity into the peer review of health research funding. The studies reviewed had methodological limitations and variable generalisability to research funders. Given these limitations it is not currently possible to recommend immediate implementation of these innovations. However, many appear promising based on existing evidence, and could be adapted as necessary by funders and evaluated. Where feasible, experimental evaluation, including randomised controlled trials, should be conducted, evaluating impact

  4. Systematic review: ursodeoxycholic acid--adverse effects and drug interactions

    NARCIS (Netherlands)

    Hempfling, W.; Dilger, K.; Beuers, U.

    2003-01-01

    BACKGROUND: Ursodeoxycholic acid is increasingly being used for the treatment of chronic cholestatic liver diseases. It appears to be generally well tolerated, but a systematic review on drug safety is lacking. AIM: As experimental data suggest a role of bile acids in the regulation of hepatic drug

  5. A systematic review of health effects of electronic cigarettes

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Døssing, Martin

    2014-01-01

    OBJECTIVE: To provide a systematic review of the existing literature on health consequences of vaporing of electronic cigarettes (ECs). METHODS: Search in: PubMed, EMBASE and CINAHL. INCLUSION CRITERIA: Original publications describing a health-related topic, published before 14 August 2014. PRISMA...

  6. p-Curve and Effect Size: Correcting for Publication Bias Using Only Significant Results.

    Science.gov (United States)

    Simonsohn, Uri; Nelson, Leif D; Simmons, Joseph P

    2014-11-01

    Journals tend to publish only statistically significant evidence, creating a scientific record that markedly overstates the size of effects. We provide a new tool that corrects for this bias without requiring access to nonsignificant results. It capitalizes on the fact that the distribution of significant p values, p-curve, is a function of the true underlying effect. Researchers armed only with sample sizes and test results of the published findings can correct for publication bias. We validate the technique with simulations and by reanalyzing data from the Many-Labs Replication project. We demonstrate that p-curve can arrive at conclusions opposite that of existing tools by reanalyzing the meta-analysis of the "choice overload" literature. © The Author(s) 2014.

  7. The Effects of Probiotics and Symbiotics on Risk Factors for Hepatic Encephalopathy: A Systematic Review.

    Science.gov (United States)

    Viramontes Hörner, Daniela; Avery, Amanda; Stow, Ruth

    2017-04-01

    Alterations in the levels of intestinal microbiota, endotoxemia, and inflammation are novel areas of interest in the pathogenesis of hepatic encephalopathy (HE). Probiotics and symbiotics are a promising treatment option for HE due to possible beneficial effects in modulating gut microflora and might be better tolerated and more cost-effective than the traditional treatment with lactulose, rifaximin or L-ornithine-L-aspartate. A systematic search of the electronic databases PubMed, ISI Web of Science, EMBASE, and Cochrane Library was conducted for randomized controlled clinical trials in adult patients with cirrhosis, evaluating the effect of probiotics and symbiotics in changes on intestinal microflora, reduction of endotoxemia, inflammation, and ammonia, reversal of minimal hepatic encephalopathy (MHE), prevention of overt hepatic encephalopathy (OHE), and improvement of quality of life. Nineteen trials met the inclusion criteria. Probiotics and symbiotics increased beneficial microflora and decreased pathogenic bacteria and endotoxemia compared with placebo/no treatment, but no effect was observed on inflammation. Probiotics significantly reversed MHE [risk ratio, 1.53; 95% confidence interval (CI): 1.14, 2.05; P=0.005] and reduced OHE development (risk ratio, 0.62; 95% CI: 0.48, 0.80; P=0.0002) compared with placebo/no treatment. Symbiotics significantly decreased ammonia levels compared with placebo (15.24; 95% CI: -26.01, -4.47; P=0.006). Probiotics did not show any additional benefit on reversal of MHE and prevention of OHE development when compared with lactulose, rifaximin, and L-ornithine-L-aspartate. Only 5 trials considered tolerance with minimal side effects reported. Although further research is warranted, probiotics and symbiotics should be considered as an alternative therapy for the treatment and management of HE given the results reported in this systematic review.

  8. Systematic review and metaanalysis of statins for heterozygous familial hypercholesterolemia in children: evaluation of cholesterol changes and side effects.

    LENUS (Irish Health Repository)

    O'Gorman, Clodagh S

    2012-02-01

    Heterozygous familial hypercholesterolemia (heFH) affects 1 in 500 individuals. Evidence supports the low-density lipoprotein (LDL)-lowering effect of statins for adults with heFH. However, there are concerns regarding the treatment children with heFH. By performing a systematic review and metaanalysis of the published literature, this study aimed to evaluate the efficacy and safety of statins used for children with heFH. A systematic review was performed by searching multiple medical databases and citations to identify reports of randomized controlled trials of statins used to treat children with heFH. The trials were retrieved, reviewed, and subjected to metaanalysis. The search yielded 2,174 titles. Of the 63 studies retrieved and reviewed, 56 were excluded, 7 were included in the systematic review, and 4 were included in the metaanalysis. Significant heterogeneity was detected. The metaanalysis showed significant LDL lowering, high-density lipoprotein (HDL) cholesterol elevation, and increases in height and weight with statins. The metaanalysis could not be performed for many side effects of statins, but individual trials showed no significant side effects. Quality assessment showed methodologic concerns, with potential for bias. For example, six trials analyzed statin effects without intention to treat despite such a stated intention. Metaanalysis shows significant LDL lowering with statin treatment. Further studies, including epidemiologic and multicenter studies, are required.

  9. A Systematic Overview of Radiation Therapy Effects in Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Gustavsson, Anita; Osterman, Birgitta; Cavallin-Staahl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was carried out by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for Hodgkin's lymphoma (HL) is based on data from 12 randomized trials and 2 meta-analyses. Data from 3 prospective studies, 29 retrospective studies and 58 other articles were also used. In total, 58 scientific articles are included, involving 27,280 patients. The results were compared with those of a similar overview from 1996 including 38,362 patients. The conclusions reached can be summarized thus: Solid scientific documentation shows that in patients with HL more than 80% in the early stages and 60-70% of younger patients in advanced stages of disease are now cured by the development of radiotherapy and combination chemotherapy. Long-term follow-up shows that after 15 to 20 years the mortality from HL in early and intermediate stages is exceeded by other causes of death, mostly secondary malignancies and cardiac deaths, especially myocardial infarction. Convincing data show that radiotherapy plays a major role in the development of solid cancers and cardiovascular disease, but no randomized trials have been performed. During the past decade increasing awareness of fatal long-term sequelae has fundamentally changed treatment strategies in early and intermediate stages. A thorough long-term follow-up is essential to evaluate the effects of the modifications of the therapy. In early stages of disease extended field irradiation is now replaced by short periods of chemotherapy followed by limited radiotherapy to decrease late sequelae. This approach is strongly supported by early reports from randomized trials. Final results cannot be fully evaluated for many years. The optimal radiation dose and volume after chemotherapy are not defined or if irradiation is needed at all

  10. The effectiveness of e-Interventions on reducing social isolation in older persons: A systematic review of systematic reviews.

    Science.gov (United States)

    Chipps, Jennifer; Jarvis, Mary Ann; Ramlall, Suvira

    2017-12-01

    As the older adult population group has been increasing in size, there has been evidence of growing social isolation and loneliness in their lives. The increased use of information communication technology and Internet-supported interventions has stimulated an interest in the benefits of e-Interventions for older people and specifically in having a role in increasing social networks and decreasing loneliness. A systematic review of e-Interventions to reduce loneliness in older people was conducted with the aim to synthesize high quality evidence on the effectiveness of e-Interventions to decrease social isolation/loneliness for older people living in community/residential care. A systematic search of 12 databases for reviews published between 2000-2017 was conducted using search term synonyms for older people, social isolation and interventions. Three independent researchers screened articles and two reviewers extracted data. The Revised-Assessment of Multiple Systematic Reviews was used to assess the quality of reviews. The final search identified 12 reviews, which included 22 unique primary research studies evaluating e-Interventions for social isolation or loneliness. The reviews were of moderate quality and the primary studies showed a lack of rigor. Loneliness was most frequently measured using the University California Los Angeles Loneliness Scale. Despite the limitations of the reviewed studies, there is inconsistent and weak evidence on using e-Interventions for loneliness in older people.

  11. Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Mitra, Souvik; Florez, Ivan D; Tamayo, Maria E; Mbuagbaw, Lawrence; Vanniyasingam, Thuva; Veroniki, Areti Angeliki; Zea, Adriana M; Zhang, Yuan; Sadeghirad, Behnam; Thabane, Lehana

    2018-03-27

    Despite increasing emphasis on conservative management of patent ductus arteriosus (PDA) in preterm infants, different pharmacotherapeutic interventions are used to treat those developing a hemodynamically significant PDA. To estimate the relative likelihood of hemodynamically significant PDA closure with common pharmacotherapeutic interventions and to compare adverse event rates. The databases of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until August 15, 2015, and updated on December 31, 2017, along with conference proceedings up to December 2017. Randomized clinical trials that enrolled preterm infants with a gestational age younger than 37 weeks treated with intravenous or oral indomethacin, ibuprofen, or acetaminophen vs each other, placebo, or no treatment for a clinically or echocardiographically diagnosed hemodynamically significant PDA. Data were independently extracted in pairs by 6 reviewers and synthesized with Bayesian random-effects network meta-analyses. Primary outcome: hemodynamically significant PDA closure; secondary: included surgical closure, mortality, necrotizing enterocolitis, and intraventricular hemorrhage. In 68 randomized clinical trials of 4802 infants, 14 different variations of indomethacin, ibuprofen, or acetaminophen were used as treatment modalities. The overall PDA closure rate was 67.4% (2867 of 4256 infants). A high dose of oral ibuprofen was associated with a significantly higher odds of PDA closure vs a standard dose of intravenous ibuprofen (odds ratio [OR], 3.59; 95% credible interval [CrI], 1.64-8.17; absolute risk difference, 199 [95% CrI, 95-258] more per 1000 infants) and a standard dose of intravenous indomethacin (OR, 2.35 [95% CrI, 1.08-5.31]; absolute risk difference, 124 [95% CrI, 14-188] more per 1000 infants). Based on the ranking statistics, a high dose of oral ibuprofen ranked as the best pharmacotherapeutic option for PDA closure (mean surface under the

  12. [Effects of tai chi in postmenopausal women with osteoporosis: a systematic review].

    Science.gov (United States)

    Chang, Ting-Jung; Ting, Yu-Ting; Sheu, Shei-Lan; Chang, Hsiao-Yun

    2014-10-01

    Tai chi has been increasingly applied in osteoporosis patients. However, systematic reviews of the efficacy of this practice have been few and of limited scope. This study reviews previous experimental research work using tai chi as an intervention in postmenopausal women with osteoporosis and to appraise the reported research designs used, tai chi methods used, and outcomes. A systematic review method was used to search 14 databases for articles published between January 1980 and July 2013. Searched keywords included: "tai chi," "osteoporosis," and "postmenopausal women". The 2,458 articles initially identified were reduced to 4 valid articles based on considerations of criteria and repeatability. The 4 valid articles used either a randomized clinical trial (RCT) or a controlled clinical trial (CCT). They were further analyzed and synthesized in terms of common variables such as balance, muscle strength, and quality of life. Three of the 4 studies identified significant pretest / posttest differences in physiological aspects of quality of life in participants but did not obtain consistent results in terms of the psychological aspects. While reports identified a significant and positive tai chi effect on balance, they all used different measurements to do so. Only one of the four studies identified significant improvement in muscle strength. Therefore, this review could not identify clear support for the effectiveness of tai chi on balance or muscle strength. This review did not definitively support the positive effects of tai chi on balance, muscle strength, and quality of life in postmenopausal women with osteoporosis. The designs used in the tai chi interventions may be referenced for future studies. We suggest that future studies use data triangulation rather than a single-item tool to validate the research in order to cross-verify the same information. This may strengthen the research and increase the credibility and the validity of related findings.

  13. A Systematic Review of the Anxiolytic-Like Effects of Essential Oils in Animal Models

    Directory of Open Access Journals (Sweden)

    Damião Pergentino de Sousa

    2015-10-01

    Full Text Available The clinical efficacy of standardized essential oils (such as Lavender officinalis, in treating anxiety disorders strongly suggests that these natural products are an important candidate source for new anxiolytic drugs. A systematic review of essential oils, their bioactive constituents, and anxiolytic-like activity is conducted. The essential oil with the best profile is Lavendula angustifolia, which has already been tested in controlled clinical trials with positive results. Citrus aurantium using different routes of administration also showed significant effects in several animal models, and was corroborated by different research groups. Other promising essential oils are Citrus sinensis and bergamot oil, which showed certain clinical anxiolytic actions; along with Achillea wilhemsii, Alpinia zerumbet, Citrus aurantium, and Spiranthera odoratissima, which, like Lavendula angustifolia, appear to exert anxiolytic-like effects without GABA/benzodiazepine activity, thus differing in their mechanisms of action from the benzodiazepines. The anxiolytic activity of 25 compounds commonly found in essential oils is also discussed.

  14. A systematic review of the effectiveness of palliative interventions to treat rectal tenesmus in cancer.

    Science.gov (United States)

    Ní Laoire, Áine; Fettes, Lucy; Murtagh, Fliss Em

    2017-12-01

    Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from date of inception to April 2016. PubMed 'related articles' search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat tenesmus were excluded. Studies involving interventions to treat pelvic pain syndromes without specific outcome measures on severity of tenesmus were excluded. The quality of the studies was assessed using a National Institute for Health and Clinical Excellence-recommended quality assessment tool. From 861 studies, 9 met full criteria and were selected. All were case series investigating the use of pharmacological interventions (diltiazem, nifedipine, methadone, mexiletine hydrochloride, lidocaine and bupivacaine), anaesthetic interventions (lumbar sympathectomy, neurolytic superior hypogastric plexus block), and endoscopic laser interventions. The included studies showed substantial heterogeneity, and therefore, a meta-analysis was not feasible. From this review, we identified a significant gap in research into the palliation of rectal tenesmus. A multimodal approach may be necessary due to the complexity of the pathophysiology of tenesmus. Future research should focus on randomised controlled trials of drug therapies whose potential

  15. Respiratory health effects of exposure to low levels of airborne endotoxin - a systematic review.

    Science.gov (United States)

    Farokhi, Azadèh; Heederik, Dick; Smit, Lidwien A M

    2018-02-08

    Elevated endotoxin levels have been measured in ambient air around livestock farms, which is a cause of concern for neighbouring residents. There is clear evidence that occupational exposure to high concentrations of airborne endotoxin causes respiratory inflammation, respiratory symptoms and lung function decline. However, health effects of exposure to low levels of endotoxin are less well described. The aim of this systematic review is to summarize published associations between exposure to relatively low levels of airborne endotoxin and respiratory health endpoints. Studies investigating respiratory effects of measured or modelled exposure to low levels of airborne endotoxin (average effects of exposure to low levels of endotoxin on respiratory symptoms and lung function. However, considerable heterogeneity existed in the outcomes of the included studies and no overall estimate could be provided by meta-analysis to quantify the possible relationship. Instead, a best evidence synthesis was performed among studies examining the exposure-response relationship between endotoxin and respiratory outcomes. Significant exposure-response relationships between endotoxin and symptoms and FEV 1 were shown in several studies, with no conflicting findings in the studies included in the best evidence synthesis. Significantly different effects of endotoxin exposure were also seen in vulnerable subgroups (atopics and patients with broncho-obstructive disease) and smokers. Respiratory health effects of exposure to low levels of airborne endotoxin (health effects, especially in vulnerable subgroups of the population.

  16. On the effects of systematic errors in analysis of nuclear scattering data

    International Nuclear Information System (INIS)

    Bennett, M.T.; Steward, C.; Amos, K.; Allen, L.J.

    1995-01-01

    The effects of systematic errors on elastic scattering differential cross-section data upon the assessment of quality fits to that data have been studied. Three cases are studied, namely the differential cross-section data sets from elastic scattering of 200 MeV protons from 12 C, of 350 MeV 16 O- 16 O scattering and of 288.6 MeV 12 C- 12 C scattering. First, to estimate the probability of any unknown systematic errors, select sets of data have been processed using the method of generalized cross validation; a method based upon the premise that any data set should satisfy an optimal smoothness criterion. In another case, the S function that provided a statistically significant fit to data, upon allowance for angle variation, became overdetermined. A far simpler S function form could then be found to describe the scattering process. The S functions so obtained have been used in a fixed energy inverse scattering study to specify effective, local, Schroedinger potentials for the collisions. An error analysis has been performed on the results to specify confidence levels for those interactions. 19 refs., 6 tabs., 15 figs

  17. The Effectiveness of the Feldenkrais Method: A Systematic Review of the Evidence

    Directory of Open Access Journals (Sweden)

    Susan Hillier

    2015-01-01

    Full Text Available The Feldenkrais Method (FM has broad application in populations interested in improving awareness, health, and ease of function. This review aimed to update the evidence for the benefits of FM, and for which populations. A best practice systematic review protocol was devised. Included studies were appraised using the Cochrane risk of bias approach and trial findings analysed individually and collectively where possible. Twenty RCTs were included (an additional 14 to an earlier systematic review. The population, outcome, and findings were highly heterogeneous. However, meta-analyses were able to be performed with 7 studies, finding in favour of the FM for improving balance in ageing populations (e.g., timed up and go test MD −1.14 sec, 95% CI −1.78, −0.49; and functional reach test MD 6.08 cm, 95% CI 3.41, 8.74. Single studies reported significant positive effects for reduced perceived effort and increased comfort, body image perception, and dexterity. Risk of bias was high, thus tempering some results. Considered as a body of evidence, effects seem to be generic, supporting the proposal that FM works on a learning paradigm rather than disease-based mechanisms. Further research is required; however, in the meantime, clinicians and professionals may promote the use of FM in populations interested in efficient physical performance and self-efficacy.

  18. The effects of probiotics on depressive symptoms in humans: a systematic review

    Directory of Open Access Journals (Sweden)

    Caroline J. K. Wallace

    2017-02-01

    Full Text Available Abstract Background Patients suffering from depression experience significant mood, anxiety, and cognitive symptoms. Currently, most antidepressants work by altering neurotransmitter activity in the brain to improve these symptoms. However, in the last decade, research has revealed an extensive bidirectional communication network between the gastrointestinal tract and the central nervous system, referred to as the “gut–brain axis.” Advances in this field have linked psychiatric disorders to changes in the microbiome, making it a potential target for novel antidepressant treatments. The aim of this review is to analyze the current body of research assessing the effects of probiotics, on symptoms of depression in humans. Methods A systematic search of five databases was performed and study selection was completed using the preferred reporting items for systematic reviews and meta-analyses process. Results Ten studies met criteria and were analyzed for effects on mood, anxiety, and cognition. Five studies assessed mood symptoms, seven studies assessed anxiety symptoms, and three studies assessed cognition. The majority of the studies found positive results on all measures of depressive symptoms; however, the strain of probiotic, the dosing, and duration of treatment varied widely and no studies assessed sleep. Conclusion The evidence for probiotics alleviating depressive symptoms is compelling but additional double-blind randomized control trials in clinical populations are warranted to further assess efficacy.

  19. Cost-effectiveness of motivational intervention with significant others for patients with alcohol misuse.

    Science.gov (United States)

    Shepard, Donald S; Lwin, Aung K; Barnett, Nancy P; Mastroleo, Nadine; Colby, Suzanne M; Gwaltney, Chad; Monti, Peter M

    2016-05-01

    To estimate the incremental cost, cost-effectiveness and benefit-cost ratio of incorporating a significant other (SO) into motivational intervention for alcohol misuse. We obtained economic data from the one year with the intervention in full operation for patients in a recent randomized trial. The underlying trial took place at a major urban hospital in the United States. The trial randomized 406 (68.7% male) eligible hazardous drinkers (196 during the economic study) admitted to the emergency department or trauma unit. The motivational interview condition consisted of one in-person session featuring personalized normative feedback. The significant other motivational interview condition comprised one joint session with the participant and SO in which the SO's perspective and support were elicited. We ascertained activities across 445 representative time segments through work sampling (including staff idle time), calculated the incremental cost in per patient of incorporating an SO, expressed the results in 2014 US$, incorporated quality and mortality effects from a closely related trial and derived the cost per quality-adjusted life-year (QALY) gained. From a health system perspective, the incremental cost per patient of adding an SO was $341.09 [95% confidence interval (CI) = $244.44-437.74]. The incremental cost per year per hazardous drinker averted was $3623 (CI = $1777-22,709), the cost per QALY gained $32,200 (CI = $15,800-201,700), and the benefit-cost ratio was 4.73 (95% CI = 0.7-9.66). If adding an SO into the intervention strategy were concentrated during the hours with highest risk or in a trauma unit, it would become even more cost-beneficial. Using criteria established by the World Health Organization (cost-effectiveness below the country's gross domestic product per capita), incorporating a significant other into a patient's motivational intervention for alcohol misuse is highly cost-effective. © 2015 Society for the Study of Addiction.

  20. Is Pilocarpine Effective in Preventing Radiation-Induced Xerostomia? A Systematic Review and Meta-analysis

    International Nuclear Information System (INIS)

    Yang, Wei-fa; Liao, Gui-qing; Hakim, Samer G.; Ouyang, Dai-qiao; Ringash, Jolie; Su, Yu-xiong

    2016-01-01

    Purpose: To evaluate the efficacy of concomitant administration of pilocarpine on radiation-induced xerostomia in patients with head and neck cancers. Methods and Materials: The PubMed, Web of Science, Cochrane Library, and ClinicalTrials were searched to identify randomized, controlled trials studying the effect of concomitant administration of pilocarpine for radiation-induced xerostomia. Included trials were systematically reviewed, and quantifiable outcomes were pooled for meta-analysis. Outcomes of interest included salivary flow, clinician-rated xerostomia grade, patient-reported xerostomia scoring, quality of life, and adverse effects. Results: Six prospective, randomized, controlled trials in 8 articles were included in this systematic review. The total number of patients was 369 in the pilocarpine group and 367 in the control group. Concomitant administration of pilocarpine during radiation could increase the unstimulated salivary flow rate in a period of 3 to 6 months after treatment, and also reduce the clinician-rated xerostomia grade. Patient-reported xerostomia was not significantly impacted by pilocarpine in the initial 3 months but was superior at 6 months. No significant difference of stimulated salivary flow rate could be confirmed between the 2 arms. Adverse effects of pilocarpine were mild and tolerable. Conclusions: The concomitant administration of pilocarpine during radiation increases unstimulated salivary flow rate and reduces clinician-rated xerostomia grade after radiation. It also relieves patients' xerostomia at 6 months and possibly at 12 months. However, pilocarpine has no effect on stimulated salivary flow rate.

  1. Is Pilocarpine Effective in Preventing Radiation-Induced Xerostomia? A Systematic Review and Meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Wei-fa; Liao, Gui-qing [Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou (China); Hakim, Samer G. [Department of Oral and Maxillofacial Surgery, University of Lübeck, Lübeck (Germany); Ouyang, Dai-qiao [Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou (China); Ringash, Jolie [Department of Radiation Oncology, Princess Margaret Cancer Centre and the University of Toronto, Toronto, Ontario (Canada); Su, Yu-xiong, E-mail: richsu@hku.hk [Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong (China)

    2016-03-01

    Purpose: To evaluate the efficacy of concomitant administration of pilocarpine on radiation-induced xerostomia in patients with head and neck cancers. Methods and Materials: The PubMed, Web of Science, Cochrane Library, and ClinicalTrials were searched to identify randomized, controlled trials studying the effect of concomitant administration of pilocarpine for radiation-induced xerostomia. Included trials were systematically reviewed, and quantifiable outcomes were pooled for meta-analysis. Outcomes of interest included salivary flow, clinician-rated xerostomia grade, patient-reported xerostomia scoring, quality of life, and adverse effects. Results: Six prospective, randomized, controlled trials in 8 articles were included in this systematic review. The total number of patients was 369 in the pilocarpine group and 367 in the control group. Concomitant administration of pilocarpine during radiation could increase the unstimulated salivary flow rate in a period of 3 to 6 months after treatment, and also reduce the clinician-rated xerostomia grade. Patient-reported xerostomia was not significantly impacted by pilocarpine in the initial 3 months but was superior at 6 months. No significant difference of stimulated salivary flow rate could be confirmed between the 2 arms. Adverse effects of pilocarpine were mild and tolerable. Conclusions: The concomitant administration of pilocarpine during radiation increases unstimulated salivary flow rate and reduces clinician-rated xerostomia grade after radiation. It also relieves patients' xerostomia at 6 months and possibly at 12 months. However, pilocarpine has no effect on stimulated salivary flow rate.

  2. Effect of outpatient exercise training programmes in patients with chronic heart failure: a systematic review

    NARCIS (Netherlands)

    van der Meer, Suzan; Zwerink, Marlies; van Brussel, M.; van der Valk, P.D.; Wajon, E.M.; van der Palen, Jacobus Adrianus Maria

    2012-01-01

    Advantages of outpatient exercise training are reduced waiting lists, better compliance, reduced time investment by the patient with reduced travel expenses, and less dependence on other people to participate. Therefore, this systematic review studies the effects of outpatient exercise training

  3. Effectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis

    NARCIS (Netherlands)

    la Chapelle, C.F.; Veersema, S.; Brölmann, H.A.M.; Jansen, F.W.

    2015-01-01

    Objective To assess whether hysteroscopic sterilization is feasible and effective in preventing pregnancy. Secondarily, to identify risk factors for failure of hysteroscopic sterilization. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Women undergoing hysteroscopic

  4. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

    Manders, M.; Groot, de C.P.G.M.; Staveren, van W.A.; Wouters-Wesseling, W.; Mulders, A.J.M.J.; Schols, J.M.G.A.; Hoefnagels, W.H.L.

    2004-01-01

    Background. The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. Methods. The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  5. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

    Manders, M.; Groot, L.C.P.G.M. de; Staveren, W.A. van; Wouters-Wesseling, W.; Mulders, A.; Schols, J.M.G.A.; Hoefnagels, W.H.L.

    2004-01-01

    BACKGROUND: The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. METHODS: The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  6. The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review

    OpenAIRE

    Sánchez-Vidaña, Dalinda Isabel; Ngai, Shirley Pui-Ching; He, Wanjia; Chow, Jason Ka-Wing; Lau, Benson Wui-Man; Tsang, Hector Wing-Hong

    2017-01-01

    Background. Depression is one of the greatest health concerns affecting 350 million people globally. Aromatherapy is a popular CAM intervention chosen by people with depression. Due to the growing popularity of aromatherapy for alleviating depressive symptoms, in-depth evaluation of the evidence-based clinical efficacy of aromatherapy is urgently needed. Purpose. This systematic review aims to provide an analysis of the clinical evidence on the efficacy of aromatherapy for depressive symptoms...

  7. Is systematic training in opioid overdose prevention effective?

    Science.gov (United States)

    Bosque-Prous, Marina; Folch, Cinta; Sarasa-Renedo, Ana; Majó, Xavier; Casabona, Jordi; Brugal, M. Teresa

    2017-01-01

    The objectives were to analyze the knowledge about overdose prevention, the use of naloxone, and the number of fatal overdoses after the implementation of Systematic Training in Overdose Prevention (STOOP) program. We conducted a quasi-experimental study, and held face-to-face interviews before (n = 725) and after (n = 722) implementation of systematic training in two different samples of people who injected opioids attending harm reduction centers. We asked participants to list the main causes of overdose and the main actions that should be taken when witnessing an overdose. We created two dependent variables, the number of (a) correct and (b) incorrect answers. The main independent variable was Study Group: Intervention Group (IG), Comparison Group (CG), Pre-Intervention Group With Sporadic Training in Overdose Prevention (PREIGS), or Pre-Intervention Group Without Training in Overdose Prevention (PREIGW). The relationship between the dependent and independent variables was assessed using a multivariate Poisson regression analysis. Finally, we conducted an interrupted time series analysis of monthly fatal overdoses before and after the implementation of systematic program during the period 2006–2015. Knowledge of overdose prevention increased after implementing systematic training program. Compared to the PREIGW, the IG gave more correct answers (IRR = 1.40;95%CI:1.33–1.47), and fewer incorrect answers (IRR = 0.33;95%CI:0.25–0.44). Forty percent of people who injected opioids who received a naloxone kit had used the kit in response to an overdose they witnessed. These courses increase knowledge of overdose prevention in people who use opioids, give them the necessary skills to use naloxone, and slightly diminish the number of fatal opioid overdoses in the city of Barcelona. PMID:29088247

  8. Effectiveness of Iyengar yoga in treating spinal (back and neck pain: A systematic review

    Directory of Open Access Journals (Sweden)

    Edith Meszaros Crow

    2015-01-01

    Full Text Available Considerable amount of money spent in health care is used for treatments of lifestyle related, chronic health conditions, which come from behaviors that contribute to morbidity and mortality of the population. Back and neck pain are two of the most common musculoskeletal problems in modern society that have significant cost in health care. Yoga, as a branch of complementary alternative medicine, has emerged and is showing to be an effective treatment against nonspecific spinal pain. Recent studies have shown positive outcome of yoga in general on reducing pain and functional disability of the spine. The objective of this study is to conduct a systematic review of the existing research within Iyengar yoga method and its effectiveness on relieving back and neck pain (defined as spinal pain. Database research form the following sources (Cochrane library, NCBI PubMed, the Clinical Trial Registry of the Indian Council of Medical Research, Google Scholar, EMBASE, CINAHL, and PsychINFO demonstrated inclusion and exclusion criteria that selected only Iyengar yoga interventions, which in turn, identified six randomized control trials dedicated to compare the effectiveness of yoga for back and neck pain versus other care. The difference between the groups on the postintervention pain or functional disability intensity assessment was, in all six studies, favoring the yoga group, which projected a decrease in back and neck pain. Overall six studies with 570 patients showed, that Iyengar yoga is an effective means for both back and neck pain in comparison to control groups. This systematic review found strong evidence for short-term effectiveness, but little evidence for long-term effectiveness of yoga for chronic spine pain in the patient-centered outcomes.

  9. Ecological validity of cost-effectiveness models of universal HPV vaccination: A systematic literature review.

    Science.gov (United States)

    Favato, Giampiero; Easton, Tania; Vecchiato, Riccardo; Noikokyris, Emmanouil

    2017-05-09

    The protective (herd) effect of the selective vaccination of pubertal girls against human papillomavirus (HPV) implies a high probability that one of the two partners involved in intercourse is immunised, hence preventing the other from this sexually transmitted infection. The dynamic transmission models used to inform immunisation policy should include consideration of sexual behaviours and population mixing in order to demonstrate an ecological validity, whereby the scenarios modelled remain faithful to the real-life social and cultural context. The primary aim of this review is to test the ecological validity of the universal HPV vaccination cost-effectiveness modelling available in the published literature. The research protocol related to this systematic review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42016034145). Eight published economic evaluations were reviewed. None of the studies showed due consideration of the complexities of human sexual behaviour and the impact this may have on the transmission of HPV. Our findings indicate that all the included models might be affected by a different degree of ecological bias, which implies an inability to reflect the natural demographic and behavioural trends in their outcomes and, consequently, to accurately inform public healthcare policy. In particular, ecological bias have the effect to over-estimate the preference-based outcomes of selective immunisation. A relatively small (15-20%) over-estimation of quality-adjusted life years (QALYs) gained with selective immunisation programmes could induce a significant error in the estimate of cost-effectiveness of universal immunisation, by inflating its incremental cost effectiveness ratio (ICER) beyond the acceptability threshold. The results modelled here demonstrate the limitations of the cost-effectiveness studies for HPV vaccination, and highlight the concern that public healthcare policy might have been

  10. The significant effects of puberty on the genetic diathesis of binge eating in girls.

    Science.gov (United States)

    Klump, Kelly L; Culbert, Kristen M; O'Connor, Shannon; Fowler, Natasha; Burt, S Alexandra

    2017-08-01

    Recent data show significant phenotypic and genetic associations between ovarian hormones and binge eating in adulthood. Theories of hormonal risk focus on puberty and the possibility that hormone activation induces changes in genetic effects that then lead to differential risk for binge eating in postpuberty and adulthood. Although this theory is difficult to test in humans, an indirect test is to examine whether genetic influences on binge eating increase during the pubertal period in girls. Prior work has shown pubertal increases in genetic influences on overall disordered eating symptoms, but no study to date has examined binge eating. The present study was the first to examine these increases for binge eating. Participants included 1,568 female twins (aged 8-25 years) from the Michigan State University Twin Registry. Binge eating and pubertal development were assessed with self-report questionnaires. Twin moderation models showed significant linear increases in genetic effects from prepuberty (5%) to postpuberty (42%), even after controlling for the effects of age and body mass index. Results provide critical support for increased genetic influences on binge eating during puberty. Additional studies are needed to identify hormonal mechanisms and fully test contemporary models of ovarian hormone risk. © 2017 Wiley Periodicals, Inc.

  11. Subjective Significance Shapes Arousal Effects on Modified Stroop Task Performance: A Duality of Activation Mechanisms Account.

    Science.gov (United States)

    Imbir, Kamil K

    2016-01-01

    Activation mechanisms such as arousal are known to be responsible for slowdown observed in the Emotional Stroop and modified Stroop tasks. Using the duality of mind perspective, we may conclude that both ways of processing information (automatic or controlled) should have their own mechanisms of activation, namely, arousal for an experiential mind, and subjective significance for a rational mind. To investigate the consequences of both, factorial manipulation was prepared. Other factors that influence Stroop task processing such as valence, concreteness, frequency, and word length were controlled. Subjective significance was expected to influence arousal effects. In the first study, the task was to name the color of font for activation charged words. In the second study, activation charged words were, at the same time, combined with an incongruent condition of the classical Stroop task around a fixation point. The task was to indicate the font color for color-meaning words. In both studies, subjective significance was found to shape the arousal impact on performance in terms of the slowdown reduction for words charged with subjective significance.

  12. Subjective Significance Shapes Arousal Effects on Modified Stroop Task Performance: a Duality of Activation Mechanisms Account

    Directory of Open Access Journals (Sweden)

    Kamil Konrad Imbir

    2016-02-01

    Full Text Available Activation mechanisms such as arousal are known to be responsible for slowdown observed in the Emotional Stroop (EST and modified Stroop tasks. Using the duality of mind perspective, we may conclude that both ways of processing information (automatic or controlled should have their own mechanisms of activation, namely, arousal for an experiential mind, and subjective significance for a rational mind. To investigate the consequences of both, factorial manipulation was prepared. Other factors that influence Stroop task processing such as valence, concreteness, frequency and word length were controlled. Subjective significance was expected to influence arousal effects. In the first study, the task was to name the color of font for activation charged words. In the second study, activation charged words were, at the same time, combined with an incongruent condition of the classical Stroop task around a fixation point. The task was to indicate the font color for color-meaning words. In both studies, subjective significance was found to shape the arousal impact on performance in terms of the slowdown reduction for words charged with subjective significance.

  13. Effectiveness and Appropriateness of mHealth Interventions for Maternal and Child Health: Systematic Review

    OpenAIRE

    Chen, Huan; Chai, Yanling; Dong, Le; Niu, Wenyi; Zhang, Puhong

    2018-01-01

    Background The application of mobile health (mHealth) technology in reproductive, maternal, newborn, and child health (RMNCH) is increasing worldwide. However, best practice and the most effective mHealth interventions have not been reviewed systematically. Objective A systematic review and meta-analysis of studies of mHealth interventions for RMNCH around the world were conducted to investigate their characteristics as well as the features and effectiveness of mHealth interventions. Methods ...

  14. The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts

    Directory of Open Access Journals (Sweden)

    Wehby George L

    2011-12-01

    Full Text Available Abstract Background Cleft lip and/or palate (CL/P increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P in South America. Methods The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates. Results There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group. Conclusions Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention. Trial Registration ClinicalTrials.gov: NCT00097149

  15. Effect size and statistical power in the rodent fear conditioning literature - A systematic review.

    Science.gov (United States)

    Carneiro, Clarissa F D; Moulin, Thiago C; Macleod, Malcolm R; Amaral, Olavo B

    2018-01-01

    Proposals to increase research reproducibility frequently call for focusing on effect sizes instead of p values, as well as for increasing the statistical power of experiments. However, it is unclear to what extent these two concepts are indeed taken into account in basic biomedical science. To study this in a real-case scenario, we performed a systematic review of effect sizes and statistical power in studies on learning of rodent fear conditioning, a widely used behavioral task to evaluate memory. Our search criteria yielded 410 experiments comparing control and treated groups in 122 articles. Interventions had a mean effect size of 29.5%, and amnesia caused by memory-impairing interventions was nearly always partial. Mean statistical power to detect the average effect size observed in well-powered experiments with significant differences (37.2%) was 65%, and was lower among studies with non-significant results. Only one article reported a sample size calculation, and our estimated sample size to achieve 80% power considering typical effect sizes and variances (15 animals per group) was reached in only 12.2% of experiments. Actual effect sizes correlated with effect size inferences made by readers on the basis of textual descriptions of results only when findings were non-significant, and neither effect size nor power correlated with study quality indicators, number of citations or impact factor of the publishing journal. In summary, effect sizes and statistical power have a wide distribution in the rodent fear conditioning literature, but do not seem to have a large influence on how results are described or cited. Failure to take these concepts into consideration might limit attempts to improve reproducibility in this field of science.

  16. Effect size and statistical power in the rodent fear conditioning literature – A systematic review

    Science.gov (United States)

    Macleod, Malcolm R.

    2018-01-01

    Proposals to increase research reproducibility frequently call for focusing on effect sizes instead of p values, as well as for increasing the statistical power of experiments. However, it is unclear to what extent these two concepts are indeed taken into account in basic biomedical science. To study this in a real-case scenario, we performed a systematic review of effect sizes and statistical power in studies on learning of rodent fear conditioning, a widely used behavioral task to evaluate memory. Our search criteria yielded 410 experiments comparing control and treated groups in 122 articles. Interventions had a mean effect size of 29.5%, and amnesia caused by memory-impairing interventions was nearly always partial. Mean statistical power to detect the average effect size observed in well-powered experiments with significant differences (37.2%) was 65%, and was lower among studies with non-significant results. Only one article reported a sample size calculation, and our estimated sample size to achieve 80% power considering typical effect sizes and variances (15 animals per group) was reached in only 12.2% of experiments. Actual effect sizes correlated with effect size inferences made by readers on the basis of textual descriptions of results only when findings were non-significant, and neither effect size nor power correlated with study quality indicators, number of citations or impact factor of the publishing journal. In summary, effect sizes and statistical power have a wide distribution in the rodent fear conditioning literature, but do not seem to have a large influence on how results are described or cited. Failure to take these concepts into consideration might limit attempts to improve reproducibility in this field of science. PMID:29698451

  17. EFFECT SIGNIFICANCE ASSESSMENT OF THE THERMODYNAMICAL FACTORS ON THE SOLID OXIDE FUEL CELL OPERATION

    Directory of Open Access Journals (Sweden)

    V. A. Sednin

    2015-01-01

    Full Text Available Technologies of direct conversion of the fuel energy into electrical power are an upcoming trend in power economy. Over the last decades a number of countries have created industrial prototypes of power plants on fuel elements (cells, while fuel cells themselves became a commercial product on the world energy market. High electrical efficiency of the fuel cells allows predictting their further spread as part of hybrid installations jointly with gas and steam turbines which specifically enables achieving the electrical efficiency greater than 70 %. Nevertheless, investigations in the area of increasing efficiency and reliability of the fuel cells continue. Inter alia, research into the effects of oxidizing reaction thermodynamic parameters, fuel composition and oxidation reaction products on effectiveness of the solid oxide fuel cells (SOFC is of specific scientific interest. The article presents a concise analysis of the fuel type effects on the SOFC efficiency. Based on the open publications experimental data and the data of numerical model studies, the authors adduce results of the statistical analysis of the SOFC thermodynamic parameters effect on the effectiveness of its functioning as well as of the reciprocative factors of these parameters and gas composition at the inlet and at the outlet of the cell. The presented diagrams reflect dimension of the indicated parameters on the SOFC operation effectiveness. The significance levels of the above listed factors are ascertained. Statistical analysis of the effects of the SOFC functionning process thermodynamical, consumption and concentration parameters demonstrates quintessential influence of the reciprocative factors (temperature – flow-rate and pressure – flow-rate and the nitrogen N2 and oxygen O2 concentrations on the operation efficiency in the researched range of its functioning. These are the parameters to be considered on a first-priority basis while developing mathematical models

  18. Weekend effect in upper gastrointestinal bleeding: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Pei-Ching Shih

    2018-01-01

    Full Text Available Aim To perform a systematic review and meta-analysis of the weekend effect on the mortality of patients with upper gastrointestinal bleeding(UGIB. Methods The review protocol has been registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42017073313 and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement. We conducted a search of the PUBMED, COCHRANE, EMBASE and CINAHL databases from inception to August 2017. All observational studies comparing mortality between UGIB patients with weekend versus weekday admissions were included. Articles that were published only in abstract form or not published in a peer-reviewed journal were excluded. The quality of articles was assessed using the Newcastle-Ottawa Scale. We pooled results from the articles using random-effect models. Heterogeneity was evaluated by the chi-square-based Q-test and I2test. To address heterogeneity, we performed sensitivity and subgroup analyses. Potential publication bias was assessed via funnel plot. Results Eighteen observational cohort studies involving 1,232,083 study patients were included. Weekend admission was associated with significantly higher 30-day or in-hospital mortality in all studies (OR = 1.12, 95% CI [1.07–1.17], P < 0.00001. Increased in-hospital mortality was also associated with weekend admission (OR = 1.12, 95% CI [1.08–1.17], P < 0.00001. No significant difference in in-hospital mortality was observed between patients admitted with variceal bleeding during the weekend or on weekdays (OR = 0.99, 95% CI [0.91–1.08], P = 0.82; however, weekend admission was associated with a 15% increase in in-hospital mortality for patients with non-variceal bleeding (OR = 1.15, 95% CI [1.09–1.21], P < 0.00001. The time to endoscopy for weekday admission was significantly less than that obtained for weekend admission (MD = −2.50, 95% CI [−4

  19. Significance of Timing on Effect of Metaphylactic Toltrazuril Treatment against Eimeriosis in Calves

    DEFF Research Database (Denmark)

    Enemark, Heidi; Dahl, Jan; Enemark, Jörg Matthias Dehn

    2015-01-01

    of Eimeria bovis and Eimeria zuernii. Three commercial herds and a total of 71 calves, aged 48 – 135 days, were included. Treatment with a single oral dose of toltrazuril (15 mg/kg) was given after relocation to common pens and one week before expected outbreak of eimeriosis. The effect of treatment...... was followed by weekly faecal sampling and weighing initially and at the end of a study period of 8 weeks. In Herd 2 and 3 toltrazuril treated calves gained on average 7.95 kg more than placebo treated calves (p = 0.007), and both oocyst excretion and prevalence of Eimeria spp. were significantly reduced...

  20. Systematic and non-systematic effects of the uncertainty of the sample position in gamma-ray spectrometry

    International Nuclear Information System (INIS)

    Vidmar, T.; Korun, M.

    2004-01-01

    When cylindrical samples placed coaxially with the detector are measured on a gamma-ray spectrometer, the position of the sample very often deviates from an ideal one with the axes of the sample and the detector less than perfectly aligned. If a calibrated source is used prior to the measurement and is presumed to have been positioned correctly, one might conclude that the misalignment of the measured sample should result in an uncertainty of the reported nuclide activity, since the efficiencies of the sample and the calibrated source are effectively different due to the difference in placement. The efficiency of a displaced cylindrical sample, however, is always lower than the one of a sample that is perfectly aligned. The net effect of misalignment can therefore be not only an increase in the uncertainty of the activity, but also a systematic error in its evaluation. Since the Guide to the Expression of Uncertainty in Measurement requires that all such systematic effects be corrected for, we have developed a method to assess the change in the efficiency resulting from misalignment and to introduce the required correction. The calculation of this correction only requires knowledge of basic sample and detector data. The uncertainty of the reported activity can then also be assessed and is influenced by the uncertainty of the efficiency evaluated around its new, corrected value. An appropriate expression for this uncertainty has been derived

  1. Toward better assessment of tornado potential in typhoons: Significance of considering entrainment effects for CAPE

    Science.gov (United States)

    Sueki, Kenta; Niino, Hiroshi

    2016-12-01

    The characteristics of typhoons that spawned tornadoes (tornadic typhoons: TTs) in Japan from 1991 to 2013 were investigated by composite analysis using the Japanese 55 year Reanalysis and compared with those of typhoons that did not spawn tornadoes (nontornadic typhoons: NTs). We found that convective available potential energy (CAPE), which considers the effects of entrainment (entraining CAPE: E-CAPE), and storm-relative environmental helicity (SREH) are significantly large in the northeast quadrant of TTs where tornadoes frequently occur and that E-CAPE and SREH in that quadrant for TTs are larger than those for NTs. On the other hand, ordinary CAPE without entrainment does not account for the spatial distribution of tornado occurrences nor does it distinguish TTs from NTs. E-CAPE is sensitive to humidity in the midtroposphere; thus, it is effective for detecting a conditionally unstable layer up to about 550 hPa, which is distinctive of TTs.

  2. Power, effects, confidence, and significance: an investigation of statistical practices in nursing research.

    Science.gov (United States)

    Gaskin, Cadeyrn J; Happell, Brenda

    2014-05-01

    improvement. Most importantly, researchers should abandon the misleading practice of interpreting the results from inferential tests based solely on whether they are statistically significant (or not) and, instead, focus on reporting and interpreting effect sizes, confidence intervals, and significance levels. Nursing researchers also need to conduct and report a priori power analyses, and to address the issue of Type I experiment-wise error inflation in their studies. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  3. Effects of the West Africa Ebola Virus Disease on Healthcare Utilization – a Systematic Review

    Directory of Open Access Journals (Sweden)

    Kim Johanna Brolin Ribacke

    2016-10-01

    Full Text Available Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reveiws. A total of 3354 articles were identified for screening and while 117 articles were read in full, 22 studies were included in the final review.Utilization of maternal health services decreased during the outbreak. The number of Caesarean sections and facility-based deliveries declined and followed a similar pattern in Guinea, Liberia and Sierra Leone. A change in the utilization of antenatal and postnatal care and family planning services was also seen, as well as a drop in utilization of children’s health services, especially in terms of vaccination coverage. In addition, the uptake of HIV/AIDS and malaria services, general hospital admissions and major surgeries decreased as well.Interestingly, it was the uptake of health service provision by the population that decreased, rather than the volume of Health service provision. Estimates from the various studies suggest that non-Ebola morbidity and mortality have increased after the onset of the outbreak in Sierra Leone, Guinea and Liberia. Reproductive, maternal and child health services was especially affected, and the decrease in facility deliveries, Caesarean sections and volume of antenatal and postnatal care visits might have significant adverse effects on maternal and newborn health. The impact of Ebola stretches far beyond Ebola cases and deaths. This review indicates that indirect health service effects are substantial and both short and long-term, and highlights the importance of support to maintain routine health service delivery and the maintenance of vaccination programs as well as preventative

  4. A Systematic Overview of Radiation Therapy Effects in Prostate Cancer

    International Nuclear Information System (INIS)

    Nilsson, Sten; Norlen, Bo Johan; Widmark, Anders

    2004-01-01

    A systematic review of radiation therapy trials in prostate cancer has been performed according to principles adopted by the Swedish Council of Technology Assessment in Health Care (SBU). This synthesis of the literature is based on data from one meta-analysis, 30 randomized trials, many dealing with hormonal therapy, 55 prospective trials, and 210 retrospective studies. Totally the studies included 152,614 patients. There is a lack of properly controlled clinical trials in most important aspects of radiation therapy in prostate cancer. The conclusions reached can be summarized as follows: There are no randomized studies that compare the outcome of surgery (radical prostatectomy) with either external beam radiotherapy or brachytherapy for patients with clinically localized low-risk prostate cancer. However, with the advent of widely accepted prognostic markers for prostate cancer (pre-treatment PSA, Gleason score, and T-stage), such comparisons have been made possible. There is substantial documentation from large single-institutional and multi-institutional series on patients with this disease category (PSA T2) disease, i.e. patients normally not suited for surgery, benefit from higher than conventional total dose. No overall survival benefit has yet been shown. Dose escalation to patients with intermediate-risk or high-risk disease can be performed with 3D conformal radiotherapy (photon or proton) boost, with Ir-192 high dose rate brachytherapy boost, or brachytherapy boost with permanent seed implantation. Despite an increased risk of urinary tract and/or rectal side effects, dose-escalated therapy can generally be safely delivered with all three techniques. There is some evidence that 3D conformal radiotherapy results in reduced late rectal toxicity and acute anal toxicity compared with radiotherapy administered with non-conformal treatment volumes. There is some evidence that postoperative external beam radiotherapy after radical prostatectomy in patients with

  5. A systematic review of the effect of yogurt consumption on chronic diseases risk markers in adults.

    Science.gov (United States)

    Dumas, Audrée-Anne; Lapointe, Annie; Dugrenier, Marilyn; Provencher, Véronique; Lamarche, Benoît; Desroches, Sophie

    2017-06-01

    We reviewed randomised controlled trials (RCTs) that have assessed the effects of yogurt containing Lactobacillus bulgaricus and Streptococcus thermophilus (LBST) on metabolic risk markers of chronic diseases in adults. We performed a systematic search in July 2016 in the scientific databases PubMed, EMBASE and The Cochrane Library. Included studies were RCTs that assessed the impact of consuming yogurt containing LBST as a treatment, and that evaluated at least one metabolic risk marker for chronic diseases compared with a control diet or a diet supplemented in another food/ingredient in healthy or chronically ill adults. Seven RCTs involving 278 participants were included in the review. Studies were conducted in the USA, France, Spain, Iran and Canada. Five studies were undertaken in healthy adults, and two were conducted among lactose malabsorbers. All studies investigated changes in blood lipids and glucose homoeostasis, with different doses of yogurt, durations of the supplementation and risks markers assessed. Consumption of LBST yogurt significantly reduced total cholesterol concentrations, ratio of total cholesterol to HDL-C and plasma glucose compared to a control yogurt-free diet or diet supplemented in another food/ingredient in two out of the seven studies. The majority of included RCTs presented high to unclear methodological risks of bias, which raises questions about the validity of their findings. Data from this systematic review indicate that the consumption of LBST yogurt shows either favourable or neutral effects on metabolic risk markers when compared with a control treatment in controlled research settings. RCTs investigating the effect of LBST yogurt consumption on metabolic risk markers of chronic diseases are scarce and presented considerable variation in methodologies making comparison between studies difficult. Further large-scale, well-designed studies assessing the impact of LBST yogurt, in particular in comparison with a control yogurt

  6. Inadvertent P-hacking among trials and systematic reviews of the effect of progestogens in pregnancy? A systematic review and meta-analysis.

    Science.gov (United States)

    Prior, M; Hibberd, R; Asemota, N; Thornton, J G

    2017-06-01

    Progestogens have been evaluated in numerous trials and meta-analyses, many of which concluded they were effective. However, two large trials PROMISE and OPPTIMUM have recently concluded that progesterone was ineffective. This raises the possibility that earlier studies and reviews had been biased by either selective publication or selective choice of outcomes, so called "P-hacking". To compare the findings all progestogen trials and systematic reviews with those of trials with pre-registered primary outcomes which avoided selective outcome reporting. Search of PubMed, the Cochrane Library and trial registries. Registration PROSPERO CRD42016035303. Systematic reviews of randomised trials comparing progestogen with placebo in pregnancy and the individual trials included in those reviews. The subset of trials reporting a pre-registered primary outcome were compared with the totality of trials and reviews. For reviews all outcomes were included. For individual trials all outcomes reported in the systematic reviews were included. For the comparison group we recorded the registered primary outcome from trials that were either registered before they started, or registered during the recruitment phase and also double blind. Nineteen of twenty-nine meta-analyses concluded that progestogens were effective. Twenty-two trials reported their pre-registered primary outcomes. There was no effect of progesterone on primary registered dichotomous outcome RR 1.00 (95% CI 0.94-1.07). Only one of the 22 showed a nominally statistically significant benefit. When evaluated in registered double-blind trials with analysis restricted to predefined primary outcomes, progestational agents in pregnancy are ineffective. Progestogens to prevent pregnancy loss, an example of P-hacking. © 2017 Royal College of Obstetricians and Gynaecologists.

  7. Sales effects of product health information at points of purchase: a systematic review.

    Science.gov (United States)

    van 't Riet, Jonathan

    2013-03-01

    Information about healthy and unhealthy nutrients is increasingly conveyed at the point of purchase. Many studies have investigated the effects of product health information on attitudes and intentions, but the empirical evidence becomes sketchier when the focus of research is actual purchase behaviour. The present paper provides an overview of empirical evidence on the effectiveness of product health information for food products at the point of purchase. A systematic literature review was conducted. Only studies were included that assessed the effect of product health information at the point of purchase on actual purchase behaviour, using data provided by stores' sales records or obtained by investigating customer receipts as the primary outcome measure. The included studies' target group comprised supermarket clientele. Several studies found no significant effects of product health information on actual purchase behaviour. Interventions were more likely to be effective when they lasted for a longer time, when they included additional intervention components, and when they targeted the absence of unhealthy nutrients instead of or in addition to the presence of healthy nutrients. No strong evidence for the effectiveness of product health information was found. The effect of intervention duration, additional promotional activities and targeting of healthy v. unhealthy nutrients should be closely examined in future studies.

  8. The effect of probiotics as a treatment for constipation in elderly people: A systematic review.

    Science.gov (United States)

    Martínez-Martínez, Maria Isabel; Calabuig-Tolsá, Raquel; Cauli, Omar

    2017-07-01

    Treating constipation in elderly people remains a challenge; the administration of probiotics may be a valid therapy for this problem as an alternative to traditional drug-based treatments. The objective of this systematic review was to evaluate the efficiency of probiotics in treating constipation in elderly people. Articles related to this topic and published, without any time limitations, in the Medline, Embase, Scopus, Lilacs, or Cochrane databases were systematically reviewed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The primary search terms were 'constipation' and 'probiotics'. The main inclusion criteria were: 1) the article was original and the whole text was published in English or Spanish and 2) included the primary search terms in the title, summary, or body text; 3) the studies had to have included 60 or more participants defined as 'elderly' and 4) have specifically evaluated the effect of the administration of probiotics. Of the 475 articles consulted, 9 met the inclusion criteria. Among the selected studies, there were four randomised and placebo-controlled trials and the remaining five reports were observational. Overall, our analysis of the randomised and placebo-controlled trials suggests that administration of probiotics significantly improved constipation in elderly individuals by 10-40% compared to placebo controls in which no probiotic was administered. The strain of bacteria most commonly tested was Bifidobacterium longum. However, caution is needed when interpreting these reports because of the heterogeneity of the original study designs, populations, and the risk of bias. Therefore, further placebo-controlled trials are necessary to determine the most efficient strains, doses, and the optimal treatment duration. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [The effectiveness of continuing care models in patients with chronic diseases: a systematic review].

    Science.gov (United States)

    Chen, Hsiao-Mei; Han, Tung-Chen; Chen, Ching-Min

    2014-04-01

    Population aging has caused significant rises in the prevalence of chronic diseases and the utilization of healthcare services in Taiwan. The current healthcare delivery system is fragmented. Integrating medical services may increase the quality of healthcare, enhance patient and patient family satisfaction with healthcare services, and better contain healthcare costs. This article introduces two continuing care models: discharge planning and case management. Further, the effectiveness and essential components of these two models are analyzed using a systematic review method. Articles included in this systematic review were all original articles on discharge-planning or case-management interventions published between February 1999 and March 2013 in any of 6 electronic databases (Medline, PubMed, Cinahl Plus with full Text, ProQuest, Cochrane Library, CEPS and Center for Chinese Studies electronic databases). Of the 70 articles retrieved, only 7 were randomized controlled trial studies. Three types of continuity-of-care models were identified: discharge planning, case management, and a hybrid of these two. All three models used logical and systematic processes to conduct assessment, planning, implementation, coordination, follow-up, and evaluation activities. Both the discharge planning model and the case management model were positively associated with improved self-care knowledge, reduced length of stay, decreased medical costs, and better quality of life. This study cross-referenced all reviewed articles in terms of target clients, content, intervention schedules, measurements, and outcome indicators. Study results may be referenced in future implementations of continuity-care models and may provide a reference for future research.

  10. Treatment of paediatric hyperthyroidism but not hypothyroidism has a significant effect on weight.

    Science.gov (United States)

    Crocker, Melissa K; Kaplowitz, Paul

    2010-12-01

    Thyroid hormones are involved in metabolic regulation, but the degree to which they affect body weight and body mass index (BMI) in children is unclear. We examined the effect of hypo- and hyperthyroidism on weight and BMI at the time of diagnosis and after appropriate treatment. Prospective and retrospective case series. Children referred for thyroid dysfunction were enrolled prospectively if their total or free T4 was elevated with TSH 20 (N = 29). Almost all patients had at least 2 classic signs or symptoms including goitre, but hyperthyroid patients had more symptoms. Mean BMI z scores at the time of diagnosis did not significantly differ between the two groups. Males with hyperthyroidism complained of weight loss more frequently and had a lower pretreatment BMI z score than hyperthyroid females. Hypothyroid patients lost a minimal amount of weight by the first follow-up (mean of 0·3 kg) and on average gained weight by the second follow-up visit. In contrast hyperthyroid patients gained a mean of 3·4 kg at the first follow-up visit and a mean of 7·1 kg by the second. Correction of hypothyroidism resulted in minimal weight loss, suggesting that hypothyroidism does not cause significant weight gain in children. In contrast, correction of the hyperthyroid state had a somewhat greater impact on weight status. These results are consistent with prior reports but surprising given the opposite metabolic effects of hypo- and hyperthyroidism. © 2010 Blackwell Publishing Ltd.

  11. Treatment of pediatric hyperthyroidism but not hypothyroidism has a significant effect on weight

    Science.gov (United States)

    Crocker, Melissa K.; Kaplowitz, Paul

    2010-01-01

    Objective Thyroid hormones are involved in metabolic regulation, but the degree to which they affect body weight and body mass index (BMI) in children is unclear. We examined the effect of hypo- and hyperthyroidism on weight and BMI at the time of diagnosis and after appropriate treatment. Design Prospective and retrospective case series Patients Children referred for thyroid dysfunction were enrolled prospectively if their total or free T4 was elevated with TSH 20 (N=29). Results Almost all patients had at least 2 classic signs or symptoms including goiter, but hyperthyroid patients had more symptoms. Mean BMI z scores at the time of diagnosis did not significantly differ between the two groups. Males with hyperthyroidism complained of weight loss more frequently and had a lower pretreatment BMI z score than hyperthyroid females. Hypothyroid patients lost a minimal amount of weight by the first follow-up (mean of 0.3 kilograms (kg)) and on average gained weight by the second follow-up visit. In contrast hyperthyroid patients gained a mean of 3.4 kg at the first follow-up visit and a mean of 7.1 kg by the second. Conclusions Correction of hypothyroidism resulted in minimal weight loss, suggesting that hypothyroidism does not cause significant weight gain in children. In contrast, correction of the hyperthyroid state had a somewhat greater impact on weight status. These results are consistent with prior reports but surprising given the opposite metabolic effects of hypo- and hyperthyroidism. PMID:20874768

  12. Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies.

    Science.gov (United States)

    Kamioka, Hiroharu; Tsutani, Kiichiro; Okuizumi, Hiroyasu; Mutoh, Yoshiteru; Ohta, Miho; Handa, Shuichi; Okada, Shinpei; Kitayuguchi, Jun; Kamada, Masamitsu; Shiozawa, Nobuyoshi; Honda, Takuya

    2010-01-01

    The objective of this review was to summarize findings on aquatic exercise and balneotherapy and to assess the quality of systematic reviews based on randomized controlled trials. Studies were eligible if they were systematic reviews based on randomized clinical trials (with or without a meta-analysis) that included at least 1 treatment group that received aquatic exercise or balneotherapy. We searched the following databases: Cochrane Database Systematic Review, MEDLINE, CINAHL, Web of Science, JDream II, and Ichushi-Web for articles published from the year 1990 to August 17, 2008. We found evidence that aquatic exercise had small but statistically significant effects on pain relief and related outcome measures of locomotor diseases (eg, arthritis, rheumatoid diseases, and low back pain). However, long-term effectiveness was unclear. Because evidence was lacking due to the poor methodological quality of balneotherapy studies, we were unable to make any conclusions on the effects of intervention. There were frequent flaws regarding the description of excluded RCTs and the assessment of publication bias in several trials. Two of the present authors independently assessed the quality of articles using the AMSTAR checklist. Aquatic exercise had a small but statistically significant short-term effect on locomotor diseases. However, the effectiveness of balneotherapy in curing disease or improving health remains unclear.

  13. A systematic review and meta-analysis of the effectiveness of nudging to increase fruit and vegetable choice

    OpenAIRE

    Broers, Valérie; De Breucker, Céline; Van den Broucke, Stephan; Luminet, Olivier

    2017-01-01

    BACKGROUND: Nudging refers to interventions that organize the choice architecture in order to alter people's behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. As a strategy to encourage healthy behaviour, nudging can serve as a complement to health education. However, the empirical evidence regarding the effectiveness of nudging as a way to influence food choice remains contradictory. To address this issue, a systematic review a...

  14. Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review

    OpenAIRE

    Jenni Suen; Jolene Thomas; Amelia Kranz; Simon Vun; Michelle Miller

    2016-01-01

    Oxidative stress (OS) and inflammatory processes initiate the first stage of cardiovascular disease (CVD). Flavonoid consumption has been related to significantly improved flow-mediated dilation and blood pressure. Antioxidant and anti-inflammatory mechanisms are thought to be involved. The effect of flavonoids on markers of oxidative stress and inflammation, in at risk individuals is yet to be reviewed. Systematic literature searches were conducted in MEDLINE, Cochrane Library, CINAHL and SC...

  15. The significance of some methodological effects on filtration and ingestion rates of the rotifer Brachionus plicatilis

    Science.gov (United States)

    Schlosser, H. J.; Anger, K.

    1982-06-01

    Filtration rate (F) and ingestion rate (I) were measured in the rotifer Brachionus plicatilis feeding on the flagellate Dunaliella spec. and on yeast cells (Saccharomyces cerevisiae). 60-min experiments in rotating bottles served as a standard for testing methodological effects on levels of F and I. A lack of rotation reduced F values by 40 %, and a rise in temperature from 18° to 23.5 °C increased them by 42 %. Ingestion rates increased significantly up to a particle (yeast) concentration of ca. 600-800 cells · μl-1; then they remained constant, whereas filtration rates decreased beyond this threshold. Rotifer density (up to 1000 ind · ml-1) and previous starvation (up to 40 h) did not significantly influence food uptake rates. The duration of the experiment proved to have the most significant effect on F and I values: in 240-min experiments, these values were on the average more than 90 % lower than in 15-min experiments. From this finding it is concluded that ingestion rates obtained from short-term experiments (60 min or less) cannot be used in energy budgets, because they severely overestimate the actual long-term feeding capacity of the rotifers. At the lower end of the particle size spectrum (2 to 3 µm) there are not only food cells, but apparently also contaminating faecal particles. Their number increased with increasing duration of experiments and lead to an underestimation of F and I. Elemental analyses of rotifers and their food suggest that B. plicatilis can ingest up to 0.6 mJ or ca. 14 % of its own body carbon within 15 min. The long term average was estimated as 3.4 mJ · ind-1 · d-1 or ca. 75 % of body carbon · d-1.

  16. Effects of ADMA upon gene expression: an insight into the pathophysiological significance of raised plasma ADMA.

    Directory of Open Access Journals (Sweden)

    Caroline L Smith

    2005-10-01

    Full Text Available Asymmetric dimethylarginine (ADMA is a naturally occurring inhibitor of nitric oxide synthesis that accumulates in a wide range of diseases associated with endothelial dysfunction and enhanced atherosclerosis. Clinical studies implicate plasma ADMA as a major novel cardiovascular risk factor, but the mechanisms by which low concentrations of ADMA produce adverse effects on the cardiovascular system are unclear.We treated human coronary artery endothelial cells with pathophysiological concentrations of ADMA and assessed the effects on gene expression using U133A GeneChips (Affymetrix. Changes in several genes, including bone morphogenetic protein 2 inducible kinase (BMP2K, SMA-related protein 5 (Smad5, bone morphogenetic protein receptor 1A, and protein arginine methyltransferase 3 (PRMT3; also known as HRMT1L3, were confirmed by Northern blotting, quantitative PCR, and in some instances Western blotting analysis to detect changes in protein expression. To determine whether these changes also occurred in vivo, tissue from gene deletion mice with raised ADMA levels was examined. More than 50 genes were significantly altered in endothelial cells after treatment with pathophysiological concentrations of ADMA (2 microM. We detected specific patterns of changes that identify pathways involved in processes relevant to cardiovascular risk and pulmonary hypertension. Changes in BMP2K and PRMT3 were confirmed at mRNA and protein levels, in vitro and in vivo.Pathophysiological concentrations of ADMA are sufficient to elicit significant changes in coronary artery endothelial cell gene expression. Changes in bone morphogenetic protein signalling, and in enzymes involved in arginine methylation, may be particularly relevant to understanding the pathophysiological significance of raised ADMA levels. This study identifies the mechanisms by which increased ADMA may contribute to common cardiovascular diseases and thereby indicates possible targets for therapies.

  17. Literature systematic review on the ophthalmological side effects of interferons

    Directory of Open Access Journals (Sweden)

    Yara Dadalti Fragoso

    2011-08-01

    Full Text Available Interferons alpha and beta have been used worldwide for a few decades, altering the natural history of several severe diseases including hepatitis C, cancer and immune-mediated conditions such as multiple sclerosis. The adverse events profile of interferons is well established, but only isolated reports of ophthalmological complications of interferon therapy have been published. The objective of this study was to carry out a literature systematic review on the subject, bringing to light the need for careful ophthalmological monitoring of patients undergoing interferon treatment. Nearly 500 cases of ophthalmological complications related to interferon have been reported. The most frequent findings were soft exudates, hemorrhages and retina ischemia.

  18. Effects of systematic sampling on satellite estimates of deforestation rates

    International Nuclear Information System (INIS)

    Steininger, M K; Godoy, F; Harper, G

    2009-01-01

    Options for satellite monitoring of deforestation rates over large areas include the use of sampling. Sampling may reduce the cost of monitoring but is also a source of error in estimates of areas and rates. A common sampling approach is systematic sampling, in which sample units of a constant size are distributed in some regular manner, such as a grid. The proposed approach for the 2010 Forest Resources Assessment (FRA) of the UN Food and Agriculture Organization (FAO) is a systematic sample of 10 km wide squares at every 1 deg. intersection of latitude and longitude. We assessed the outcome of this and other systematic samples for estimating deforestation at national, sub-national and continental levels. The study is based on digital data on deforestation patterns for the five Amazonian countries outside Brazil plus the Brazilian Amazon. We tested these schemes by varying sample-unit size and frequency. We calculated two estimates of sampling error. First we calculated the standard errors, based on the size, variance and covariance of the samples, and from this calculated the 95% confidence intervals (CI). Second, we calculated the actual errors, based on the difference between the sample-based estimates and the estimates from the full-coverage maps. At the continental level, the 1 deg., 10 km scheme had a CI of 21% and an actual error of 8%. At the national level, this scheme had CIs of 126% for Ecuador and up to 67% for other countries. At this level, increasing sampling density to every 0.25 deg. produced a CI of 32% for Ecuador and CIs of up to 25% for other countries, with only Brazil having a CI of less than 10%. Actual errors were within the limits of the CIs in all but two of the 56 cases. Actual errors were half or less of the CIs in all but eight of these cases. These results indicate that the FRA 2010 should have CIs of smaller than or close to 10% at the continental level. However, systematic sampling at the national level yields large CIs unless the

  19. Clinically significant bleeding in incurable cancer patients: effectiveness of hemostatic radiotherapy

    International Nuclear Information System (INIS)

    Cihoric, Nikola; Crowe, Susanne; Eychmüller, Steffen; Aebersold, Daniel M; Ghadjar, Pirus

    2012-01-01

    This study was performed to evaluate the outcome after hemostatic radiotherapy (RT) of significant bleeding in incurable cancer patients. Patients treated by hemostatic RT between November 2006 and February 2010 were retrospectively analyzed. Bleeding was assessed according to the World Health Organization (WHO) scale (grade 0 = no bleeding, 1 = petechial bleeding, 2 = clinically significant bleeding, 3 = bleeding requiring transfusion, 4 = bleeding associated with fatality). The primary endpoint was bleeding at the end of RT. Key secondary endpoints included overall survival (OS) and acute toxicity. The bleeding score before and after RT were compared using the Wilcoxon signed rank test. Time to event endpoints were estimated using the Kaplan Meier method. Overall 62 patients were analyzed including 1 patient whose benign cause of bleeding was pseudomyxoma peritonei. Median age was 66 (range, 37–93) years. Before RT, bleeding was graded as 2 and 3 in 24 (39%) and 38 (61%) patients, respectively. A median dose of 20 (range, 5–45) Gy of hemostatic RT was applied to the bleeding site. At the end of RT, there was a statistically significant difference in bleeding (p < 0.001); it was graded as 0 (n = 39), 1 (n = 12), 2 (n = 6), 3 (n = 4) and 4 (n = 1). With a median follow-up of 19.3 (range, 0.3-19.3) months, the 6-month OS rate was 43%. Forty patients died (65%); 5 due to bleeding. No grade 3 or above acute toxicity was observed. Hemostatic RT seems to be a safe and effective treatment for clinically and statistically significantly reducing bleeding in incurable cancer patients

  20. Exercise effects on bone mineral density in older men: a systematic review with special emphasis on study interventions.

    Science.gov (United States)

    Kemmler, W; Shojaa, M; Kohl, M; von Stengel, S

    2018-04-05

    This systematic review detected only limited positive effects of exercise on bone mineral density in older men. Further, based on the present literature, we were unable to suggest dedicated exercise prescriptions for this male cohort that might differ from recommendations based on studies with postmenopausal women. The primary aim of this systematic review was to determine the effect of exercise on bone mineral density (BMD) in healthy older men. A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement included only randomized or non-randomized controlled trials of exercise training ≥ 6 months with study groups of ≥ eight healthy men aged 50 years or older, not using bone-relevant pharmacological therapy, that determined BMD by dual-energy X-ray absorptiometry. We searched PubMed, Scopus, Web of Science, Cochrane, Science Direct, and Eric up to November 2016. Risk of bias was assessed using the PEDro scale. We identified eight trials with 789 participants (PEDro-score, mean value 6 of 10) which satisfied our eligibility criteria. Studies vary considerably with respect to type and composition of exercise. Study interventions of six trials were considered to be appropriate for successfully addressing BMD in this cohort. Between-group differences were not or not consistently reported by three studies. Three studies reported significant exercise effects on BMD for proximal femur; one of them determined significant differences between the exercise groups. None of the exercise trials determined significant BMD effects at the lumbar spine. Based on the present studies, there is only limited evidence for a favorable effect of exercise on BMD in men. More well-designed and sophisticated studies on BMD in healthy older men have to address this topic. Further, there is a need to define intervention quality standards and implement a universal scoring system that allows this pivotal determinant

  1. [Systematically induced effects of Tetranychus cinnabarinus infestation on chemical defense in Zea mays inbred lines].

    Science.gov (United States)

    Zhu, Yu-xi; Yang, Qun-fang; Huang, Yu-bi; Li, Qing

    2015-09-01

    In the present study, we investigated the systematically induced production of defense-related compounds, including DIMBOA, total phenol, trypsin inhibitors (TI) and chymotrypsin inhibitor (CI), by Tetranychus cinnabarinus infestation in Zea mays. The first leaves of two corn in-bred line seedlings, the mite-tolerant line ' H1014168' and the mite-sensitive line 'H1014591', were sucked by T. cinnabarinus adult female for seven days, and then the contents of DIMBOA, total phenol, TI and CI were measured in the second leaf and in the roots, respectively. Results showed that as compared to the unsucked control, all contents of DIMBOA, total phenol, TI and CI induced by T. cinnabarinus sucking were significantly higher in the second leaf of both inbred lines as well as in the roots of the mite-tolerant 'H1014168'. However, in the roots of 'H1014591', these defense compounds had different trends, where there was a higher induction of TI and a lower level of total phenol than that of the healthy control, while had almost no difference in DIMBOA and CI. These findings suggested that the infestation of T. cinnabarinus could systematically induce accumulation of defense-related compounds, and this effect was stronger in the mite-tolerant inbred line than in the mite-sensitive inbred line.

  2. Systematic review on effectiveness of interventional programmes in treating childhood obesity

    Directory of Open Access Journals (Sweden)

    Hasanain Faisal Ghazi

    2017-05-01

    Full Text Available Background: The prevalence of childhood obesity is alarming and studies have shown that overweight and obese children carry more risk of developing a range of related health problems when they become older. The aim of this systematic review was to evaluate the effectiveness of childhood obesity intervention programmes. Methods: Systematic review of published literature from 2008 to 2015. Articles were excluded if they were published before 2008, if they were not published in English; if they had incomplete statistical data; and if the participants did not belong to the age category of 6 to 12 years. All eligible articles were independently reviewed by two reviewers to assess study quality. Results: Ten studies met the inclusion criteria. Most were conducted in a health care setting (n = 5 or schoolbased setting (n = 4, including one in a rural area. Half of the articles were published in 2013 and all studies had an almost equal gender distribution. All studies sought reduction in anthropometric/ body composition as their main outcomes. Only three studies were rated as strong in quality while the others were moderate. Conclusions: Most of the interventional studies included in our review showed a significant improvement for obese children. Four out of 11 studies showed that physical activity and diet had a great impact on child obesity, while other studies showed that a hospital-care setting or school-based setting and parental involvement were more beneficial in treating obesity.

  3. The effect of total knee arthroplasty on patients' balance and incidence of falls: a systematic review.

    Science.gov (United States)

    Moutzouri, M; Gleeson, N; Billis, E; Tsepis, E; Panoutsopoulou, I; Gliatis, J

    2017-11-01

    Despite the high incidence of falls in patients with OA, few studies have explored whether falls risk is affected after patients undergo total knee arthroplasty (TKA). Therefore, the aim of this systematic review was to identify the extent of the effects of TKA on balance and incidence of falls by critically reviewing the available literature. A systematic review of published literature sources was conducted up to March 2014. All studies assessing balance and incidence of falls after TKA (without physiotherapeutic intervention) were included. The methodological quality of each study was reviewed using the Critical Appraisal Skill Programme tool. Thirteen studies were included, comprising of ten cohort studies (Level II) and three studies with Level of evidence III. Findings provide evidence that TKA improves significantly single-limb standing balance (~60%) and dynamic balance up to 1-year following surgery (Level of evidence II). Moreover, TKA influences positively fear of falling and incidence of falls by switching 54.2 % of pre-operative fallers to post-operative non-fallers (Level of evidence II-III). It is highlighted that knee extension strength, proprioception and symmetrization of postural strategies have not fully recovered post-TKA and influence balance performance. Clinically, these persistent deficits need to be mitigated by physiotherapy even before TKA takes place.

  4. Effects οf Yoga οn cancer patients: Secondary analysis οf Systematic Reviews/Meta-Analyses

    Directory of Open Access Journals (Sweden)

    Dimos Mastrogiannis

    2016-09-01

    Full Text Available Introduction: Western medicine’s model has been enriched with alternative management and treatment methods. Yoga is a technique that incorporates physical exercises, breathing methods, meditation and relaxation which has been proposed to have positive effects on cancer patients. Aim: The aim of the present study is to critically review findings of systematic reviews/meta-analyses that are available in the international literature, regarding the effects of yoga on cancer patients. Methodology: Literature review was performed in five (5 databases: PubMed, Scopus, EMBASE, Web of Science and Cochrane Database of systematic Reviews. Authors adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analysis model in order to perform a critical review of the existing literature. Methodological assessment of papers under review was performed according to criteria of the Assessment of Multiple Systematic Reviews instrument. Inclusion criteria were the English language, research undertaken in adults and evaluation of effects of yoga as the primary intervention. Results: Although there is a lack of guidelines regarding the assessment of systematic reviews using the above mentioned instruments, 16 papers were included in the present study. Findings are confounding, even though there is evidence supporting the use of yoga in certain types of cancer. Specifically, improvements in quality of life and psychological wellbeing, anxiety, however, not pain reduction, have been reported in women suffering from breast cancer, however, no statistically significant effect has been documented in patients with haematological malignancies. Conclusions: The majority of studies about the effects of yoga on quality of life, fatigue, sleep quality, anxiety, and depression have small samples. There is a trend towards an overall quality of life improvement, nonetheless, the lack of sufficiently powered randomized controlled trials prevents the extraction of a safe

  5. Blood pressure-lowering effect of Shinrin-yoku (Forest bathing): a systematic review and meta-analysis.

    Science.gov (United States)

    Ideno, Yuki; Hayashi, Kunihiko; Abe, Yukina; Ueda, Kayo; Iso, Hiroyasu; Noda, Mitsuhiko; Lee, Jung-Su; Suzuki, Shosuke

    2017-08-16

    Shinrin-yoku (experiencing the forest atmosphere or forest bathing) has received increasing attention from the perspective of preventive medicine in recent years. Some studies have reported that the forest environment decreases blood pressure. However, little is known about the possibility of anti-hypertensive applications of Shinrin-yoku. This study aimed to evaluate preventive or therapeutic effects of the forest environment on blood pressure. We systematically reviewed the medical literature and performed a meta-analysis.Four electronic databases were systematically searched for the period before May 2016 with language restriction of English and Japanese. The review considered all published, randomized, controlled trials, cohort studies, and comparative studies that evaluated the effects of the forest environment on changes in systolic blood pressure. A subsequent meta-analysis was performed. Twenty trials involving 732 participants were reviewed. Systolic blood pressure of the forest environment was significantly lower than that of the non-forest environment. Additionally, diastolic blood pressure of the forest environment was significantly lower than that of the non-forest environment. This systematic review shows a significant effect of Shinrin-yoku on reduction of blood pressure.

  6. The effectiveness and cost-effectiveness of first aid interventions for burns given to caregivers of children: A systematic review.

    Science.gov (United States)

    Nurmatov, Ulugbek B; Mullen, Stephen; Quinn-Scoggins, Harriet; Mann, Mala; Kemp, Alison

    2018-05-01

    the effectiveness and cost-effectiveness of burns first-aid educational interventions given to caregivers of children. Systematic review of eligible studies from seven databases, international journals, trials repositories and contacted international experts. Of 985 potential studies, four met the inclusion criteria. All had high risk of bias and weak global rating. Two studies identified a statistically significant increase in knowledge after of a media campaign. King et al. (41.7% vs 63.2%, pfirst-aid training program and showed a reduction in use of harmful traditional methods for burns in children (29% vs 16.1%, pfirst aid administration. High quality clinical trials are needed. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  7. Significant effect of Ca2+ on improving the heat resistance of lactic acid bacteria.

    Science.gov (United States)

    Huang, Song; Chen, Xiao Dong

    2013-07-01

    The heat resistance of lactic acid bacteria (LAB) has been extensively investigated due to its highly practical significance. Reconstituted skim milk (RSM) has been found to be one of the most effective protectant wall materials for microencapsulating microorganisms during convective drying, such as spray drying. In addition to proteins and carbohydrate, RSM is rich in calcium. It is not clear which component is critical in the RSM protection mechanism. This study investigated the independent effect of calcium. Ca(2+) was added to lactose solution to examine its influence on the heat resistance of Lactobacillus rhamnosus ZY, Lactobacillus casei Zhang, Lactobacillus plantarum P8 and Streptococcus thermophilus ND03. The results showed that certain Ca(2+) concentrations enhanced the heat resistance of the LAB strains to different extents, that is produced higher survival and shorter regrowth lag times of the bacterial cells. In some cases, the improvements were dramatic. More scientifically insightful and more intensive instrumental study of the Ca(2+) behavior around and in the cells should be carried out in the near future. In the meantime, this work may lead to the development of more cost-effective wall materials with Ca(2+) added as a prime factor. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

  8. Absorbing systematic effects to obtain a better background model in a search for new physics

    International Nuclear Information System (INIS)

    Caron, S; Horner, S; Sundermann, J E; Cowan, G; Gross, E

    2009-01-01

    This paper presents a novel approach to estimate the Standard Model backgrounds based on modifying Monte Carlo predictions within their systematic uncertainties. The improved background model is obtained by altering the original predictions with successively more complex correction functions in signal-free control selections. Statistical tests indicate when sufficient compatibility with data is reached. In this way, systematic effects are absorbed into the new background model. The same correction is then applied on the Monte Carlo prediction in the signal region. Comparing this method to other background estimation techniques shows improvements with respect to statistical and systematic uncertainties. The proposed method can also be applied in other fields beyond high energy physics.

  9. The effects of workplace physical activity interventions in men: a systematic review.

    Science.gov (United States)

    Wong, Jason Y L; Gilson, Nicholas D; van Uffelen, Jannique G Z; Brown, Wendy J

    2012-07-01

    The workplace is cited as a promising setting for physical activity (PA) promotion, but workplace PA interventions tend not to specifically target men. The aim of this article was to review the literature on workplace PA interventions for men and to identify key issues for future intervention development. Articles targeting PA at the workplace were located through a structured database search. Information on intervention strategies and PA outcomes were extracted. Only 13 studies (10.5%) reviewed focused on men, of which 5 showed significant increases in PA. These studies used generic, multicomponent, health promotion strategies with a variety of timeframes, self-report PA measures, and PA outcomes. The systematic review identified that evidence on the effectiveness of workplace PA interventions for men is equivocal and highlighted methodological concerns. Future research should use reliable and valid measures of PA and interventions that focus specifically on men's needs and PA preferences.

  10. [Are Interventions Promoting Physical Activity Cost-Effective? A Systematic Review of Reviews].

    Science.gov (United States)

    Rütten, Alfred; Abu-Omar, Karim; Burlacu, Ionut; Schätzlein, Valentin; Suhrcke, Marc

    2017-03-01

    On the basis of international published reviews, this systematic review aims to determine the health economic benefits of interventions promoting physical activity.This review of reviews is based on a systematic literature research in 10 databases (e. g. PubMed, Scopus, SPORTDiscus) supplemented by hand searches from January 2000 to October 2015. Publications were considered in the English or German language only. Results of identified reviews were derived.In total, 18 reviews were identified that could be attributed to interventions promoting physical activity (2 reviews focusing on population-based physical activity interventions, 10 reviews on individual-based and 6 reviews on both population-based and individual-based physical activity interventions). Results showed that population-based physical activity interventions are of great health economic potential if reaching a wider population at comparably low costs. Outstanding are political and environmental strategies, as well as interventions supporting behavioural change through information. The most comprehensive documentation for interventions promoting physical activity could be found for individual-based strategies (i. e. exercise advice or exercise programs). However, such programs are comparatively less cost-effective due to limited reach and higher utilization of resources.The present study provides an extensive review and analysis of the current international state of research regarding the health economic evaluation of interventions promoting physical activity. Results show favourable cost-effectiveness for interventions promoting physical activity, though significant differences in the effectiveness between various interventions were noticed. The greatest potential for cost-effectiveness can be seen in population-based interventions. At the same time, there is a need to acknowledge the limitations of the economic evidence in this field which are attributable to methodological challenges and

  11. Systematic renormalization of the effective theory of Large Scale Structure

    International Nuclear Information System (INIS)

    Abolhasani, Ali Akbar; Mirbabayi, Mehrdad; Pajer, Enrico

    2016-01-01

    A perturbative description of Large Scale Structure is a cornerstone of our understanding of the observed distribution of matter in the universe. Renormalization is an essential and defining step to make this description physical and predictive. Here we introduce a systematic renormalization procedure, which neatly associates counterterms to the UV-sensitive diagrams order by order, as it is commonly done in quantum field theory. As a concrete example, we renormalize the one-loop power spectrum and bispectrum of both density and velocity. In addition, we present a series of results that are valid to all orders in perturbation theory. First, we show that while systematic renormalization requires temporally non-local counterterms, in practice one can use an equivalent basis made of local operators. We give an explicit prescription to generate all counterterms allowed by the symmetries. Second, we present a formal proof of the well-known general argument that the contribution of short distance perturbations to large scale density contrast δ and momentum density π(k) scale as k 2 and k, respectively. Third, we demonstrate that the common practice of introducing counterterms only in the Euler equation when one is interested in correlators of δ is indeed valid to all orders.

  12. Effectiveness of school-based smoking prevention curricula: systematic review and meta-analysis.

    Science.gov (United States)

    Thomas, Roger E; McLellan, Julie; Perera, Rafael

    2015-03-10

    To assess effectiveness of school-based smoking prevention curricula keeping children never-smokers. Systematic review, meta-analysis. MEDLINE (1966+), EMBASE (1974+), Cinahl, PsycINFO (1967+), ERIC (1982+), Cochrane CENTRAL, Health Star, Dissertation Abstracts, conference proceedings. pooled analyses, fixed-effects models, adjusted ORs. Risk of bias assessed with Cochrane Risk of Bias tool. 50 randomised controlled trials (RCTs) of school-based smoking curricula. Never-smokers age 5-18 (n=143,495); follow-up ≥6 months; all countries; no date/language limitations. Information, social influences, social competence, combined social influences/competence and multimodal curricula. Remaining a never-smoker at follow-up. Pooling all curricula, trials with follow-up ≤1 year showed no statistically significant differences compared with controls (OR 0.91 (0.82 to 1.01)), though trials of combined social competence/social influences curricula had a significant effect on smoking prevention (7 trials, OR 0.59 (95% CI 0.41 to 0.85)). Pooling all trials with longest follow-up showed an overall significant effect in favour of the interventions (OR 0.88 (0.82 to 0.95)), as did the social competence (OR 0.65 (0.43 to 0.96)) and combined social competence/social influences curricula (OR 0.60 (0.43 to 0.83)). No effect for information, social influences or multimodal curricula. Principal findings were not sensitive to inclusion of booster sessions in curricula or to whether they were peer-led or adult-led. Differentiation into tobacco-only or multifocal curricula had a similar effect on the primary findings. Few trials assessed outcomes by gender: there were significant effects for females at both follow-up periods, but not for males. RCTs of baseline never-smokers at longest follow-up found an overall significant effect with average 12% reduction in starting smoking compared with controls, but no effect for all trials pooled at ≤1 year. However, combined social

  13. Space radiation-induced bystander effect: kinetics of biologic responses, mechanisms, and significance of secondary radiations

    International Nuclear Information System (INIS)

    Gonon, Geraldine

    2011-01-01

    Widespread evidence indicates that exposure of cell cultures to a particles results in significant biological changes in both the irradiated and non-irradiated bystander cells in the population. The induction of non-targeted biological responses in cell cultures exposed to low fluences of high charge (Z) and high energy (E) particles is relevant to estimates of the health risks of space radiation and to radiotherapy. Here, we investigated the mechanisms underlying the induction of stressful effects in confluent normal human fibroblast cultures exposed to low fluences of 1000 MeV/u iron ions (linear energy transfer (LET) 151 keV/μm), 600 MeV/u silicon ions (LET 50 keV/μm) or 290 MeV/u carbon ions (LET 13 keV/μm). We compared the results with those obtained in cell cultures exposed, in parallel, to low fluences of 0.92 MeV/u a particles (LET 109 keV/μm). Induction of DNA damage, changes in gene expression, protein carbonylation and lipid peroxidation during 24 h after exposure of confluent cultures to mean doses as low as 0.2 cGy of iron or silicon ions strongly supported the propagation of stressful effects from irradiated to bystander cells. At a mean dose of 0.2 cGy, only 1 and 3 % of the cells would be targeted through the nucleus by an iron or silicon ion, respectively. Within 24 h post-irradiation, immunoblot analyses revealed significant increases in the levels of phospho-TP53 (serine 15), p21Waf1 (also known as CDKN1A), HDM2, phospho-ERK1/2, protein carbonylation and lipid peroxidation. The magnitude of the responses suggested participation of non-targeted cells in the response. Furthermore, when the irradiated cell populations were subcultured in fresh medium shortly after irradiation, greater than expected increases in the levels of these markers were also observed during 24 h. Together, the results imply a rapidly propagated and persistent bystander effect. In situ analyses in confluent cultures showed 53BP1 foci formation, a marker of DNA damage, in

  14. Modified Cross Feedback Control for a Magnetically Suspended Flywheel Rotor with Significant Gyroscopic Effects

    Directory of Open Access Journals (Sweden)

    Yuan Ren

    2014-01-01

    Full Text Available For magnetically suspended rigid rotors (MSRs with significant gyroscopic effects, phase lag of the control channel is the main factor influencing the system nutation stability and decoupling performance. At first, this paper proves that the phase lag of the cross channel instead of the decentralized channel is often the main factor influencing the system nutation stability at high speeds. Then a modified cross feedback control strategy based on the phase compensation of cross channel is proposed to improve the stability and decoupling performances. The common issues associated with the traditional control methods have been successfully resolved by this method. Analysis, simulation, and experimental results are presented to demonstrate the feasibility and superiority of the proposed control method.

  15. A Cloud Greenhouse Effect on Mars: Significant Climate Change in the Recent Past

    Science.gov (United States)

    Haberle, Robert M.; Kahre, Melinda A.; Schaeffer, James R.; Montmessin, Frank; Phillips, R J.

    2012-01-01

    The large variations in Mars orbit parameters are known to be significant drivers of climate change on the Red planet. The recent discovery of buried CO2 ice at the South Pole adds another dimension to climate change studies. In this paper we present results from the Ames GCM that show within the past million years it is possible that clouds from a greatly intensified Martian hydrological cycle may have produced a greenhouse effect strong enough to raise global mean surface temperatures by several tens of degrees Kelvin. It is made possible by the ability of the Martian atmosphere to transport water to high altitudes where cold clouds form, reduce the outgoing longwave radiation, and drive up surface temperatures to maintain global energy balance.

  16. Significance of Serum Pepsinogens as a Biomarker for Gastric Cancer and Atrophic Gastritis Screening: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Huang, Ya-kai; Yu, Jian-chun; Kang, Wei-ming; Ma, Zhi-qiang; Ye, Xin; Tian, Shu-bo; Yan, Chao

    2015-01-01

    Background Human pepsinogens are considered promising serological biomarkers for the screening of atrophic gastritis (AG) and gastric cancer (GC). However, there has been controversy in the literature with respect to the validity of serum pepsinogen (SPG) for the detection of GC and AG. Consequently, we conducted a systematic review and meta-analysis to assess the diagnostic accuracy of SPG in GC and AG detection. Methods We searched PubMed, Embase, and the Chinese National Knowledge Infrastructure (CNKI) for correlative original studies published up to September 30, 2014. The summary sensitivity, specificity, positive diagnostic likelihood ratio (DLR+), negative diagnostic likelihood ratio (DLR-), area under the summary receiver operating characteristic curve (AUC) and diagnostic odds ratio (DOR) were used to evaluate SPG in GC and AG screening based on bivariate random effects models. The inter-study heterogeneity was evaluated by the I2 statistics and publication bias was assessed using Begg and Mazumdar’s test. Meta-regression and subgroup analyses were performed to explore study heterogeneity. Results In total, 31 studies involving 1,520 GC patients and 2,265 AG patients were included in the meta-analysis. The summary sensitivity, specificity, DLR+, DLR-, AUC and DOR for GC screening using SPG were 0.69 (95% CI: 0.60–0.76), 0.73 (95% CI: 0.62–0.82), 2.57 (95% CI: 1.82–3.62), and 0.43 (95% CI: 0.34–0.54), 0.76 (95% CI: 0.72–0.80) and 6.01 (95% CI: 3.69–9.79), respectively. For AG screening, the summary sensitivity, specificity, DLR+, DLR-, AUC and DOR were 0.69 (95% CI: 0.55–0.80), 0.88 (95% CI: 0.77–0.94), 5.80 (95% CI: 3.06–10.99), and 0.35 (95% CI: 0.24–0.51), 0.85 (95% CI: 0.82–0.88) and 16.50 (95% CI: 8.18–33.28), respectively. In subgroup analysis, the use of combination of concentration of PGI and the ratio of PGI:PGII as measurement of SPG for GC screening yielded sensitivity of 0.70 (95% CI: 0.66–0.75), specificity of 0

  17. Significance of Serum Pepsinogens as a Biomarker for Gastric Cancer and Atrophic Gastritis Screening: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Ya-kai Huang

    Full Text Available Human pepsinogens are considered promising serological biomarkers for the screening of atrophic gastritis (AG and gastric cancer (GC. However, there has been controversy in the literature with respect to the validity of serum pepsinogen (SPG for the detection of GC and AG. Consequently, we conducted a systematic review and meta-analysis to assess the diagnostic accuracy of SPG in GC and AG detection.We searched PubMed, Embase, and the Chinese National Knowledge Infrastructure (CNKI for correlative original studies published up to September 30, 2014. The summary sensitivity, specificity, positive diagnostic likelihood ratio (DLR+, negative diagnostic likelihood ratio (DLR-, area under the summary receiver operating characteristic curve (AUC and diagnostic odds ratio (DOR were used to evaluate SPG in GC and AG screening based on bivariate random effects models. The inter-study heterogeneity was evaluated by the I2 statistics and publication bias was assessed using Begg and Mazumdar's test. Meta-regression and subgroup analyses were performed to explore study heterogeneity.In total, 31 studies involving 1,520 GC patients and 2,265 AG patients were included in the meta-analysis. The summary sensitivity, specificity, DLR+, DLR-, AUC and DOR for GC screening using SPG were 0.69 (95% CI: 0.60-0.76, 0.73 (95% CI: 0.62-0.82, 2.57 (95% CI: 1.82-3.62, and 0.43 (95% CI: 0.34-0.54, 0.76 (95% CI: 0.72-0.80 and 6.01 (95% CI: 3.69-9.79, respectively. For AG screening, the summary sensitivity, specificity, DLR+, DLR-, AUC and DOR were 0.69 (95% CI: 0.55-0.80, 0.88 (95% CI: 0.77-0.94, 5.80 (95% CI: 3.06-10.99, and 0.35 (95% CI: 0.24-0.51, 0.85 (95% CI: 0.82-0.88 and 16.50 (95% CI: 8.18-33.28, respectively. In subgroup analysis, the use of combination of concentration of PGI and the ratio of PGI:PGII as measurement of SPG for GC screening yielded sensitivity of 0.70 (95% CI: 0.66-0.75, specificity of 0.79 (95% CI: 0.79-0.80, DOR of 6.92 (95% CI: 4.36-11.00, and

  18. Effects of the Pilates method on neck pain: a systematic review

    OpenAIRE

    Cemin, Natália Fernanda; Schmit, Emanuelle Francine Detogni; Candotti, Cláudia Tarragô

    2017-01-01

    Abstract Introduction: The Pilates method has been used for neck pain reduction. Objective: To systematically review randomized and non-randomized controlled trials that assessed the effects of Pilates on neck pain when compared to other groups (CRD42015025987). Methods: This study involved a systematic review directed by the PRISMA Statement based on the recommendations of the Cochrane Colaboration, registered in PROSPERO under the code CRD42015025987. The following databases were searche...

  19. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

    OpenAIRE

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-01-01

    Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

  20. The Effectiveness of Dance Interventions to Improve Older Adults’ Health: A Systematic Literature Review

    Science.gov (United States)

    Hwang, Phoebe Woei-Ni; Braun, Kathryn L.

    2017-01-01

    Background Physical inactivity is commonly observed among individuals aged ≥60 y. Identified barriers to sedentary older adults beginning activity include low self-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture. Dancing has the potential to be an attractive physical activity that can be adjusted to fit a target populations age, physical limitations, and culture. Objectives This review examined the benefits to physical health of dance interventions among older adults. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search using the PubMed database was conducted. Eighteen studies met the inclusion and exclusion criteria and were analyzed for type of intervention, the study’s design, participants’ demographics, and outcomes, including attrition. Results The 18 articles reported on studies conducted in North America, South America, Europe, and Asia. Of the styles of dancing, 6 studies used ballroom, 5 used contemporary, 4 used cultural, 1 used pop, and 2 used jazz. Two studies targeted older adults with pre-existing medical conditions. The average age of participants ranged from 52–87 y. Researchers used a variety of measures to assess effectiveness; (1) 3 of 5 (60%) that used measures to assess flexibility showed significant positive results; (2) 23 of 28 (82%) that used measures of muscular strength and endurance showed significant positive changes; (3) 8 of 9 (89%) that used measures of balance showed significant positive changes; (4) 8 of 10 (80%) that used measures of cognitive ability showed significant positive changes; and (5) the one that measured cardiovascular endurance showed significant positive changes. Only 6 studies reported participation, and they found low attrition. Conclusions The findings suggest that dance, regardless of its style, can significantly improve muscular strength and endurance, balance, and other aspects of

  1. [Descemet's stripping automated endothelial keratoplasty (DEAEK). Systematic review of clinical-effectiveness and safety].

    Science.gov (United States)

    Paz-Valiñas, L; de la Fuente-Cid, R; de Rojas-Silva, M V; López-Rodríguez, I; López-García, M

    2015-04-01

    To conduct a systematic review of the efficacy/effectiveness, safety and cost of Descemet's stripping automated endothelial keratoplasty (DSAEK) technique in patients with corneal endothelial failure. Comprehensive literature search conducted in the main biomedical databases from January-May 2012. Following a critical perusal of the total of 485 abstracts retrieved, 16 case series and one economic evaluation study were included. Corrected distance visual acuity and uncorrected distance visual acuity improved after treatment with DSAEK, attaining values of 0.6 to 0.8 and 0.5 respectively. The degree of post-DSAEK astigmatism was not significant with respect to baseline values. The main complications were graft dislocation-detachment (1.5-23%), primary failure (0-12%) and endothelial rejection (0.8-8.5%). In Fuchs' dystrophy and bullous keratopathy, data on the effectiveness of DSAEK indicate post-intervention improvement in uncorrected and corrected distance visual acuity. Astigmatism arising after DSAEK was not significant. The most significant post-DSAEK complications are linked to the viability of the graft, with the most frequent complications being dislocation-detachment and, to a lesser extent, endothelial rejection. The studies that assess DSAEK are case series, and for the most part retrospective. The quality of this type of studies is both low and limited. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  2. Effective Interventions in Overweight or Obese Young Children: Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Hoek, van E.; Feskens, E.J.M.; Bouwman, L.I.; Janse, A.J.

    2014-01-01

    Abstract Background: Treatment programs for overweight and obese young children are of variable effectiveness, and the characteristics of effective programs are unknown. In this systematic review with meta-analysis, the effectiveness of treatment programs for these children is summarized. Methods:

  3. Complementary and Alternative Medicine: The Mozart Effect on Childhood Epilepsy--A Systematic Review

    Science.gov (United States)

    Brackney, Dana E.; Brooks, Jessica L.

    2018-01-01

    This systematic review examines the effectiveness of Mozart's music in decreasing seizures in children with epilepsy (Mozart Effect) using the Johns Hopkins Nursing Evidence-Based Practice rating scale©. A search for articles with "Mozart Effect," "child*," and "epilepsy" was conducted in CINAHL Complete, Science…

  4. Medication effects on the rate of orthodontic tooth movement: a systematic literature review.

    NARCIS (Netherlands)

    Bartzela, T.N.; Turp, J.C.; Motschall, E.; Maltha, J.C.

    2009-01-01

    INTRODUCTION: Recently, several reviews have been published on the effects of medications on bone physiology and the clinical side effects in orthodontics. However, the effects of medications on the rate of orthodontic tooth movement have not been evaluated. METHODS: A systematic literature review

  5. [Different aluminum adjuvants significantly enhances the effect of immunization on Brucella Omp31].

    Science.gov (United States)

    Qing, Rui; Xiang, Qingke; Liu, Zhongqi; Xiao, Fei; Yang, Fan

    2018-02-01

    Objective To investigate the effect of aluminum phosphate (AP) and aluminum hydroxide (AH) as adjuvants on Brucella outer membrane protein 31 (Omp31) in inducing humoral and cellular immune responses and immune protection. Methods AP and AH adjuvants were prepared and separately mixed with Brucella Omp31 protein to measure the adsorption rates. The AP- and AH-absorbed Omp31 protein were intraperitoneally injected into BLAB/c mice at 0, 2, and 4 weeks, and meanwhile, unabsorbed Omp31 protein and PBS were used as controls. The levels of serum IgG, IgG1, IgG2a and genital tract secretion sIgA were determined by ELISA at 0, 2, 4 and 6 weeks. Spleen cells were collected for culture at 6 weeks, and the cells were stimulated by Omp31 for 48 hours followed by the analysis of IFN-γ and IL-10 levels in the supernatants by ELISA, and the determination of lymphocyte proliferation by CCK-8 assay. The mice were challenged with Brucella at 6 weeks, and bacterial content in spleen tissue was determined 1 and 2 weeks later. Results AP and AH could absorb over 70% and 85% of the Omp31 protein, respectively, for solutions at all the tested concentrations. ELISA suggested that serum IgG, IgG1, IgG2a and genital tract sIgA levels peaked 2 weeks after the last immunization for both AP and AH groups, and antibody level was higher in the AP and AH groups than the control groups, and higher in the AH group than in the AP group. CCK-8 assay showed that the proliferating rate of lymphocytes induced by the AH group was significantly higher than that by the AP group, and the AH group also showed significantly higher IFN-γ level in the supernatant than the AP group, but no significant difference in IL-10 level. The AH group had remarkably lower bacterial load in the spleen than the AP group 2 weeks after challenged by Brucella 16M strain. Conclusion Both AP and AH adjuvants effectively enhanced immunogenicity and immune protection of the Brucella Omp31 protein, and AH was superior to AP in

  6. Effectiveness of technologies in the treatment of post-stroke anomia: A systematic review

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    Monica Lavoie

    2015-04-01

    Procedures and analyses: The PRISMA statement(1 for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions was used as a guideline to conduct the present review. A systematic search of publications on PubMed and PsycInfo was conducted. Experimental studies designed to assess the effectiveness of an intervention delivered by a technology, namely computer, smart tablet or teletreatment, to specifically improve anomia in post-stroke participants were selected, without limitations as to the dates of publication. The main outcomes studied were improvement in naming skills and generalization to untreated items and daily communication. The Downs and Black checklist for randomised and non-randomised studies of health care interventions(2 was used by two reviewers (ML and JM to conduct the methodological quality assessment. Results: A total of 20 studies were included in this review. Up to now, computer is by far the most popular technology, whereas only a few studies aimed at exploring the effectiveness of smart tablet or teletreatment. In some studies, technology was used as a therapy tool in a clinical setting, in the presence of the clinician, while in others, therapy with technology was self-administered at home, without the clinician. All studies confirmed the effectiveness of therapy provided by technology to improve naming of trained items. However, generalization to untrained items is unclear and assessment of generalization to daily communication is scarce. Conclusions: The results of this systematic review confirm that technology is a promising avenue in the management of post-stroke anomia. Self-administered therapies are particularly interesting since they allow increasing significantly the intensity and frequency of therapeutic activities, a factor that has been explicitly recognized as a positive determinant of the efficacy of language treatment(3. In future studies, ecological tasks aiming to evaluate therapy

  7. Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol.

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    Murphy, Jacqueline; Pritchard, Mark G; Cheng, Lok Yin; Janarthanan, Roshni; Leal, José

    2018-03-14

    Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways. A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures.We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation.Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status. This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be

  8. Effects of acupuncture on sensory perception: a systematic review and meta-analysis.

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    Baeumler, Petra I; Fleckenstein, Johannes; Takayama, Shin; Simang, Michael; Seki, Takashi; Irnich, Dominik

    2014-01-01

    The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception. Our findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its

  9. No significant effect of prefrontal tDCS on working memory performance in older adults

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    Jonna eNilsson

    2015-12-01

    Full Text Available Transcranial direct current stimulation (tDCS has been put forward as a non-pharmacological alternative for alleviating cognitive decline in old age. Although results have shown some promise, little is known about the optimal stimulation parameters for modulation in the cognitive domain. In this study, the effects of tDCS over the dorsolateral prefrontal cortex (dlPFC on working memory performance were investigated in thirty older adults. An N-back task assessed working memory before, during and after anodal tDCS at a current strength of 1mA and 2mA, in addition to sham stimulation. The study used a single-blind, cross-over design. The results revealed no significant effect of tDCS on accuracy or response times during or after stimulation, for any of the current strengths. These results suggest that a single session of tDCS over the dlPFC is unlikely to improve working memory, as assessed by an N-back task, in old age.

  10. Effects of bovine pregnancy on the fatty acid composition of milk: the significance for humans needs.

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    Barreiro, R; Regal, P; Díaz-Bao, M; Vázquez, B I; Cepeda, A

    2017-04-01

    Milk from 40 Holstein dairy cows was collected from two different farms in Galicia (Spain). The differences in the fatty acid composition of two groups of cows, 20 pregnant and 20 non-pregnant, was studied to determine whether pregnancy status is a determinant factor that can alter the fatty acid profile of milk. Gas-chromatography (GC) coupled to flame ionisation detection (FID) was used for the determination of the fatty acids. Differences in the milk fatty acids between pregnant and non-pregnant cows were pronounced showing statistically significant differences for some fatty acids and the total saturated and monounsaturated fatty acids. Milk from non-pregnant cows was lower in saturated fatty acids and higher in monounsaturated fatty acids (unlike milk from pregnant cows). The effects of the consumption of bovine milk, particularly milk fat, on human health have been studied in depth and sometimes are associated with negative effects, but milk has also several beneficial characteristics linked to some fatty acids.

  11. Confounding and Statistical Significance of Indirect Effects: Childhood Adversity, Education, Smoking, and Anxious and Depressive Symptomatology

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    Mashhood Ahmed Sheikh

    2017-08-01

    Full Text Available The life course perspective, the risky families model, and stress-and-coping models provide the rationale for assessing the role of smoking as a mediator in the association between childhood adversity and anxious and depressive symptomatology (ADS in adulthood. However, no previous study has assessed the independent mediating role of smoking in the association between childhood adversity and ADS in adulthood. Moreover, the importance of mediator-response confounding variables has rarely been demonstrated empirically in social and psychiatric epidemiology. The aim of this paper was to (i assess the mediating role of smoking in adulthood in the association between childhood adversity and ADS in adulthood, and (ii assess the change in estimates due to different mediator-response confounding factors (education, alcohol intake, and social support. The present analysis used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 4,530, a representative prospective cohort study of men and women. Seven childhood adversities (low mother's education, low father's education, low financial conditions, exposure to passive smoke, psychological abuse, physical abuse, and substance abuse distress were used to create a childhood adversity score. Smoking status was measured at a mean age of 54.7 years (Tromsø IV, and ADS in adulthood was measured at a mean age of 61.7 years (Tromsø V. Mediation analysis was used to assess the indirect effect and the proportion of mediated effect (% of childhood adversity on ADS in adulthood via smoking in adulthood. The test-retest reliability of smoking was good (Kappa: 0.67, 95% CI: 0.63; 0.71 in this sample. Childhood adversity was associated with a 10% increased risk of smoking in adulthood (Relative risk: 1.10, 95% CI: 1.03; 1.18, and both childhood adversity and smoking in adulthood were associated with greater levels of ADS in adulthood (p < 0.001. Smoking in adulthood did not significantly

  12. The Effectiveness of Music in Pediatric Healthcare: A Systematic Review of Randomized Controlled Trials

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    Karline Treurnicht Naylor

    2011-01-01

    Full Text Available The aim of this study was to systematically review the effectiveness of music on pediatric health-related outcomes. Five electronic databases were searched for randomized controlled/crossover trial designs published between 1984 and 2009. Eligible studies used music as a therapy or intervention, included participants 1 to 18 years, and focused on at least one health-related outcome (with the exclusion of procedural pain. Seventeen studies met the inclusion criteria. Quantitative synthesis was hampered by an inability to aggregate data arising from heterogeneity of interventions, outcomes and measurement tools. Qualitative synthesis revealed significant improvements in one or more health outcomes within four of seven trials involving children with learning and developmental disorders; two of three trials involving children experiencing stressful life events; and four of five trials involving children with acute and/or chronic physical illness. No significant effects were found for two trials involving children with mood disorders and related psychopathology. These findings offer limited qualitative evidence to support the effectiveness of music on health-related outcomes for children and adolescents with clinical diagnoses. Recommendations for establishing a consensus on research priorities and addressing methodological limitations are put forth to support the continued advancement of this popular intervention.

  13. The Effectiveness of Music in Pediatric Healthcare: A Systematic Review of Randomized Controlled Trials

    Science.gov (United States)

    Treurnicht Naylor, Karline; Kingsnorth, Shauna; Lamont, Andrea; McKeever, Patricia; Macarthur, Colin

    2011-01-01

    The aim of this study was to systematically review the effectiveness of music on pediatric health-related outcomes. Five electronic databases were searched for randomized controlled/crossover trial designs published between 1984 and 2009. Eligible studies used music as a therapy or intervention, included participants 1 to 18 years, and focused on at least one health-related outcome (with the exclusion of procedural pain). Seventeen studies met the inclusion criteria. Quantitative synthesis was hampered by an inability to aggregate data arising from heterogeneity of interventions, outcomes and measurement tools. Qualitative synthesis revealed significant improvements in one or more health outcomes within four of seven trials involving children with learning and developmental disorders; two of three trials involving children experiencing stressful life events; and four of five trials involving children with acute and/or chronic physical illness. No significant effects were found for two trials involving children with mood disorders and related psychopathology. These findings offer limited qualitative evidence to support the effectiveness of music on health-related outcomes for children and adolescents with clinical diagnoses. Recommendations for establishing a consensus on research priorities and addressing methodological limitations are put forth to support the continued advancement of this popular intervention. PMID:20976017

  14. Efficiency, effectiveness and treatment stability of clear aligners: A systematic review and meta-analysis.

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    Zheng, M; Liu, R; Ni, Z; Yu, Z

    2017-08-01

    The objective of this study was to perform a systematic review of the orthodontic literature with regard to efficiency, effectiveness and stability of treatment outcome with clear aligners compared with treatment with conventional brackets. An electronic search without time or language restrictions was undertaken in October 2014 in the following electronic databases: Google Scholar, the Cochrane Oral Health Group's Trials Register, Scopus, CENTRAL, MEDLINE via OVID, EMBASE via OVID and Web of Science. We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two authors were responsible for study selection, validity assessment and data extraction. Four controlled clinical trials including a total of 252 participants satisfied the inclusion criteria. We grouped the trials into four main comparisons. One randomized controlled trial was classified as level 1B evidence, and three cohort studies were classified as level 2B evidence. Clear aligners appear to have a significant advantage with regard to chair time and treatment duration in mild-to-moderate cases based on several cross-sectional studies. No other differences in stability and occlusal characteristics after treatment were found between the two systems. Despite claims about the effectiveness of clear aligners, evidence is generally lacking. Shortened treatment duration and chair time in mild-to-moderate cases appear to be the only significant effectiveness of clear aligners over conventional systems that are supported by the current evidence. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Effects of acute sleep deprivation on state anxiety levels: a systematic review and meta-analysis.

    Science.gov (United States)

    Pires, Gabriel Natan; Bezerra, Andreia Gomes; Tufik, Sergio; Andersen, Monica Levy

    2016-08-01

    Increased anxiety levels have been widely recognized as one of the most important consequences of sleep deprivation. However, despite this general consensus, there are still aspects of this relationship, such as the extent of the anxiogenic potential and the specific effects of different types of sleep deprivation, which remain unclear. As no broad review has been undertaken to evaluate this relationship, we performed a systematic review and meta-analysis regarding the effects of sleep deprivation on state anxiety. Our search strategy encompassed two databases - Pubmed/Medline and Scopus - through which we were able to identify 756 articles. After the selection process, 18 articles, encompassing 34 experiments, composed our final sample. Our analyses indicate that sleep deprivation, whether total or not, leads to a significant increase in state anxiety levels, but sleep restriction does not. Regarding the effect of the length of the period of sleep deprivation, no significant results were observed, but there was a notable tendency for an increase in anxiety in longer sleep deprivations. With regard to tools, the State-Trait Anxiety Inventory (STAI) seems to be the best one to measure sleep-induced anxiogenesis, while the Profile of Mood States (POMS) presented inconclusive results. In conclusion, it can be affirmed that sleep deprivation induces a state of increased anxiety, with similar results also in the case of total sleep deprivation; however, results in more specific experimental conditions are not definitive. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review.

    Science.gov (United States)

    Shi, Zhenrong; MacBeth, Angus

    2017-01-01

    Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

  17. Hydrologic effects of large southwestern USA wildfires significantly increase regional water supply: fact or fiction?

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    Wine, M. L.; Cadol, D.

    2016-08-01

    In recent years climate change and historic fire suppression have increased the frequency of large wildfires in the southwestern USA, motivating study of the hydrological consequences of these wildfires at point and watershed scales, typically over short periods of time. These studies have revealed that reduced soil infiltration capacity and reduced transpiration due to tree canopy combustion increase streamflow at the watershed scale. However, the degree to which these local increases in runoff propagate to larger scales—relevant to urban and agricultural water supply—remains largely unknown, particularly in semi-arid mountainous watersheds co-dominated by winter snowmelt and the North American monsoon. To address this question, we selected three New Mexico watersheds—the Jemez (1223 km2), Mogollon (191 km2), and Gila (4807 km2)—that together have been affected by over 100 wildfires since 1982. We then applied climate-driven linear models to test for effects of fire on streamflow metrics after controlling for climatic variability. Here we show that, after controlling for climatic and snowpack variability, significantly more streamflow discharged from the Gila watershed for three to five years following wildfires, consistent with increased regional water yield due to enhanced infiltration-excess overland flow and groundwater recharge at the large watershed scale. In contrast, we observed no such increase in discharge from the Jemez watershed following wildfires. Fire regimes represent a key difference between the contrasting responses of the Jemez and Gila watersheds with the latter experiencing more frequent wildfires, many caused by lightning strikes. While hydrologic dynamics at the scale of large watersheds were previously thought to be climatically dominated, these results suggest that if one fifth or more of a large watershed has been burned in the previous three to five years, significant increases in water yield can be expected.

  18. Flipped Classroom in Organic Chemistry Has Significant Effect on Students’ Grades

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    Caroline Cormier

    2018-01-01

    Full Text Available The flipped classroom as a form of active pedagogy in postsecondary chemistry has been developed during the last 10 years and has been gaining popularity with instructors and students ever since. In the current paradigm in science, technology, engineering, and mathematics education, it is widely recognized that active learning has significant positive effects on students’ grades. Postsecondary organic chemistry is a difficult course for students, and the traditional way of teaching does not foster students’ active involvement. Implementation of active pedagogy could increase students’ achievement in this course. However, few quantitative data are available on the impact of active pedagogy in general, or flipped classrooms in particular, on learning in organic chemistry at a postsecondary level. Thus, in this study, we evaluated the gain on final grade scores in organic chemistry after implementing a flipped classroom approach to promote active learning in this course. We encouraged students to be active by having them watch educational videos before each class and then having them work during class time on problems that focused on applying the concepts presented in the videos. Exams were the same as those completed by students in the traditional classrooms of our college. In an a posteriori analysis of our students’ grades, we compared final grades in traditional classrooms (control group, N = 66 and in flipped classrooms (experimental group, N = 151. The sample was stratified in three categories depending on students’ academic ability in college, from low-achieving to high-achieving students. Our results show that students in the experimental group have significantly higher final grades in organic chemistry than those in the control group, that is, 77% for students in the active classroom vs. 73% in the traditional classroom (p < 0.05. The effect was the greatest for low-achieving students, with final scores of 70% in

  19. Effective implementation of research into practice: an overview of systematic reviews of the health literature

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    Fraser Alec

    2011-06-01

    Full Text Available Abstract Background The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. Conclusions This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials.

  20. Effective implementation of research into practice: an overview of systematic reviews of the health literature.

    Science.gov (United States)

    Boaz, Annette; Baeza, Juan; Fraser, Alec

    2011-06-22

    The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials).

  1. No significant effect of the SLCO1B1 polymorphism on the pharmacokinetics of ursodeoxycholic acid.

    Science.gov (United States)

    Xiang, Xiaoqiang; Vakkilainen, Juha; Backman, Janne T; Neuvonen, Pertti J; Niemi, Mikko

    2011-11-01

    To investigate possible effects of the SLCO1B1 polymorphism on the pharmacokinetics of ursodeoxycholic acid (UDCA) and its metabolites in healthy volunteers. In a crossover study with two phases, 15 healthy volunteers with the SLCO1B1*1A/*1A genotype, seven with the *1B/*1B genotype, and five with the *15/*15 or *5/*15 genotype ingested placebo or a single 150-mg dose of UDCA. Plasma concentrations of bile acids and their biosynthesis marker were determined up to 24 h post-ingestion by liquid chromatography-tandem mass spectrometry. The SLCO1B1 genotype had no significant effect on the pharmacokinetics of UDCA. The geometric mean ratios (95% confidence interval) of UDCA area under the plasma concentration-time curve from 0 to 12 h (AUC(0-12)) in subjects with the SLCO1B1*1B/*1B genotype and in subjects with the SLCO1B1*15/*15 or *5/*15 genotype to the AUC(0-12) in subjects with the SLCO1B1*1A/*1A genotype were 1.07 (0.85, 1.35; P = 0.459) and 0.93 (0.75, 1.15; P = 0.563), respectively. In addition, following either placebo or UDCA administration, the SLCO1B1 polymorphism showed no association with the AUC(0-24) of the glycine and taurine conjugates of UDCA, with endogenous bile acids, or with the incremental AUC(0-24) of a bile acid synthesis marker. Compared with placebo, UDCA ingestion increased the AUC(0-24) of cholic acid, glycochenodeoxycholic acid, glycocholic acid, and glycodeoxycholic acid by 1.5-, 1.1-, 1.2-, and 1.2- fold (P acids.

  2. Effect of protraction facemask on the temporomandibular joint: a systematic review.

    Science.gov (United States)

    Huang, Xinqi; Cen, Xiao; Liu, Jun

    2018-03-12

    The aim of this study was to assess the influence of protraction facemask (PFM) on temporomandibular joint (TMJ) of skeletal Class III malocclusion patients. Literature searches were carried out electronically in five English and three Chinese databases (Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, Embase, MEDLINE (via Ovid), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and VIP Database). The date of the most recent search was 22 March 2017. Randomized controlled trials, controlled clinical trials, cohort studies, and before-after studies comparing the effect of PFM and other treatments on TMJ were included. The data were collected and extracted by three authors. The risk of bias in the RCTs was assessed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. For the nonrandomized studies, the risk of bias was judged with Newcastle-Ottawa Scale. For the 261 articles identified, 13 studies with 522 participants were included for the final qualitative analysis. Three studies were graded as high value of evidence, while seven studies and the other three studies were graded as moderate value and low value respectively. According to the available evidence, PFM contributed to the significant increase of CondAx-SBL and the significant decrease of CondAx-ML. Thin-plate spline (TPS) analysis showed a horizontal compression in condyles. Condyles tended to move superiorly and posteriorly. Concerning the occurrence of temporomandibular disorders (TMD), PFM was not involved in aggravating TMJ symptoms and signs. Clinical evidence suggests that PFM might contribute to the morphologic adaptation of TMJs and displacement of condyles, and PFM may well be not a risk factor for the development of TMD.

  3. The effect of warm-up on surgical performance: a systematic review.

    Science.gov (United States)

    Abdalla, Gamal; Moran-Atkin, Erin; Chen, Grace; Schweitzer, Michael A; Magnuson, Thomas H; Steele, Kimberley E

    2015-06-01

    The concept of warming-up before a performance has been accepted across many disciplines including sports and music. In contrast, it is uncommon for a surgeon to "warm-up" prior to operating. To date, few studies from various specialties have attempted to answer this question whether warm-up improved the intraoperative performance of the surgeon. However, there has not been a systematic review of these studies. The aim of our systematic review is to assess the effect of warming-up preoperatively on the laparoscopic performance of the surgeon. Pubmed and scopus were searched to identify all published prospective observational studies, which involved either residents, fellows or attending surgeons. We excluded case reports, reviews, non-English studies, and medical student participation. Study risk of bias were assessed regarding sequence generation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases, using a validated Cochrane Collaboration's tool. Out of 241 studies, 6 met the inclusion criteria. All included studies were randomized with half of them being randomized controlled studies and the rest randomized crossover studies. The total number of operative cases was 196, including 98 warm-up and 98 non warm-up. The total number of participants was 87, with the largest number in a single study being 38 and the average sample size of all studies was 14. All six studies assessed various aspects of laparoscopic surgical performances. Significant improvement in the intraoperative laparoscopic performance was observed with warming-up preoperatively in five out of six studies (p study failed to reach statistical significance (p > 0.05). Warming-up before an operative procedure improve a trainee's technical, cognitive, and psychomotor performance. Further studies are necessary to assess the ways in which warm-up could impact a surgeon's performance, and to identify the optimal timing and duration of warm-up prior to

  4. Orthognathic Surgery Has a Significant Effect on Perceived Personality Traits and Emotional Expressions.

    Science.gov (United States)

    Mazzaferro, Daniel M; Wes, Ari M; Naran, Sanjay; Pearl, Rebecca; Bartlett, Scott P; Taylor, Jesse A

    2017-11-01

    The effects of orthognathic surgery go beyond objective cephalometric correction of facial and dental disproportion and malocclusion, respectively. The authors hypothesized that there is tangible improvement following surgery that alters publicly perceived personality traits and emotions. The authors used Amazon.com's Mechanical Turk (MTurk), a crowdsourcing tool, to determine how preoperative and postoperative images of orthognathic surgery patients were perceived on six personality traits and six emotional expressions based on posteroanterior and lateral photographs. Blinded respondents provided demographic information and were randomly assigned to one of two sets of 20 photographs (10 subjects before and after surgery). Data on 20 orthognathic surgery patients were collected from 476 individuals. The majority of participants were female (52.6 percent), 18 to 39 years old (67.9 percent), Caucasian (76.6 percent), had some college or technical training or graduated college (72.7 percent), and had an annual income between $20,000 and $99,999 (74.6 percent). A paired t test analysis found that subjects were perceived significantly more favorably after orthognathic surgery in 12 countenance categories: more dominant, trustworthy, friendly, intelligent, attractive, and happy; and also less threatening, angry, surprised, sad, afraid, and disgusted (p surgery than those earning less (p orthognathic surgery, with both perceived personality traits and emotions deemed more favorable. Additional work is needed to better understand the physiologic underpinnings of such findings. Crowdsourcing technology offers a unique opportunity for surgeons to gather data regarding laypeople's perceptions of surgical outcomes in areas such as orthognathic surgery.

  5. Significant enhancement of metal heat dissipation from mechanically exfoliated graphene nanosheets through thermal radiation effect

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    Junxiong Hu

    2017-05-01

    Full Text Available We demonstrate a facile approach to significantly enhance the heat dissipation potential of conventional aluminum (Al heat sinks by mechanically coating graphene nanosheets. For Al and graphene-coated Al heat sinks, the change in temperature with change in coating coverage, coating thickness and heat flux are studied. It is found that with the increase in coating coverage from 0 to 100%, the steady-state temperature is decreased by 5 °C at a heat flux of 1.8 W cm-1. By increasing the average thickness of graphene coating from 480 nm to 1900 nm, a remarkable temperature reduction up to 7 °C can be observed. Moreover, with the increase in heat flux from 1.2 W cm-1 to 2.4 W cm-1, the temperature difference between uncoated and graphene-coated samples increases from 1 °C to 6 °C. The thermal analysis and finite element simulation reveal that the thermal radiation plays a key role in enhancing the heat dissipation performance. The effect of heat convection remains weak owing to the low air velocity at surface-air boundary. This work provides a technological innovation in improving metal heat dissipation using graphene nanosheets.

  6. Significance tests to determine the direction of effects in linear regression models.

    Science.gov (United States)

    Wiedermann, Wolfgang; Hagmann, Michael; von Eye, Alexander

    2015-02-01

    Previous studies have discussed asymmetric interpretations of the Pearson correlation coefficient and have shown that higher moments can be used to decide on the direction of dependence in the bivariate linear regression setting. The current study extends this approach by illustrating that the third moment of regression residuals may also be used to derive conclusions concerning the direction of effects. Assuming non-normally distributed variables, it is shown that the distribution of residuals of the correctly specified regression model (e.g., Y is regressed on X) is more symmetric than the distribution of residuals of the competing model (i.e., X is regressed on Y). Based on this result, 4 one-sample tests are discussed which can be used to decide which variable is more likely to be the response and which one is more likely to be the explanatory variable. A fifth significance test is proposed based on the differences of skewness estimates, which leads to a more direct test of a hypothesis that is compatible with direction of dependence. A Monte Carlo simulation study was performed to examine the behaviour of the procedures under various degrees of associations, sample sizes, and distributional properties of the underlying population. An empirical example is given which illustrates the application of the tests in practice. © 2014 The British Psychological Society.

  7. Uncertainty from the choice of microphysics scheme in convection-permitting models significantly exceeds aerosol effects

    Directory of Open Access Journals (Sweden)

    B. White

    2017-10-01

    Full Text Available This study investigates the hydrometeor development and response to cloud droplet number concentration (CDNC perturbations in convection-permitting model configurations. We present results from a real-data simulation of deep convection in the Congo basin, an idealised supercell case, and a warm-rain large-eddy simulation (LES. In each case we compare two frequently used double-moment bulk microphysics schemes and investigate the response to CDNC perturbations. We find that the variability among the two schemes, including the response to aerosol, differs widely between these cases. In all cases, differences in the simulated cloud morphology and precipitation are found to be significantly greater between the microphysics schemes than due to CDNC perturbations within each scheme. Further, we show that the response of the hydrometeors to CDNC perturbations differs strongly not only between microphysics schemes, but the inter-scheme variability also differs between cases of convection. Sensitivity tests show that the representation of autoconversion is the dominant factor that drives differences in rain production between the microphysics schemes in the idealised precipitating shallow cumulus case and in a subregion of the Congo basin simulations dominated by liquid-phase processes. In this region, rain mass is also shown to be relatively insensitive to the radiative effects of an overlying layer of ice-phase cloud. The conversion of cloud ice to snow is the process responsible for differences in cold cloud bias between the schemes in the Congo. In the idealised supercell case, thermodynamic impacts on the storm system using different microphysics parameterisations can equal those due to aerosol effects. These results highlight the large uncertainty in cloud and precipitation responses to aerosol in convection-permitting simulations and have important implications not only for process studies of aerosol–convection interaction, but also for

  8. Effects of Hibiscus sabdariffa L. on serum lipids: a systematic review and meta-analysis.

    Science.gov (United States)

    Aziz, Zoriah; Wong, Su Yuen; Chong, Nyuk Jet

    2013-11-25

    Prevention of cardiovascular disease by modifying its major risk factors, including serum cholesterol levels, is an important strategy. Hibiscus sabdariffa L. has been promoted for reducing cholesterol levels, but its reported impact on cholesterol levels has been inconsistent. The study aimed to assess systematically the evidence and quality of current research on the effect of Hibiscus sabdariffa L. on blood lipids and its adverse effects. Electronic databases were searched up to June 2013 for relevant randomised controlled trials (RCTs). Journals and conference proceedings were also searched. The quality of the selected trials was assessed using the Cochrane Risk of Bias Assessment Tool. The efficacy results of similar studies were pooled if they used the same comparator. Outcomes examined were levels of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides. Six studies involving 474 subjects met our inclusion criteria. These studies varied in terms of the types of interventions, comparators used, and duration of trials. Overall, Hibiscus sabdariffa L. did not produce any significant effect on any of the outcomes examined, when compared with placebo, black tea or diet. With short-term use it is well tolerated. The available evidence from RCTs does not support the efficacy of Hibiscus sabdariffa L. in lowering serum lipids. Further rigorously designed trials with larger sample sizes are warranted to confirm the effects of HS on serum lipids. © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Effect of aquatic exercise training on lipids profile and glycaemia: A systematic review

    Directory of Open Access Journals (Sweden)

    R. Delevatti

    2015-12-01

    Full Text Available The objective of this study was to investigate the acute and chronic effects of aquatic exercise training on glycaemia and lipids profile. A systematic review of clinical trials was performed assessing the effects of aquatic exercise and/or training in upright position on lipids profile and glycaemic index. Two raters independently assessed the eligibility criteria and the methodological quality of the studies using the PEDro scale. Average and standard deviation of all variables significantly altered by the interventions were extracted for calculating percentage alterations. Three studies involving the acute effect of aquatic aerobic exercise on the variables of interest were analysed, with two of them demonstrating the efficacy of this type of training in improving lipids profile. Nine studies involving the chronic effects of aquatic training on the same variables were also analysed; eight of them, which assessed different training interventions for different populations, reported benefits of exercise regarding these variables. In conclusion, the improvements found in response to aquatic exercise training in upright position in glycaemia and lipids profile indicate the aquatic environment as a favourable environment for conducting exercise programmes.

  10. A systematic review of possible serious adverse health effects of nicotine replacement therapy.

    Science.gov (United States)

    Lee, Peter N; Fariss, Marc W

    2017-04-01

    We conducted a systematic literature review to identify and critically evaluate studies of serious adverse health effects (SAHEs) in humans using nicotine replacement therapy (NRT) products. Serious adverse health effects refer to adverse events, leading to substantial disruption of the ability to conduct normal life functions. Strength of evidence evaluations and conclusions were also determined for the identified SAHEs. We evaluated 34 epidemiological studies and clinical trials, relating NRT use to cancer, reproduction/development, CVD, stroke and/or other SAHEs in patients, and four meta-analyses on effects in healthy populations. The overall evidence suffers from many limitations, the most significant being the short-term exposure (≤12 weeks) and follow-up to NRT product use in most of the studies, the common failure to account for changes in smoking behaviour following NRT use, and the sparse information on SAHEs by type of NRT product used. The only SAHE from NRT exposure we identified was an increase in respiratory congenital abnormalities reported in one study. Limited evidence indicated a lack of effect between NRT exposure and SAHEs for CVD and various reproduction/developmental endpoints. For cancer, stroke and other SAHEs, the evidence was inadequate to demonstrate any association with NRT use. Our conclusions agree with recent statements from authoritative bodies.

  11. Systematic investigation of the effects of organic film structure on light emitting diode performance

    Science.gov (United States)

    Joswick, M. D.; Campbell, I. H.; Barashkov, N. N.; Ferraris, J. P.

    1996-09-01

    We present a systematic investigation of the effects of organic film structure on light emitting diode (LED) performance. Metal/organic film/metal LEDs were fabricated using a five ring, poly(phenylene vinylene) related oligomer as the active layer. The structure of the vacuum evaporated oligomer films was varied from amorphous to polycrystalline by changing the substrate temperature during deposition. The intrinsic properties of the oligomer films and the LED performance were measured. The measured intrinsic film properties include: optical absorption, photoluminescence (PL) spectra, PL lifetime, PL efficiency, and effective carrier mobility. The measured device characteristics include current-voltage, capacitance-voltage, electroluminescence (EL) efficiency, and the contact metal/organic film Schottky barrier heights. The optical absorption and PL properties of the films are weakly dependent on film structure but the effective carrier mobility decreases with increasing crystallinity. The EL quantum efficiency decreases by more than one order of magnitude, the drive voltage at a fixed current increases, and the electron Schottky barrier height increases as the crystallinity of the film is increased. The diode current-voltage characteristic is determined by the dominant hole current and the electroluminescence efficiency is controlled by the contact limited electron injection. These results demonstrate significant effects of organic film structure on the performance of organic LEDs.

  12. Systematic investigation of the effects of organic film structure on light emitting diode performance

    Energy Technology Data Exchange (ETDEWEB)

    Joswick, M.D.; Campbell, I.H. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Barashkov, N.N.; Ferraris, J.P. [The University of Texas at Dallas, Richardson, Texas 75080 (United States)

    1996-09-01

    We present a systematic investigation of the effects of organic film structure on light emitting diode (LED) performance. Metal/organic film/metal LEDs were fabricated using a five ring, poly(phenylene vinylene) related oligomer as the active layer. The structure of the vacuum evaporated oligomer films was varied from amorphous to polycrystalline by changing the substrate temperature during deposition. The intrinsic properties of the oligomer films and the LED performance were measured. The measured intrinsic film properties include: optical absorption, photoluminescence (PL) spectra, PL lifetime, PL efficiency, and effective carrier mobility. The measured device characteristics include current{endash}voltage, capacitance{endash}voltage, electroluminescence (EL) efficiency, and the contact metal/organic film Schottky barrier heights. The optical absorption and PL properties of the films are weakly dependent on film structure but the effective carrier mobility decreases with increasing crystallinity. The EL quantum efficiency decreases by more than one order of magnitude, the drive voltage at a fixed current increases, and the electron Schottky barrier height increases as the crystallinity of the film is increased. The diode current{endash}voltage characteristic is determined by the dominant hole current and the electroluminescence efficiency is controlled by the contact limited electron injection. These results demonstrate significant effects of organic film structure on the performance of organic LEDs. {copyright} {ital 1996 American Institute of Physics.}

  13. Effectiveness of Social Marketing Interventions to Promote Physical Activity Among Adults: A Systematic Review.

    Science.gov (United States)

    Xia, Yuan; Deshpande, Sameer; Bonates, Tiberius

    2016-11-01

    Social marketing managers promote desired behaviors to an audience by making them tangible in the form of environmental opportunities to enhance benefits and reduce barriers. This study proposed "benchmarks," modified from those found in the past literature, that would match important concepts of the social marketing framework and the inclusion of which would ensure behavior change effectiveness. In addition, we analyzed behavior change interventions on a "social marketing continuum" to assess whether the number of benchmarks and the role of specific benchmarks influence the effectiveness of physical activity promotion efforts. A systematic review of social marketing interventions available in academic studies published between 1997 and 2013 revealed 173 conditions in 92 interventions. Findings based on χ 2 , Mallows' Cp, and Logical Analysis of Data tests revealed that the presence of more benchmarks in interventions increased the likelihood of success in promoting physical activity. The presence of more than 3 benchmarks improved the success of the interventions; specifically, all interventions were successful when more than 7.5 benchmarks were present. Further, primary formative research, core product, actual product, augmented product, promotion, and behavioral competition all had a significant influence on the effectiveness of interventions. Social marketing is an effective approach in promoting physical activity among adults when a substantial number of benchmarks are used and when managers understand the audience, make the desired behavior tangible, and promote the desired behavior persuasively.

  14. The Effects of Digital Marketing of Unhealthy Commodities on Young People: A Systematic Review

    Science.gov (United States)

    Buchanan, Limin; Kelly, Bridget; Kariippanon, Kishan

    2018-01-01

    The marketing of unhealthy commodities through traditional media is known to impact consumers’ product attitudes and behaviors. Less is known about the impacts of digital marketing (online promotional activities), especially among young people who have a strong online presence. This review systematically assesses the relationship between digital marketing and young people’s attitudes and behaviors towards unhealthy commodities. Literature was identified in June 2017 by searches in six electronic databases. Primary studies (both qualitative and quantitative) that examined the effect of digital marketing of unhealthy food or beverages, alcohol and tobacco products on young people’s (12 to 30 years) attitudes, intended and actual consumption were reviewed. 28 relevant studies were identified. Significant detrimental effects of digital marketing on the intended use and actual consumption of unhealthy commodities were revealed in the majority of the included studies. Findings from the qualitative studies were summarized and these findings provided insights on how digital marketing exerts effects on young people. One of the key findings was that marketers used peer-to-peer transmission of messages on social networking sites (e.g., friends’ likes and comments on Facebook) to blur the boundary between marketing contents and online peer activities. Digital marketing of unhealthy commodities is associated with young people’s use and beliefs of these products. The effects of digital marketing varied between product types and peer endorsed marketing (earned media) may exert greater negative impacts than owned or paid media marketing. PMID:29382140

  15. The Effects of Digital Marketing of Unhealthy Commodities on Young People: A Systematic Review.

    Science.gov (United States)

    Buchanan, Limin; Kelly, Bridget; Yeatman, Heather; Kariippanon, Kishan

    2018-01-29

    The marketing of unhealthy commodities through traditional media is known to impact consumers' product attitudes and behaviors. Less is known about the impacts of digital marketing (online promotional activities), especially among young people who have a strong online presence. This review systematically assesses the relationship between digital marketing and young people's attitudes and behaviors towards unhealthy commodities. Literature was identified in June 2017 by searches in six electronic databases. Primary studies (both qualitative and quantitative) that examined the effect of digital marketing of unhealthy food or beverages, alcohol and tobacco products on young people's (12 to 30 years) attitudes, intended and actual consumption were reviewed. 28 relevant studies were identified. Significant detrimental effects of digital marketing on the intended use and actual consumption of unhealthy commodities were revealed in the majority of the included studies. Findings from the qualitative studies were summarized and these findings provided insights on how digital marketing exerts effects on young people. One of the key findings was that marketers used peer-to-peer transmission of messages on social networking sites (e.g., friends' likes and comments on Facebook) to blur the boundary between marketing contents and online peer activities. Digital marketing of unhealthy commodities is associated with young people's use and beliefs of these products. The effects of digital marketing varied between product types and peer endorsed marketing (earned media) may exert greater negative impacts than owned or paid media marketing.

  16. The Effects of Digital Marketing of Unhealthy Commodities on Young People: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Limin Buchanan

    2018-01-01

    Full Text Available The marketing of unhealthy commodities through traditional media is known to impact consumers’ product attitudes and behaviors. Less is known about the impacts of digital marketing (online promotional activities, especially among young people who have a strong online presence. This review systematically assesses the relationship between digital marketing and young people’s attitudes and behaviors towards unhealthy commodities. Literature was identified in June 2017 by searches in six electronic databases. Primary studies (both qualitative and quantitative that examined the effect of digital marketing of unhealthy food or beverages, alcohol and tobacco products on young people’s (12 to 30 years attitudes, intended and actual consumption were reviewed. 28 relevant studies were identified. Significant detrimental effects of digital marketing on the intended use and actual consumption of unhealthy commodities were revealed in the majority of the included studies. Findings from the qualitative studies were summarized and these findings provided insights on how digital marketing exerts effects on young people. One of the key findings was that marketers used peer-to-peer transmission of messages on social networking sites (e.g., friends’ likes and comments on Facebook to blur the boundary between marketing contents and online peer activities. Digital marketing of unhealthy commodities is associated with young people’s use and beliefs of these products. The effects of digital marketing varied between product types and peer endorsed marketing (earned media may exert greater negative impacts than owned or paid media marketing.

  17. Effectiveness of computer-aided learning in oral health among patients and caregivers: a systematic review.

    Science.gov (United States)

    Ab Malik, Normaliza; Zhang, Jiaguan; Lam, Otto Lok Tao; Jin, Lijian; McGrath, Colman

    2017-01-01

    Computer-aided learning (CAL) offers enormous potential in disseminating oral health care information to patients and caregivers. The effectiveness of CAL, however, remains unclear. The purpose of this study was to systematically review published evidence on the effectiveness of CAL in disseminating oral health care information to patients and caregivers. A structured comprehensive search was undertaken among 7 electronic databases (PUBMED, CINAHL Plus, EMBASE, SCOPUS, WEB of SCIENCE, the Cochrane Library, and PsycINFO) to identify relevant studies. Randomized controlled trials (RCTs) and observational studies were included in this review. Papers were screened by 2 independent reviewers, and studies that met the inclusion criteria were selected for further assessment. A total of 2915 papers were screened, and full texts of 53 potentially relevant papers (κ = 0.885) were retrieved. A total of 5 studies that met the inclusion criteria (1 RCT, 1 quasi-experimental study, and 3 post-intervention studies) were identified. Outcome measures included knowledge, attitude, behavior, and oral health. Significant improvements in clinical oral health parameters (P effectiveness of CAL interventions for oral health care among patients and caregivers. Synthesis of the data suggests that CAL has positive impacts on knowledge, attitude, behavior, and oral health. Further high- quality studies on the effectiveness of CAL in promoting oral health are warranted. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Effects of caffeine intake on muscle strength and power: a systematic review and meta-analysis.

    Science.gov (United States)

    Grgic, Jozo; Trexler, Eric T; Lazinica, Bruno; Pedisic, Zeljko

    2018-01-01

    Caffeine is commonly used as an ergogenic aid. Literature about the effects of caffeine ingestion on muscle strength and power is equivocal. The aim of this systematic review and meta-analysis was to summarize results from individual studies on the effects of caffeine intake on muscle strength and power. A search through eight databases was performed to find studies on the effects of caffeine on: (i) maximal muscle strength measured using 1 repetition maximum tests; and (ii) muscle power assessed by tests of vertical jump. Meta-analyses of standardized mean differences (SMD) between placebo and caffeine trials from individual studies were conducted using the random effects model. Ten studies on the strength outcome and ten studies on the power outcome met the inclusion criteria for the meta-analyses. Caffeine ingestion improved both strength (SMD = 0.20; 95% confidence interval [CI]: 0.03, 0.36; p  = 0.023) and power (SMD = 0.17; 95% CI: 0.00, 0.34; p  = 0.047). A subgroup analysis indicated that caffeine significantly improves upper (SMD = 0.21; 95% CI: 0.02, 0.39; p  = 0.026) but not lower body strength (SMD = 0.15; 95% CI: -0.05, 0.34; p  = 0.147). The meta-analyses showed significant ergogenic effects of caffeine ingestion on maximal muscle strength of upper body and muscle power. Future studies should more rigorously control the effectiveness of blinding. Due to the paucity of evidence, additional findings are needed in the female population and using different forms of caffeine, such as gum and gel.

  19. Medicinal Plants with Multiple Effects on Cardiovascular Diseases: A Systematic Review.

    Science.gov (United States)

    Rouhi-Boroujeni, Hojjat; Heidarian, Esfandiar; Rouhi-Boroujeni, Hamid; Deris, Fatemeh; Rafieian-Kopaei, Mahmoud

    2017-01-01

    Hyperlipidemia, obesity, hypertension, and diabetes are the most important risk factors for cardiovascular diseases. The aim of this systematic review article is to introduce the medicinal plants that exert significant clinical effects on hypertension, hyperlipidemia, obesity, and diabetes. In this review article, the international research databases including MEDLINE, Google scholar, EBSCO, Academic Search, Web of Science, SciVerse, Scopus (SCOPUS), EBSCO, Academic Search, Cochrane, Central Register of Controlled Trials (CENTRAL) and a Chinese database (China Network Knowledge Infrastructure [CNKI]) were searched using the key words hyperlipidemia, hypertension, diabetes, herbal, obesity, and phytomedicine, matched by MESH, from their respective inceptions up to March, 2016. The plants that were effective on one, two, three, or all of four diseases were determined. The doses, side effects, the most important pharmaceutically effective compounds, the used organs, and important points regarding usage were separately recorded. Also known clinically significant interactions were presented. 1023 articles were found to be about medicinal plants and hypertension, 1912 articles about medicinal plants and hyperlipidemia, 810 articles about medicinal plants and obesity, 1174 articles about medicinal plants and diabetes. Of 144 plants included in the analysis, 83 were found to be effective on hyperlipidemia, 100 on hypertension, 66 on obesity, and 72 on diabetes. 43 plants were found to be effective on two diseases, 14 on three diseases, and 34 on all four diseases. Three plants (Tomato, Cranberry and Pomegranate), in food and therapeutic doses, were found to be used to treat cardiovascular diseases especially in pre-eclampsia and hyperlipidemia in pregnancy. Regarding the findings of this study, we can argue that the medicinal plants, other than monotherapy, can be used as poly-therapy, to treat cardiovascular diseases. Copyright© Bentham Science Publishers; For any

  20. Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies.

    Science.gov (United States)

    Bécares, Laia; Dewey, Michael E; Das-Munshi, Jayati

    2017-12-14

    Despite increased ethnic diversity in more economically developed countries it is unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes. We systematically searched Medline, PsychINFO, Sociological Abstracts, Web of Science from inception to 31 March 2016. We obtained additional data from study authors. We conducted random-effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation, and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences, and psychosis. We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences [odds ratio (OR) 0.82 (95% confidence interval (CI) 0.76-0.89)] and suicidal ideation [OR 0.88 (95% CI 0.79-0.98)] for each 10 percentage-point increase in own ethnic density. For CMD, depression, and anxiety, associations were indicative of protective effects of own ethnic density; however, results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis. The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.

  1. Drotrecogin alfa (activated in severe sepsis: a systematic review and new cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Brophy James M

    2007-06-01

    Full Text Available Abstract Background Activated drotrecogin alfa (human activated protein C, rhAPC, is produced by recombinant DNA technology, and purports to improve clinical outcomes by counteracting the inflammatory and thrombotic consequences of severe sepsis. Controversy exists around the clinical benefits of this drug and an updated economic study that considers this variability is needed. Methods A systematic literature review was performed using Medline, Embase and the International Network of Agencies for Health Technology Assessment (INAHTA databases to determine efficacy, safety and previous economic studies. Our economic model was populated with systematic estimates of these parameters and with population life tables for longer term survival information. Monte Carlo simulations were used to estimate the incremental cost-effectiveness ratios (ICERs and variance for the decision analytic models. Results Two randomized clinical trials (RCTS of drotrecogin alfa in adults with severe sepsis and 8 previous economic studies were identified. Although associated with statistical heterogeneity, a pooled analysis of the RCTs did not show a statistically significant 28-day mortality benefit for drotrecogin alfa compared to placebo either for all patients (RR: 0.93, 95% CI: 0.69, 1.26 or those at highest risk as measured by APACHE II ≥ 25 (RR: 0.90, 95% CI: 0.54, 1.49. Our economic analysis based on the totality of the available clinical evidence suggests that the cost-effectiveness of drotrecogin alfa is uncertain ( Conclusion The evidence supporting the clinical and economic attractiveness of drotrecogin alfa is not conclusive and further research appears to be indicated.

  2. Effectiveness of lockouts in reducing alcohol-related harm: Systematic review.

    Science.gov (United States)

    Nepal, Smriti; Kypri, Kypros; Pursey, Kirrilly; Attia, John; Chikritzhs, Tanya; Miller, Peter

    2018-05-01

    Australian jurisdictions have introduced lockouts to prevent alcohol-related violence. Lockouts prohibit patrons from entering licensed premises after a designated time while allowing sale and consumption of alcohol to continue. Their purposes include managing the movement of intoxicated patrons, and preventing violence and disorder by dispersing times that patrons leave premises. We sought to evaluate the effectiveness of lockouts in preventing alcohol-related harm. We systematically searched electronic databases and reference lists and asked authors to identify relevant studies published to 1 June 2017. We deemed studies eligible if they evaluated lockouts, and if outcome measures included: assault, emergency department attendances, alcohol-related disorders or drink-driving offences. Two reviewers independently extracted data. After screening 244 records, we identified five studies from electronic databases, two from reference lists search and one from a Google search (N = 8). Two studies showed a decline in assaults; a third study showed reductions occurred only inside licensed premises; two studies showed an increase in assaults; and three studies showed no association. The studies had significant design and other limitations. Lockouts have been implemented across Australian jurisdictions as a strategy to prevent alcohol-related harm, despite limited evidence. In this systematic review, we synthesised findings from studies that evaluated lockouts as stand-alone interventions, to help clarify debate on their utility as a harm prevention strategy. There is not good evidence that lockouts prevent alcohol-related harm, in contrast to what is known about stopping the sale of alcohol earlier, for which there is evidence of effectiveness. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  3. The Effects of Meditation on Grey Matter Atrophy and Neurodegeneration: A Systematic Review.

    Science.gov (United States)

    Last, Nicole; Tufts, Emily; Auger, Leslie E

    2017-01-01

    The present systematic review is based on the premise that a variety of neurodegenerative diseases are accompanied by grey matter atrophy in the brain and meditation may impact this. Given that age is a major risk factor for many of these progressive and neurodegenerative diseases and that the percentage of the population over the age of 65 is quickly increasing, there is an obvious need for prompt treatment and prevention advances in research. As there is currently no cure for Alzheimer's disease and other neurodegenerative diseases, many are seeking non-pharmacological treatment options in attempts to offset the disease-related cognitive and functional declines. On the basis of a growing body of research suggesting that meditation is effective in increasing grey matter volume in healthy participants, this paper systematically reviewed the literature regarding the effects of meditation on restoring grey matter volume in healthy individuals and those affected by neurodegeneration. This review searched PubMed, CINAHL, and APA PsycNET to identify original studies that included MRI imaging to measure grey matter volume in meditators and post-mindfulness-based intervention participants compared to controls. Thirteen studies were considered eligible for review and involved a wide variety of meditation techniques and included participants with and without cognitive impairment. All studies reported significant increases in grey matter volume in the meditators/intervention group, albeit in assorted regions of the brain. Limited research exists on the mechanisms through which meditation affects disease-related neurodegeneration, but preliminary evidence suggests that it may offset grey matter atrophy.

  4. Meta-analysis and systematic review of studies on the effectiveness of HIV stigma reduction programs.

    Science.gov (United States)

    Mak, Winnie W S; Mo, Phoenix K H; Ma, Gloria Y K; Lam, Maggie Y Y

    2017-09-01

    The present study conducted a meta-analysis and systematic review on studies evaluating the effectiveness of stigma reduction programs in improving knowledge and reducing negative attitudes towards people living with HIV (PLHIV). Meta-analysis (k = 42 studies) found significant and small effect sizes in the improvement of the participants' knowledge of HIV/AIDS from interventions with (Cohen's d = 0.48, 95% CI [0.30, 0.66]) and without control groups (Cohen's d = 0.42, 95% CI [0.28, 0.57]). Significant and small effect sizes were found in the improvement of the participants' attitudes toward PLHIV from interventions with (Cohen's d = 0.39, 95% CI [0.23, 0.55]) and without control groups (Cohen's d = 0.25, 95% CI [0.11, 0.39]). Significant and small effect sizes were sustained at the follow-up assessments. Subgroup analysis showed that number of intervention sessions, intervention settings, and sample type significantly moderated the effect sizes in the meta-analysis. Findings from the systematic review of 35 studies indicated that most of the included studies showed positive results in reducing negative attitudes toward PLHIV and improving HIV-related knowledge. Most of the included studies tended to have low methodological quality. The present meta-analysis and systematic review indicated that the studies generally found small improvement in HIV-related knowledge and reduction in negative attitudes towards PLHIV among the stigma reduction programs being evaluated. High-quality stigma reduction programs with multidimensional stigma indicators and psychometrically sound outcome measures are highly warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Effects of pilates on patients with chronic non-specific low back pain: a systematic review

    Science.gov (United States)

    Lin, Hui-Ting; Hung, Wei-Ching; Hung, Jia-Ling; Wu, Pei-Shan; Liaw, Li-Jin; Chang, Jia-Hao

    2016-01-01

    [Purpose] To evaluate the effects of Pilates on patients with chronic low back pain through a systematic review of high-quality articles on randomized controlled trials. [Subjects and Methods] Keywords and synonyms for “Pilates” and “Chronic low back pain” were used in database searches. The databases included PubMed, Physiotherapy Evidence Database (PEDro), Medline, and the Cochrane Library. Articles involving randomized controlled trials with higher than 5 points on the PEDro scale were reviewed for suitability and inclusion. The methodological quality of the included randomized controlled trials was evaluated using the PEDro scale. Relevant information was extracted by 3 reviewers. [Results] Eight randomized controlled trial articles were included. Patients with chronic low back pain showed statistically significant improvement in pain relief and functional ability compared to patients who only performed usual or routine health care. However, other forms of exercise were similar to Pilates in the improvement of pain relief and functional capacity. [Conclusion] In patients with chronic low back pain, Pilates showed significant improvement in pain relief and functional enhancement. Other exercises showed effects similar to those of Pilates, if waist or torso movement was included and the exercises were performed for 20 cumulative hours. PMID:27821970

  6. The effectiveness of manual stretching in the treatment of plantar heel pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Parish Ben

    2011-06-01

    Full Text Available Abstract Background Plantar heel pain is a commonly occurring foot complaint. Stretching is frequently utilised as a treatment, yet a systematic review focusing only on its effectiveness has not been published. This review aimed to assess the effectiveness of stretching on pain and function in people with plantar heel pain. Methods Medline, EMBASE, CINAHL, AMED, and The Cochrane Library were searched from inception to July 2010. Studies fulfilling the inclusion criteria were independently assessed, and their quality evaluated using the modified PEDro scale. Results Six studies including 365 symptomatic participants were included. Two compared stretching with a control, one study compared stretching to an alternative intervention, one study compared stretching to both alternative and control interventions, and two compared different stretching techniques and durations. Quality rating on the modified Pedro scale varied from two to eight out of a maximum of ten points. The methodologies and interventions varied significantly between studies, making meta-analysis inappropriate. Most participants improved over the course of the studies, but when stretching was compared to alternative or control interventions, the changes only reached statistical significance in one study that used a combination of calf muscle stretches and plantar fascia stretches in their stretching programme. Another study comparing different stretching techniques, showed a statistically significant reduction in some aspects of pain in favour of plantar fascia stretching over calf stretches in the short term. Conclusions There were too few studies to assess whether stretching is effective compared to control or other interventions, for either pain or function. However, there is some evidence that plantar fascia stretching may be more effective than Achilles tendon stretching alone in the short-term. Appropriately powered randomised controlled trials, utilizing validated outcome

  7. ICU Acquisition Rate, Risk Factors, and Clinical Significance of Digestive Tract Colonization With Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Detsis, Marios; Karanika, Styliani; Mylonakis, Eleftherios

    2017-04-01

    To evaluate the acquisition rate, identify risk factors, and estimate the risk for subsequent infection, associated with the colonization of the digestive tract with extended-spectrum beta-lactamase-producing Enterobacteriaceae during ICU-hospitalization. PubMed, EMBASE, and reference lists of all eligible articles. Included studies provided data on ICU-acquired colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae in previously noncolonized and noninfected patients and used the double disk synergy test for extended-spectrum beta-lactamase-producing Enterobacteriaceae phenotypic confirmation. Studies reporting extended-spectrum beta-lactamase-producing Enterobacteriaceae outbreaks or data on pediatric population were excluded. Two authors independently assessed study eligibility and performed data extraction. Thirteen studies (with 15,045 ICUs-patients) were evaluated using a random-effect model and a meta-regression analysis. The acquisition rate of digestive tract colonization during ICU stay was 7% (95% CI, 5-10) and it varies from 3% (95% CI, 2-4) and 4% (95% CI, 2-6) in the Americas and Europe to 21% (95% CI, 9-35) in the Western Pacific region. Previous hospitalization (risk ratio, 1.57 [95% CI, 1.07-2.31]) or antibiotic use (risk ratio, 1.65 [95% CI, 1.15-2.37]) and exposure to beta-lactams/beta-lactamase inhibitors (risk ratio, 1.78 [95% CI, 1.24-2.56]) and carbapenems (risk ratio, 2.13 [95% CI, 1.49-3.06]) during the ICU stay were independent risk factors for ICU-acquired colonization. Importantly, colonized patients were more likely to develop an extended-spectrum beta-lactamase-producing Enterobacteriaceae infection (risk ratio, 49.62 [95% CI, 20.42-120.58]). The sensitivity and specificity of prior colonization to predict subsequent extended-spectrum beta-lactamase-producing Enterobacteriaceae infection were 95.1% (95% CI, 54.7-99.7) and 89.2% (95% CI, 77.2-95.3), respectively. The ICU acquisition rate of extended-spectrum beta

  8. The Effectiveness of Nursing Education on Clinical Outcomes of Patients With Heart Failure: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kollia

    2016-04-01

    Full Text Available Context Many nursing educational approaches have been applied on patients with heart failure (HF to improve their outcomes. The results of these approaches on outcomes of patients with HF remain controversial. Evidence Acquisition The aim of this study was to highlight the importance of nursing education to improve the outcomes of patients with HF, such as self-care behaviour, quality of life, mortality, readmission and hospitalization rates. A systematic review was conducted in the MEDLINE database on investigations punished from 2000 to 2012. The search terms used were self-care, heart failure, nursing, and education. A total of 22 studies complied with the eligibility criteria for this review. Results The findings of the reviewed studies showed that self-care behaviour of patients who received nursing education improved significantly. No significant improvement was noticed in the health-related quality of life. Additionally, there was no significant reduction in readmission, hospitalization and mortality rates of patients after implementing this educational process. Conclusions The effectiveness of nursing education on self-care behaviour of HF patients was clearly demonstrated. Methodological differences in development and implementation of education programs, made the comparison between the results of the studies difficult.

  9. The effectiveness of knowledge translation strategies used in public health: a systematic review

    Directory of Open Access Journals (Sweden)

    LaRocca Rebecca

    2012-09-01

    Full Text Available Abstract Background Literature related to the effectiveness of knowledge translation (KT strategies used in public health is lacking. The capacity to seek, analyze, and synthesize evidence-based information in public health is linked to greater success in making policy choices that have the best potential to yield positive outcomes for populations. The purpose of this systematic review is to identify the effectiveness of KT strategies used to promote evidence-informed decision making (EIDM among public health decision makers. Methods A search strategy was developed to identify primary studies published between 2000–2010. Studies were obtained from multiple electronic databases (CINAHL, Medline, EMBASE, and the Cochrane Database of Systematic Reviews. Searches were supplemented by hand searching and checking the reference lists of included articles. Two independent review authors screened studies for relevance, assessed methodological quality of relevant studies, and extracted data from studies using standardized tools. Results After removal of duplicates, the search identified 64, 391 titles related to KT strategies. Following title and abstract review, 346 publications were deemed potentially relevant, of which 5 met all relevance criteria on full text screen. The included publications were of moderate quality and consisted of five primary studies (four randomized controlled trials and one interrupted time series analysis. Results were synthesized narratively. Simple or single KT strategies were shown in some circumstances to be as effective as complex, multifaceted ones when changing practice including tailored and targeted messaging. Multifaceted KT strategies led to changes in knowledge but not practice. Knowledge translation strategies shown to be less effective were passive and included access to registries of pre-processed research evidence or print materials. While knowledge brokering did not have a significant effect generally

  10. Effectiveness of interventions for the development of leadership skills among nurses: a systematic review protocol.

    Science.gov (United States)

    Darragh, Michael; Traynor, Victoria; Joyce-McCoach, Joanne

    2016-06-01

    What interventions are the most effective for the development of leadership skills for nurses?The review objective is to systematically review the evidence to identify the effectiveness of interventions for the development of leadership skills among nurses. Centre for Evidence-based Initiatives in Health Care - University of Wollongong: an Affiliate Center of the Joanna Briggs Institute.

  11. How long do news framing effects last? A systematic review of longitudinal studies

    NARCIS (Netherlands)

    Lecheler, S.; de Vreese, C.H.

    2016-01-01

    A growing number of experimental studies investigate the duration of news framing effects. This article presents a systematic review of the theoretical premises, experimental designs, and individual-level moderators in these studies. Our results suggest that most studies report effects that persist

  12. Building work engagement: A systematic review and meta‐analysis investigating the effectiveness of work engagement interventions

    Science.gov (United States)

    Patterson, Malcolm; Dawson, Jeremy

    2016-01-01

    Summary Low work engagement may contribute towards decreased well‐being and work performance. Evaluating, boosting and sustaining work engagement are therefore of interest to many organisations. However, the evidence on which to base interventions has not yet been synthesised. A systematic review with meta‐analysis was conducted to assess the evidence for the effectiveness of work engagement interventions. A systematic literature search identified controlled workplace interventions employing a validated measure of work engagement. Most used the Utrecht Work Engagement Scale (UWES). Studies containing the relevant quantitative data underwent random‐effects meta‐analyses. Results were assessed for homogeneity, systematic sampling error, publication bias and quality. Twenty studies met the inclusion criteria and were categorised into four types of interventions: (i) personal resource building; (ii) job resource building; (iii) leadership training; and (iv) health promotion. The overall effect on work engagement was small, but positive, k = 14, Hedges g = 0.29, 95%‐CI = 0.12–0.46. Moderator analyses revealed a significant result for intervention style, with a medium to large effect for group interventions. Heterogeneity between the studies was high, and the success of implementation varied. More studies are needed, and researchers are encouraged to collaborate closely with organisations to design interventions appropriate to individual contexts and settings, and include evaluations of intervention implementation. © 2016 The Authors. Journal of Organizational Behavior published by John Wiley & Sons, Ltd. PMID:28781428

  13. Building work engagement: A systematic review and meta-analysis investigating the effectiveness of work engagement interventions.

    Science.gov (United States)

    Knight, Caroline; Patterson, Malcolm; Dawson, Jeremy

    2017-07-01

    Low work engagement may contribute towards decreased well-being and work performance. Evaluating, boosting and sustaining work engagement are therefore of interest to many organisations. However, the evidence on which to base interventions has not yet been synthesised. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of work engagement interventions. A systematic literature search identified controlled workplace interventions employing a validated measure of work engagement. Most used the Utrecht Work Engagement Scale (UWES). Studies containing the relevant quantitative data underwent random-effects meta-analyses. Results were assessed for homogeneity, systematic sampling error, publication bias and quality. Twenty studies met the inclusion criteria and were categorised into four types of interventions: (i) personal resource building; (ii) job resource building; (iii) leadership training; and (iv) health promotion. The overall effect on work engagement was small, but positive, k  = 14, Hedges g  = 0.29, 95%-CI = 0.12-0.46. Moderator analyses revealed a significant result for intervention style, with a medium to large effect for group interventions. Heterogeneity between the studies was high, and the success of implementation varied. More studies are needed, and researchers are encouraged to collaborate closely with organisations to design interventions appropriate to individual contexts and settings, and include evaluations of intervention implementation. © 2016 The Authors. Journal of Organizational Behavior published by John Wiley & Sons, Ltd.

  14. Effectiveness of physical activity on patients with depression and Parkinson's disease: A systematic review.

    Directory of Open Access Journals (Sweden)

    Pei-Ling Wu

    Full Text Available In this paper we aimed to systematically review the literature on physical activity's effect on depressive symptoms in Parkinson disease.Depression is a common symptom of Parkinson's disease and is associated with increased disability, rapid progression of motor symptoms, mortality, and adverse effects on Quality of Life.A systematic review of primary research was undertaken and conducted according to the Preferred Reporting Items for Systematic Reviews.Databases Scopus, Psycho-info, CINAHL, PubMed, and ProQuest Cochrance were searched from January 2006 to June 2017. The language was restricted to English.Abstracts were screened and reviewed against the eligibility criteria (participants' mean age were ≥ 60 with PD, PA interventions, depression as one of outcome variables, and Randomized Control Trail or quasi-experimental design. Two reviewers appraised the quality of the data extracted. The modified Jadad scale assessed the quality of the methodology of the published papers.The database search yielded 769 abstracts, 11 of which were included in this review and awarded scores ranging from 3 to 8 (Scale scores range from 0 to 8 points, higher scores indicated better quality by the raters. These 11 studies included 342 patients and executed 17 kinds of physical activity programs. Results of this review show empirical evidence to support the efficacy of physical activity for the population with Parkinson's disease. Aerobic training exercise significantly improved the participants' scores on the Unified Parkinson's Disease Rating Scale, the Beck Depression Inventory, and the Quality of Life of the patients. Qigong improved scores in UPDRS-III and decreased incidences of multiple non-motor symptoms and depression. Furthermore, a balance-training program, such as Tai Chi, can improve postural stability and Quality of Life.Physical activity may assuage the degeneration of motor skills and depression as well as increase the Quality of Life of

  15. A systematic review and meta-analysis of the effectiveness of nudging to increase fruit and vegetable choice.

    Science.gov (United States)

    Broers, Valérie J V; De Breucker, Céline; Van den Broucke, Stephan; Luminet, Olivier

    2017-10-01

    Nudging refers to interventions that organize the choice architecture in order to alter people's behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. As a strategy to encourage healthy behaviour, nudging can serve as a complement to health education. However, the empirical evidence regarding the effectiveness of nudging as a way to influence food choice remains contradictory. To address this issue, a systematic review and meta-analysis was conducted to test the effects of nudging to encourage people to select more fruit and vegetables. A systematic literature search was performed on PubMed, Medline, PsycInfo, Cochrane library, Scopus and Google Scholar. After quality assessment, 20 articles (23 studies) were retained for narrative synthesis. Twelve articles (14 studies) contained enough information to calculate effect-sizes for meta-analysis using Comprehensive Meta-analysis software. The meta-analysis shows that nudging interventions that aim to increase fruit and/or vegetable choice/sales/servings have a moderately significant effect (d = 0.30), with the largest effect for altering placement (d = 0.39) and combined nudges (d = 0.28). The results of this review provide an indication of the effectiveness of nudging on fruit and vegetable choice in terms of actual effect-sizes, while also highlighting the problems that must be addressed before more definitive conclusions can be drawn. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  16. Geomorphic Effects, Chronologies, and Archaeological Significance of El Nino Floods in Southern Peru

    Science.gov (United States)

    Magilligan, F. J.; Manners, R.; Goldstein, P.

    2003-12-01

    The catastrophic effects of large floods have been well documented, on both contemporary and paleo-timecales, especially for the conterminous U.S. Less is known, however, about extreme events in hyper-arid sub-tropical climates where synoptic scale meteorological causes, such as El Nino-Southern Oscillation events, are the driving atmospheric mechanism. This research documents the geomorphic effects of extreme floods in the Moquegua River valley of southern Peru, in the core of the Atacama Desert. Using a combination of geomorphic mapping, hydrolologic modeling, aerial photography, ASTER satellite imagery, and GIS, we document the geomorphic signature of large contemporary floods within the mid-valley section (1500 masl) of the Rio Moquegua. Stratigraphic evidence and paleostage indicators of paleofloods, such as slackwater deposits and preserved high level flood gravels, are used to evidence late Holocene paleoflood magnitude-frequency relationships. On contemporary timescales, channel belt expansion by lateral erosion during large floods, such as the recent '97 and '98 floods, correspond to as much as 30-40 hectares of floodplain loss along the 20 km study reach. Sixty years of repeat aerial photography indicates that channel belt expansion and floodplain erosion commonly occurs along the Rio Moquegua. The frequent resetting of floodplain alluvium conditioned by these large floods is supported by radiocarbon dating of floodplain exposures. These dates indicate that most of the contemporary floodplain alluvium is younger that 560 14C yrs BP. The highest terrace remnants date to 3250 14C yrs BP and record a series of overbank flood gravels. Evidence for the regionally extensive Miraflores ENSO flood, ca. 1300 AD, exists in tributary and along mainstem sections. This flood has been documented along the coasts of Northern Chile to northern Peru, and has been evoked to explain significant social collapse. Our field evidence indicates that it catastrophically affected

  17. Cost-Effectiveness of Competing Treatment Strategies for Clostridium difficile Infection: A Systematic Review.

    Science.gov (United States)

    Le, Phuc; Nghiem, Van T; Mullen, Patricia Dolan; Deshpande, Abhishek

    2018-04-01

    BACKGROUND Clostridium difficile infection (CDI) presents a substantial economic burden and is associated with significant morbidity. While multiple treatment strategies have been evaluated, a cost-effective management strategy remains unclear. OBJECTIVE We conducted a systematic review to assess cost-effectiveness analyses of CDI treatment and to summarize key issues for clinicians and policy makers to consider. METHODS We searched PubMed and 5 other databases from inception to August 2016. These searches were not limited by study design or language of publication. Two reviewers independently screened the literature, abstracted data, and assessed methodological quality using the Drummond and Jefferson checklist. We extracted data on study characteristics, type of CDI, treatment characteristics, and model structure and inputs. RESULTS We included 14 studies, and 13 of these were from high-income countries. More than 90% of these studies were deemed moderate-to-high or high quality. Overall, 6 studies used a decision-tree model and 7 studies used a Markov model. Cost of therapy, time horizon, treatment cure rates, and recurrence rates were common influential factors in the study results. For initial CDI, fidaxomicin was a more cost-effective therapy than metronidazole or vancomycin in 2 of 3 studies. For severe initial CDI, 2 of 3 studies found fidaxomicin to be the most cost-effective therapy. For recurrent CDI, fidaxomicin was cost-effective in 3 of 5 studies, while fecal microbiota transplantation (FMT) by colonoscopy was consistently cost-effective in 4 of 4 studies. CONCLUSIONS The cost-effectiveness of fidaxomicin compared with other pharmacologic therapies was not definitive for either initial or recurrent CDI. Despite its high cost, FMT by colonoscopy may be a cost-effective therapy for recurrent CDI. A consensus on model design and assumptions are necessary for future comparison of CDI treatment. Infect Control Hosp Epidemiol 2018;39:412-424.

  18. Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

    Science.gov (United States)

    Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

    2011-11-01

    Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Palliative patients’ and significant others’ experiences of transitions concerning organizational, psychosocial and existential issues during the course of incurable cancer: A systematic review protocol

    DEFF Research Database (Denmark)

    Madsen, Rikke; Uhrenfeldt, Lisbeth

    2014-01-01

    ABSTRACT Review question/objective The objective of this review is to identify, appraise and synthesize the best available evidence exploring palliative patients’ or their significant others’ experiences of transitions during the course of incurable cancer. In this review, transitions are concept...... exploring euthanasia will be excluded because euthanasia is not included in the WHO definition of palliation. KEYWORDS Lived experience; incurable cancer; patient; significant other; transition; organizational; psychosocial; existential...

  20. Comparing the Effectiveness of Systematic Desensitization and Distraction on Pain and Fear in Children with Dental Problems

    Directory of Open Access Journals (Sweden)

    Maryam Fallah

    2016-04-01

    Full Text Available Background & objectives: One of the difficulties of community of dentists, especially dentists dealing with children, is the pain and fear of dental treatment. The purpose of this study was to investigate the effectiveness of systematic desensitization and distraction on reducing fear and pain in children with dental problems. Methods: This is a quasi-experimental study designed with pretest-posttest multi groups according to control group. For this purpose, 45 children with dental problems referred to the dental clinic of Ardabil was selected and divided into three groups of 15 people: systematic desensitization (n=15, distraction (n=15 and control group (n=15. All of three groups answered to dental fears survey and numeric scale of pain as pre-test. Then, the therapeutic method of systematic desensitization and distraction was performed on two experimental groups. After completion of the treatments, three groups answered to dental fear survey and numeric scale of pain. Multivariate analysis of covariance was used for the analysis of the data. Results: The results showed a significant difference in the score of post-test between three groups in pain (F=197.27; p<0.001 anddental fear (F=178.36; p<0.001. LSD post hoc test results showed that systematic desensitization method was more effective in reduction of pain and the distraction method was more affective in reduction of dental fear. Conclusion: The results of this study indicate that psychological interventions of distracting and systematic desensitization can be used to reduce fear and pain at pediatric clinics.

  1. A Systematic Overview of Radiation Therapy Effects in Brain Tumours

    International Nuclear Information System (INIS)

    Berg, Gertrud; Blomquist, Erik; Cavallin-Staahl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for brain tumours is based on data from 9 randomized trials and 1 meta-analysis. Moreover, data from 2 prospective studies, 3 retrospective studies and 4 other articles were used. In total, 19 scientific articles are included, involving 4,266 patients. The results were compared with those of a similar overview from 1996 including 11,252 patients. The conclusions reached can be summarized as follows: The conclusion from SBU 129/2 that curative treatment is not available for patients with high-grade malignant glioma (grade III and IV) is still valid. The survival benefit from postoperative radiotherapy compared to supportive care only or chemotherapy is about 3-4 months, as demonstrated in earlier randomized studies. Quality of life is now currently estimated and considered to be of major importance when reporting the outcome of treatment for patients with brain tumours. There is no scientific evidence that radiotherapy using hyper- and hypofractionation leads to longer survival for patients with high-grade malignant glioma than conventional radiotherapy. There is large documentation, but only one randomized study. There is some documentation to support the view that patients with grade IV glioma and poor prognosis can be treated with hypofractionation and with an outcome similar to that after conventional fractionation. A shorter treatment time should be convenient for the patient. Documentation of the benefit of a radiotherapy boost with brachytherapy is limited and no conclusion can be drawn. There is no scientific evidence that radiotherapy prolongs life for patients with low-grade glioma. There are some data supporting that radiotherapy can be used to treat symptoms in

  2. Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses.

    Science.gov (United States)

    López, Néstor J; Uribe, Sergio; Martinez, Benjamín

    2015-02-01

    Preterm birth is a major cause of neonatal morbidity and mortality in both developed and developing countries. Preterm birth is a highly complex syndrome that includes distinct clinical subtypes in which many different causes may be involved. The results of epidemiological, molecular, microbiological and animal-model studies support a positive association between maternal periodontal disease and preterm birth. However, the results of intervention studies carried out to determine the effect of periodontal treatment on reducing the risk of preterm birth are controversial. This systematic review critically analyzes the methodological issues of meta-analyses of the studies to determine the effect of periodontal treatment to reduce preterm birth. The quality of the individual randomized clinical trials selected is of highest relevance for a systematic review. This article describes the methodological features that should be identified a priori and assessed individually to determine the quality of a randomized controlled trial performed to evaluate the effect of periodontal treatment on pregnancy outcomes. The AMSTAR and the PRISMA checklist tools were used to assess the quality of the six meta-analyses selected, and the bias domain of the Cochrane Collaboration's Tool was applied to evaluate each of the trials included in the meta-analyses. In addition, the methodological characteristics of each clinical trial were assessed. The majority of the trials included in the meta-analyses have significant methodological flaws that threaten their internal validity. The lack of effect of periodontal treatment on preterm birth rate concluded by four meta-analyses, and the positive effect of treatment for reducing preterm birth risk concluded by the remaining two meta-analyses are not based on consistent scientific evidence. Well-conducted randomized controlled trials using rigorous methodology, including appropriate definition of the exposure, adequate control of confounders for

  3. A Systematic Review of the Safety and Effect of Neurofeedback on Fatigue and Cognition.

    Science.gov (United States)

    Luctkar-Flude, Marian; Groll, Dianne

    2015-07-01

    Many cancer survivors continue to experience ongoing symptoms, such as fatigue and cognitive impairment, which are poorly managed and have few effective, evidence-based treatment options. Neurofeedback is a noninvasive, drug-free form of brain training that may alleviate long-term symptoms reported by cancer patients. The purpose of this systematic review of the literature was to describe the effectiveness and safety of neurofeedback for managing fatigue and cognitive impairment. A systematic review of the literature was conducted using Joanna Briggs Institute (JBI) methodology. A comprehensive search of 5 databases was conducted: Medline, CINAHL, AMED, PsycInfo, and Embase. Randomized and nonrandomized controlled trials, controlled before and after studies, cohort, case control studies, and descriptive studies were included in this review. Twenty-seven relevant studies were included in the critical appraisals. The quality of most studies was poor to moderate based on the JBI critical appraisal checklists. Seventeen studies were deemed of sufficient quality to be included in the review: 10 experimental studies and 7 descriptive studies. Of these, only 2 were rated as high-quality studies and the remaining were rated as moderate quality. All 17 included studies reported positive results for at least one fatigue or cognitive outcome in a variety of populations, including 1 study with breast cancer survivors. Neurofeedback interventions were well tolerated with only 3 studies reporting any side effects. Despite issues with methodological quality, the overall positive findings and few reported side effects suggest neurofeedback could be helpful in alleviating fatigue and cognitive impairment. Currently, there is insufficient evidence that neurofeedback is an effective therapy for management of these symptoms in cancer survivors, however, these promising results support the need for further research with this patient population. More information about which

  4. Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis.

    Science.gov (United States)

    Welton, Nicky J; McAleenan, Alexandra; Thom, Howard Hz; Davies, Philippa; Hollingworth, Will; Higgins, Julian Pt; Okoli, George; Sterne, Jonathan Ac; Feder, Gene; Eaton, Diane; Hingorani, Aroon; Fawsitt, Christopher; Lobban, Trudie; Bryden, Peter; Richards, Alison; Sofat, Reecha

    2017-05-01

    Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model. Systematic review, meta-analysis and cost-effectiveness analysis. Primary care. Adults. Screening strategies, defined by screening test, age at initial and final screens, screening interval and format of screening {systematic opportunistic screening [individuals offered screening if they consult with their general practitioner (GP)] or systematic population screening (when all eligible individuals are invited to screening)}. Sensitivity, specificity and diagnostic odds ratios; the odds ratio of detecting new AF cases compared with no screening; and the mean incremental net benefit compared with no screening. Two reviewers screened the search results, extracted data and assessed the risk of bias. A DTA meta-analysis was perfomed, and a decision tree and Markov model was used to evaluate the cost-effectiveness of the screening strategies. Diagnostic test accuracy depended on the screening test and how it was interpreted. In general, the screening tests identified in our review had high sensitivity (> 0.9). Systematic population and systematic opportunistic screening strategies were found to be similarly effective, with an estimated 170 individuals needed to be screened to detect one additional AF case compared with no screening. Systematic opportunistic screening was more likely to be cost-effective

  5. Effect of acute hypoxia on cognition: A systematic review and meta-regression analysis.

    Science.gov (United States)

    McMorris, Terry; Hale, Beverley J; Barwood, Martin; Costello, Joseph; Corbett, Jo

    2017-03-01

    A systematic meta-regression analysis of the effects of acute hypoxia on the performance of central executive and non-executive tasks, and the effects of the moderating variables, arterial partial pressure of oxygen (PaO 2 ) and hypobaric versus normobaric hypoxia, was undertaken. Studies were included if they were performed on healthy humans; within-subject design was used; data were reported giving the PaO 2 or that allowed the PaO 2 to be estimated (e.g. arterial oxygen saturation and/or altitude); and the duration of being in a hypoxic state prior to cognitive testing was ≤6days. Twenty-two experiments met the criteria for inclusion and demonstrated a moderate, negative mean effect size (g=-0.49, 95% CI -0.64 to -0.34, p<0.001). There were no significant differences between central executive and non-executive, perception/attention and short-term memory, tasks. Low (35-60mmHg) PaO 2 was the key predictor of cognitive performance (R 2 =0.45, p<0.001) and this was independent of whether the exposure was in hypobaric hypoxic or normobaric hypoxic conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Effectiveness of horticultural therapy: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Kamioka, Hiroharu; Tsutani, Kiichiro; Yamada, Minoru; Park, Hyuntae; Okuizumi, Hiroyasu; Honda, Takuya; Okada, Shinpei; Park, Sang-Jun; Kitayuguchi, Jun; Abe, Takafumi; Handa, Shuichi; Mutoh, Yoshiteru

    2014-10-01

    To summarize the evidence from randomized controlled trials (RCTs) on the effects of horticultural therapy (HT). Studies were eligible if they were RCTs. Studies included one treatment group in which HT was applied. We searched the following databases from 1990 up to August 20, 2013: MEDLINE via PubMed, CINAHL, Web of Science, Ichushi-Web, GHL, WPRIM, and PsyclNFO. We also searched all Cochrane Database and Campbell Systematic Reviews up to September 20, 2013. Four studies met all inclusion criteria. The language of all eligible publications was English and Korean. Target diseases and/or symptoms were dementia, severe mental illness such as schizophrenia, bipolar disorder, and major depression, frail elderly in nursing home, and hemiplegic patients after stroke. These studies showed significant effectiveness in one or more outcomes for mental health and behavior. However, our review especially detected omissions of the following descriptions: method used to generate randomization, concealment, blinding, and intention-to-treat analysis. In addition, the results of this study suggested that the RCTs conducted have been of relatively low quality. Although there was insufficient evidence in the studies of HT due to poor methodological and reporting quality and heterogeneity, HT may be an effective treatment for mental and behavioral disorders such as dementia, schizophrenia, depression, and terminal-care for cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Effects of transcranial direct current stimulation on motor learning in healthy individuals: a systematic review

    Directory of Open Access Journals (Sweden)

    Águida Foerster

    Full Text Available Introduction Transcranial direct current stimulation (tDCS has been used to modify cortical excitability and promote motor learning. Objective To systematically review published data to investigate the effects of transcranial direct current stimulation on motor learning in healthy individuals. Methods Randomized or quasi-randomized studies that evaluated the tDCS effects on motor learning were included and the risk of bias was examined by Cochrane Collaboration’s tool. The following electronic databases were used: PubMed, Scopus, Web of Science, LILACS, CINAHL with no language restriction. Results It was found 160 studies; after reading the title and abstract, 17 of those were selected, but just 4 were included. All studies involved healthy, right-handed adults. All studies assessed motor learning by the Jebsen Taylor Test or by the Serial Finger Tapping Task (SFTT. Almost all studies were randomized and all were blinding for participants. Some studies presented differences at SFTT protocol. Conclusion The result is insufficient to draw conclusions if tDCS influences the motor learning. Furthermore, there was significant heterogeneity of the stimulation parameters used. Further researches are needed to investigate the parameters that are more important for motor learning improvement and measure whether the effects are long-lasting or limited in time.

  8. The Alcock Paczy'nski test with Baryon Acoustic Oscillations: systematic effects for future surveys

    Energy Technology Data Exchange (ETDEWEB)

    Lepori, Francesca; Viel, Matteo; Baccigalupi, Carlo [SISSA—International School for Advanced Studies, Via Bonomea 265, 34136 Trieste (Italy); Dio, Enea Di [INAF—Osservatorio Astronomico di Trieste, Via G.B. Tiepolo 11, I-34143 Trieste (Italy); Durrer, Ruth, E-mail: flepori@sissa.it, E-mail: enea.didio@oats.inaf.it, E-mail: viel@oats.inaf.it, E-mail: carlo.baccigalupi@sissa.it, E-mail: Ruth.Durrer@unige.ch [Université de Genève, Département de Physique Théorique and CAP, 24 quai Ernest-Ansermet, CH-1211 Genève 4 (Switzerland)

    2017-02-01

    We investigate the Alcock Paczy'nski (AP) test applied to the Baryon Acoustic Oscillation (BAO) feature in the galaxy correlation function. By using a general formalism that includes relativistic effects, we quantify the importance of the linear redshift space distortions and gravitational lensing corrections to the galaxy number density fluctuation. We show that redshift space distortions significantly affect the shape of the correlation function, both in radial and transverse directions, causing different values of galaxy bias to induce offsets up to 1% in the AP test. On the other hand, we find that the lensing correction around the BAO scale modifies the amplitude but not the shape of the correlation function and therefore does not introduce any systematic effect. Furthermore, we investigate in details how the AP test is sensitive to redshift binning: a window function in transverse direction suppresses correlations and shifts the peak position toward smaller angular scales. We determine the correction that should be applied in order to account for this effect, when performing the test with data from three future planned galaxy redshift surveys: Euclid, the Dark Energy Spectroscopic Instrument (DESI) and the Square Kilometer Array (SKA).

  9. Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Wang, Ralph C; Smith-Bindman, Rebecca; Whitaker, Evans; Neilson, Jersey; Allen, Isabel Elaine; Stoller, Marshall L; Fahimi, Jahan

    2017-03-01

    Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone. MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design. Meta-analysis was conducted with a random-effects model and subgroup analyses were conducted to determine sources of heterogeneity. Eight randomized controlled trials (N=1,384) contained sufficient information for inclusion. The pooled risk of stone passage in the tamsulosin arm was 85% versus 66% in the placebo arm, but substantial heterogeneity existed across trials (I 2 =80.2%; Ptamsulosin (risk difference=22%; 95% confidence interval 12% to 33%; number needed to treat=5). The meta-analysis of the small stone subgroup (Tamsulosin significantly improves stone passage in patients with larger stones, whereas the effect of tamsulosin is diminished in those with smaller stones, who are likely to pass their stone regardless of treatment. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  10. Effect of music in endoscopy procedures: systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Man Cai; Zhang, Ling Yi; Zhang, Yu Long; Zhang, Ya Wu; Xu, Xiao Dong; Zhang, You Cheng

    2014-10-01

    Endoscopies are common clinical examinations that are somewhat painful and even cause fear and anxiety for patients. We performed this systematic review and meta-analysis of randomized controlled trials to determine the effect of music on patients undergoing various endoscopic procedures. We searched the Cochrane Library, Issue 6, 2013, PubMed, and EMBASE databases up to July 2013. Randomized controlled trials comparing endoscopies, with and without the use of music, were included. Two authors independently abstracted data and assessed risk of bias. Subgroup analyses were performed to examine the impact of music on different types of endoscopic procedures. Twenty-one randomized controlled trials involving 2,134 patients were included. The overall effect of music on patients undergoing a variety of endoscopic procedures significantly improved pain score (weighted mean difference [WMD] = -1.53, 95% confidence interval [CI] [-2.53, -0.53]), anxiety (WMD = -6.04, 95% CI [-9.61, -2.48]), heart rate (P = 0.01), arterial pressure (P music group, compared with the control group. Furthermore, music had little effect for patients undergoing colposcopy and bronchoscopy in the subanalysis. Our meta-analysis suggested that music may offer benefits for patients undergoing endoscopy, except in colposcopy and bronchoscopy. Wiley Periodicals, Inc.

  11. Effects of physical therapy in older women with urinary incontinence: a systematic review

    Directory of Open Access Journals (Sweden)

    Vanessa S. Pereira

    Full Text Available BACKGROUND: Urinary incontinence (UI is one of the most common public health problems among older women. Despite conservative treatment being recommended as the first treatment option, the effects of physical therapy in older women with UI is unclear. OBJECTIVE: This study aimed to systematically review the evidence about the effects of physical therapy on urinary symptoms in older women with UI. METHOD: The literature search for studies evaluating conservative treatment for incontinent in elderly women was conducted on Pubmed/Medline, Lilacs, Scielo, ISI Web of Knowledge and PEDro. We selected clinical trials published in English and Portuguese after the year 2000. The methodological quality of the studies was assessed using the PEDro scale. The results were analyzed using a critical review method. RESULTS: Six studies were reviewed in full revealing that pelvic floor muscle training was the treatment option in most studies. Five of the six selected studies were classified as having high methodological quality. There was significant improvement in urinary symptoms after treatment in five of the six selected studies. CONCLUSIONS: It was concluded that physical therapy treatment seems to be effective to decrease urinary incontinence symptoms in older women. However, the small number of studies and the use of concurrent interventions limit the conclusions on this issue.

  12. Effects of chocolate on cognitive function and mood: a systematic review.

    Science.gov (United States)

    Scholey, Andrew; Owen, Lauren

    2013-10-01

    A systematic review was conducted to evaluate whether chocolate or its constituents were capable of influencing cognitive function and/or mood. Studies investigating potentially psychoactive fractions of chocolate were also included. Eight studies (in six articles) met the inclusion criteria for assessment of chocolate or its components on mood, of which five showed either an improvement in mood state or an attenuation of negative mood. Regarding cognitive function, eight studies (in six articles) met the criteria for inclusion, of which three revealed clear evidence of cognitive enhancement (following cocoa flavanols and methylxanthine). Two studies failed to demonstrate behavioral benefits but did identify significant alterations in brain activation patterns. It is unclear whether the effects of chocolate on mood are due to the orosensory characteristics of chocolate or to the pharmacological actions of chocolate constituents. Two studies have reported acute cognitive effects of supplementation with cocoa polyphenols. Further exploration of the effect of chocolate on cognitive facilitation is recommended, along with substantiation of functional brain changes associated with the components of cocoa.

  13. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects.

    Science.gov (United States)

    Papageorgiou, Spyridon N; Gölz, Lina; Jäger, Andreas; Eliades, Theodore; Bourauel, Christoph

    2016-04-01

    The aim of this systematic review was to compare the therapeutic and adverse effects of lingual and labial orthodontic fixed appliances from clinical trials on human patients in an evidence-based manner. Randomized and prospective non-randomized clinical trials comparing lingual and labial appliances were included. Risk of bias within and across studies was assessed using the Cochrane tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses. Six electronic databases were searched from inception to July 2015, without limitations. A total of 13 papers pertaining to 11 clinical trials were included with a total of 407 (34% male/66% female) patients. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort, increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty, and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. Based on existing trials, there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low. © 2016 Eur J Oral Sci.

  14. Homeopathy and systematics: a systematic analysis of the therapeutic effects of the plant species used in homeopathy.

    Science.gov (United States)

    Bharatan, V

    2008-07-01

    The therapeutic effects of the plant species used in homeopathy have never been subjected to systematic analysis. A survey of the various Materiae Medicae shows that over 800 plant species are the source of medicines in homeopathy. As these medicines are considered related to one another with respect to their therapeutic effects for treating similar symptoms, the aim is to classify and map them using the concept of homology. This involves placing the discipline of homeopathy into a comparative framework using these plant medicines as taxa, therapeutic effects as characters, and contemporary cladistic techniques to analyse these relationships. The results are compared using cladograms based on different data sets used in biology (e.g. morphological characters and DNA sequences) to test whether similar cladistic patterns exist among these medicines. By classifying the therapeutic actions, genuine homologies can be distinguished from homoplasies. As this is a comparative study it has been necessary first to update the existing nomenclature of the plant species in the homeopathic literature in line with the current International Code of Botanical Nomenclature.

  15. Systematic study of shell effect near drip-lines

    International Nuclear Information System (INIS)

    Adhikari, S.; Samanta, C.

    2004-01-01

    The variation of nuclear shell effects with nucleon numbers is evaluated using the modified Bethe–Weizsaecker mass formula (BWM) and the measured atomic masses. The shell effects at magic neutron numbers N=8, 20, 28, 50, 82 and 126 and magic proton numbers Z=8, 20, 28, 50 and 82 are found to vary rapidly approaching the drip-lines. The shell effect due to one magic number increases on approaching another magic number. Thus, shell effects are not always negligible near the drip-lines. (author)

  16. Effects of Coenzyme Q10 on Markers of Inflammation: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Junya Zhai

    Full Text Available Chronic inflammation contributes to the onset and development of metabolic diseases. Clinical evidence has suggested that coenzyme Q10 (CoQ10 has some effects on inflammatory markers. However, these results are equivocal. The aim of this systematic review was to assess the effects of CoQ10 on serum levels of inflammatory markers in people with metabolic diseases.Electronic databases were searched up to February 2016 for randomized controlled trials (RCTs. The outcome parameters were related to inflammatory factors, including interleukin-6 (IL-6, tumor necrosis factor-alpha (TNF-α and C reactive protein (CRP. RevMan software was used for meta-analysis. Meta-regression analysis, Egger line regression test and Begg rank correlation test were performed by STATA software.Nine trials involving 428 subjects were included in this meta-analysis. The results showed that compared with control group, CoQ10 supplementation has significantly improved the serum level of CoQ10 by 1.17μg/ml [MD = 1.17, 95% CI (0.47 to 1.87 μg/ml, I2 = 94%]. Meanwhile, it has significantly decreased TNF-α by 0.45 pg/ml [MD = -0.45, 95% CI (-0.67 to -0.24 pg/ml, I2 = 0%]. No significant difference was observed between CoQ10 and placebo with regard to CRP [MD = -0.21, 95% CI (-0.60 to 0.17 mg/L, I2 = 21%] and IL-6 [MD = -0.89, 95% CI (-1.95 to 0.16 pg/ml, I2 = 84%].CoQ10 supplementation may partly improve the process of inflammatory state. The effects of CoQ10 on inflammation should be further investigated by conducting larger sample size and well-defined trials of long enough duration.

  17. The effect of interior lead hazard controls on children's blood lead concentrations: a systematic evaluation.

    Science.gov (United States)

    Haynes, Erin; Lanphear, Bruce P; Tohn, Ellen; Farr, Nick; Rhoads, George G

    2002-01-01

    Dust control is often recommended to prevent children's exposure to residential lead hazards, but the effect of these controls on children's blood lead concentrations is uncertain. We conducted a systematic review of randomized, controlled trials of low-cost, lead hazard control interventions to determine the effect of lead hazard control on children's blood lead concentration. Four trials met the inclusion criteria. We examined mean blood lead concentration and elevated blood lead concentrations (> or = 10 microg/dL, > or = 15 microg/dL, and > or = 20 microg/dL) and found no significant differences in mean change in blood lead concentration for children by random group assignment (children assigned to the intervention group compared with those assigned to the control group). We found no significant difference between the intervention and control groups in the percentage of children with blood lead > or = 10 microg/dL, 29% versus 32% [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.56-1.3], but there was a significant difference in the percentage of children with blood lead > or = 15 microg/dL between the intervention and control groups, 6% versus 14% (OR, 0.40; 95% CI, 0.21-0.80) and in the percentage of children with blood lead > or = 20 microg/dL between the intervention and control groups, 2% versus 6% (OR, 0.29; 95% CI, 0.10-0.85). We conclude that although low-cost, interior lead hazard control was associated with 50% or greater reduction in the proportion of children who had blood lead concentrations exceeding 15 microg/dL and > or = 20 microg/dL, there was no substantial effect on mean blood lead concentration.

  18. Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings.

    Science.gov (United States)

    Rieger, Kendra L; Hack, Thomas F; Beaver, Kinta; Schofield, Penelope

    2018-04-01

    To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Effect of maternal body mass index on hormones in breast milk: a systematic review.

    Science.gov (United States)

    Andreas, Nicholas J; Hyde, Matthew J; Gale, Chris; Parkinson, James R C; Jeffries, Suzan; Holmes, Elaine; Modi, Neena

    2014-01-01

    Maternal Body Mass Index (BMI) is positively associated with infant obesity risk. Breast milk contains a number of hormones that may influence infant metabolism during the neonatal period; these may have additional downstream effects on infant appetite regulatory pathways, thereby influencing propensity towards obesity in later life. To conduct a systematic review of studies examining the association between maternal BMI and the concentration of appetite-regulating hormones in breast milk. Pubmed was searched for studies reporting the association between maternal BMI and leptin, adiponectin, insulin, ghrelin, resistin, obestatin, Peptide YY and Glucagon-Like Peptide 1 in breast milk. Twenty six studies were identified and included in the systematic review. There was a high degree of variability between studies with regard to collection, preparation and analysis of breast milk samples. Eleven of fifteen studies reporting breast milk leptin found a positive association between maternal BMI and milk leptin concentration. Two of nine studies investigating adiponectin found an association between maternal BMI and breast milk adiponectin concentration; however significance was lost in one study following adjustment for time post-partum. No association was seen between maternal BMI and milk adiponectin in the other seven studies identified. Evidence for an association between other appetite regulating hormones and maternal BMI was either inconclusive, or lacking. A positive association between maternal BMI and breast milk leptin concentration is consistently found in most studies, despite variable methodology. Evidence for such an association with breast milk adiponectin concentration, however, is lacking with additional research needed for other hormones including insulin, ghrelin, resistin, obestatin, peptide YY and glucagon-like peptide-1. As most current studies have been conducted with small sample sizes, future studies should ensure adequate sample sizes and

  20. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review

    Science.gov (United States)

    2017-01-01

    Background Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR). Health information technology (HIT) in the form of Computerised Decision Support (CDS) represents an option for improving antimicrobial prescribing and containing AMR. Objectives To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings. Methods A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing) OR (clinical decision support) AND (antibiotic or antibacterial or antimicrobial) AND (hospital or secondary care or inpatient). Studies were evaluated for quality using a 10-point rating scale. Results Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]). Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]). CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted. Conclusions CDS has the potential to improve the adequacy of antibiotic

  1. Effect of maternal body mass index on hormones in breast milk: a systematic review.

    Directory of Open Access Journals (Sweden)

    Nicholas J Andreas

    Full Text Available Maternal Body Mass Index (BMI is positively associated with infant obesity risk. Breast milk contains a number of hormones that may influence infant metabolism during the neonatal period; these may have additional downstream effects on infant appetite regulatory pathways, thereby influencing propensity towards obesity in later life.To conduct a systematic review of studies examining the association between maternal BMI and the concentration of appetite-regulating hormones in breast milk.Pubmed was searched for studies reporting the association between maternal BMI and leptin, adiponectin, insulin, ghrelin, resistin, obestatin, Peptide YY and Glucagon-Like Peptide 1 in breast milk.Twenty six studies were identified and included in the systematic review. There was a high degree of variability between studies with regard to collection, preparation and analysis of breast milk samples. Eleven of fifteen studies reporting breast milk leptin found a positive association between maternal BMI and milk leptin concentration. Two of nine studies investigating adiponectin found an association between maternal BMI and breast milk adiponectin concentration; however significance was lost in one study following adjustment for time post-partum. No association was seen between maternal BMI and milk adiponectin in the other seven studies identified. Evidence for an association between other appetite regulating hormones and maternal BMI was either inconclusive, or lacking.A positive association between maternal BMI and breast milk leptin concentration is consistently found in most studies, despite variable methodology. Evidence for such an association with breast milk adiponectin concentration, however, is lacking with additional research needed for other hormones including insulin, ghrelin, resistin, obestatin, peptide YY and glucagon-like peptide-1. As most current studies have been conducted with small sample sizes, future studies should ensure adequate sample

  2. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review.

    Directory of Open Access Journals (Sweden)

    Christopher E Curtis

    Full Text Available Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR. Health information technology (HIT in the form of Computerised Decision Support (CDS represents an option for improving antimicrobial prescribing and containing AMR.To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings.A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing OR (clinical decision support AND (antibiotic or antibacterial or antimicrobial AND (hospital or secondary care or inpatient. Studies were evaluated for quality using a 10-point rating scale.Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]. Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]. CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted.CDS has the potential to improve the adequacy of antibiotic coverage and marginally decrease mortality in

  3. Effectiveness of physiotherapy for lateral epicondylitis : a systematic review

    NARCIS (Netherlands)

    Smidt, Nynke; Assendelft, Willem J J; Arola, Heikki; Malmivaara, Antti; Greens, Sally; Buchbinder, Rachelle; van der Windt, Daniëlle A W M; Bouter, Lex M

    2003-01-01

    AIM: To evaluate the available evidence of the effectiveness of physiotherapy for lateral epicondylitis of the elbow. METHOD: Randomised controlled trials (RCTs) identified by a highly sensitive search strategy in six databases in combination with reference checking. Two independent reviewers

  4. The Neuroprotection Effect of Oxygen Therapy: A Systematic Review ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... investigating the neuroprotective effect of oxygen, but the outcomes as well as ...... Neuroprotective gases – Fantasy or reality for clinical use? Prog .... of oxygen on brain tissue oxygen tension in children with severe traumatic ...

  5. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    Science.gov (United States)

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  6. Effect of Systematic Desensitization on the Training of Counselors

    Science.gov (United States)

    Monke, Robert H.

    1971-01-01

    In determining whether the technique of desensitization would reduce the initial anxiety experienced by the beginning counselor trainee, analyses of the data revealed significantly less self-reported anxiety in the experimental group. No differences were found in heart rate, skin resistance, and tape-evaluation measures. (Author/CG(

  7. The effectiveness of education in the recognition and management of deteriorating patients: A systematic review.

    Science.gov (United States)

    Connell, Clifford J; Endacott, Ruth; Jackman, Jennifer A; Kiprillis, Noelleen R; Sparkes, Louise M; Cooper, Simon J

    2016-09-01

    Survival from in-hospital cardiac arrest is poor. Clinical features, including abnormal vital signs, often indicate patient deterioration prior to severe adverse events. Early warning systems and rapid response teams are commonly used to assist the health profession in the identification and management of the deteriorating patient. Education programs are widely used in the implementation of these systems. The effectiveness of the education is unknown. The aims of this study were to identify: (i) the evidence supporting educational effectiveness in the recognition and management of the deteriorating patient and (ii) outcome measures used to evaluate educational effectiveness. A mixed methods systematic review of the literature was conducted using studies published between 2002 and 2014. Included studies were assessed for quality and data were synthesized thematically, while original data are presented in tabular form. Twenty-three studies were included in the review. Most educational programs were found to be effective reporting significant positive impacts upon learners, patient outcomes and organisational systems. Outcome measures related to: i learners, for example knowledge and performance, ii systems, including activation and responses of rapid response teams, and iii patients, including patient length of stay and adverse events. All but one of the programs used blended teaching with >87% including medium to high fidelity simulation. In situ simulation was employed in two of the interventions. The median program time was eight hours. The longest program lasted 44h however one of the most educationally effective programs was based upon a 40min simulation program. Educational interventions designed to improve the recognition and management of patient deterioration can improve learner outcomes when they incorporate medium to high-fidelity simulation. High-fidelity simulation has demonstrated effectiveness when delivered in brief sessions lasting only forty minutes

  8. Effects of sanitation on cognitive development and school absence: A systematic review.

    Science.gov (United States)

    Sclar, G D; Garn, J V; Penakalapati, G; Alexander, K T; Krauss, J; Freeman, M C; Boisson, S; Medlicott, K O; Clasen, T

    2017-08-01

    We undertook this systematic review to explore the relationship between sanitation and learning outcomes, specifically cognitive development and absence. We searched leading databases to identify experimental and observational studies that address the effect of sanitation on our outcomes of interest. We identified 17 studies that met the review's eligibility criteria, four reporting on measures of cognitive development, 12 on school absence (with two studies reporting on school and work absence), and one study that reported on both outcomes. We assessed the risk of bias of individual studies as well as the overall strength of evidence for each outcome. Because of fundamental differences among the studies in terms of sanitation exposure and outcome measurement, pooling results via meta-analysis was deemed inappropriate so a descriptive review is presented. Studies reported that access to household sanitation was associated with measures of improved cognitive ability in children. However, collectively these studies were rated by GRADE as poor methodological quality with significant potential for confounding and bias, including publication bias. Studies on the association between household, community or school sanitation and school absence yielded mixed results. Some sanitation studies reported lower absence while others reported higher absence. Only the two randomized controlled trials reported no overall effects on absence even when combining sanitation with water supply improvements and hygiene promotion. Study quality as assessed by GRADE was again generally poor. While studies to date provide some support for positive effects from sanitation on cognitive development, the effects on school absence are uncertain. Differences in effects may be due to differences in study settings, type of sanitation exposure and most notably in outcome definitions. Further research in multiple settings using rigorous study designs and measuring intermediate outcomes such as exposure

  9. Investigating the effectiveness of technologies applied to assist seniors: A systematic literature review.

    Science.gov (United States)

    Khosravi, Pouria; Ghapanchi, Amir Hossein

    2016-01-01

    Recently, a number of Information and Communication Technologies have emerged with the aim to provide innovative and efficient ways to help seniors in their daily life and to reduce the cost of healthcare. Studies have been conducted to introduce an assistive technology to support seniors and to investigate the acceptance of these assistive technologies; however, research illustrating the effectiveness of assistive technologies is scant. This study undertakes a systematic literature review of ScienceDirect, PubMed, ProQuest and IEEE Explore databases to investigate current empirical studies on the assistive technologies applied in aged care. Our systematic review of an initial set of 2035 studies published from 2000 to 2014 examines the role of assistive technologies in seniors' daily lives, from enhancements in their mobility to improvements in the social connectedness and decreases in readmission to hospitals. This study found eight key issues in aged care that have been targeted by researchers from different disciplines (e.g., ICT, health and social science), namely, dependent living, fall risk, chronic disease, dementia, social isolation, depression, poor well-being, and poor medication management. This paper also identified the assistive technologies that have been proposed to overcome those problems, and we categorised these assistive technologies into six clusters, namely, general ICT, robotics, telemedicine, sensor technology, medication management applications, and video games. In addition, we analyzed the effectiveness of the identified technologies and noted that some technologies can change and enhance seniors' daily lives and relieve their problems. Our analysis showed a significant growth in the number of publications in this area in the past few years. It also showed that most of the studies in this area have been conducted in North America. Assistive technologies are a reality and can be applied to improve quality of life, especially among older age

  10. A systematic review of randomized controlled trials on curative and health enhancement effects of forest therapy

    Directory of Open Access Journals (Sweden)

    Kamioka H

    2012-07-01

    Full Text Available Hiroharu Kamioka,1 Kiichiro Tsutani,2 Yoshiteru Mutoh,3 Takuya Honda,4 Nobuyoshi Shiozawa,5 Shinpei Okada,6 Sang-Jun Park,6 Jun Kitayuguchi,7 Masamitsu Kamada,8 Hiroyasu Okuizumi,9 Shuichi Handa91Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, 2Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 3Todai Policy Alternatives Research Institute, The University of Tokyo, Tokyo, 4Japanese Society for the Promotion of Science, Tokyo, 5Food Labeling Division, Consumer Affairs Agency, Cabinet Office, Government of Japan, Tokyo, 6Physical Education and Medicine Research Foundation, Nagano, 7Physical Education and Medicine Research Center Unnan, Shimane, 8Department of Environmental and Preventive Medicine, Shimane University School of Medicine, Shimane, 9Mimaki Onsen (Spa Clinic, Tomi City, Nagano, JapanObjective: To summarize the evidence for curative and health enhancement effects through forest therapy and to assess the quality of studies based on a review of randomized controlled trials (RCTs.Study design: A systematic review based on RCTs.Methods: Studies were eligible if they were RCTs. Studies included one treatment group in which forest therapy was applied. The following databases – from 1990 to November 9, 2010 – were searched: MEDLINE via PubMed, CINAHL, Web of Science, and Ichushi-Web. All Cochrane databases and Campbell Systematic Reviews were also searched up to November 9, 2010.Results: Two trials met all inclusion criteria. No specific diseases were evaluated, and both studies reported significant effectiveness in one or more outcomes for health enhancement. However, the results of evaluations with the CONSORT (Consolidated Standards of Reporting Trials 2010 and CLEAR NPT (A Checklist to Evaluate a Report of a Nonpharmacological Trial checklists generally showed a remarkable lack of description in the studies. Furthermore, there was a

  11. Effectiveness of Acupuncture for Primary Ovarian Insufficiency: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Jo, Junyoung; Lee, Yoon Jae; Lee, Hyangsook

    2015-01-01

    Objective. This systematic review aimed to assess current evidence from randomized controlled trials (RCTs) on the effects of acupuncture for patients with primary ovarian insufficiency (POI). Methods. We searched twelve databases to identify relevant studies published before July 2014. The outcomes were serum follicle-stimulating hormone (FSH) levels and resumption of menstruation. Two reviewers independently assessed the risk of bias using the Cochrane's tool, extracted the results, and evaluated the overall level of the evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results. Eight RCTs were selected. Acupuncture significantly lowered serum FSH levels and more women receiving acupuncture reported resumption of menses. However, the results should be interpreted with caution due to a small number of participants, high risk of bias for blinding, and likely publication bias. The level of evidence for FSH level and resumption of menses were assessed as "low" using GRADE. Conclusion. The current evidence on acupuncture for POI is insufficient to draw a firm conclusion due to scarcity of studies with a low risk of bias and likely publication bias. Further rigorously designed and conducted studies are needed to confirm the effectiveness and safety of acupuncture in patients with POI.

  12. Effectiveness of Acupuncture for Primary Ovarian Insufficiency: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Junyoung Jo

    2015-01-01

    Full Text Available Objective. This systematic review aimed to assess current evidence from randomized controlled trials (RCTs on the effects of acupuncture for patients with primary ovarian insufficiency (POI. Methods. We searched twelve databases to identify relevant studies published before July 2014. The outcomes were serum follicle-stimulating hormone (FSH levels and resumption of menstruation. Two reviewers independently assessed the risk of bias using the Cochrane’s tool, extracted the results, and evaluated the overall level of the evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE criteria. Results. Eight RCTs were selected. Acupuncture significantly lowered serum FSH levels and more women receiving acupuncture reported resumption of menses. However, the results should be interpreted with caution due to a small number of participants, high risk of bias for blinding, and likely publication bias. The level of evidence for FSH level and resumption of menses were assessed as “low” using GRADE. Conclusion. The current evidence on acupuncture for POI is insufficient to draw a firm conclusion due to scarcity of studies with a low risk of bias and likely publication bias. Further rigorously designed and conducted studies are needed to confirm the effectiveness and safety of acupuncture in patients with POI.

  13. The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review.

    Science.gov (United States)

    Hammond, Alison; Prior, Yeliz

    2016-09-01

    Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA. We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016. Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength. Heterogeneity of outcome measures meant meta-analysis was not possible. Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective. Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Effect of vitamin D supplementation on patients with systemic lupus erythematosus: a systematic review.

    Science.gov (United States)

    Sousa, Joyce Ramalho; Rosa, Érica Patrícia Cunha; Nunes, Ivone Freires de Oliveira Costa; Carvalho, Cecilia Maria Resende Gonçalves de

    The objective of this systematic review was to analyze clinical trials carried out for the investigation of the effect of vitamin D supplementation on systemic lupus erythematosus. The research was performed from August to September 2016, without limits regarding year of publication, restriction of gender, age, and ethnicity. For the guiding question, the PICO strategy was employed. To evaluate the quality of the publications the PRISMA protocol and Jadad scale were used. The risk of bias analysis of the clinical trials was performed using the Cochrane collaboration tool. After the process of article selection and removal of duplicates, four articles were identified as eligible. The results of three studies showed a positive effect of supplementation on disease activity reduction and significant improvement in levels of inflammatory markers, fatigue, and endothelial function. Only one study showed no improvement in disease activity after supplementation. Moreover, all studies showed an increase in serum vitamin D levels. The data from this review provide evidence on the benefits of vitamin D supplementation in patients with lupus and vitamin D insufficiency/deficiency. However, it is still necessary to elucidate whether vitamin D acts in the protection against this metabolic disorder, as well as the standardization of the type, dose and time of vitamin D supplementation. Copyright © 2017. Published by Elsevier Editora Ltda.

  15. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review.

    Science.gov (United States)

    Cullinane, Frances L; Boocock, Mark G; Trevelyan, Fiona C

    2014-01-01

    To establish the effectiveness of eccentric exercise as a treatment intervention for lateral epicondylitis. ProQuest, Medline via EBSCO, AMED, Scopus, Web of Science, CINAHL. A systematic review was undertaken to identify randomized and controlled clinical trials incorporating eccentric exercise as a treatment for patients diagnosed with lateral epicondylitis. Studies were included if: they incorporated eccentric exercise, either in isolation or as part of a multimodal treatment protocol; they assessed at least one functional or disability outcome measure; and the patients had undergone diagnostic testing. The methodological quality of each study was assessed using the Modified Cochrane Musculoskeletal Injuries Group score sheet. Twelve studies met the inclusion criteria. Three were deemed 'high' quality, seven were 'medium' quality, and two were 'low' quality. Eight of the studies were randomized trials investigating a total of 334 subjects. Following treatment, all groups inclusive of eccentric exercise reported decreased pain and improved function and grip strength from baseline. Seven studies reported improvements in pain, function, and/or grip strength for therapy treatments inclusive of eccentric exercise when compared with those excluding eccentric exercise. Only one low-quality study investigated the isolated effects of eccentric exercise for treating lateral epicondylitis and found no significant improvements in pain when compared with other treatments. The majority of consistent findings support the inclusion of eccentric exercise as part of a multimodal therapy programme for improved outcomes in patients with lateral epicondylitis.

  16. Scope and effectiveness of mobile phone messaging for HIV/AIDS care: a systematic review.

    Science.gov (United States)

    van Velthoven, M H M M T; Brusamento, S; Majeed, A; Car, J

    2013-01-01

    The objective of this mixed method systematic review was to assess the scope, effectiveness, acceptability and feasibility of the use of mobile phone messaging for HIV infection prevention, treatment and care. We comprehensively searched the peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed study quality of included studies (any research design) focusing on mobile phone messaging interventions for HIV care. We present a narrative overview of the results. Twenty-one studies met the inclusion criteria: three randomized controlled trials, 11 interventional studies using other study designs and seven qualitative or cross-sectional studies. We also found six on-going trials and 21 projects. Five of the on-going trials and all the above mentioned projects took place in low or middle-income countries. Mobile phone messaging was researched for HIV prevention, appointment reminders, HIV testing reminders, medication adherence and for communication between health workers. Of the three randomized controlled trials assessing the use of short message service (SMS) to improve medication adherence, two showed positive results. Other interventional studies did not provide significant results. In conclusion, despite an extensive search we found limited evidence on the effectiveness of mobile phone messaging for HIV care. There is a need to adequately document outcomes and constraints of programs using mobile phone messaging to support HIV care to assess the impact and to focus on best practice.

  17. Neurolinguistic programming: a systematic review of the effects on health outcomes.

    Science.gov (United States)

    Sturt, Jackie; Ali, Saima; Robertson, Wendy; Metcalfe, David; Grove, Amy; Bourne, Claire; Bridle, Chris

    2012-11-01

    Neurolinguistic programming (NLP) in health care has captured the interest of doctors, healthcare professionals, and managers. To evaluate the effects of NLP on health-related outcomes. Systematic review of experimental studies. The following data sources were searched: MEDLINE, PsycINFO, ASSIA, AMED, CINAHL, Web of Knowledge, CENTRAL, NLP specialist databases, reference lists, review articles, and NLP professional associations, training providers, and research groups. Searches revealed 1459 titles from which 10 experimental studies were included. Five studies were randomised controlled trials (RCTs) and five were pre-post studies. Targeted health conditions were anxiety disorders, weight maintenance, morning sickness, substance misuse, and claustrophobia during MRI scanning. NLP interventions were mainly delivered across 4-20 sessions although three were single session. Eighteen outcomes were reported and the RCT sample sizes ranged from 22 to 106. Four RCTs reported no significant between group differences with the fifth finding in favour of the NLP arm (F = 8.114, P<0.001). Three RCTs and five pre-post studies reported within group improvements. Risk of bias across all studies was high or uncertain. There is little evidence that NLP interventions improve health-related outcomes. This conclusion reflects the limited quantity and quality of NLP research, rather than robust evidence of no effect. There is currently insufficient evidence to support the allocation of NHS resources to NLP activities outside of research purposes.

  18. Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: a systematic review of systematic reviews and meta-analyses.

    Science.gov (United States)

    Elbert, Niels J; van Os-Medendorp, Harmieke; van Renselaar, Wilco; Ekeland, Anne G; Hakkaart-van Roijen, Leona; Raat, Hein; Nijsten, Tamar E C; Pasmans, Suzanne G M A

    2014-04-16

    eHealth potentially enhances quality of care and may reduce health care costs. However, a review of systematic reviews published in 2010 concluded that high-quality evidence on the benefits of eHealth interventions was still lacking. We conducted a systematic review of systematic reviews and meta-analyses on the effectiveness/cost-effectiveness of eHealth interventions in patients with somatic diseases to analyze whether, and to what possible extent, the outcome of recent research supports or differs from previous conclusions. Literature searches were performed in PubMed, EMBASE, The Cochrane Library, and Scopus for systematic reviews and meta-analyses on eHealth interventions published between August 2009 and December 2012. Articles were screened for relevance based on preset inclusion and exclusion criteria. Citations of residual articles were screened for additional literature. Included papers were critically appraised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement before data were extracted. Based on conclusions drawn by the authors of the included articles, reviews and meta-analyses were divided into 1 of 3 groups: suitable, promising, or limited evidence on effectiveness/cost-effectiveness. Cases of uncertainty were resolved by consensus discussion. Effect sizes were extracted from papers that included a meta-analysis. To compare our results with previous findings, a trend analysis was performed. Our literature searches yielded 31 eligible reviews, of which 20 (65%) reported on costs. Seven papers (23%) concluded that eHealth is effective/cost-effective, 13 (42%) underlined that evidence is promising, and others found limited or inconsistent proof. Methodological quality of the included reviews and meta-analyses was generally considered high. Trend analysis showed a considerable accumulation of literature on eHealth. However, a similar percentage of papers concluded that eHealth is effective/cost-effective or

  19. Effectiveness of empathy in general practice: a systematic review.

    NARCIS (Netherlands)

    Derksen, F.; Bensing, J.; Lagro-Janssen, A.

    2013-01-01

    Background: Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice.

  20. The cognitive effects of opioids in cancer: a systematic review

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Lundorff, Lena; Pimenta, Cibele Andrucioli de Mattos

    2008-01-01

    OBJECTIVE AND METHODS: In order to better understand the effects of opioids on the cognitive function in cancer pain patients, a literature search was performed in PubMed, EMBASE, PsycInfo, CINAHL and Lilacs databases. Ten controlled trials were selected and classified according to the study design...

  1. Effectiveness of empathy in general practice: a systematic review

    NARCIS (Netherlands)

    Derksen, F.; Bensing, J.; Lagro-Janssen, A.

    2013-01-01

    BACKGROUND: Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice.

  2. The Neuroprotection Effect of Oxygen Therapy: A Systematic Review ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... NBO on oxidative cerebral metabolism and oxygen treatment for severe TBI was not an all or nothing phenomenon but represented a graduated effect.[27] In the following clinical trial, they evaluated the combination of HBO and NBO as a single treatment. Compared with standard care (control treatment), ...

  3. Clinical Significance of ErbB Receptor Family in Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yuh-Shyan Tsai

    2012-01-01

    Full Text Available The prognostic importance of examining ErbB receptor family expression in human bladder cancer remains uncertain. Using published evidence, we examined the clinical value and the updated results of clinical trials targeting ErbB receptor family members. Twenty-seven articles from 65 references related to ErbB receptor expression assessment in bladder cancer were reviewed. The estimates included the association significance, hazard ratios, and 95% confidence intervals (CIs from actuarial curves and survival analyses. A meta-analysis was done on those reports using univariate log-rank tests or a Cox-regression model. The methods of analysis and study subjects chosen varied widely among studies. The overall risks of disease progression for patients with EGFR or ErbB2 overexpression were 4.5 (95% CI: 2.5–8.4 and 1.1 (95% CI: 0.6–1.9, and the risks of mortality were 3.0 (95% CI: 1.6–5.9 and 1.1 (95% CI: 1.0–1.2, respectively. However, the significance of coexpression patterns of the ErbB receptor family remains controversial. None of six clinical trials yielded convincing results for blockading ErbB receptor signaling in urothelial carcinoma. The results of this analysis suggest that assessing co-expression patterns of the ErbB family may provide better prognostic information for bladder cancer patients.

  4. Effect of treatment of obstructive sleep apnea on depressive symptoms: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Marcus Povitz

    2014-11-01

    Full Text Available BACKGROUND: Obstructive sleep apnea (OSA is associated with increased morbidity and mortality, and decreased quality of life. Treatment with continuous positive airway pressure (CPAP or mandibular advancement devices (MADs is effective for many symptoms of OSA. However, it remains controversial whether treatment with CPAP or MAD also improves depressive symptoms. METHODS AND FINDINGS: We performed a systematic review and meta-analysis of randomized controlled trials that examined the effect of CPAP or MADs on depressive symptoms in patients with OSA. We searched Medline, EMBASE, the Cochrane Central Registry of Controlled Trials, and PsycINFO from the inception of the databases until August 15, 2014, for relevant articles. In a random effects meta-analysis of 19 identified trials, CPAP treatment resulted in an improvement in depressive symptoms compared to control, but with significant heterogeneity between trials (Q statistic, p<0.001; I(2 = 71.3%, 95% CI: 54%, 82%. CPAP treatment resulted in significantly greater improvement in depressive symptoms in the two trials with a higher burden of depression at baseline (meta-regression, p<0.001. The pooled standardized mean difference (SMD in depressive symptoms with CPAP treatment in these two trial populations with baseline depression was 2.004 (95% CI: 1.387, 2.621, compared to 0.197 (95% CI: 0.059, 0.334 for 15 trials of populations without depression at baseline. Pooled estimates of the treatment effect of CPAP were greater in parallel arm trials than in crossover trials (meta-regression, p = 0.076. Random effects meta-analysis of five trials of MADs showed a significant improvement in depressive symptoms with MADs versus controls: SMD = 0.214 (95% CI: 0.026, 0.401 without significant heterogeneity (I(2 = 0%, 95% CI: 0%, 79%. Studies were limited by the use of depressive symptom scales that have not been validated specifically in people with OSA. CONCLUSIONS: CPAP and MADs may be useful

  5. The effectiveness of self help technologies for emotional problems in adolescents: a systematic review

    Directory of Open Access Journals (Sweden)

    Bower Peter

    2008-07-01

    Full Text Available Abstract Background Adolescence is a transition period that involves physiological, psychological, and social changes. Emotional problems such as symptoms of anxiety and depression may develop due to these changes. Although many of these problems may not meet diagnostic thresholds, they may develop into more severe disorders and may impact on functioning. However, there are barriers that may make it difficult for adolescents to receive help from health professionals for such problems, one of which is the limited availability of formal psychological therapy. One way of increasing access to help for such problems is through self help technology (i.e. delivery of psychological help through information technology or paper based formats. Although there is a significant evidence base concerning self help in adults, the evidence base is much weaker in adolescents. This study aims to examine the effectiveness of self help technology for the treatment of emotional problems in adolescents by conducting a systematic review of randomized and quasi-experimental evidence. Methods Five major electronic databases were searched: Medline, PsycInfo, Embase, Cochrane Controlled Trials Register and CINAHL. In addition, nine journals were handsearched and the reference lists of all studies were examined for any additional studies. Fourteen studies were identified. Effect sizes were calculated across 3 outcome measures: attitude towards self (e.g. self esteem; social cognition (e.g. self efficacy; and emotional symptoms (i.e. depression and anxiety symptoms. Results Meta analysis showed small, non-significant effect size for attitude towards self (ES = -0.14, 95% CI = -0.72 to 0.43, a medium, non-significant effect size for social cognition (ES = -0.49, 95% CI = -1.23 to 0.25 and a medium, non-significant effect size for emotional symptoms (ES = -0.47, 95% CI = -1.00 to 0.07. However, these findings must be considered preliminary, because of the small number of

  6. The effect of very low-calorie diets on renal and hepatic outcomes: a systematic review

    Directory of Open Access Journals (Sweden)

    Roll

    2013-10-01

    Full Text Available Catherine Rolland,1 Alexandra Mavroeidi,2 Kelly L Johnston,3 John Broom1,31Centre for Obesity Research and Epidemiology (CORE, Faculty of Health and Social Care, Robert Gordon University, Aberdeen, Scotland, UK; 2School of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, Scotland, UK; 3LighterLife Ltd, Harlow, Essex, UKAbstract: Very low-calorie diets (VLCDs are an effective means by which to induce clinically significant weight loss. However, their acceptance by health care practitioners and the public is generally lower than that for other nonsurgical weight loss methods. Whilst there is currently little evidence to suggest they have any detrimental effect on hepatic and renal health, data assessing these factors remain limited. We carried out a systematic review of the literature on randomized controlled trials that had a VLCD component and that reported outcomes for hepatic and renal health, published between January 1980 and December 2012. Cochrane criteria were followed, and eight out of 196 potential articles met the inclusion criteria. A total of 548 participants were recruited across the eight studies. All eight studies reported significant weight loss following the VLCD. Changes in hepatic and renal outcomes were variable but generally led to either no change or improvements in either of these. Due to the heterogeneity in the quality and methodology of the studies included, the effect of VLCDs on hepatic and renal outcomes remains unclear at this stage. Further standardized research is therefore required to fully assess the impact of VLCDs on these outcome measures, to better guide clinical practice.Keywords: obesity, liver, kidney, weight loss, health

  7. Systematic Review of Kinship Care Effects on Safety, Permanency, and Well-Being Outcomes

    Science.gov (United States)

    Winokur, Marc A.; Holtan, Amy; Batchelder, Keri E.

    2018-01-01

    Objective: Children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers. This systematic review evaluated the effect of kinship care placement compared to foster care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. Methods:…

  8. Young Children and Tablets: A Systematic Review of Effects on Learning and Development

    Science.gov (United States)

    Herodotou, C.

    2018-01-01

    Mobile applications are popular among young children, yet there is a dearth of studies examining their impact on learning and development. A systematic review identified 19 studies reporting learning effects on children 2 to 5 years old. The number of children participating in experimental, quasi-experimental, or mixed-method studies was 862 and…

  9. The Effects of Metaphorical Framing on Political Persuasion : A Systematic Literature Review

    NARCIS (Netherlands)

    Boeynaems, A.; Burgers, C.; Konijn, E.A.; Steen, G.J.

    2017-01-01

    Effects of metaphorical framing of political issues on opinion have been studied widely by two approaches: a critical-discourse approach (CDA) and a response-elicitation approach (REA). The current article reports a systematic literature review (N = 109) that examines whether these approaches report

  10. Effectiveness of exercise therapy: a best-evidence summary of systematic reviews.

    NARCIS (Netherlands)

    Smidt, N.; Vet, H.C.W. de; Bouter, L.M.; Dekker, J.; Arendzen, J.H.; Bie, R.A. de; Bierma-Zeinstra, S.M.; Helders, P.J.M.; Keus, S.H.J.; Kwakkel, G.; Lenssen, T.; Oostendorp, R.A.B.; Ostelo, R.W.J.G.; Reijman, M.; Terwee, C.B.; Theunissen, C.; Thomas, S.; Baar, M.E. van; Hul, A. van 't; Peppen, R.P. van; Verhagen, A.; Windt, D.A.W.M. van der

    2005-01-01

    The purpose of this project was to summarise the available evidence on the effectiveness of exercise therapy for patients with disorders of the musculoskeletal, nervous, respiratory, and cardiovascular systems. Systematic reviews were identified by means of a comprehensive search strategy in 11

  11. Systematic screening for Chlamydia trachomatis : Estimating cost-effectiveness using dynamic modeling and Dutch data

    NARCIS (Netherlands)

    de Vries, R.; Van Bergen, J.E.A.M.; de Jong-van den Berg, Lolkje; Postma, Maarten

    2006-01-01

    To estimate the cost-effectiveness of a systematic one-off Chlamydia trachomatis (CT) screening program including partner treatment for Dutch young adults. Data on infection prevalence, participation rates, and sexual behavior were obtained from a large pilot study conducted in The Netherlands.

  12. Systematic screening for Chlamydia trachomatis: estimating cost-effectiveness using dynamic modeling and Dutch data

    NARCIS (Netherlands)

    de Vries, Robin; van Bergen, Jan E. A. M.; de Jong-van den Berg, Lolkje T. W.; Postma, Maarten J.

    2006-01-01

    To estimate the cost-effectiveness of a systematic one-off Chlamydia trachomatis (CT) screening program including partner treatment for Dutch young adults. Data on infection prevalence, participation rates, and sexual behavior were obtained from a large pilot study conducted in The Netherlands.

  13. Effects of Ready-to-Eat-Cereals on Key Nutritional and Health Outcomes : A Systematic Review

    NARCIS (Netherlands)

    Priebe, Marion G.; McMonagle, Jolene R.

    2016-01-01

    Background In many countries breakfast cereals are an important component of breakfast. This systematic review assesses the contribution of consumption of ready-to eat cereal (RTEC) to the recommended nutrient intake. Furthermore, the effects of RTEC consumption on key health parameters are

  14. Effect of Active Lessons on Physical Activity, Academic, and Health Outcomes: A Systematic Review

    Science.gov (United States)

    Martin, Rosemarie; Murtagh, Elaine M.

    2017-01-01

    Purpose: The purpose of this study was to conduct a systematic review of classroom-based physical activity interventions that integrate academic content and assess the effectiveness of the interventions on physical activity, learning, facilitators of learning, and health outcomes. Method: Six electronic databases (ERIC, PubMed, Google Scholar,…

  15. A systematic review of the effect of thermal processing on the allergenicity of tree nuts

    NARCIS (Netherlands)

    Masthoff, L.J.; Hoff, R.; Verhoeckx, K.C.M.; Os-Medendorp, H. van; Michelsen-Huisman, A.; Baumert, J.L.; Pasmans, S.G.; Meijer, Y.; Knulst, A.C.

    2013-01-01

    Background Allergenicity of foods can be influenced by processing. Tree nuts are an important source of nutrition and increasingly consumed; however, processing methods are quite variable and data are currently lacking on the effects of processing on allergenicity. Objective To perform a systematic

  16. The most effective way of delivering a Train-the-Trainers program: A systematic review

    NARCIS (Netherlands)

    Pearce, Jennifer; Mann, Mala K.; Jones, Caryl; van Buschbach, Susanne; Olff, Miranda; Bisson, Jonathan I.

    2012-01-01

    Introduction: Previous literature has shown that multifaceted, interactive interventions may be the most effective way to train health and social care professionals. A Train-the-Trainer (TTT) model could incorporate all these components. We conducted a systematic review to determine the overall

  17. Train the Trainer Effectiveness Trials of Behavioral Intervention for Individuals with Autism: A Systematic Review

    Science.gov (United States)

    Shire, Stephanie Yoshiko; Kasari, Connie

    2014-01-01

    This systematic review examines train the trainer (TTT) effectiveness trials of behavioral interventions for individuals with autism spectrum disorder (ASD). Published methodological quality scales were used to assess studies including participant description, research design, intervention, outcomes, and analysis. Twelve studies including 9 weak…

  18. Health effects of protein intake in healthy elderly populations: a systematic literature review

    DEFF Research Database (Denmark)

    Pedersen, Agnes N.; Cederholm, Tommy

    2014-01-01

    The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy elderly persons in order to evaluate the evidence for an optimal protein intake. The literature search covered year 2000-...

  19. Clinical review: Thyroid dysfunction and effects on coagulation and fibrinolysis: A systematic review

    NARCIS (Netherlands)

    Squizzato, A.; Romualdi, E.; Buller, H. R.; Gerdes, V. E. A.

    2007-01-01

    Context: Various changes in the coagulation-fibrinolytic system have been described in patients with an excess or deficiency of thyroid hormones. The purpose of this systematic review is to summarize the effects of hyperthyroidism and hypothyroidism on these systems. Evidence Acquisition: All

  20. The functional effects of physical exercise training in frail older people : a systematic review

    NARCIS (Netherlands)

    Chin A Paw, M.J.M.; van Uffelen, J.G.Z.; Riphagen, I.; van Mechelen, W.

    2008-01-01

    This systematic review describes the effect of exercise training on physical performance in frail older people. Randomized controlled trials were identified from searches in PubMed, EMBASE and CENTRAL from January 1995 through August 2007. Two reviewers independently screened the trials for

  1. Leadership of mayors and governors during crises: a systematic review on tasks and effectiveness.

    NARCIS (Netherlands)

    Jong, W.; Dückers, M.L.A.; Velden, P.G. van der

    2016-01-01

    The aim of this article is to provide a systematic review of peer-reviewed literature on leadership tasks and effectiveness of mayors and governors during drastic collective events. A total of 34 peer-reviewed articles met our criteria. They were analysed using the theoretical framework by Boin on

  2. The limited prosocial effects of meditation: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Kreplin, U.; Farias, M.; Brazil, I.A.

    2018-01-01

    Many individuals believe that meditation has the capacity to not only alleviate mental-illness but to improve prosociality. This article systematically reviewed and meta-analysed the effects of meditation interventions on prosociality in randomized controlled trials of healthy adults. Five types of

  3. Effects of Task-Oriented Circuit Class Training on Walking Competency After Stroke A Systematic Review

    NARCIS (Netherlands)

    Wevers, Lotte; van de Port, Ingrid; Vermue, Mathijs; Mead, Gillian; Kwakkel, Gert

    Background and Purpose-There is increasing interest in the potential benefits of circuit class training after stroke, but its effectiveness is uncertain. Our aim was to systematically review randomized, controlled trials of task-oriented circuit class training on gait and gait-related activities in

  4. A systematic review of the health and social effects of menstrual hygiene management.

    Science.gov (United States)

    Sumpter, Colin; Torondel, Belen

    2013-01-01

    Differing approaches to menstrual hygiene management (MHM) have been associated with a wide range of health and psycho-social outcomes in lower income settings. This paper systematically collates, summarizes and critically appraises the available evidence. Following the PRISMA guidelines a structured search strategy was used to identify articles investigating the effects of MHM on health and psycho-social outcomes. The search was conducted in May 2012 and had no date limit. Data was extracted and quality of methodology was independently assessed by two researchers. Where no measure of effect was provided, but sufficient data were available to calculate one, this was undertaken. Meta-analysis was conducted where sufficient data were available. 14 articles were identified which looked at health outcomes, primarily reproductive tract infections (RTI). 11 articles were identified investigating associations between MHM, social restrictions and school attendance. MHM was found to be associated with RTI in 7 papers. Methodologies however varied greatly and overall quality was low. Meta-analysis of a subset of studies found no association between confirmed bacterial vaginosis and MHM (OR: 1.07, 95% CI: 0.52-2.24). No other substantial associations with health outcomes were found. Although there was good evidence that educational interventions can improve MHM practices and reduce social restrictions there was no quantitative evidence that improvements in management methods reduce school absenteeism. The management of menstruation presents significant challenges for women in lower income settings; the effect of poor MHM however remains unclear. It is plausible that MHM can affect the reproductive tract but the specific infections, the strength of effect, and the route of transmission, remain unclear. There is a gap in the evidence for high quality randomised intervention studies which combine hardware and software interventions, in particular for better understanding the

  5. Health effects related to wind turbine noise exposure: a systematic review.

    Science.gov (United States)

    Schmidt, Jesper Hvass; Klokker, Mads

    2014-01-01

    Wind turbine noise exposure and suspected health-related effects thereof have attracted substantial attention. Various symptoms such as sleep-related problems, headache, tinnitus and vertigo have been described by subjects suspected of having been exposed to wind turbine noise. This review was conducted systematically with the purpose of identifying any reported associations between wind turbine noise exposure and suspected health-related effects. A search of the scientific literature concerning the health-related effects of wind turbine noise was conducted on PubMed, Web of Science, Google Scholar and various other Internet sources. All studies investigating suspected health-related outcomes associated with wind turbine noise exposure were included. Wind turbines emit noise, including low-frequency noise, which decreases incrementally with increases in distance from the wind turbines. Likewise, evidence of a dose-response relationship between wind turbine noise linked to noise annoyance, sleep disturbance and possibly even psychological distress was present in the literature. Currently, there is no further existing statistically-significant evidence indicating any association between wind turbine noise exposure and tinnitus, hearing loss, vertigo or headache. Selection bias and information bias of differing magnitudes were found to be present in all current studies investigating wind turbine noise exposure and adverse health effects. Only articles published in English, German or Scandinavian languages were reviewed. Exposure to wind turbines does seem to increase the risk of annoyance and self-reported sleep disturbance in a dose-response relationship. There appears, though, to be a tolerable level of around LAeq of 35 dB. Of the many other claimed health effects of wind turbine noise exposure reported in the literature, however, no conclusive evidence could be found. Future studies should focus on investigations aimed at objectively demonstrating whether or not

  6. The protective effect of meniscus allograft transplantation on articular cartilage: a systematic review of animal studies.

    Science.gov (United States)

    Rongen, J J; Hannink, G; van Tienen, T G; van Luijk, J; Hooijmans, C R

    2015-08-01

    Despite widespread reporting on clinical results, the effect of meniscus allograft transplantation on the development of osteoarthritis is still unclear. The aim of this study was to systematically review all studies on the effect of meniscus allograft transplantation on articular cartilage in animals. Pubmed and Embase were searched for original articles concerning the effect of meniscus allograft transplantation on articular cartilage compared with both its positive (meniscectomy) and negative (either sham or non-operated) control in healthy animals. Outcome measures related to assessment of damage to articular cartilage were divided in five principal outcome categories. Standardized mean differences (SMD) were calculated and pooled to obtain an overall SMD and 95% confidence interval. 17 articles were identified, representing 14 original animal cohorts with an average timing of data collection of 24 weeks [range 4 weeks; 30 months]. Compared to a negative control, meniscus allograft transplantation caused gross macroscopic (1.45 [0.95; 1.95]), histological (3.43 [2.25; 4.61]) damage to articular cartilage, and osteoarthritic changes on radiographs (3.12 [1.42; 4.82]). Moreover, results on histomorphometrics and cartilage biomechanics are supportive of this detrimental effect on cartilage. On the other hand, meniscus allograft transplantation caused significantly less gross macroscopic (-1.19 [-1.84; -0.54]) and histological (-1.70 [-2.67; -0.74]) damage to articular cartilage when compared to meniscectomy. However, there was no difference in osteoarthritic changes on plain radiographs (0.04 [-0.48; 0.57]), and results on histomorphometrics and biomechanics did neither show a difference in effect between meniscus allograft transplantation and meniscectomy. In conclusion, although meniscus allograft transplantation does not protect articular cartilage from damage, it reduces the extent of it when compared with meniscectomy. Copyright © 2015 Osteoarthritis

  7. The Effect of Low Carbohydrate Diets on Fertility Hormones and Outcomes in Overweight and Obese Women: A Systematic Review

    Science.gov (United States)

    McGrice, Melanie; Porter, Judi

    2017-01-01

    (1) Background: Medical interventions including assisted reproductive technologies have improved fertility outcomes for many sub-fertile couples. Increasing research interest has investigated the effect of low carbohydrate diets, with or without energy restriction. We aimed to systematically review the published literature to determine the extent to which low carbohydrate diets can affect fertility outcomes; (2) Methods: The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42016042669) and followed Preferred Reporting Items For Systematic Reviews and Meta-Analyses guidelines. Infertile women were the population of interest, the intervention was low carbohydrate diets (less than 45% total energy from carbohydrates), compared to usual diet (with or without co-treatments). Four databases were searched from date of commencement until April 2016; a supplementary Google scholar search was also undertaken. Title and abstract, then full text review, were undertaken independently and in duplicate. Reference lists of included studies and relevant systematic reviews were checked to ensure that all relevant studies were identified for inclusion. Quality assessment was undertaken independently by both authors using the Quality Criteria Checklist for Primary Research. Outcome measures were improved fertility outcomes defined by an improvement in reproductive hormones, ovulation rates and/or pregnancy rates; (3) Results: Seven studies fulfilled the inclusion criteria and were included in the evidence synthesis. Interventions were diverse and included a combination of low carbohydrate diets with energy deficit or other co-treatments. Study quality was rated as positive for six studies, suggesting a low risk of bias, with one study rated as neutral. Of the six studies which reported changes in reproductive hormones, five reported significant improvements post intervention; (4) Conclusion: The findings of these

  8. THE EFFECTS OF GUIDED SYSTEMATIC AEROBIC DANCE PROGRAMME ON THE SELF-ESTEEM OF ADULTS

    OpenAIRE

    Tihanyi Hos, Agnes

    2005-01-01

    In our research we were seeking answers of the effects of guided, “age-needs specific,” systematic, group aerobic exercise programmes on the self-esteem and self-image of middle-aged women. Fifty three women (ages 48.6 + 5.1) took part in the study who had not participated in any systematic fitness training and worked in intellectual occupations. We formed two groups, i.e., the experimental (EG) and the control (CG) group. Members of the experimental group (n= 25) volunteered to participate i...

  9. How Effective Are Active Videogames Among the Young and the Old? Adding Meta-analyses to Two Recent Systematic Reviews.

    Science.gov (United States)

    van 't Riet, Jonathan; Crutzen, Rik; Lu, Amy Shirong

    2014-10-01

    Two recent systematic reviews have surveyed the existing evidence for the effectiveness of active videogames in children/adolescents and in elderly people. In the present study, effect sizes were added to these systematic reviews, and meta-analyses were performed. All reviewed studies were considered for inclusion in the meta-analyses, but only studies were included that investigated the effectiveness of active videogames, used an experimental design, and used actual health outcomes as the outcome measures (body mass index for children/adolescents [k=5] and functional balance for the elderly [k=6]). The average effect of active videogames in children and adolescents was small and nonsignificant: Hedges' g=0.20 (95 percent confidence interval, -0.08 to 0.48). Limited heterogeneity was observed, and no moderator analyses were performed. For the effect of active videogames on functional balance in the elderly, the analyses revealed a medium-sized and significant effect of g=0.68 (95 percent confidence interval, 0.13-1.24). For the elderly studies, substantial heterogeneity was observed. Moderator analyses showed that there were no significant effects of using a no-treatment control group versus an alternative treatment control group or of using games that were especially created for health-promotion purposes versus off-the-shelf games. Also, intervention duration and frequency, sample size, study quality, and dropout did not significantly moderate the effect of active videogames. The results of these meta-analyses provide preliminary evidence that active videogames can have positive effects on relevant outcome measures in children/adolescents and elderly individuals.

  10. Hypnosis Intervention Effects on Sleep Outcomes: A Systematic Review.

    Science.gov (United States)

    Chamine, Irina; Atchley, Rachel; Oken, Barry S

    2018-02-15

    Sleep improvement is a promising target for preventing and modifying many health problems. Hypnosis is considered a cost-effective and safe intervention with reported benefits for multiple health conditions. There is a growing body of research assessing the efficacy of hypnosis for various health conditions in which sleep was targeted as a primary or secondary outcome. This review aimed to investigate the effects of hypnosis interventions on sleep, to describe the hypnotic procedures, and to evaluate potential adverse effects of hypnosis. We reviewed studies (prior to January 2017) using hypnosis in adults for sleep problems and other conditions comorbid with sleep problems, with at least one sleep outcome measure. Randomized controlled trials and other prospective studies were included. One hundred thirty-nine nonduplicate abstracts were screened, and 24 of the reviewed papers were included for qualitative analysis. Overall, 58.3% of the included studies reported hypnosis benefit on sleep outcomes, with 12.5% reporting mixed results, and 29.2% reporting no hypnosis benefit; when only studies with lower risk of bias were reviewed the patterns were similar. Hypnosis intervention procedures were summarized and incidence of adverse experiences assessed. Hypnosis for sleep problems is a promising treatment that merits further investigation. Available evidence suggests low incidence of adverse events. The current evidence is limited because of few studies assessing populations with sleep complaints, small samples, and low methodological quality of the included studies. Our review points out some beneficial hypnosis effects on sleep but more high-quality studies on this topic are warranted. © 2018 American Academy of Sleep Medicine

  11. Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation.

    Science.gov (United States)

    Wilby, J; Kainth, A; Hawkins, N; Epstein, D; McIntosh, H; McDaid, C; Mason, A; Golder, S; O'Meara, S; Sculpher, M; Drummond, M; Forbes, C

    2005-04-01

    To examine the clinical effectiveness, tolerability and cost-effectiveness of gabapentin (GBP), lamotrigine (LTG), levetiracetam (LEV), oxcarbazepine (OXC), tiagabine (TGB), topiramate (TPM) and vigabatrin (VGB) for epilepsy in adults. Electronic databases. Internet resources. Pharmaceutical company submissions. Selected studies were screened and quality assessed. Separate analyses assessed clinical effectiveness, serious, rare and long-term adverse events and cost-effectiveness. An integrated economic analysis incorporating information on costs and effects of newer and older antiepileptic drugs (AEDs) was performed to give direct comparisons of long-term costs and benefits. A total of 212 studies were included in the review. All included systematic reviews were Cochrane reviews and of good quality. The quality of randomised controlled trials (RCTs) was variable. Assessment was hampered by poor reporting of methods of randomisation, allocation concealment and blinding. Few of the non-randomised studies were of good quality. The main weakness of the economic evaluations was inappropriate use of the cost-minimisation design. The included systematic reviews reported that newer AEDs were effective as adjunctive therapy compared to placebo. For newer versus older drugs, data were available for all three monotherapy AEDs, although data for OXC and TPM were limited. There was limited, poor-quality evidence of a significant improvement in cognitive function with LTG and OXC compared with older AEDs. However, there were no consistent statistically significant differences in other clinical outcomes, including proportion of seizure-free patients. No studies assessed effectiveness of AEDs in people with intellectual disabilities or in pregnant women. There was very little evidence to assess the effectiveness of AEDs in the elderly; no significant differences were found between LTG and carbamazepine monotherapy. Sixty-seven RCTs compared adjunctive therapy with placebo, older

  12. Effects of soy protein containing isoflavones in patients with chronic kidney disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Jing, Zhou; Wei-Jie, Yuan

    2016-02-01

    Recent studies have demonstrated mixed results on the effects of soy intake in patients with CKD, and this have not been systematically analyzed. We conducted this meta-analysis to identify and evaluate the effects of soy protein intake in patients with CKD. A comprehensive search of Medline, Embase and the Cochrane Database of Systematic Reviews was performed in December 2013 and updated in April 2014 for any new trials. Randomized trials designed to evaluate the effects of dietary soy in patients with CKD were collected. Weighted mean effect sizes were calculated for net changes using random-effect or fixed-effect model. All statistical analysis were calculated by RevMan software 5.2 available free from the Cochrane Collaboration. 12 studies (280 participants) were included. And we found that dietary soy was associated with significant decrease of serum creatinine, serum phosphorus, CRP (C reactive protein)and proteinuria in the predialysis subgroup. The mean difference was -0.05 mg/dL (95% CI: -0.10, -0.00 mg/dL; P = 0.04) for serum creatinine, -0.13 mg/dL (95% CI: -0.26, -0.01 mg/dL; P = 0.04) for serum phosphorus, -0.98 mg/L (95% CI: -1.25, -0.71 mg/L; P protein containing isoflavones intake significantly decreased serum creatinine, serum phosphorus, CRP and proteinura in predialysis patients, while no significant change was found in creatinine clearance and glomerular filtration rate. We also found that soy protein intake could maintain the nutritional status in dialysis patients, though no significant change in CRP, BUN, and serum phosphorus was detected. Future large, long-term RCTs are still needed to clarify the effects of soy protein intake in patients with CKD. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. Designing systematic conservation assessments that promote effective implementation: best practice from South Africa.

    Science.gov (United States)

    Knight, Andrew T; Driver, Amanda; Cowling, Richard M; Maze, Kristal; Desmet, Philip G; Lombard, Amanda T; Rouget, Mathieu; Botha, Mark A; Boshoff, Andre F; Castley, J Guy; Goodman, Peter S; Mackinnon, Kathy; Pierce, Shirley M; Sims-Castley, Rebecca; Stewart, Warrick I; von Hase, Amrei

    2006-06-01

    Systematic conservation assessment and conservation planning are two distinct fields of conservation science often confused as one and the same. Systematic conservation assessment is the technical, often computer-based, identification of priority areas for conservation. Conservation planning is composed of a systematic conservation assessment coupled with processes for development of an implementation strategy and stakeholder collaboration. The peer-reviewed conservation biology literature abounds with studies analyzing the performance of assessments (e.g., area-selection techniques). This information alone, however can never deliver effective conservation action; it informs conservation planning. Examples of how to translate systematic assessment outputs into knowledge and then use them for "doing" conservation are rare. South Africa has received generous international and domestic funding for regional conservation planning since the mid-1990s. We reviewed eight South African conservation planning processes and identified key ingredients of best practice for undertaking systematic conservation assessments in a way that facilitates implementing conservation action. These key ingredients include the design of conservation planning processes, skills for conservation assessment teams, collaboration with stakeholders, and interpretation and mainstreaming of products (e.g., maps) for stakeholders. Social learning institutions are critical to the successful operationalization of assessments within broader conservation planning processes and should include not only conservation planners but also diverse interest groups, including rural landowners, politicians, and government employees.

  14. The significance of the grasshopper effect on the atmospheric distribution of persistent organic substances

    Science.gov (United States)

    Semeena, V. S.; Lammel, Gerhard

    2005-04-01

    Slowly degradable, semivolatile organic compounds (SOCs) may undergo more than one volatilization-transport-deposition cycle through the atmosphere (multi-hopping). The significance of this process for the potential for long-range transport (LRT) is addressed for the first time. We use a multicompartment model which in turn is based on a general circulation model. The results suggest that both transport by single-hopping and multi-hopping contribute significantly to LRT of DDT and γ-HCH (lindane) and to accumulation in high latitudes. A larger fraction of the molecules transported by multi-hopping than of the molecules transported by single-hopping is deposited to the world's oceans. Multi-hopping prevails in the boundary layer far from the source regions. However, single-hopping contributes an almost equal amount to the deposition of DDT and γ-HCH in the Arctic.

  15. Significance of the Capacity Recovery Effect in Pouch Lithium-Sulfur Battery Cells

    DEFF Research Database (Denmark)

    Knap, Vaclav; Zhang, Teng; Stroe, Daniel Loan

    2016-01-01

    Lithium-Sulfur (Li-S) batteries are an emerging energy storage technology, which is technically-attractive due to its high theoretical limits; practically, it is expected that Li-S batteries will result into lighter energy storage devices with higher capacities than traditional Lithium-ion...... batteries. One of the actual disadvantages for this technology is the highly pronounced rate capacity effect, which reduces the available capacity to be discharged when high currents are used. This drawback might be addressed by the use of the capacity recovery effect, which by introducing relaxation...... periods between consecutive pulse discharges of the battery, increases the available discharge capacity of the cell. The capacity recovery effect of the Li-S cell is studied in this paper using the pulse discharge technique, considering its dependence on the applied current, discharge step length...

  16. Cardiovascular Effects of Olive, a Qur’anic Fruit: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Heidari

    2014-12-01

    Full Text Available Background and Objective: Today, much attention is being paid to the prevention of cardiovascular diseases. In some parts of the world, the rate of cardiovascular disease is low due to a Mediterranean diet containing olive oil. This systematic review examined the verses and traditions in order to express opinions on olive and compare it with the findings of modern medicine. Methods: This is a qualitative systematic review of studies  in which data  were collected from Qur'an, traditions, and related articles on the internet, limited to English and Persian and without time limitation by using the keywords olive, heart disease and Mediterranean diet. Results: This systematic review demonstrated that olive in the Quran is a clear sign to scientists. Moreover, its use is recommended in the authentic traditions. Conclusion: Based on the results, olive has been found to be effective in reducing mortality and preventing cardiovascular diseases.

  17. A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise

    Directory of Open Access Journals (Sweden)

    Kamioka H

    2011-03-01

    Full Text Available Hiroharu Kamioka1, Kiichiro Tsutani2, Yoshiteru Mutoh3, Hiroyasu Okuizum4, Miho Ohta5, Shuichi Handa4, Shinpei Okada6, Jun Kitayuguchi7, Masamitsu Kamada7, Nobuyoshi Shiozawa8, Sang-Jun Park4, Takuya Honda4, Shoko Moriyama41Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, Japan; 2Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, 3Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan; 4Mimaki Onsen (Spa Clinic, Tomi City, Japan; 5Laboratory of Aqua, Health, and Sports Medicine, 6Physical Education and Medicine Research Foundation, Nagano, Japan; 7Physical Education and Medicine Research Center Unnan, Unnan City, Japan; 8Department of Longevity and Social Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanBackground: The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonrandomized controlled trials (nRCTs.Methods: Study design was a systematic review of nonrandomized controlled trials. Trials were eligible if they were nonrandomized clinical trials. Studies included one treatment group in which aquatic exercise was applied. We searched the following databases from 2000 up to July 20, 2009: MEDLINE via PubMed, CINAHL, and Ichushi-Web.Results: Twenty-one trials met all inclusion criteria. Languages included were English (N = 9, Japanese (N = 11, and Korean (N = 1. Target diseases were knee and/or hip osteoarthritis, poliomyelitis, chronic kidney disease, discomforts of pregnancy, cardiovascular diseases, and rotator cuff tears. Many studies on nonspecific disease (healthy participants were included. All studies reported significant effectiveness in at least one or more outcomes. However results of evaluations with the TREND and CLEAR-NPT checklists generally

  18. The effects of radiation on the diseases of aging in experimental animals: gerontological significance

    International Nuclear Information System (INIS)

    Hollander, C.F.; Zwieten, M.J. van; Broerse, J.J.

    1979-01-01

    A study of the effect of different types and doses of ionizing radiation on the induction of mammary tumours in rats and the role of ovarian hormones in tumour indication is reported. The occurrence of other diseases in the irradiated animals is also studied and compared to those occurring in non-irradiated controls. (Auth.)

  19. Confidence Intervals: From tests of statistical significance to confidence intervals, range hypotheses and substantial effects

    Directory of Open Access Journals (Sweden)

    Dominic Beaulieu-Prévost

    2006-03-01

    Full Text Available For the last 50 years of research in quantitative social sciences, the empirical evaluation of scientific hypotheses has been based on the rejection or not of the null hypothesis. However, more than 300 articles demonstrated that this method was problematic. In summary, null hypothesis testing (NHT is unfalsifiable, its results depend directly on sample size and the null hypothesis is both improbable and not plausible. Consequently, alternatives to NHT such as confidence intervals (CI and measures of effect size are starting to be used in scientific publications. The purpose of this article is, first, to provide the conceptual tools necessary to implement an approach based on confidence intervals, and second, to briefly demonstrate why such an approach is an interesting alternative to an approach based on NHT. As demonstrated in the article, the proposed CI approach avoids most problems related to a NHT approach and can often improve the scientific and contextual relevance of the statistical interpretations by testing range hypotheses instead of a point hypothesis and by defining the minimal value of a substantial effect. The main advantage of such a CI approach is that it replaces the notion of statistical power by an easily interpretable three-value logic (probable presence of a substantial effect, probable absence of a substantial effect and probabilistic undetermination. The demonstration includes a complete example.

  20. Significant effect of grain size distribution on compaction rates in granular aggregates

    NARCIS (Netherlands)

    Niemeijer, André|info:eu-repo/dai/nl/370832132; Elsworth, Derek; Marone, Chris

    2009-01-01

    We investigate the role of pressure solution in deformation of upper- to mid-crustal rocks using aggregates of halite as a room temperature analog for fluid-assisted deformation processes in the Earth's crust. Experiments evaluate the effects of initial grain size distribution on macroscopic

  1. How effects on health equity are assessed in systematic reviews of interventions.

    Science.gov (United States)

    Welch, Vivian; Tugwell, Peter; Petticrew, Mark; de Montigny, Joanne; Ueffing, Erin; Kristjansson, Betsy; McGowan, Jessie; Benkhalti Jandu, Maria; Wells, George A; Brand, Kevin; Smylie, Janet

    2010-12-08

    Enhancing health equity has now achieved international political importance with endorsement from the World Health Assembly in 2009.  The failure of systematic reviews to consider effects on health equity is cited by decision-makers as a limitation to their ability to inform policy and program decisions.  To systematically review methods to assess effects on health equity in systematic reviews of effectiveness. We searched the following databases up to July 2 2010: MEDLINE, PsychINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Index to Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on October 7 2010. We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. Data were extracted using a pre-tested form by two independent reviewers. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews.  Thirty-four methodological studies were included.  The methods used by these included studies were: 1) Targeted approaches (n=22); 2) gap approaches (n=12) and gradient approach (n=1).  Gender or sex was assessed in eight out of 34 studies, socioeconomic status in ten studies, race/ethnicity in seven studies, age in seven studies, low and middle income countries in 14 studies, and two studies assessed multiple factors across health inequity may exist.Only three studies provided a definition of health equity. Four methodological approaches to assessing effects on health equity were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (all 34 studies used a type of descriptive method); 2) descriptive assessment of reporting

  2. Systematic review: effective management strategies for lactose intolerance.

    Science.gov (United States)

    Shaukat, Aasma; Levitt, Michael D; Taylor, Brent C; MacDonald, Roderick; Shamliyan, Tatyana A; Kane, Robert L; Wilt, Timothy J

    2010-06-15

    Lactose intolerance resulting in gastrointestinal symptoms is a common health concern. Diagnosis and management of this condition remain unclear. To assess the maximum tolerable dose of lactose and interventions for reducing symptoms of lactose intolerance among persons with lactose intolerance and malabsorption. Multiple electronic databases, including MEDLINE and the Cochrane Library, for trials published in English from 1967 through November 2009. Randomized, controlled trials of individuals with lactose intolerance or malabsorption. Three investigators independently reviewed articles, extracted data, and assessed study quality. 36 unique randomized studies (26 on lactase- or lactose-hydrolyzed milk supplements, lactose-reduced milk, or tolerable doses of lactose; 7 on probiotics; 2 on incremental lactose administration for colonic adaptation; and 1 on another agent) met inclusion criteria. Moderate-quality evidence indicated that 12 to 15 g of lactose (approximately 1 cup of milk) is well tolerated by most adults. Evidence was insufficient that lactose-reduced solution or milk with a lactose content of 0 to 2 g, compared with greater than 12 g, is effective in reducing symptoms of lactose intolerance. Evidence for probiotics, colonic adaptation, and other agents was also insufficient. Most studies evaluated persons with lactose malabsorption rather than lactose intolerance. Variation in enrollment criteria, outcome reporting, and the composition and dosing of studied agents precluded pooling of results and limited interpretation. Most individuals with presumed lactose intolerance or malabsorption can tolerate 12 to 15 g of lactose. Additional studies are needed to determine the effectiveness of lactose intolerance treatment.

  3. Beyond the Effects of Comprehensive Sexuality Education: The Significant Prospective Effects of Youth Assets on Contraceptive Behaviors.

    Science.gov (United States)

    Green, Jennifer; Oman, Roy F; Vesely, Sara K; Cheney, Marshall; Carroll, Leslie

    2017-12-01

    The purpose of the study was to prospectively determine if youth assets were significantly associated with contraception use after accounting for the effects of youths' exposure to comprehensive sexuality education programming. Prospective associations between youth asset scores, comprehensive sexuality education topics received, type of contraceptive used, and consistent contraceptive use were analyzed using multinomial and binomial logistic regression in a sample of 757 sexually active youth. Higher youth asset scores were associated with condom use (adjusted odds ratio [AOR] = 1.51, 95% CI = 1.01-2.28), hormonal birth control use (AOR = 2.71, 95% CI = 1.69-4.35), dual method use (AOR = 2.35, 95% CI = 1.44-3.82), and consistent contraceptive use (AOR = 1.97, 95% CI = 1.38-2.82). After controlling for youths' experience with comprehensive sexuality education, higher youth asset scores remained a significant predictor of hormonal birth control use (AOR = 2.09, 95% CI = 1.28-3.42), dual method use (AOR = 2.58, 95% CI = 1.61-4.15), and consistent contraceptive use (AOR = 1.95, 95% CI = 1.36-2.80). Youth serving organizations that are interested in preventing teen pregnancy should consider widespread implementation of evidence-based youth development programs that focus on building and strengthening specific youth assets. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. The antiplatelet effects of nitrates: is it of clinical significance in patients with cardiovascular disease?

    Science.gov (United States)

    Zhou, Rui-Hai; Frishman, William H

    2010-01-01

    Organic nitrates have been used for over a century in cardiovascular therapy and are still widely used in the treatment of acute coronary syndromes, chronic angina pectoris, and congestive heart failure. Nitrates, together with sodium nitroprusside, generally referred to as nitrovasodilators, exert their biologic effects via the release of nitric oxide. They are also known as nitric oxide donors. The mechanism of action of these drugs is traditionally believed to lie in their arterial vasodilation and venodilation effects, resulting in an improvement of coronary artery blood supply and/or reduction of cardiac workload in the treatment of coronary artery disease and congestive heart failure. Recently it has been recognized that these drugs also have intrinsic antiplatelet and antithrombotic effects, demonstrated both in vitro and in vivo, which would add further rationale for the use of these drugs in atherothrombotic diseases. Research has shown that nitrovasodilators can nonselectively inhibit platelet aggregation induced by multiple stimuli. However, clinical trials have yielded conflicting results regarding clinical outcome, especially with long-term nitrate use. The potentially beneficial effects of nitrates could be negated by the development of tolerance and the generation of deleterious oxidative stress causing endothelial dysfunction during continuous nitrate administration. Much progress has been made in the development of new nitric oxide donors devoid of oxidant-generating properties. Novel combination therapies with nitrovasodilators plus antioxidants or agents with antioxidant properties have shown promise in reducing or reversing tolerance, potentiating antiplatelet effects, and improving clinical outcome. It is expected that clinical introduction of novel nitrovasodilator regimens will provide a new approach to the prevention and treatment of atherothrombotic diseases. Large-scale clinical trials will ultimately provide the evidence-based answers.

  5. Treatment effectiveness and fidelity of manual therapy to the knee: A systematic review and meta-analysis.

    Science.gov (United States)

    Salamh, Paul; Cook, Chad; Reiman, Michael P; Sheets, Charles

    2017-09-01

    Manual therapy (MT) is a commonly used treatment for knee osteoarthritis (OA) but to date only one systematic review has explored its effectiveness. The purpos e of the present study was to perform a systematic review and meta-analysis of the literature, to determine the effectiveness and fidelity of studies using MT techniques in individuals with knee OA. Relevant studies were assessed for inclusion. Effectiveness was measured using effect sizes, and methodological bias and treatment fidelity were both explored. Effect sizes were calculated using standardized mean differences (SMD) based on pooled data depending on statistical and clinical heterogeneity, as well as risk of bias. The search captured 2,969 studies; after screening, 12 were included. Four had a low risk of bias and high treatment fidelity. For self-reported function, comparing MT with no treatment resulted in a large effect size (standardized mean difference [SMD] 0.84), as did adding MT to a comparator treatment (SMD 0.78). A significant difference was found for pain when adding MT to a comparator treatment (SMD 0.73). The findings in the present meta-analytical review support the use of MT versus a number of different comparators for improvement in self-reported knee function. Lesser support is present for pain reduction, and no endorsement of functional performance can be made at this time. Copyright © 2016 John Wiley & Sons, Ltd.

  6. The effects of nursing preceptorship on new nurses' competence, professional socialization, job satisfaction and retention: A systematic review.

    Science.gov (United States)

    Ke, Ya-Ting; Kuo, Chia-Chi; Hung, Chich-Hsiu

    2017-10-01

    The aim of this study was to determine the effects of nursing preceptorship on the competence, job satisfaction, professional socialization and retention of new nurses. Although studies have focused on the effects of nursing preceptorship on new nurses' competence and retention, a systematic review of the overall effects is lacking. A quantitative systematic review. Five English/Chinese databases were searched for original articles published before June 2015 and only six articles published between 2001-2014 were included in the final analysis. Joanna Briggs Methodology was used to process one randomization control trial, one quasi-experimental study and four observational studies. Two appraisers independently reviewed each study using the standardized critical appraisal tools from the Joanna Briggs Institute. The most adopted preceptorship was a fixed preceptor/preceptee model and one-on-one for 1-3-month duration. It showed that new nurses' overall competence increased significantly due to preceptorship. Only a few studies explored the effects of preceptorship on the job satisfaction and professional socialization of new nurses. Clear conclusions regarding the effect of preceptorship on nurses' retention rate could not be made because of inconsistent time points for calculation and a lack of control groups in the study design. Preceptorship can improve new nurses' nursing competence; however, more studies are needed to ascertain its effects on new nurses' retention rates, job satisfaction and professional socialization to promote nursing care quality and resolve nursing shortages. © 2017 John Wiley & Sons Ltd.

  7. A new method of discriminating different types of post-Archean ophiolitic basalts and their tectonic significance using Th-Nb and Ce-Dy-Yb systematics

    Directory of Open Access Journals (Sweden)

    Emilio Saccani

    2015-07-01

    Full Text Available In this paper, a new discrimination diagram using absolute measures of Th and Nb is applied to post-Archean ophiolites to best discriminate a large number of different ophiolitic basalts. This diagram was obtained using >2000 known ophiolitic basalts and was tested using ∼560 modern rocks from known tectonic settings. Ten different basaltic varieties from worldwide ophiolitic complexes have been examined. They include two basaltic types that have never been considered before, which are: (1 medium-Ti basalts (MTB generated at nascent forearc settings; (2 a type of mid-ocean ridge basalts showing garnet signature (G-MORB that characterizes Alpine-type (i.e., non volcanic rifted margins and ocean-continent transition zones (OCTZ. In the Th-Nb diagram, basalts generated in oceanic subduction-unrelated settings, rifted margins, and OCTZ can be distinguished from subduction-related basalts with a misclassification rate <1%. This diagram highlights the chemical variation of oceanic, rifted margin, and OCTZ basalts from depleted compositions to progressively more enriched compositions reflecting, in turn, the variance of source composition and degree of melting within the MORB-OIB array. It also highlights the chemical contributions of enriched (OIB-type components to mantle sources. Enrichment of Th relative to Nb is particularly effective for highlighting crustal input via subduction or crustal contamination. Basalts formed at continental margin arcs and island arc with a complex polygenetic crust can be distinguished from those generated in intra-oceanic arcs in supra-subduction zones (SSZ with a misclassification rate <1%. Within the SSZ group, two sub-settings can be recognized with a misclassification rate <0.5%. They are: (1 SSZ influenced by chemical contribution from subduction-derived components (forearc and intra-arc sub-settings characterized by island arc tholeiitic (IAT and boninitic basalts; (2 SSZ with no contribution from subduction

  8. The Effect of Yoga on Menstrual Disorders: A Systematic Review.

    Science.gov (United States)

    Oates, Jennifer

    2017-06-01

    To summarize and evaluate evidence for the effect of yoga on menstrual disorders. PubMed, CINAHL/MEDLINE, Web of Science, AMED, and Scopus were searched for English-language literature relevant to the review question. All primary research studies were included. Fifteen studies described in 18 papers were included in the review. A range of yoga interventions were used. Some studies used a combination of Asana, Pranayama, and other yogic relaxation or meditation techniques. All included studies reported some change in their outcome measures, suggesting reduced symptoms of menstrual distress following a yoga intervention; however, the heterogeneity and intensity of the interventions and outcome measures meant that findings have limited generalizability and applicability in practice settings. Further research on the relationship between yoga practice and menstrual disorders is warranted, but there must be both consistency in the methods, measures, and quality of studies and a shift toward research on yoga practices that are replicable outside of the clinical trial setting.

  9. [Effectiveness of acupuncture in postoperative ileus: a systematic review and Meta-analysis].

    Science.gov (United States)

    Cheong, Kah Bik; Zhang, Jiping; Huang, Yong

    2016-06-01

    To conduct a systematic review and Meta-analysis of the effectiveness of acupuncture and common acupoint selection for postoperative ileus (POI). Randomized controlled trials (RCTs) comparing acupuncture and non-acupuncture treatment were identified from the databases PubMed, Cochrane, EBSCO (Academic Source Premier and MEDLINE), Ovid (including Evidence-Based Medicine Reviews), China National Knowledge Infrastructure, and Wanfang Data. The data from eligible studies were extracted and a Meta-analysis performed using a fixed-effects model. Results were expressed as relative risk (RR) for dichotomous data, and 95% CI (confidence intervals) were calculated. Each trial was evaluated using the CONSORT (Consolidated Standards of Reporting Trials) and STRICTA (STandards for Reporting Interventions in Controlled Trials of Acupuncture) guideline . The quality of the study was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Of the 69 studies screened, eight RCTs were included for review. Among these, four RCTs (with a total of 123 patients in the intervention groups and 124 patients in the control groups) met the criteria for Meta-analysis. The Meta-analysis results indicated that acupuncture combined with usual care showed a significantly higher total effective rate than the control condition (usual care) (RR 1.09, 95% CI 1.01, 1.18; P = 0.02). Zusanli (ST 36) and Shangjuxu (ST 37) were the most common acupoints selected. However, the quality of the studies was generally low, as they did not emphasize the use of blinding. The results suggested that acupuncture might be effective in improving POI; however, a definite conclusion could not be drawn because of the low quality of trials. Further large-scale, high-quality randomized clinical trials are needed to validate these findings and to develop a standardized method of treatment. We hope that the present results will lead to improved research, resulting in better

  10. The effect of Ramadan fasting on cardiometabolic risk factors and anthropometrics parameters: A systematic review.

    Science.gov (United States)

    Mazidi, Mohsen; Rezaie, Peyman; Chaudhri, Owais; Karimi, Ehsan; Nematy, Mohsen

    2015-01-01

    Fasting during the month of Ramadan is a religious rituals of all healthy adult Muslims. However, there is no clear agreement on the effects of Ramadan fasting on cardiovascular disease. Comorbidities and factors such as age, gender, health status, daily duration of fasting, food intake before and after fasting may impact on a fasting individual's cardiometabolic risk. This review was undertaken to assess the effects of Ramadan fasting on: the incidence of cardiovascular disease during the month of Ramadan; the clinical status of patients with stable cardiac disease; and any alterations in cardiometabolic risk profile. A systematic search was undertaken for studies that investigated the impact of Ramadan fasting on cardiovascular outcomes and risk factors. Electronic databases including MEDLINE, Scopus and Web of Knowledge were searched from 1982 up to 2014. The incidence of acute cardiac illness during Ramadan fasting was similar when compared to non-fasting days. Ramadan fasting is associated with elevations in high-density lipoprotein cholesterol (HDL-c), and reductions in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (T-chol). However, the lipid profile of diabetic patients deteriorated significantly during Ramadan fasting. In addition, Ramadan fasting lowers body weight, body fat percentage and BMI (body mass index). However, the relationship between weight reduction and loss of body fat is not studied. The majority of patients with stable cardiac illness can opt for Ramadan fasting safely. However, the long term effects of Ramadan fasting on cardiovascular outcomes and risk factors remains uncertain, and the apparent discordant effects in individuals with and without diabetes mellitus merits further study.

  11. The effects of culture on guideline discordant gestational weight gain: a systematic review protocol.

    Science.gov (United States)

    Manyanga, Taru; da Silva, Danilo F; Ferraro, Zachary M; Harvey, Alysha L J; Wilson, Shanna; Ockenden, Holly N; Adamo, Kristi B

    2015-11-03

    A significant proportion of women exceeds or does not meet the Institute of Medicine's gestational weight gain (GWG) guidelines. Inadequate, excessive GWG or weight loss during pregnancy is associated with an increased risk of negative maternal and fetal outcomes. Among the many determinants of GWG identified in the 2009 Institute of Medicine guidelines, culture was named as one of the few whose influence has not been fully explored. Some cultural beliefs may erroneously promote overeating as "eating for two" and discourage physical activity during pregnancy, but there is lack of empirical evidence on how culture affects GWG. The purpose of this systematic review is to examine the effects of culture on GWG. Ten electronic databases will be searched to identify studies reporting on the effects of culture on GWG. Grey literature, published conference abstracts, websites of relevant organizations and reference lists of included studies will also be searched. Studies that report on effects of culture, acculturation, ethnicity, race, nationality, ancestry and identity on GWG in adult women will be included. Quality of evidence will be evaluated using the grading of recommendations, assessment, development and evaluations (GRADE) approach to rating evidence. Study selection, data extraction and risk of bias assessment will be conducted by two independent reviewers, with disagreements being resolved by consensus or third party adjudication as needed. Formal meta-analyses will be conducted among included studies that are sufficiently statistically and clinically homogeneous. This review will provide a comprehensive assessment and synthesis of current evidence and will draw attention to potential gaps where future research on the effects of culture on guideline discordant gestational weight gain remains to be conducted. PROSPERO CRD42015023399.

  12. Effectiveness of Biology-Based Methods for Inhibiting Orthodontic Tooth Movement. A Systematic Review.

    Science.gov (United States)

    Cadenas de Llano-Pérula, M; Yañez-Vico, R M; Solano-Reina, E; Palma-Fernandez, J C; Iglesias-Linares, A

    Several experimental studies in the literature have tested different biology-based methods for inhibiting or decreasing orthodontic tooth movement (OTM) in humans. This systematic review investigated the effects of these interventions on the rate of tooth movement. Electronic [MedLine; SCOPUS; Cochrane Library; OpenGrey;Web of Science] and manual searches were conducted up to January 26th, 2016 in order to identify publications of clinical trials that compared the decreasing or inhibiting effects of different biology-based methods over OTM in humans. A primary outcome (rate of OTM deceleration/inhibition) and a number of secondary outcomes were examined (clinical applicability, orthodontic force used, possible side effects). Two reviewers selected the studies complying with the eligibility criteria (PICO format) and assessed risk of bias [Cochrane Collaboration's tool]. Data collection and analysis were performed following the Cochrane recommendations. From the initial electronic search, 3726 articles were retrieved and 5 studies were finally included. Two types of biology-based techniques used to reduce the rate of OTM in humans were described: pharmacological and low-level laser therapy. In the first group, human Relaxin was compared to a placebo and administered orally. It was described as having no effect on the inhibition of OTM in humans after 32 days, while the drug tenoxicam, injected locally, inhibited the rate of OTM by up to 10% in humans after 42 days. In the second group, no statistically significant differences were reported, compared to placebo, for the rate of inhibition of OTM in humans after 90 days of observation when a 860 nm continuous wave GaAlA slow-level laser was used. The currently available data do not allow us to draw definitive conclusions about the use of various pharmacological substances and biology-based therapies in humans able to inhibit or decrease the OTM rate. There is an urgent need for more sound well-designed randomized

  13. Effectiveness of acupuncture for angina pectoris: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Yu, Changhe; Ji, Kangshou; Cao, Huijuan; Wang, Ying; Jin, Hwang Hye; Zhang, Zhe; Yang, Guanlin

    2015-03-28

    The purpose of this systematic review is to assess the effectiveness of acupuncture for angina pectoris. Eleven electronic databases were searched until January 2013. The study included randomized controlled trials that the effectiveness of acupuncture alone was compared to anti-angina medicines (in addition to conventional treatment) and the effectiveness of a combination of acupuncture plus anti-angina medicines was compared to anti-angina medicines alone. The trial selection, data extraction, quality assessment and data analytic procedures outlined in the 2011 Cochrane Handbook were involved. The study included 25 randomized controlled trials (involving 2,058 patients) that met our inclusion criteria. The pooled results showed that the number of patients with ineffectiveness of angina relief was less in the combined acupuncture-anti-angina treatment group than in the anti-angina medicines alone group (RR 0.33, 95% CI 0.23-0.47, p angina medicines alone group, fewer patients in the combined treatment group showed no ECG improvement (RR 0.50, 95% CI 0.40-0.62, p angina medicines alone for both outcome measures. Only four trials mentioned adverse effects. One trial found no significant difference between acupuncture and Chinese medicine, and three reported no adverse events. The quality of the trials was found to be low. The findings showed very low evidence to support the use of acupuncture for improving angina symptoms and ECG of angina patients. However, the quality of the trials included in this study was low. Large and rigorously designed trials are needed to confirm the potential benefit and adverse events of acupuncture.

  14. Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis.

    Science.gov (United States)

    Van Doren, Jessica; Arns, Martijn; Heinrich, Hartmut; Vollebregt, Madelon A; Strehl, Ute; K Loo, Sandra

    2018-02-14

    Neurofeedback (NF) has gained increasing interest in the treatment of attention-deficit/hyperactivity disorder (ADHD). Given learning principles underlie NF, lasting clinical treatment effects may be expected. This systematic review and meta-analysis addresses the sustainability of neurofeedback and control treatment effects by considering randomized controlled studies that conducted follow-up (FU; 2-12 months) assessments among children with ADHD. PubMed and Scopus databases were searched through November 2017. Within-group and between-group standardized mean differences (SMD) of parent behavior ratings were calculated and analyzed. Ten studies met inclusion criteria (NF: ten studies, N = 256; control: nine studies, N = 250). Within-group NF effects on inattention were of medium effect size (ES) (SMD = 0.64) at post-treatment and increased to a large ES (SMD = 0.80) at FU. Regarding hyperactivity/impulsivity, NF ES were medium at post-treatment (SMD = 0.50) and FU (SMD = 0.61). Non-active control conditions yielded a small significant ES on inattention at post-treatment (SMD = 0.28) but no significant ES at FU. Active treatments (mainly methylphenidate), had large ES for inattention (post: SMD = 1.08; FU: SMD = 1.06) and medium ES for hyperactivity/impulsivity (post: SMD = 0.74; FU: SMD = 0.67). Between-group analyses also revealed an advantage of NF over non-active controls [inattention (post: SMD = 0.38; FU: SMD = 0.57); hyperactivity-impulsivity (post: SMD = 0.25; FU: SMD = 0.39)], and favored active controls for inattention only at pre-post (SMD = - 0.44). Compared to non-active control treatments, NF appears to have more durable treatment effects, for at least 6 months following treatment. More studies are needed for a properly powered comparison of follow-up effects between NF and active treatments and to further control for non-specific effects.

  15. A Systematic Overview of Radiation Therapy Effects in Head and Neck Cancer

    International Nuclear Information System (INIS)

    Zackrisson, Bjoern; Mercke, Claes; Strander, Hans; Wennerberg, Johan; Cavallin-Staahl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for head and neck cancer is based on data from 39 randomized trials and 1 meta-analysis. In total, 40 scientific articles are included, involving 20,893 patients. The results were compared with those of a similar overview from 1996 including 79,174 patients. The conclusions reached can be summarized as follows: General, non-nasopharynx: Substantial evidence indicates that the tumour effect of radiotherapy can be increased by the concomitant administration of chemotherapeutic agents, particularly cisplatin and 5-fluorouracil. There is moderate evidence of a survival benefit of radiation combined with concomitant chemotherapy compared to radiation alone. However, the results are equivocal. There is substantial evidence in published studies for an increased frequency of severe acute side effects as a result of concomitant chemotherapy and radiotherapy. There are very few studies that allow any estimates of the risk for serious late side effects. There is a weak indication of an increased risk for serious fibrosis. Comment: The general quality of studies and the lack of information on serious side effects indicate a need for large, well-designed clinical studies with a reasonable follow-up. Larynx preservation studies: There is strong evidence that larynx preservation is possible in 50% of the patients surviving for 5 years with hypopharyngeal cancers when treated with neoadjuvant chemotherapy and radical radiotherapy. There is a non-significant trend for the overall survival being lower in non-surgically treated patients than in those treated with primary surgery and postoperative radiotherapy. Nasopharynx There is moderate evidence that patients with nasopharyngeal carcinomas

  16. The effects of fennel on menstrual bleeding: A systematic review and meta-analysis.

    Science.gov (United States)

    Abdollahi, Nafiseh Ghassab; Mirghafourvand, Mojgan; Mollazadeh, Sanaz

    2018-03-02

    Introduction Fennel has many medicinal properties and is used in the treatment of dysmenorrhea. Given the widespread use of herbal medicine among women for menstrual problems and considering the fact that there has been no study to date about the effect of fennel on menstrual bleeding and duration of menstrual bleeding through systematic review, the present study was conducted to determine the effect of fennel on the amount (primary outcome) and duration of menstrual bleeding and its side-effects (secondary outcomes). Materials All articles, including Persian and English, with no time limit were searched for in the following databases: Medline (through PubMed), Scopus, EMBASE (through Ovid), Cochrane Library, Web of Sciences, Google Scholar, ProQuest, Clininaltrial.gov, SID, Magiran, Irandoc, and Iranmedex, using MeSH terms, including menstrual bleeding, menstruation, severity of bleeding, hypermenorrhea, menorrhagia, fennel, fennelin, Foeniculum vulgare, dysmenorrhea, and painful menstruation, which were searched separately or in combination. Two authors separately reviewed articles to determine the inclusion criteria, and any disagreement was resolved by reaching consensus with a third person. Results A total of 7993 articles were identified through searching the databases, of which 7327 were excluded as duplicates and 666 were screened for inclusion. Six hundread and forty six were excluded by title and abstract based on not being relevant to the review and being conducted on animals. Eventually, six articles were included in the study and four articles entered into the meta-analysis. The results from meta-analysis showed that using fennel caused a significant increase in mean menstrual bleeding in the first cycle after treatment in the intervention group compared to the control (Std. mean difference: 0.46; 95 % CI: 0.18-0.73; p = 0.001; I2 = 9 %). However, it had no significant effect on menstrual bleeding in the second cycle after treatment (Mean

  17. An integrated PRA module for fast determination of risk significance and improvement effectiveness

    International Nuclear Information System (INIS)

    Chao, Chun-Chang; Lin, Jyh-Der

    2004-01-01

    With the widely use of PRA technology in risk-informed applications, to predict the changes of CDF and LERF becomes a standard process for risk-informed applications. This paper describes an integrated PRA module prepared for risk-informed applications. The module contains a super risk engine, a super fault tree engine, an advanced PRA model and a tool for data base maintenance. The individual element of the module also works well for purpose other than risk-informed applications. The module has been verified and validated through a series of scrupulous benchmark tests with similar software. The results of the benchmark tests showed that the module has remarkable accuracy and speed even for an extremely large-size top-logic fault tree as well as for the case in which large amount of MCSs may be generated. The risk monitor for nuclear power plants in Taiwan is the first application to adopt the module. The results predicted by the risk monitor are now accepted by the regulatory agency. A tool to determine the risk significance according to the inspection findings will be the next application to adopt the module in the near future. This tool classified the risk significance into four different color codes according to the level of increase on CDF. Experience of application showed that the flexibility, the accuracy and speed of the module make it useful in any risk-informed applications when risk indexes must be determined by resolving a PRA model. (author)

  18. Significance of atmospheric effects of heat rejection from energy centers in the semi arid northwest

    International Nuclear Information System (INIS)

    Ramsdell, J.V.; Drake, R.L.; Young, J.R.

    1976-01-01

    The results presented in this paper have been obtained using simple atmospheric models in an attempt to optimize heat sink management in a conceptual nuclear energy center (NEC) at Hanford. The models have been designed to be conservatice in the sense that they are biased toward over prediction of the impact of cooling system effluents on humidity and fog. Thus the models are screening tools to be used to identify subjects for further, more realistic examination. Within this context the following conclusions have been reached: the evaluation of any atmospheric impact postulated for heat dissipation must be conducted in quantitative terms which can be used to determine the significance of the impact; of the potential atmospheric impacts of large heat releases from energy centers, the one most amenable to quantitative evaluation in meaningful terms as the increase in fog; a postulated increase in frequency of fog can be translated into terms of visibility and both can be evaluated statistically; the translation of a increase in fog to visibility terms permits economic evaluation of the impact; and the predicted impact of the HNEC on fog and visibility is statistically significant whether the energy center consists of 20 or 40 units

  19. Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects.

    Science.gov (United States)

    Farzandipour, Mehrdad; Nabovati, Ehsan; Sharif, Reihane; Arani, Marzieh Heidarzadeh; Anvari, Shima

    2017-10-01

    Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify

  20. How effective are active videogames among the young and the old? Adding meta-analyses to two recent systematic reviews

    NARCIS (Netherlands)

    Riet, J.P. van 't; Crutzen, R.M.M.; Lu, A.S.

    2014-01-01

    Objective: Two recent systematic reviews have surveyed the existing evidence for the effectiveness of active videogames in children/adolescents and in elderly people. In the present study, effect sizes were added to these systematic reviews, and meta-analyses were performed. Materials and Methods:

  1. The UK's Levy Control Framework for renewable electricity support: Effects and significance

    International Nuclear Information System (INIS)

    Lockwood, Matthew

    2016-01-01

    There is a long-standing debate over price vs. quantity approaches to supporting the deployment of renewable electricity technologies. In the context of a recent shift from quantity to price-based support, the UK has also introduced a new form of budgetary framework, the Levy Control Framework (LCF). The introduction of the LCF has been very important for investors but has received relatively little attention in the academic literature. The paper gives an overview of the LCF, explores its effects on renewables policy, on consumers and on investor confidence arguing that an unintended consequence of its introduction has been to increase uncertainty, through interactions with underlying support mechanisms. A number of problems with the current scope and design of the LCF are noted. It is argued that the LCF is best understood as aimed at avoiding a political backlash against renewable support policy in a context where the benefits of such policy are concentrated economically and socially. The paper concludes by placing the LCF within a wider context of a shift towards greater budgetary control over renewable energy support policy across European countries. - Highlights: • Gives an description of the Levy Control Framework. • Analyses the effects of the LCF on UK renewable policy. • Reviews possible purposes of the LCF. • Evaluates the effects of the LCF on consumers and investors. • Places the LCF in context of greater cost control over renewables across the EU.

  2. Vaccination with OK-432 followed by TC-1 tumor lysate leads to significant antitumor effects.

    Science.gov (United States)

    Chen, I-Ju; Yen, Chih-Feng; Lin, Kun-Ju; Lee, Chyi-Long; Soong, Yung-Kuei; Lai, Chyong-Huey; Lin, Cheng-Tao

    2011-07-01

    Human papillomavirus (HPV) infects large numbers of women worldwide and is present in more than 99% of all cervical cancer. TC-1 cell is a cell line with high expression of E7 antigen of HPV type 16 and its cell lysate has been demonstrated as an ideal inducer of E7-specific, antitumor immunity. OK-432 (Picibanil), a penicillin-killed Streptococcus pyogenes, has been reported with potent immunomodulation properties in cancer treatment by stimulating the maturation of dendritic cells (DCs) and secretion of Th-1 type cytokines. The current study demonstrated that a protocol to immunize the C57BL/6 mice with OK-432 followed by treatment with TC-1 lysate can generate markedly increased immune responses of E7-specific CD4(+) T cells and a moderate increase of natural killer (NK) cell, as well as a satisfactorily protective and therapeutic antitumor effect by triggering the DCs to prime T cells. Depletion of lymphocyte subset in vivo suggested that the antitumor effects could be dominantly executed by CD8+ T cells and followed by NK cells, and both of these reactions were induced by the generation of robust E7-specific CD4(+) T helper cell response. These findings warrant OK-432 combination with tumor-lysate as an effective and safe vaccine in future clinical application of cervical cancer.

  3. Germ cell toxicity: significance in genetic and fertility effects of radiation and chemicals

    International Nuclear Information System (INIS)

    Oakberg, E.F.

    1983-01-01

    The response of the male and female to radiation and chemicals is different. Any loss of oocytes in the female cannot be replaced, and if severe enough, will result in a shortening of the reproductive span. In the male, a temporary sterile period may be induced owing to destruction of the differentiating spermatogonia, but the stem cells are the most resistant spermatogonial type, are capable of repopulating the seminiferous epithelium, and fertility usually returns. The response of both the male and female changes with development of the embryonic to the adult gonad, and with differentiation and maturation in the adult. The primordial germ cells, early oocytes, and differentiating spermatogonia of the adult male are unusually sensitive to the cytotoxic action of noxious agents, but each agent elicits a specific response owing to the intricate biochemical and physiological changes associated with development and maturation of the gametes. The relationship of germ cell killing to fertility is direct, and long-term fertility effects can be predicted from histological analysis of the gonads. The relationship to genetic effects, on the other hand, is indirect, and acts primarily by limiting the cell stages available for testing, by affecting the distribution of mitotically active stem cells among the different stages of the mitotic cycle, and thereby, changing both the type and frequency of genetic effects observed. 100 references, 38 figures, 7 tables

  4. Beyond the body: A systematic review of the nonphysical effects of a surgical career.

    Science.gov (United States)

    Oskrochi, Youssof; Maruthappu, Mahiben; Henriksson, Maria; Davies, Alun H; Shalhoub, Joseph

    2016-02-01

    Training as a physician has been demonstrated to be a source of personal and familial distress; we sought to assess and analyze the holistic impact of a surgical career by examining nonphysical effects on surgeons and their families. The MEDLINE database was searched systematically from inception to June 2014 in accordance with PRISMA guidance. Two reviewers independently reviewed articles using predefined inclusion and exclusion criteria. We found 71 articles that met our inclusion criteria. Fifty-four studies (77%) assessed burnout with a reported prevalence of 12.6-58% (mean, 34.6%; SD, 11.0%). Workload was found to be the most significant contributor to burnout. Rates of psychiatric morbidity ranged between 16 and 37% (mean, 25.3%; SD, 6.6%) and rates of suicidal ideation, especially among more senior surgeons and those involved in malpractice, was higher than the general population. Depression was reported in 30.8-37.5% (mean, 33.9%; SD, 3.1%). All were strongly associated with workload and burnout, indicative of a likely synergistic effect. Other risk factors included junior status and younger age, poor professional relationships, work-home conflicts and poor work-life balance. Protective factors included marriage or spousal support, career satisfaction, autonomy, and academic practice. Surgeons have a high prevalence of burnout, psychiatric morbidity, and depression, with suicidal ideation rates higher than the general population. Professional factors contribute significantly to these phenomena. Although personal and familial factors are protective, they are eroded by the overwhelming impact of professional factors; nevertheless, career satisfaction rates remain high. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: A systematic review

    Science.gov (United States)

    Silvestre-Rangil, Javier; Bagan, Leticia; Bagan, Jose V.

    2016-01-01

    Background Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. Material and Methods A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment. Results Eight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP, IL-6 and TNFα showed a non significant tendency to decrease as a result of treatment. Conclusions Nonsurgical treatment improved the periodontal condition of patients with periodontitis and RA, with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies are therefore needed to more firmly establish possible significant relations between the two disease processes. Key words:Periodontitis, rheumatoid arthritis, periodontal treatment. PMID:26946202

  6. Clinically significant cardiopulmonary events and the effect of definition standardization on apnea of prematurity management.

    Science.gov (United States)

    Powell, M B F; Ahlers-Schmidt, C R; Engel, M; Bloom, B T

    2017-01-01

    To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge. Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded. Data and records were used to indicate when the new definition of clinically significant cardiopulmonary events (CSCPEs) and concurrent education was implemented. Preimplementation and postimplementation cohorts were compared. Incidence fell from 74% diagnosed with apnea of prematurity at baseline to 49% diagnosed with CSCPE postimplementation (Pdefinitions and treatments reduced the use of caffeine and cardiorespiratory monitors upon NICU dismissal.

  7. Corrections for the effects of significant wave height and attitude on Geosat radar altimeter measurements

    Science.gov (United States)

    Hayne, G. S.; Hancock, D. W., III

    1990-01-01

    Range estimates from a radar altimeter have biases which are a function of the significant wave height (SWH) and the satellite attitude angle (AA). Based on results of prelaunch Geosat modeling and simulation, a correction for SWH and AA was already applied to the sea-surface height estimates from Geosat's production data processing. By fitting a detailed model radar return waveform to Geosat waveform sampler data, it is possible to provide independent estimates of the height bias, the SWH, and the AA. The waveform fitting has been carried out for 10-sec averages of Geosat waveform sampler data over a wide range of SWH and AA values. The results confirm that Geosat sea-surface-height correction is good to well within the original dm-level specification, but that an additional height correction can be made at the level of several cm.

  8. Effects of Domestic Violence on Children and Significance of Psychosocial Support

    Directory of Open Access Journals (Sweden)

    Neslihan Lok

    2016-06-01

    Full Text Available Nowadays increasing complexity of living conditions of children influence every aspect of family atmosphere, parent-child relationships and child rearing practices. These are significant factors in development of childrens personality and sustaining their mental health. Although family environment is considered to be safest environment for children, many parents grind them consciously or unconsciously on the grounds of edification which might cause problems in their physical, spiritual, mental and affective growth leading them to be unhealthy individuals. Therefore, children exposed to violence by their family members should be determined by a multidisciplinary team to make a psychosocial support available. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 156-161

  9. Effect of postmortem sampling technique on the clinical significance of autopsy blood cultures.

    Science.gov (United States)

    Hove, M; Pencil, S D

    1998-02-01

    Our objective was to investigate the value of postmortem autopsy blood cultures performed with an iodine-subclavian technique relative to the classical method of atrial heat searing and antemortem blood cultures. The study consisted of a prospective autopsy series with each case serving as its own control relative to subsequent testing, and a retrospective survey of patients coming to autopsy who had both autopsy blood cultures and premortem blood cultures. A busy academic autopsy service (600 cases per year) at University of Texas Medical Branch Hospitals, Galveston, Texas, served as the setting for this work. The incidence of non-clinically relevant (false-positive) culture results were compared using different methods for collecting blood samples in a prospective series of 38 adult autopsy specimens. One hundred eleven adult autopsy specimens in which both postmortem and antemortem blood cultures were obtained were studied retrospectively. For both studies, positive culture results were scored as either clinically relevant or false positives based on analysis of the autopsy findings and the clinical summary. The rate of false-positive culture results obtained by an iodine-subclavian technique from blood drawn soon after death were statistically significantly lower (13%) than using the classical method of obtaining blood through the atrium after heat searing at the time of the autopsy (34%) in the same set of autopsy subjects. When autopsy results were compared with subjects' antemortem blood culture results, there was no significant difference in the rate of non-clinically relevant culture results in a paired retrospective series of antemortem blood cultures and postmortem blood cultures using the iodine-subclavian postmortem method (11.7% v 13.5%). The results indicate that autopsy blood cultures obtained using the iodine-subclavian technique have reliability equivalent to that of antemortem blood cultures.

  10. Effect of posture on the diurnal variation in clinically significant diabetic macular edema.

    Science.gov (United States)

    Polito, Antonio; Polini, Giovanni; Chiodini, Raffaella Gortana; Isola, Miriam; Soldano, Franca; Bandello, Francesco

    2007-07-01

    To investigate the role of posture and other systemic factors in the diurnal variation of clinically significant diabetic macular edema (CSDME). Ten eyes of 10 diabetic subjects with CSDME underwent four OCT foveal thickness measurements with StratusOCT at 9 AM and 12, 3, and 6 PM consecutively on two different days, with the subject in an upright position on one and in a recumbent position on the other. For the "recumbent-position" measurements, the patients were admitted the night before and remained in bed during the entire day of testing. Clinical laboratory results at baseline included HbA1c, urinary albumin, and serum creatinine. Refraction and Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity were also measured before each OCT measurement was taken. Variations in blood pressure, body temperature, plasma glucose, renin, aldosterone, and cortisol levels were measured and then correlated with macular thickness. Foveal thickening decreased in all cases over the course of the day. The decrease, however, was significantly greater for the upright-position measurements (relative mean +/- SD decrease of 20.6% +/- 6.5% in the upright position and 6.2% +/- 4.6% in the recumbent position). Visual acuity improved by at least 1 ETDRS line in three eyes in the upright position as opposed to only one eye in the recumbent position. There seemed to be no association between any of the systemic factors studied and foveal thickening, with the exception of cortisol. The results support the hypothesis that posture and hydrostatic pressure play a major role in determining time-related shifts in CSDME and suggest that the forces of Starling's law can in part, account for CSDME formation.

  11. A Systematic Review of the Effectiveness of Knowledge Translation Interventions for Chronic Noncancer Pain Management

    OpenAIRE

    Ospina, Maria B; Taenzer, Paul; Rashiq, Saifee; MacDermid, Joy C; Carr, Eloise; Chojecki, Dagmara; Harstall, Christa; Henry, James L

    2013-01-01

    BACKGROUND: Reliable evidence detailing effective treatments and management practices for chronic noncancer pain exists. However, little is known about which knowledge translation (KT) interventions lead to the uptake of this evidence in practice.OBJECTIVES: To conduct a systematic review of the effectiveness of KT interventions for chronic noncancer pain management.METHODS: Comprehensive searches of electronic databases, the gray literature and manual searches of journals were undertaken. Ra...

  12. The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review

    OpenAIRE

    Shi, Zhenrong; MacBeth, Angus

    2017-01-01

    Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing...

  13. Effects of the application of therapeutic massage in children with cancer: a systematic review

    OpenAIRE

    Rodríguez-Mansilla, Juan; González-Sánchez, Blanca; Torres-Piles, Silvia; Martín, Jorge Guerrero; Jiménez-Palomares, María; Bellino, Macarena Núñez

    2017-01-01

    ABSTRACT Objective: to learn about the effects of the use of therapeutic massage in children with cancer. Method: systematic review of controlled clinical trials The search was conducted in November 2014 in the following databases: Pubmed, CSIC, Dialnet, Scopus, Cochrane and PEDro. Inclusion criteria were: clinical trials, published in English or Spanish, analyzing the effects of massage on the different stages and types of childhood cancer (between 1 and 18 years old). Results: of 1007...

  14. Rumen-protected choline: A significance effect on dairy cattle nutrition.

    Science.gov (United States)

    Jayaprakash, G; Sathiyabarathi, M; Robert, M Arokia; Tamilmani, T

    2016-08-01

    Choline is a vitamin-like substance it has multi-function in animal production, reproduction, and health. The transition period is most crucial stage in lactation cycle of dairy cows due to its association with negative hormonal and energy balances. Unfortunately, unprotected choline easily degrades in the rumen; therefore, choline added to the diet in a rumen-protected form. The use of rumen-protected choline (RPC) is a preventive measurement for the fatty liver syndrome and ketosis; may improve milk production as well as milk composition and reproduction parameters. This review summarizes the effectiveness of RPC on animal production, health, and reproduction.

  15. [Bendamustine-rituximab therapy is effective for transformed follicular lymphoma with significant expression of p53].

    Science.gov (United States)

    Kuroda, Hiroyuki; Jomen, Wataru; Miura, Shogo; Arihara, Yohei; Yamada, Michiko; Hirako, Tasuku; Abe, Tomoyuki; Sakurai, Tamaki; Fujii, Shigeyuki; Maeda, Masahiro; Fujita, Miri; Nagashima, Kazuo; Okagawa, Yutaka; Hoki, Toshifumi; Kato, Junji

    2013-08-01

    We describe a patient with transformed follicular lymphoma(FL), expressing p53 but remaining in complete remission(CR) due to bendamustine-rituximab(BR)therapy. She was a 64-year-old female diagnosed with stage IV FL(grade 3A)in July 2007 when she was admitted with right lower abdominal pain and body weight loss. Colonoscopy revealed Bauhin' valve lymphoma of the terminal ileum, and computed tomography(CT)scan showed lymphadenopathy, involving the cervical, mediastinal para-aortic lymph nodes and right tonsil. She received chemotherapy with eight courses of CHOP therapy with rituximab and achieved CR. Two and a half years later, mediastinal lymph node swelling relapsed, and ibritumomab tiuxetan therapy induced the second CR. After ten months, however, a third relapse occurred as a submucosal tumor(SMT)of the stomach. Gastric SMT biopsy showed diffuse large B cell lymphoma(DLBCL)transformation with immunohistochemical expression of p53. Although gastric SMT disappeared after radiotherapy, which achieved the third CR, lymph node swelling was detected again in the para-aortic and-iliac artery lymph nodes in September 2011. Subsequently, she was treated with five courses of BR therapy, because bendamustine had been reported to be effective for p53 gene-deficient B cell neoplasms. The therapy was successful and achieved the fourth CR, demonstrating that BR therapy was effective for p53-expressing DLBCL.

  16. The significant role of plasmonic effects in femtosecond laser-induced grating fabrication on the nanoscale

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Min; Zhao, Fuli [State Key Laboratory of Optoelectronic Materials and Technologies, Sun Yat-sen University, Guangzhou, 510275 (China); Cheng, Ya; Xu, Zhizhan [State Key Laboratory of High Field Laser Physics, Shanghai Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, P.O. Box 800-211, Shanghai, 201800 (China)

    2013-02-15

    Nowadays, plasmonics aiming at manipulating light beyond the diffraction limit has aroused great interest on account of the promise of nanoscale optical devices. Generally, the ability to break diffraction barrier is achieved via controlling surface plasmons (SPs) on artificial structures as products of human ingenuity. Here, nevertheless, it is demonstrated that in short-pulse laser ablation ultrafast active plasmonic structures spontaneously generate by virtue of plasmonic effects rather than human will. First, with the experimental results on ZnO, Si, and GaAs, explicit evidence is provided for the grating-splitting phenomenon that acts as a direct route for the formation of laser-induced deep-subwavelength gratings. The splitting mechanism can break through the diffraction limit and push laser-induced structures towards the nanoscale. Then, through comprehensive numerical studies based on the viewpoint of plasmonics, it can be confirmed that the grating-splitting phenomenon originates in the conversion of SP modes from the resonant to the nonresonant mode and further to the inphase or antiphase asymmetric mode. In short, plasmonic effects play an important role in ultrafast laser-induced grating splitting towards the nanoscale, which will provide new insights into the mechanisms of ultrafast laser-induced nanostructures. (copyright 2012 by WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  17. The significant role of plasmonic effects in femtosecond laser-induced grating fabrication on the nanoscale

    International Nuclear Information System (INIS)

    Huang, Min; Zhao, Fuli; Cheng, Ya; Xu, Zhizhan

    2013-01-01

    Nowadays, plasmonics aiming at manipulating light beyond the diffraction limit has aroused great interest on account of the promise of nanoscale optical devices. Generally, the ability to break diffraction barrier is achieved via controlling surface plasmons (SPs) on artificial structures as products of human ingenuity. Here, nevertheless, it is demonstrated that in short-pulse laser ablation ultrafast active plasmonic structures spontaneously generate by virtue of plasmonic effects rather than human will. First, with the experimental results on ZnO, Si, and GaAs, explicit evidence is provided for the grating-splitting phenomenon that acts as a direct route for the formation of laser-induced deep-subwavelength gratings. The splitting mechanism can break through the diffraction limit and push laser-induced structures towards the nanoscale. Then, through comprehensive numerical studies based on the viewpoint of plasmonics, it can be confirmed that the grating-splitting phenomenon originates in the conversion of SP modes from the resonant to the nonresonant mode and further to the inphase or antiphase asymmetric mode. In short, plasmonic effects play an important role in ultrafast laser-induced grating splitting towards the nanoscale, which will provide new insights into the mechanisms of ultrafast laser-induced nanostructures. (copyright 2012 by WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  18. Effect of Plasma Membrane Semipermeability in Making the Membrane Electric Double Layer Capacitances Significant.

    Science.gov (United States)

    Sinha, Shayandev; Sachar, Harnoor Singh; Das, Siddhartha

    2018-01-30

    Electric double layers (or EDLs) formed at the membrane-electrolyte interface (MEI) and membrane-cytosol interface (MCI) of a charged lipid bilayer plasma membrane develop finitely large capacitances. However, these EDL capacitances are often much larger than the intrinsic capacitance of the membrane, and all of these capacitances are in series. Consequently, the effect of these EDL capacitances in dictating the overall membrane-EDL effective capacitance C eff becomes negligible. In this paper, we challenge this conventional notion pertaining to the membrane-EDL capacitances. We demonstrate that, on the basis of the system parameters, the EDL capacitance for both the permeable and semipermeable membranes can be small enough to influence C eff . For the semipermeable membranes, however, this lowering of the EDL capacitance can be much larger, ensuring a reduction of C eff by more than 20-25%. Furthermore, for the semipermeable membranes, the reduction in C eff is witnessed over a much larger range of system parameters. We attribute such an occurrence to the highly nonintuitive electrostatic potential distribution associated with the recently discovered phenomena of charge-inversion-like electrostatics and the attainment of a positive zeta potential at the MCI for charged semipermeable membranes. We anticipate that our findings will impact the quantification and the identification of a large number of biophysical phenomena that are probed by measuring the plasma membrane capacitance.

  19. Structural Magnetic Resonance Imaging Correlates of Aggression in Psychosis: A Systematic Review and Effect Size Analysis

    Directory of Open Access Journals (Sweden)

    Sonja Widmayer

    2018-06-01

    Full Text Available Background: Aggression in psychoses is of high clinical importance, and volumetric MRI techniques have been used to explore its structural brain correlates.Methods: We conducted a systematic review searching EMBASE, ScienceDirect, and PsycINFO through September 2017 using thesauri representing aggression, psychosis, and brain imaging. We calculated effect sizes for each study and mean Hedge's g for whole brain (WB volume. Methodological quality was established using the PRISMA checklist (PROSPERO: CRD42014014461.Results: Our sample consisted of 12 studies with 470 patients and 155 healthy controls (HC. After subtracting subjects due to cohort overlaps, 314 patients and 96 HC remained. Qualitative analyses showed lower volumes of WB, prefrontal regions, temporal lobe, hippocampus, thalamus and cerebellum, and higher volumes of lateral ventricles, amygdala, and putamen in violent vs. non-violent people with schizophrenia. In quantitative analyses, violent persons with schizophrenia exhibited a significantly lower WB volume than HC (p = 0.004, and also lower than non-violent persons with schizophrenia (p = 0.007.Conclusions: We reviewed evidence for differences in brain volume correlates of aggression in persons with schizophrenia. Our results point toward a reduced whole brain volume in violent as opposed to non-violent persons with schizophrenia. However, considerable sample overlap in the literature, lack of reporting of potential confounding variables, and missing research on affective psychoses limit our explanatory power. To permit stronger conclusions, further studies evaluating structural correlates of aggression in psychotic disorders are needed.

  20. Plyometric Training Effects on Athletic Performance in Youth Soccer Athletes: A Systematic Review.

    Science.gov (United States)

    Bedoya, Abigail A; Miltenberger, Matthew R; Lopez, Rebecca M

    2015-08-01

    The purpose of this systematic review was to critically analyze the literature to determine the effectiveness of plyometric training on athletic performance in youth soccer athletes. A total of 7 studies were included in this review after meeting the following criteria: (a) used plyometric training programs to assess athletic performance, (b) subjects were soccer athletes aged preadolescent up to 17 years, and (c) were published from 2000 to January 2014. Study methods were assessed using the PEDro scale with scores ranging from 4 to 6. Results showed similarities and differences in methodologies and procedures among the included studies. Athletic performance consisting of kicking distance, speed, jumping ability, and agility significantly improved because of plyometric training interventions. The current evidence suggests that plyometric training should be completed 2 days per week for 8-10 weeks during soccer practice with a 72-hour rest period between plyometric training days. The initial number of foot contacts should be 50-60 per session and increase to no more than 80-120 foot contacts per session for this age group to prevent overuse injuries. A total of 3-4 plyometric training exercises should be performed 2-4 sets for 6-15 repetitions per training session. The evidence and the literature suggest that plyometric training for this age group should only be implemented using recommended safety guidelines such as those published by the Canadian Society for Exercise Physiology and the National Strength and Conditioning Association and under appropriate supervision by trained personnel.

  1. Structural Magnetic Resonance Imaging Correlates of Aggression in Psychosis: A Systematic Review and Effect Size Analysis.

    Science.gov (United States)

    Widmayer, Sonja; Sowislo, Julia F; Jungfer, Hermann A; Borgwardt, Stefan; Lang, Undine E; Stieglitz, Rolf D; Huber, Christian G

    2018-01-01

    Background: Aggression in psychoses is of high clinical importance, and volumetric MRI techniques have been used to explore its structural brain correlates. Methods: We conducted a systematic review searching EMBASE, ScienceDirect, and PsycINFO through September 2017 using thesauri representing aggression, psychosis, and brain imaging. We calculated effect sizes for each study and mean Hedge's g for whole brain (WB) volume. Methodological quality was established using the PRISMA checklist (PROSPERO: CRD42014014461). Results: Our sample consisted of 12 studies with 470 patients and 155 healthy controls (HC). After subtracting subjects due to cohort overlaps, 314 patients and 96 HC remained. Qualitative analyses showed lower volumes of WB, prefrontal regions, temporal lobe, hippocampus, thalamus and cerebellum, and higher volumes of lateral ventricles, amygdala, and putamen in violent vs. non-violent people with schizophrenia. In quantitative analyses, violent persons with schizophrenia exhibited a significantly lower WB volume than HC ( p = 0.004), and also lower than non-violent persons with schizophrenia ( p = 0.007). Conclusions: We reviewed evidence for differences in brain volume correlates of aggression in persons with schizophrenia. Our results point toward a reduced whole brain volume in violent as opposed to non-violent persons with schizophrenia. However, considerable sample overlap in the literature, lack of reporting of potential confounding variables, and missing research on affective psychoses limit our explanatory power. To permit stronger conclusions, further studies evaluating structural correlates of aggression in psychotic disorders are needed.

  2. Neurolinguistic programming: a systematic review of the effects on health outcomes

    Science.gov (United States)

    Sturt, Jackie; Ali, Saima; Robertson, Wendy; Metcalfe, David; Grove, Amy; Bourne, Claire; Bridle, Chris

    2012-01-01

    Background Neurolinguistic programming (NLP) in health care has captured the interest of doctors, healthcare professionals, and managers. Aim To evaluate the effects of NLP on health-related outcomes. Design and setting Systematic review of experimental studies. Method The following data sources were searched: MEDLINE®, PsycINFO, ASSIA, AMED, CINAHL®, Web of Knowledge, CENTRAL, NLP specialist databases, reference lists, review articles, and NLP professional associations, training providers, and research groups. Results Searches revealed 1459 titles from which 10 experimental studies were included. Five studies were randomised controlled trials (RCTs) and five were pre-post studies. Targeted health conditions were anxiety disorders, weight maintenance, morning sickness, substance misuse, and claustrophobia during MRI scanning. NLP interventions were mainly delivered across 4–20 sessions although three were single session. Eighteen outcomes were reported and the RCT sample sizes ranged from 22 to 106. Four RCTs reported no significant between group differences with the fifth finding in favour of the NLP arm (F = 8.114, Peffect. There is currently insufficient evidence to support the allocation of NHS resources to NLP activities outside of research purposes. PMID:23211179

  3. The Significance of the Bystander Effect: Modeling, Experiments, and More Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Brenner, David J.

    2009-07-22

    Non-targeted (bystander) effects of ionizing radiation are caused by intercellular signaling; they include production of DNA damage and alterations in cell fate (i.e. apoptosis, differentiation, senescence or proliferation). Biophysical models capable of quantifying these effects may improve cancer risk estimation at radiation doses below the epidemiological detection threshold. Understanding the spatial patterns of bystander responses is important, because it provides estimates of how many bystander cells are affected per irradiated cell. In a first approach to modeling of bystander spatial effects in a three-dimensional artificial tissue, we assumed the following: (1) The bystander phenomenon results from signaling molecules (S) that rapidly propagate from irradiated cells and decrease in concentration (exponentially in the case of planar symmetry) as distance increases. (2) These signals can convert cells to a long-lived epigenetically activated state, e.g. a state of oxidative stress; cells in this state are more prone to DNA damage and behavior alterations than normal and therefore exhibit an increased response (R) for many end points (e.g. apoptosis, differentiation, micronucleation). These assumptions were implemented by a mathematical formalism and computational algorithms. The model adequately described data on bystander responses in the 3D system using a small number of adjustable parameters. Mathematical models of radiation carcinogenesis are important for understanding mechanisms and for interpreting or extrapolating risk. There are two classes of such models: (1) long-term formalisms that track pre-malignant cell numbers throughout an entire lifetime but treat initial radiation dose-response simplistically and (2) short-term formalisms that provide a detailed initial dose-response even for complicated radiation protocols, but address its modulation during the subsequent cancer latency period only indirectly. We argue that integrating short- and long

  4. Effects of non-soy legume consumption on C-reactive protein: a systematic review and meta-analysis.

    Science.gov (United States)

    Salehi-Abargouei, Amin; Saraf-Bank, Sahar; Bellissimo, Nick; Azadbakht, Leila

    2015-05-01

    Because of conflicting results of presented studies, the aim of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to examine the effect of non-soy legume intake on inflammatory markers and C-reactive protein (CRP). We searched Pubmed, ISI Web of Knowledge, SCOPUS, and Google Scholar for relevant studies up to July 2013, using medical subject headings [MeSH] and other related keywords. Nine RCTs were systematically reviewed to examine the effect of non-soy legume consumption on inflammatory markers. Eight studies involving 464 participants were included in the meta-analysis. The results of the meta-analysis showed that non-soy legume consumption had a trend toward a significant effect on decreasing CRP and high-sensitivity (hs)-CRP concentrations (mean difference (MD) = -0.21; 95% confidence interval [CI], -0.44 to 0.02; P = 0.068). There was no overall effect of non-soy legume consumption on CRP or hs-CRP levels in either the parallel or crossover study designs. Our subgroup analysis of CRP type and study design, showed that non-soy legume intake had a significant effect on CRP levels in parallel studies (MD = -1.01; 95% CI, -1.78 to -0.23; P = 0.011) and a significant effect on hs-CRP levels (MD = -0.53; 95% CI, -0.95 to -0.11; P = 0.014) and in the crossover sub group (MD = -0.68; 95% CI, -1.28 to -0.08; P = 0.026). This review of RCTs showed that non-soy legume consumption may contribute to reductions in CRP and hs-CRP concentrations. However, further controlled clinical trials are needed to investigate the effect of non-soy legume intake on other inflammatory markers. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Significant Effect of Pore Sizes on Energy Storage in Nanoporous Carbon Supercapacitors.

    Science.gov (United States)

    Young, Christine; Lin, Jianjian; Wang, Jie; Ding, Bing; Zhang, Xiaogang; Alshehri, Saad M; Ahamad, Tansir; Salunkhe, Rahul R; Hossain, Shahriar A; Khan, Junayet Hossain; Ide, Yusuke; Kim, Jeonghun; Henzie, Joel; Wu, Kevin C-W; Kobayashi, Naoya; Yamauchi, Yusuke

    2018-04-20

    Mesoporous carbon can be synthesized with good control of surface area, pore-size distribution, and porous architecture. Although the relationship between porosity and supercapacitor performance is well known, there are no thorough reports that compare the performance of numerous types of carbon samples side by side. In this manuscript, we describe the performance of 13 porous carbon samples in supercapacitor devices. We suggest that there is a "critical pore size" at which guest molecules can pass through the pores effectively. In this context, the specific surface area (SSA) and pore-size distribution (PSD) are used to show the point at which the pore size crosses the threshold of critical size. These measurements provide a guide for the development of new kinds of carbon materials for supercapacitor devices. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Background: Providing anesthesia for gastrointestinal (GI endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. Materials and Methods: This retrospective cohort study included patients with a body mass index (BMI >40 kg/m 2 that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. Results: A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA. These desaturation episodes were found to be statistically independent of increasing BMI of patients. Conclusion: Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  7. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect.

    Science.gov (United States)

    Goudra, Basavana Gouda; Singh, Preet Mohinder; Penugonda, Lakshmi C; Speck, Rebecca M; Sinha, Ashish C

    2014-01-01

    Providing anesthesia for gastrointestinal (GI) endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. This retrospective cohort study included patients with a body mass index (BMI) >40 kg/m(2) that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA). These desaturation episodes were found to be statistically independent of increasing BMI of patients. Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  8. Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia.

    Science.gov (United States)

    Morin, Mélanie; Carroll, Marie-Soleil; Bergeron, Sophie

    2017-07-01

    Pelvic floor muscle physical therapy is recommended in clinical guidelines for women with provoked vestibulodynia (PVD). Including isolated or combined treatment modalities, physical therapy is viewed as an effective first-line intervention, yet no systematic review concerning the effectiveness of physical therapy has been conducted. To systematically appraise the current literature on the effectiveness of physical therapy modalities for decreasing pain during intercourse and improving sexual function in women with PVD. A systematic literature search using PubMed, Scopus, CINHAL, and PEDro was conducted until October 2016. Moreover, a manual search from reference lists of included articles was performed. Ongoing trials also were reviewed using clinicaltrial.gov and ISRCTNregistry. Randomized controlled trials, prospective and retrospective cohorts, and case reports evaluating the effect of isolated or combined physical therapy modalities in women with PVD were included in the review. Main outcome measures were pain during intercourse, sexual function, and patient's perceived improvement. The literature search resulted in 43 eligible studies including 7 randomized controlled trials, 20 prospective studies, 5 retrospective studies, 6 case reports, and 6 study protocols. Most studies had a high risk of bias mainly associated with the lack of a comparison group. Another common bias was related to insufficient sample size, non-validated outcomes, non-standardized intervention, and use of other ongoing treatment. The vast majority of studies showed that physical therapy modalities such as biofeedback, dilators, electrical stimulation, education, multimodal physical therapy, and multidisciplinary approaches were effective for decreasing pain during intercourse and improving sexual function. The positive findings for the effectiveness of physical therapy modalities in women with PVD should be investigated further in robust and well-designed randomized controlled trials

  9. Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis.

    Science.gov (United States)

    Posso, Margarita; Puig, Teresa; Carles, Misericòrdia; Rué, Montserrat; Canelo-Aybar, Carlos; Bonfill, Xavier

    2017-11-01

    Double reading is the strategy of choice for mammogram interpretation in screening programmes. It remains, however, unknown whether double reading is still the strategy of choice in the context of digital mammography. Our aim was to determine the effectiveness and cost-effectiveness of double reading versus single reading of digital mammograms in screening programmes. We performed a systematic review by searching the PubMed, Embase, and Cochrane Library databases up to April 2017. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist to assess the methodological quality of the diagnostic studies and economic evaluations, respectively. A proportion's meta-analysis approach, 95% Confidence Intervals (95% CI) and test of heterogeneity (P values) were used for pooled results. Costs are expressed US$ PPP (United States Dollar purchasing power parities). The PROSPERO ID of this Systematic Review's protocol is CRD42014013804. Of 1473 potentially relevant hits, four high-quality