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Sample records for support systematic sacrifice

  1. Similar outcome after retention or sacrifice of the posterior cruciate ligament in total knee arthroplasty : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Verra, Wiebe C.; van den Boom, Lennard G. H.; Jacobs, Wilco C. H.; Schoones, Jan W.; Wymenga, Ate B.; Nelissen, Rob G. H. H.

    Background and purpose - To retain or to sacrifice the posterior cruciate ligament (PCL) in total knee arthroplasty (TKA) remains a matter of discussion. In this systematic review, we wanted to find differences in functional and clinical outcome between the 2 methods. Methods - We conducted a

  2. Remembering sacrifices: attitude and beliefs among second-generation Korean Americans regarding family support.

    Science.gov (United States)

    Yoo, Grace J; Kim, Barbara W

    2010-06-01

    Korean immigration peaked in the mid-1980s, so that large cohorts of post-1965 immigrants are now approaching or entering retirement. As the baby boomer generation ages, few studies have examined how the lack of retirement savings and eldercare plans combined with cultural expectations such as filial piety may pose challenges for aging Korean immigrants and their adult children. This exploratory study examines attitudes and beliefs among 1.5 and 2nd generation Korean American adults regarding filial expectations and support for aging immigrant parents. In-depth interviews conducted with 124 adult children of immigrants show that their attitudes and beliefs around filial care were primarily motivated by feelings of gratitude and a strong sense of responsibility toward their parents. In addition, because Korean immigrant parents often face language and financial barriers, adult children were preparing themselves for future support of their parents' finances, health care and long-term care needs. Although both adult sons and daughters expressed a desire to care for their parents, adult daughters often discussed in detail their concerns and worries about future care of their parents. The findings of this paper illustrate how the intersections of gender, culture, and class inform attitudes and beliefs regarding aging and family support among Korean American families.

  3. Kafka and sacrifice

    Directory of Open Access Journals (Sweden)

    Peter Speedwell

    2015-12-01

    Full Text Available The author explores the central importance of death in Bakhtin’s carnival and notes that death is joyfully accepted as it gets rid of the old and makes space for the new. Death for Bakhtin is “life’s regeneration”. But in many societies both simple and sophisticated this is not the case. Here we deal with a sacrificial logic where death is feared and displaced onto a sacrificial victim who is killed for the benefit of the majority. Although we like to think of modern society as being beyond sacrifice we see it in many cultural formations. The author uses anthropology as an interpretive key to explain the story of Franz Kafka’s Metamorphosis. Indeed the Metamorphosis reads like a purificatory rite in which one member of the social group (a family becomes a monster (the insect, literally and is slowly but systematically rejected by the other members of his family. In the end, Gregor the insect/family member who has become a kind of filthy cockroach, dies to save his family from further disgust. His body is disposed of anonymously. At the end of the story we see Gregor’s sister has bloomed into adolescence and so (without doing too much damage to the text we can interpret the story as a kind of spring purification right to discard the bad and the rotten and bring in the good and the fertile.

  4. Sacrifice as a plot device

    Directory of Open Access Journals (Sweden)

    Ashikhmanova Natalya Alexandrovna

    2015-12-01

    Full Text Available It is considered the plot device “sacrifice” as a meaningful component of the narrative. It sets a minimum of substantive meaning of this formation (the idea of getting something over the loss of something. The main types of sacrifice: sacrifice and self-sacrifice. Sacrifice means bringing something to sacrifice for the sake of an idea or someone else and implies a greater degree of external attributes. Self-sacrifice brings a loss of the intrinsic value of the character. Sacrifice as the action takes place consciously and, as a rule, does not require compensation in return. Victims sacrifice not only material things but spiritual as well. Their actions are certainly driven by the idea, which is of value. In the case of self-sacrifice victim is itself a victim. Present for sacrifice plays a certain role in the development of some of the stories of fabulous narratives. Search of the present can be a starting point in the development of fantastic narrative plot. As a sacrifice the present can be considered in three forms: in the form of material expression, in the form of immaterial substance, as well as a way to transfer the character into magical power through knowledge empowerment of its formulaic spells.

  5. The Animal Sacrifice in Religious Rituals or Beliefs

    Directory of Open Access Journals (Sweden)

    Tereza Rodrigues Vieira

    2016-12-01

    Full Text Available Based on a bibliographical research, this article has the scope of the analysis of the sacrifice of nonhuman animals in religious rituals or beliefs practiced in Brazilian territory. By bringing moral, ethical and legal support, this national reality will be discussed in order to arrive at an answer of which good should be protected and guaranteed: religious freedom or the life of nonhuman animals?

  6. Artificial Nutritional Support Registries: systematic review.

    Science.gov (United States)

    Castelló-Botía, I; Wanden-Berghe, C; Sanz-Valero, J

    2009-01-01

    The nutritional registries are data bases through which we obtain the information to understand the nutrition of populations. Several main nutrition societies of the world have these types of registries, outstanding the NADYA (Home artificial and Ambulatory nutrition) group in Spain. The object of this study is to determine by means of a systematic review, the existent scientific production in the international data bases referred to nutritional support registries. Descriptive transversal study of the results of a critical bibliographic research done in the bioscience data bases: MEDLINE, EMBASE, The Cochrane Library, ISI (Web of Sciences), LILACS, CINHAL. A total of 20 original articles related to nutritional registries were found and recovered. Eleven registries of eight countries were identified: Australia, Germany, Italy, Japan, Spain, Sweden, United Status and United Kingdom. The Price Index was of 65% and all the articles were published in the last 20 years. The Price Index highlights the innovativeness of this practice. The articles related to nutritional support are heterogeneous with respect to data and population, which exposes this as a limitation for a combined analysis.

  7. Sjiele sacrifices, Odin treasures and Saami graves?

    Directory of Open Access Journals (Sweden)

    Inger Zachrisson

    1987-01-01

    Full Text Available This paper presents archaeological findings described as Saami metal deposits. These well-known "Finds from Lapp Places of Sacrifice", objects from the Viking Age and Early Middle Ages, were mostly found in northern Sweden. The author also presents a research project dealing with prehistoric and medieval Saami graves from the south Saami area.

  8. Sacrifice and self-sacrifice of Prince Lazar in the national epic from Christian and pagan aspects

    Directory of Open Access Journals (Sweden)

    Bojanić-Ćirković Mirjana D.

    2014-01-01

    Full Text Available This paper approaches the motives of sacrifice and self-sacrifice of Prince Lazar as a key to the construction of this epic character. At the beginning, consulting dictionaries and previous research, we determine the terminology and concepts of sacrifice self-sacrifice. Approaching the analysis of these motifs in the epic poems and accepting attitudes about their developmental line that ranges from medieval to folk literature, first search for Christian self-sacrifice. In the final part of the paper we provide a synthesis of Christian and pagan influence on the shaping of Lazarus motif of sacrifice and self-sacrifice with an emphasis on their share, hierarchy and function.

  9. The psychology of martyrdom: making the ultimate sacrifice in the name of a cause.

    Science.gov (United States)

    Bélanger, Jocelyn J; Caouette, Julie; Sharvit, Keren; Dugas, Michelle

    2014-09-01

    Martyrdom is defined as the psychological readiness to suffer and sacrifice one's life for a cause. An integrative set of 8 studies investigated the concept of martyrdom by creating a new tool to quantitatively assess individuals' propensity toward self-sacrifice. Studies 1A-1C consisted of psychometric work attesting to the scale's unidimensionality, internal consistency, and temporal stability while examining its nomological network. Studies 2A-2B focused on the scale's predictive validity, especially as it relates to extreme behaviors and suicidal terrorism. Studies 3-5 focused on the influence of self-sacrifice on automatic decision making, costly and altruistic behaviors, and morality judgments. Results involving more than 2,900 participants from different populations, including a terrorist sample, supported the proposed conceptualization of martyrdom and demonstrated its importance for a vast repertoire of cognitive, emotional, and behavioral phenomena. Implications and future directions for the psychology of terrorism are discussed. 2014 APA, all rights reserved

  10. Mechanisms of action of lumbar supports : a systematic review

    NARCIS (Netherlands)

    van Poppel, M N; de Looze, M P; Koes, B W; Smid, T; Bouter, L M

    2000-01-01

    STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports. SUMMARY OF BACKGROUND DATA: A restriction of trunk

  11. The real victims of the islamic feast of sacrifice: injuries related to the sacrifice.

    Science.gov (United States)

    Bildik, Fikret; Yardan, Türker; Demircan, Ahmet; Uçkan, Mustafa Ulkü; Ergin, Mehmet; Hacioğlu, Emel Gülçin

    2010-07-01

    During the Feast of Sacrifice in Muslim countries, thousands of animals are slaughtered every year. Many injuries occur during the sacrifice. Thus, the aim of this study was to determine the demographic characteristics of patients, their slaughtering experience, types of injury, and related hospital costs. This prospective observational study was conducted in Emergency Departments (EDs) of Gazi University and Ankara Training and Research Hospital. One hundred and twenty adult patients were admitted to EDs with injuries related to the slaughter and processing of meat during two consecutive Feasts of Sacrifice. The average age of patients was 41.85 +/- 13.6, and 101 patients (84.2%) were male. One hundred sixteen patients (96.7%) were not professionals. Ninety-seven patients (80.8%) were admitted to EDs on the first day of the feasts. Ninety-nine injuries (82.5%) were related to cutting tools, and 21 patients (17.5%) were admitted with complaints of either falling or being harmed by animals. Fourteen patients (11.7%) with tendon lacerations, finger amputations, extremity fractures, and eye traumas were taken into surgery. Hospital costs were a median 104.76 [67.48-322.12] Turkish Liras (74.30 [47.86-228.45] USD). Proper conditions for slaughter should be provided and professionals should perform the slaughter and/or processing of the meat. EDs should be supplied both more equipment and physicians, especially on the first days of the feast.

  12. Physical Activity and Social Support in Adolescents: A Systematic Review

    Science.gov (United States)

    Mendonça, Gerfeson; Cheng, Luanna Alexandra; Mélo, Edilânea Nunes; de Farias, José Cazuza, Jr.

    2014-01-01

    The objective of this review was to systematically synthesize the results of original studies on the association between physical activity and social support in adolescents, published until April 2011. Searches were carried out in Adolec, ERIC, Lilacs, Medline, SciELO, Scopus, SportsDiscus and Web of Science electronic databases and the reference…

  13. Sacrifice: an ethical dimension of caring that makes suffering meaningful.

    Science.gov (United States)

    Helin, Kaija; Lindström, Unni A

    2003-07-01

    This article is intended to raise the question of whether sacrifice can be regarded stituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today's ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and serve as general sources of knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotian with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas' ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer's ethical outlook, but sacrifice can also be understood as a potential process of transformation health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of

  14. [Information system for supporting the Nursing Care Systematization].

    Science.gov (United States)

    Malucelli, Andreia; Otemaier, Kelly Rafaela; Bonnet, Marcel; Cubas, Marcia Regina; Garcia, Telma Ribeiro

    2010-01-01

    It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional practice documentation. This paper describes the methodological steps and results of the information system development - requirements elicitation, modeling, object-relational mapping, implementation and system validation.

  15. [Sacred psychoactive seeds and ritual sacrifices in the Moche culture].

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    Carod-Artal, F J; Vázquez-Cabrera, C B

    Archaeological findings have confirmed the existence of representations of ritual human sacrifices on pottery belonging to the Moche culture (100-750 AD) in northern Peru; until recently these images were thought to be mythological narrations. We review the archaeological and ethno-historical data concerning Moche sacrifices and we attempt to identify the psychoactive seeds and plants used during such rites. Ethno-historical data from different chronicles of the New World written in the 16th century state that hamala seeds (belonging to the species Nectandra) were used for their analgesic, sedative, narcotic and anticoagulating properties, and that chamico, or stramonium, had an intoxicating effect on those who took it. There were two kinds of Moche rituals, that is, sacrifices as offerings to divinities and as exemplary punishments. Methods of sacrifice included slitting victims' throats, dismembering them and throwing them off mountains. The sacrifices of the Moche were part of a complex and elaborate ritual which consisted in capturing prisoners, parading them with nooses around their necks, making offerings, preparing the officiants and the community, consummation of the sacrifice and presenting the blood to the priest in a chalice. Human sacrifices were part of the propitiatory ceremonies held in honour of the gods in order to favour human fertility, obtain good harvests and preserve a plentiful supply of water for irrigating the valleys. The therapeutic properties of the seeds of the Nectandra species favoured their utilisation in the ritual sacrifices of the Moche culture. Their use was probably associated with stramonium and San Pedro cactus, which contain extracts rich in hallucinogenic alkaloids.

  16. Human Activity Recognition Supported on Indoor Localization: A Systematic Review.

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    Cerón, Jesús; López, Diego M

    2018-01-01

    The number of older adults is growing worldwide. This has a social and economic impact in all countries because of the increased number of older adults affected by chronic diseases, health emergencies, and disabilities, representing at the end high cost for the health system. To face this problem, the Ambient Assisted Living (AAL) domain has emerged. Its main objective is to extend the time that older adults can live independently in their homes. AAL is supported by different fields and technologies, being Human Activity Recognition (HAR), control of vital signs and location tracking the three of most interest during the last years. To perform a systematic review about Human Activity Recognition (HAR) approaches supported on Indoor Localization (IL) and vice versa, describing the methods they have used, the accuracy they have obtained and whether they have been directed towards the AAL domain or not. A systematic review of six databases was carried out (ACM, IEEE Xplore, PubMed, Science Direct and Springer). 27 papers were found. They were categorised into three groups according their approach: paper focus on 1. HAR, 2. IL, 3. HAR and IL. A detailed analysis of the following factors was performed: type of methods and technologies used for HAR, IL and data fusion, as well as the precision obtained for them. This systematic review shows that the relationship between HAR and IL has been very little studied, therefore providing insights of its potential mutual support to provide AAL solutions.

  17. Social networks, support and early psychosis: a systematic review.

    Science.gov (United States)

    Gayer-Anderson, C; Morgan, C

    2013-06-01

    Background. There is strong evidence that those with a long-standing psychotic disorder have fewer social contacts and less social support than comparison groups. There is less research on the extent of social contacts and support prior to or at the onset of psychosis. In the light of recent evidence implicating a range of social experiences and contexts at the onset of psychosis, it is relevant to establish whether social networks and support diminished before or at the time of onset and whether the absence of such supports might contribute to risk, either directly or indirectly. We, therefore, conducted a systematic review of this literature to establish what is currently known about the relationship between social networks, support and early psychosis. Methods. We identified all studies investigating social networks and support in first episode psychosis samples and in general population samples with measures of psychotic experiences or schizotype by conducting systematic searches of electronic databases using pre-defined search terms and criteria. Findings were synthesized using non-quantitative approaches. Results. Thirty-eight papers were identified that met inclusion criteria. There was marked methodological heterogeneity, which limits the capacity to draw direct comparisons. Nonetheless, the existing literature suggests social networks (particularly close friends) and support diminished both among first episode samples and among non-clinical samples reporting psychotic experiences or with schizotype traits, compared with varying comparison groups. These differences may be more marked for men and for those from minority ethnic populations. Conclusions. Tentatively, reduced social networks and support appear to pre-date onset of psychotic disorder. However, the substantial methodological heterogeneity among the existing studies makes comparisons difficult and suggests a need for more robust and comparable studies on networks, support and early psychosis.

  18. The Sacrifice and the Ludic Stances Reflected Through the Theatre Practice of the 20th Century

    Czech Academy of Sciences Publication Activity Database

    Koubová, Alice

    2017-01-01

    Roč. 72, č. 6 (2017), s. 451-462 ISSN 0046-385X R&D Projects: GA ČR(CZ) GA16-23046S Institutional support: RVO:67985955 Keywords : performative turn * performance * sacrifice * ludic stance * play * postmodern condition * Brecht * Benjamin * Grotowski Subject RIV: AA - Philosophy ; Religion OBOR OECD: Philosophy , History and Philosophy of science and technology http://www.klemens.sav.sk/fiusav/doc/filozofia/2017/6/451-462.pdf

  19. Self-sacrifice, self-transcendence and nurses' professional self.

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    Pask, Elizabeth J

    2005-10-01

    In this paper I elaborate a notion of nurses' professional self as one who is attracted towards intrinsic value. My previous work in 2003 has shown how nurses, who see intrinsic value in their work, experience self-affirmation when they believe that they have made a difference to that which they see to have value. The aim of this work is to reveal a further aspect of nurses' professional self. I argue that nurses' desire towards that which they see to have intrinsic value, is a necessary and self-transcending aspect of a nurses' professional self. I argue further that nurses' desire towards intrinsic value inevitably involves their vulnerability. Nurses who see intrinsic value are shown to be vulnerable to self-sacrifice in their inclination to work for the good of their patients, at the expense of themselves. Yet an ability to transcend their self in this way remains a necessary aspect of a nurse's professional self, which requires nurture and support through nurse education.

  20. Social support and nocturnal blood pressure dipping: a systematic review.

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    Fortmann, Addie L; Gallo, Linda C

    2013-03-01

    Attenuated nocturnal blood pressure (BP) dipping is a better predictor of cardiovascular disease (CVD) morbidity and mortality than resting BP measurements. Studies have reported associations between social support, variously defined, and BP dipping. A systematic review of the literature was conducted to investigate associations of functional and structural social support with nocturnal BP dipping assessed over a minimum of 24 hours. A total of 297 articles were identified. Of these, 11 met criteria for inclusion; all studies were cross-sectional in design and included adult participants only (mean age = 19 to 72 years). Evidence was most consistent for an association between functional support and BP dipping, such that 5 of 7 studies reported statistically (or marginally) significant positive associations with BP dipping. Statistically significant functional support-BP dipping associations were moderate (standardized effect size (d) = 0.41) to large (d = 2.01) in magnitude. Studies examining structural support were fewer and relatively less consistent; however, preliminary evidence was observed for associations of marital status and social contact frequency with BP dipping. Statistically significant structural support findings were medium (d = 0.53) to large (d = 1.13) in magnitude. Overall, findings suggest a link between higher levels of functional support and greater nocturnal BP dipping; preliminary evidence was also observed for the protective effects of marriage and social contact frequency. Nonetheless, the relatively small number of studies conducted to date and the heterogeneity of findings across meaningful subgroups suggest that additional research is needed to substantiate these conclusions.

  1. Peer Support for the Hardly Reached: A Systematic Review.

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    Sokol, Rebeccah; Fisher, Edwin

    2016-07-01

    Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached according to a variety of circumstances that fall into 3 domains: individual (e.g., psychological factors), demographic (e.g., socioeconomic status), and cultural-environmental (e.g., social network). Several reports have indicated that peer support is an effective means of reaching hardly reached individuals. However, no review has explored peer support effectiveness in relation to the circumstances associated with being hardly reached or across diverse health problems. To conduct a systematic review assessing the reach and effectiveness of peer support among hardly reached individuals, as well as peer support strategies used. Three systematic searches conducted in PubMed identified studies that evaluated peer support programs among hardly reached individuals. In aggregate, the searches covered articles published from 2000 to 2015. Eligible interventions provided ongoing support for complex health behaviors, including prioritization of hardly reached populations, assistance in applying behavior change plans, and social-emotional support directed toward disease management or quality of life. Studies were excluded if they addressed temporally isolated behaviors, were limited to protocol group classes, included peer support as the dependent variable, did not include statistical tests of significance, or incorporated comparison conditions that provided appreciable social support. We abstracted data regarding the primary health topic, categorizations of hardly reached groups, program reach, outcomes, and strategies employed. We conducted a 2-sample t test to determine whether reported strategies were related to reach. Forty-seven studies met our inclusion criteria, and these studies represented each of the 3 domains of circumstances assessed (individual, demographic, and cultural-environmental). Interventions

  2. Canonical understanding of the sacrifice of Isaac: The influence of ...

    African Journals Online (AJOL)

    2016-07-08

    Jul 8, 2016 ... Martyrdom has granted benefits to the people of ... Testament, as the authoritative text and understands the text primarily in the canonical context ... This is more significant in terms of ..... This image of the Father-Son relation recurs in the NT, ..... this passage is Abraham's obedience, not Isaac's self-sacrifice.

  3. The Significance of Blood Sacrifice in the Old Testament

    African Journals Online (AJOL)

    DrNneka

    redemption. Life with God was made possible by blood in the sacrifice. Thus, the ... communion, making propitiation, cleansing, averting evils or failures to providing .... show the evidence of his undivided loyalty to the covenant friendship. To this call ... gives a seemingly befitting working definition for our purpose. According ...

  4. Child Sacrifice: Black America's Price of Paying the Media Piper.

    Science.gov (United States)

    Orange, Carolyn M.; George, Amiso M.

    2000-01-01

    Explores the sacrifice of African American children to the broadcast media and video games in terms of the players ("media pipers"), the messages ("piping"), and the consequences to children. Proposes some solutions for the problems associated with excessive television viewing and undesirable programming. (SLD)

  5. The Role of Self-Sacrifice in Moral Dilemmas.

    Directory of Open Access Journals (Sweden)

    Sonya Sachdeva

    Full Text Available Centuries' worth of cultural stories suggest that self-sacrifice may be a cornerstone of our moral concepts, yet this notion is largely absent from recent theories in moral psychology. For instance, in the footbridge version of the well-known trolley car problem the only way to save five people from a runaway trolley is to push a single man on the tracks. It is explicitly specified that the bystander cannot sacrifice himself because his weight is insufficient to stop the trolley. But imagine if this were not the case. Would people rather sacrifice themselves than push another? In Study 1, we find that people approve of self-sacrifice more than directly harming another person to achieve the same outcome. In Studies 2 and 3, we demonstrate that the effect is not broadly about sensitivity to self-cost, instead there is something unique about sacrificing the self. Important theoretical implications about agent-relativity and the role of causality in moral judgments are discussed.

  6. Sacrifice in Early Christianity : The Social Dimension of a Metaphor

    NARCIS (Netherlands)

    Rouwhorst, Gerard; Duyndam, Joachim; Korte, Anne-Marie; Poorthuis, Marcel

    2016-01-01

    In Early Christianity the term 'sacrifice' was understood in a metaphorical way. The key to this metaphorical was to be found in the life and the death of Jesus Christ which which was interpreted as a self-offering and, for its part, constituted the model of the Christian way of life. Although this

  7. Intimacy Behaviors and Relationship Satisfaction for Cohabitors: Intimate Sacrifices Are Not Always Beneficial.

    Science.gov (United States)

    Young, Valerie J; Curran, Melissa A

    2016-08-17

    Guided by interdependence theory, the authors examined how relationship satisfaction is explained by intimate behavior sacrifices in a sample of cohabitors (N = 200). Specifically, it was predicted that characteristics of intimate behavior sacrifices, such as ease and partner appreciation should alter the association of sacrifice frequency and relationship satisfaction. The pattern that emerged demonstrates lower satisfaction for cohabitors when they frequently made intimate sacrifices and their partners were less appreciative of the sacrifices. When making frequent, but less appreciated, intimacy sacrifices for their partner, cohabitors may struggle with intimacy behaviors that are partner oriented.

  8. A Text-Mining Framework for Supporting Systematic Reviews.

    Science.gov (United States)

    Li, Dingcheng; Wang, Zhen; Wang, Liwei; Sohn, Sunghwan; Shen, Feichen; Murad, Mohammad Hassan; Liu, Hongfang

    2016-11-01

    Systematic reviews (SRs) involve the identification, appraisal, and synthesis of all relevant studies for focused questions in a structured reproducible manner. High-quality SRs follow strict procedures and require significant resources and time. We investigated advanced text-mining approaches to reduce the burden associated with abstract screening in SRs and provide high-level information summary. A text-mining SR supporting framework consisting of three self-defined semantics-based ranking metrics was proposed, including keyword relevance, indexed-term relevance and topic relevance. Keyword relevance is based on the user-defined keyword list used in the search strategy. Indexed-term relevance is derived from indexed vocabulary developed by domain experts used for indexing journal articles and books. Topic relevance is defined as the semantic similarity among retrieved abstracts in terms of topics generated by latent Dirichlet allocation, a Bayesian-based model for discovering topics. We tested the proposed framework using three published SRs addressing a variety of topics (Mass Media Interventions, Rectal Cancer and Influenza Vaccine). The results showed that when 91.8%, 85.7%, and 49.3% of the abstract screening labor was saved, the recalls were as high as 100% for the three cases; respectively. Relevant studies identified manually showed strong topic similarity through topic analysis, which supported the inclusion of topic analysis as relevance metric. It was demonstrated that advanced text mining approaches can significantly reduce the abstract screening labor of SRs and provide an informative summary of relevant studies.

  9. [Mitral valve endocarditis after Turkish "Festival of Sacrifice"].

    Science.gov (United States)

    Blaich, A; Fasel, D; Kaech, C; Frei, R

    2011-09-01

    Erysipelothrix rhusiopathiae is the causative agent of swine erysipelas. Systemic infections caused by E. rhusiopathiae are rare, but often (90%) associated with endocarditis. In about 60% of cases endocarditis develops on normal heart valves, and despite appropriate antibiotic therapy about one-third of the patients requires valve replacement. We report the case of a housewife, who developed a mitral valve endocarditis due to E. rhusiopathiae after preparing meat for the Turkish "Festival of Sacrifice".

  10. Giving up Something Good for Something Better: Sacred Sacrifices Made by Religious Youth

    Science.gov (United States)

    Dollahite, David C.; Layton, Emily; Bahr, Howard M.; Walker, Anthony B.; Thatcher, Jennifer Y.

    2009-01-01

    The concept of sacrifice was formerly a key variable in theorizing about religion and society. Secularization theory and conceptual models equating sacrifice with cost have reduced its usage and apparent relevance, although it continues to be of interest in anthropology and religious studies. Research on sacrifice has been neglected in the social…

  11. Policy-Relevant Systematic Reviews to Strengthen Health Systems: Models and Mechanisms to Support Their Production

    Science.gov (United States)

    Oliver, Sandra; Dickson, Kelly

    2016-01-01

    Support for producing systematic reviews about health systems is less well developed than for those about clinical practice. From interviewing policy makers and systematic reviewers we identified institutional mechanisms which bring systematic reviews and policy priorities closer by harnessing organisational and individual motivations, emphasising…

  12. Against dichotomies: On mature care and self-sacrifice in care ethics.

    Science.gov (United States)

    van Nistelrooij, Inge; Leget, Carlo

    2017-09-01

    In previous issues of this journal, Carol Gilligan's original concept of mature care has been conceptualized by several (especially Norwegian) contributors. This has resulted in a dichotomous view of self and other, and of self-care and altruism, in which any form of self-sacrifice is rejected. Although this interpretation of Gilligan seems to be quite persistent in care-ethical theory, it does not seem to do justice to either Gilligan's original work or the tensions experienced in contemporary nursing practice. A close reading of Gilligan's concept of mature care leads to a view that differs radically from any dichotomy of self-care and altruism. Instead of a dichotomous view, a dialectical view on self and other is proposed that builds upon connectedness and might support a care-ethical view of nursing that is more consistent with Gilligan's own critical insights such as relationality and a practice-based ethics. A concrete case taken from nursing practice shows the interconnectedness of professional and personal responsibility. This underpins a multilayered, complex view of self-realization that encompasses sacrifices as well. When mature care is characterized as a practice of a multilayered connectedness, caregivers can be acknowledged for their relational identity and nursing practices can be recognized as multilayered and interconnected. This view is better able to capture the tensions that are related to today's nursing as a practice, which inevitably includes sacrifices of self. In conclusion, a further discussion on normative conceptualizations of care is proposed that starts with a non-normative scrutiny of caring practices.

  13. When giving feels good. The intrinsic benefits of sacrifice in romantic relationships for the communally motivated.

    Science.gov (United States)

    Kogan, Aleksandr; Impett, Emily A; Oveis, Christopher; Hui, Bryant; Gordon, Amie M; Keltner, Dacher

    2010-12-01

    Who benefits most from making sacrifices for others? The current study provides one answer to this question by demonstrating the intrinsic benefits of sacrifice for people who are highly motivated to respond to a specific romantic partner's needs noncontingently, a phenomenon termed communal strength. In a 14-day daily-experience study of 69 romantic couples, communal strength was positively associated with positive emotions during the sacrifice itself, with feeling appreciated by the partner for the sacrifice, and with feelings of relationship satisfaction on the day of the sacrifice. Furthermore, feelings of authenticity for the sacrifice mediated these associations. Several alternative hypotheses were ruled out: The effects were not due to individuals higher in communal strength making qualitatively different kinds of sacrifices, being more positive in general, or being involved in happier relationships. Implications for research and theory on communal relationships and positive emotions are discussed.

  14. Is advanced life support better than basic life support in prehospital care? A systematic review

    Directory of Open Access Journals (Sweden)

    Ryynänen Olli-Pekka

    2010-11-01

    Full Text Available Abstract Background - Prehospital care is classified into ALS- (advanced life support and BLS- (basic life support levels according to the methods used. ALS-level prehospital care uses invasive methods, such as intravenous fluids, medications and intubation. However, the effectiveness of ALS care compared to BLS has been questionable. Aim - The aim of this systematic review is to compare the effectiveness of ALS- and BLS-level prehospital care. Material and methods - In a systematic review, articles where ALS-level prehospital care was compared to BLS-level or any other treatment were included. The outcome variables were mortality or patient's health-related quality of life or patient's capacity to perform daily activities. Results - We identified 46 articles, mostly retrospective observational studies. The results on the effectiveness of ALS in unselected patient cohorts are contradictory. In cardiac arrest, early cardiopulmonary resuscitation and defibrillation are essential for survival, but prehospital ALS interventions have not improved survival. Prehospital thrombolytic treatment reduces mortality in patients having a myocardial infarction. The majority of research into trauma favours BLS in the case of penetrating trauma and also in cases of short distance to a hospital. In patients with severe head injuries, ALS provided by paramedics and intubation without anaesthesia can even be harmful. If the prehospital care is provided by an experienced physician and by a HEMS organisation (Helicopter Emergency Medical Service, ALS interventions may be beneficial for patients with multiple injuries and severe brain injuries. However, the results are contradictory. Conclusions - ALS seems to improve survival in patients with myocardial infarction and BLS seems to be the proper level of care for patients with penetrating injuries. Some studies indicate a beneficial effect of ALS among patients with blunt head injuries or multiple injuries. There is

  15. Online Peer-to-Peer Support for Young People With Mental Health Problems: A Systematic Review

    OpenAIRE

    Ali, Kathina; Farrer, Louise; Gulliver, Amelia; Griffiths, Kathleen M

    2015-01-01

    Background Adolescence and early adulthood are critical periods for the development of mental disorders. Online peer-to-peer communication is popular among young people and may improve mental health by providing social support. Previous systematic reviews have targeted Internet support groups for adults with mental health problems, including depression. However, there have been no systematic reviews examining the effectiveness of online peer-to-peer support in improving the mental health of a...

  16. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    NARCIS (Netherlands)

    Hem, M.H.; Pedersen, R.; Norvoll, R.; Molewijk, A.C.

    2015-01-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five

  17. Gift and sacrifice: parental involvement in Latino adolescents' education.

    Science.gov (United States)

    Ceballo, Rosario; Maurizi, Laura K; Suarez, Gloria A; Aretakis, Maria T

    2014-01-01

    Although myriad studies document the benefits of parental involvement in education on various indicators of children's academic performance, less research examines parental involvement among adolescents in low-income Latino families. Incorporating a multidimensional conceptualization of parental involvement, this study examined the relation between parental involvement and academic outcomes in a sample of 223 low-income, Latino adolescents. Results indicated that three types of parental involvement (gift/sacrifice, future discussions/academic socialization, and school involvement) had significant, positive associations with academic outcomes. Moreover, our results suggest that parents' stories about struggles with poverty and immigration are an important component of parental involvement, contributing to adolescents' desire to succeed academically and "give back" to parents. Additionally, our findings indicated that the positive relations between parental involvement and academic outcomes were stronger for immigrant youth and for those with higher endorsements of the Latino cultural value of respeto (respect).

  18. Social support and protection from depression: systematic review of current findings in Western countries.

    Science.gov (United States)

    Gariépy, Geneviève; Honkaniemi, Helena; Quesnel-Vallée, Amélie

    2016-10-01

    Numerous studies report an association between social support and protection from depression, but no systematic review or meta-analysis exists on this topic. To review systematically the characteristics of social support (types and source) associated with protection from depression across life periods (childhood and adolescence; adulthood; older age) and by study design (cross-sectional v cohort studies). A systematic literature search conducted in February 2015 yielded 100 eligible studies. Study quality was assessed using a critical appraisal checklist, followed by meta-analyses. Sources of support varied across life periods, with parental support being most important among children and adolescents, whereas adults and older adults relied more on spouses, followed by family and then friends. Significant heterogeneity in social support measurement was noted. Effects were weaker in both magnitude and significance in cohort studies. Knowledge gaps remain due to social support measurement heterogeneity and to evidence of reverse causality bias. © The Royal College of Psychiatrists 2016.

  19. Does Sacrifice Avert Violence? Reflections from Nepal and the People’s War

    Directory of Open Access Journals (Sweden)

    Marie Lecomte-Tilouine

    2013-10-01

    Full Text Available This article attempts to address the link between sacrifice and violence by exploring the settings in which they are to be found in the ritual order governing socio-political organization. It is based on extensive ethnographic work in Nepal, a country that was regarded as a safe haven until it was swept up in a revolutionary movement that combined Maoist ideology with a sacrificial impetus. If warlike movements generate an ideology of legitimization that borrows religious imagery, those supported by a revolutionary ideal tend to spiritualize violence to the point of developing a genuine mysticism. This was the case of the People’s War in Nepal, which was presented as an apocalypse, led by warriors rejoicing in their own suffering and glorifying martyrdom as the supreme means of achieving the ideal goal of a classless society.

  20. Sacrifice in Modernity: Community, Ritual, Identity : From Nationalism and Nonviolence to Health Care and Harry Potter

    NARCIS (Netherlands)

    Duyndam, J.; Korte, A.-M.; Poorthuis, Marcel

    2016-01-01

    Sacrifice seems to belong to a religious context of the past. In Sacrifice in Modernity: Community, Ritual, Identity it is demonstrated how sacrificial themes remain an essential element in our post-modern society. The shaping of community, performing rituals and the search for identity, three main

  1. Perceived Sacrifice and Few Alternatives Commitments: The Motivational Underpinnings of Continuance Commitment's Subdimensions

    Science.gov (United States)

    Vandenberghe, Christian; Panaccio, Alexandra

    2012-01-01

    Using work on self-concepts and Conservation of Resources theory, the present research examined the motivational underpinnings of continuance commitment's subcomponents of perceived sacrifice and few alternatives. Study 1 (N=208) found job scope to be positively related to perceived sacrifice commitment, and negatively related to few alternatives…

  2. Current Status of Mechanical Circulatory Support: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos

    2012-01-01

    Full Text Available Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support.

  3. Suppression sours sacrifice: emotional and relational costs of suppressing emotions in romantic relationships.

    Science.gov (United States)

    Impett, Emily A; Kogan, Aleksandr; English, Tammy; John, Oliver; Oveis, Christopher; Gordon, Amie M; Keltner, Dacher

    2012-06-01

    What happens when people suppress their emotions when they sacrifice for a romantic partner? This multimethod study investigates how suppressing emotions during sacrifice shapes affective and relationship outcomes. In Part 1, dating couples came into the laboratory to discuss important romantic relationship sacrifices. Suppressing emotions was associated with emotional costs for the partner discussing his or her sacrifice. In Part 2, couples participated in a 14-day daily experience study. Within-person increases in emotional suppression during daily sacrifice were associated with decreases in emotional well-being and relationship quality as reported by both members of romantic dyads. In Part 3, suppression predicted decreases in relationship satisfaction and increases in thoughts about breaking up with a romantic partner 3 months later. In the first two parts of the study, authenticity mediated the costly effects of suppression. Implications for research on close relationships and emotion regulation are discussed.

  4. Support needs of patients with COPD: a systematic literature search and narrative review.

    Science.gov (United States)

    Gardener, A Carole; Ewing, Gail; Kuhn, Isla; Farquhar, Morag

    2018-01-01

    Understanding the breadth of patients' support needs is important for the delivery of person-centered care, particularly in progressive long-term conditions such as chronic obstructive pulmonary disease (COPD). Existing reviews identify important aspects of managing life with COPD with which patients may need support (support needs); however, none of these comprehensively outlines the full range of support needs that patients can experience. We therefore sought to systematically determine the full range of support needs for patients with COPD to inform development of an evidence-based tool to enable person-centered care. We conducted a systematic search and narrative review of the literature. Medline (Ovid), EMBASE, PsycINFO, Cochrane Library, and CINAHL were systematically searched for papers which included data addressing key aspects of support need, as identified by patients with COPD. Relevant data were extracted, and a narrative analysis was conducted. Thirty-one papers were included in the review, and the following 13 domains (broad areas) of support need were identified: 1) understanding COPD, 2) managing symptoms and medication, 3) healthy lifestyle, 4) managing feelings and worries, 5) living positively with COPD, 6) thinking about the future, 7) anxiety and depression, 8) practical support, 9) finance work and housing, 10) families and close relationships, 11) social and recreational life, 12) independence, and 13) navigating services. These 13 domains of support need were mapped to three of the four overarching categories of need commonly used in relevant national strategy documents (ie, physical, psychological, and social); however, support needs related to the fourth category (spiritual) were notably absent. This review systematically identifies the comprehensive set of domains of support need for patients with COPD. The findings provide the evidence base for a tool to help patients identify and express their support needs, which underpins a proposed

  5. Systematic Review of Interventions Supported by ICT for the Prevention Treatment of Occupational Stress.

    Science.gov (United States)

    Narváez, Santiago; Tobar, Angela M; López, Diego M

    2014-01-01

    Stress-related disorders have become one of the main problems of public health in many countries and of worldwide organizations, and they are expected to become more common in the forthcoming decades. This article aims at providing a systematic review and a descriptive evaluation of the interventions supported by ICT for the prevention and treatment of occupational stress. A systematic review of five databases (EBSCO, The Cochrane Library, PubMed, ScienceDirect and IEEEXplorer) was carried out. This article provides a quantitative and qualitative description of 21 studies about occupational stress interventions supported by ICT. The following factors were considered for the analysis: impact of the intervention, design of the study, type of intervention, purpose of the intervention, type of instrument for the measurement of occupational stress, and type of ICT used. The systematic review demonstrated that interventions supported by ICT for the prevention and treatment of occupational stress are scarce but effective.

  6. Validation of virtual learning object to support the teaching of nursing care systematization

    Directory of Open Access Journals (Sweden)

    Pétala Tuani Candido de Oliveira Salvador

    Full Text Available ABSTRACT Objective: to describe the content validation process of a Virtual Learning Object to support the teaching of nursing care systematization to nursing professionals. Method: methodological study, with quantitative approach, developed according to the methodological reference of Pasquali's psychometry and conducted from March to July 2016, from two-stage Delphi procedure. Results: in the Delphi 1 stage, eight judges evaluated the Virtual Object; in Delphi 2 stage, seven judges evaluated it. The seven screens of the Virtual Object were analyzed as to the suitability of its contents. The Virtual Learning Object to support the teaching of nursing care systematization was considered valid in its content, with a Total Content Validity Coefficient of 0.96. Conclusion: it is expected that the Virtual Object can support the teaching of nursing care systematization in light of appropriate and effective pedagogical approaches.

  7. Support management in schizophrenia: a systematic review of current literature

    Directory of Open Access Journals (Sweden)

    Pompili M

    2012-12-01

    techniques have more rapid remission and relapse less frequently than patients treated only pharmacologically.Keywords: schizophrenia, support management, nonpharmacological treatment, cognitive behavioral therapy

  8. How sacrifice impacts the giver and the recipient: insights from approach-avoidance motivational theory.

    Science.gov (United States)

    Impett, Emily A; Gere, Judith; Kogan, Aleksandr; Gordon, Amie M; Keltner, Dacher

    2014-10-01

    This study investigated how sacrificing for approach versus avoidance goals shapes the giver's and the recipient's emotions and relationship quality. A sample of 80 dating couples participated in a three-part study in which they discussed sacrifice in the laboratory (Part 1), reported on their daily sacrifices for 14 days (Part 2), and completed a follow-up survey 3 months later (Part 3). When partners discussed a sacrifice they had made for approach goals, they experienced greater relationship quality, whereas when they discussed a sacrifice they had made for avoidance goals, they experienced poorer relationship quality. These effects were replicated with outside observer reports. On days when partners sacrificed for approach goals, both partners experienced increased relationship quality, but on days when people sacrificed for avoidance goals, the giver experienced decreased relationship quality. These effects were mediated by positive and negative emotions, respectively. Approach sacrifice goals predicted increases in relationship quality and avoidance sacrifice goals predicted decreases in relationship quality, as reported by both partners 3 months later. Sacrifice per se does not help or harm relationships, but the goals that people pursue when they give up their own interests can critically shape the quality of intimate bonds. © 2013 Wiley Periodicals, Inc.

  9. La cosa y el sacrificio // The thing and the sacrifice

    Directory of Open Access Journals (Sweden)

    Juan Guillermo Uribe

    2012-06-01

    Full Text Available La introducción de la noción de das Ding, la Cosa, en el Seminario 7, La ética del psicoanálisis, es de una importancia crucial tanto para la clínica psicoanalítica como para la reflexión ética general. Lacan toma de Kant la noción de ley moral como imperativo categórico, que para Kant tiene la fuerza de una ley necesaria por su articulación lógica. Lacan le da a das Ding el mismo estatuto de coerción categórica. De esa forma articula lo real del goce con el Más allá del principio de placer de Freud. Lo escandaloso es que el psicoanálisis desvela la posición del sujeto de querer estar bien en el mal y las consecuencias de sacrifico que esto impone. // The introduction of the notion of das Ding, the Thing, in the 7 Seminar: the ethics of the psychoanalysis is of crucial importance as well as for the clinic psychoanalytic as for the general ethics reflection. Lacan takes from Kant the notion of moral law as categorical imperative, which, for him, it has the force of a necessary law for its logical articulation. Lacan gives to das Ding the same statute of categorical coercion. i.e., he articulate the real part of the enjoyment with the Freud's beyond the pleasure principle. The scandalous point is that the psychoanalysis shows the position of the subject when he/she wants to be good in the middle of the bad conditions and the sacrifice consequences this entails.

  10. Communication Partners Supporting Children with Complex Communication Needs Who Use AAC: A Systematic Review

    Science.gov (United States)

    Shire, Stephanie Y.; Jones, Nancy

    2015-01-01

    Communication partners who efficiently use augmentative and alternative communication (AAC) are essential interaction partners for children learning to communicate using AAC. This systematic review examines studies targeting interventions designed to help communication partners support children with complex communication needs who use AAC.…

  11. Treadmill Training with Partial Body-Weight Support in Children with Cerebral Palsy: A Systematic Review

    Science.gov (United States)

    Mutlu, Akmer; Krosschell, Kristin; Spira, Deborah Gaebler

    2009-01-01

    OKAim: The aim of this systematic review was to examine the literature on the effects of partial body-weight support treadmill training (PBWSTT) in children with cerebral palsy (CP) on functional outcomes and attainment of ambulation. Method: We searched the relevant literature from 1950 to July 2007. We found eight studies on the use of PWSBTT on…

  12. Transformational leadership and task cohesion in sport: the mediating role of inside sacrifice.

    Science.gov (United States)

    Cronin, Lorcan Donal; Arthur, Calum Alexander; Hardy, James; Callow, Nichola

    2015-02-01

    In this cross-sectional study, we examined a mediational model whereby transformational leadership is related to task cohesion via sacrifice. Participants were 381 American (Mage = 19.87 years, SD = 1.41) Division I university athletes (188 males, 193 females) who competed in a variety of sports. Participants completed measures of coach transformational leadership, personal and teammate inside sacrifice, and task cohesion. After conducting multilevel mediation analysis, we found that both personal and teammate inside sacrifice significantly mediated the relationships between transformational leadership behaviors and task cohesion. However, there were differential patterns of these relationships for male and female athletes. Interpretation of the results highlights that coaches should endeavor to display transformational leadership behaviors as they are related to personal and teammate inside sacrifices and task cohesion.

  13. Contemplating the ultimate sacrifice: identity fusion channels pro-group affect, cognition, and moral decision making.

    Science.gov (United States)

    Swann, William B; Gómez, Angel; Buhrmester, Michael D; López-Rodríguez, Lucía; Jiménez, Juan; Vázquez, Alexandra

    2014-05-01

    Although most people acknowledge the moral virtue in sacrificing oneself to save others, few actually endorse self-sacrifice. Seven experiments explored the cognitive and emotional mechanisms that underlie such endorsements. Participants responded to 1 of 2 moral dilemmas in which they could save 5 members of their country only by sacrificing themselves. Over 90% of participants acknowledged that the moral course of action was to sacrifice oneself to save others (Experiment 1), yet only those who were strongly fused with the group preferentially endorsed self-sacrifice (Experiments 2-7). The presence of a concern with saving group members rather than the absence of a concern with self-preservation motivated strongly fused participants to endorse sacrificing themselves for the group (Experiment 3). Analyses of think aloud protocols suggested that saving others was motivated by emotional engagement with the group among strongly fused participants but by utilitarian concerns among weakly fused participants (Experiment 4). Hurrying participants' responses increased self-sacrifice among strongly fused participants but decreased self-sacrifice among weakly fused participants (Experiment 5). Priming the personal self increased endorsement of self-sacrifice among strongly fused participants but further reduced endorsement of self-sacrifice among weakly fused participants (Experiment 6). Strongly fused participants ignored utilitarian considerations, but weakly fused persons endorsed self-sacrifice more when it would save more people (Experiment 7). Apparently, the emotional engagement with the group experienced by strongly fused persons overrides the desire for self-preservation and compels them to translate their moral beliefs into self-sacrificial behavior.

  14. Support needs of patients with COPD: a systematic literature search and narrative review

    Directory of Open Access Journals (Sweden)

    Gardener AC

    2018-03-01

    Full Text Available A Carole Gardener,1 Gail Ewing,2 Isla Kuhn,3 Morag Farquhar4 1Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; 2Centre for Family Research, University of Cambridge, Cambridge, UK; 3University of Cambridge Medical School Library, University of Cambridge, Cambridge, UK; 4School of Health Sciences, University of East Anglia, Norwich, UK Introduction: Understanding the breadth of patients’ support needs is important for the delivery of person-centered care, particularly in progressive long-term conditions such as chronic obstructive pulmonary disease (COPD. Existing reviews identify important aspects of managing life with COPD with which patients may need support (support needs; however, none of these comprehensively outlines the full range of support needs that patients can experience. We therefore sought to systematically determine the full range of support needs for patients with COPD to inform development of an evidence-based tool to enable person-centered care.Methods: We conducted a systematic search and narrative review of the literature. Medline (Ovid, EMBASE, PsycINFO, Cochrane Library, and CINAHL were systematically searched for papers which included data addressing key aspects of support need, as identified by patients with COPD. Relevant data were extracted, and a narrative analysis was conducted.Results: Thirty-one papers were included in the review, and the following 13 domains (broad areas of support need were identified: 1 understanding COPD, 2 managing symptoms and medication, 3 healthy lifestyle, 4 managing feelings and worries, 5 living positively with COPD, 6 thinking about the future, 7 anxiety and depression, 8 practical support, 9 finance work and housing, 10 families and close relationships, 11 social and recreational life, 12 independence, and 13 navigating services. These 13 domains of support need were mapped to three of the four overarching categories of need

  15. Expatriate support and success : A systematic review of organization-based sources of social support

    NARCIS (Netherlands)

    van der Laken, P.A.; van Engen, M.L.; van Veldhoven, M.J.P.M.; Paauwe, J.

    2016-01-01

    Purpose The purpose of this paper is to review empirical research on the relationship between organization-based social support and the success of international assignments (IAs). Design/methodology/approach Four search engines were used to obtain empirical studies relating organization-based social

  16. Implant Supported Fixed Restorations versus Implant Supported Removable Overdentures: A Systematic Review

    Science.gov (United States)

    Selim, Khaled; Ali, Sherif; Reda, Ahmed

    2016-01-01

    AIM: The aim of this study is to systematically evaluate and compare implant retained fixed restoration versus implant retained over denture. MATERIAL AND METHODS: Search was made in 2 databases including PubMed and PubMed Central. Title and abstract were screened to select studies comparing implant retained fixed restorations versus implant retained removable overdentures. Articles which did not follow the inclusion criteria were excluded. Included papers were then read carefully for a second stage filter, this was followed by manual searching of bibliography of selected articles. RESULTS: The search resulted in 5 included papers. One study evaluated the masticatory function, while the other 4 evaluated the patient satisfaction. Two of them used Visual Analogue Scale (VAS) as a measurement tool, while the other two used VAS and Categorical Scales (CAT). Stability, ability to chew, ability to clean, ability to speak and esthetics were the main outcomes of the 4 included papers. CONCLUSION: Conflicting results was observed between the fixed and removable restorations. PMID:28028423

  17. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    Science.gov (United States)

    Hem, Marit Helene; Pedersen, Reidar; Norvoll, Reidun; Molewijk, Bert

    2015-06-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded 'grey zone articles', in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients' and caregivers' views on ethical challenges, is presented. © The Author(s) 2014.

  18. Systematic review: Effective home support in dementia care, components and impacts - Stage 2, effectiveness of home support interventions.

    Science.gov (United States)

    Clarkson, Paul; Hughes, Jane; Roe, Brenda; Giebel, Clarissa M; Jolley, David; Poland, Fiona; Abendstern, Michele; Chester, Helen; Challis, David

    2018-03-01

    The aim of this study was to explicate the outcomes of home support interventions for older people with dementia and/or their carers to inform clinical practice, policy and research. Most people with dementia receive support at home. However, components and effectiveness of home support interventions have been little explored. Systematic review with narrative summary. Electronic searches of published studies in English using PubMed, Cochrane Central Register of Controlled Trials, PsychINFO, CINAHL, Applied Social Science Index and CSA Social Services Abstracts. Databases and sources were searched from inception to April 2014 with no date restrictions to locate studies. The PRISMA statement was followed and established systematic review methods used. Using 14 components of care for people with dementia and their carers, identified previously, data across studies were synthesized. Interventions were grouped and described and effectiveness ratings applied. Qualitative studies were synthesized using key themes. Seventy studies (four qualitative) were included. Most were directed to carers and of high quality. Seven interventions for carers and two for people with dementia were identified, covering 81% of studies. Those relating to daily living, cognitive training and physical activity for people with dementia were absent. Measures of effectiveness were influenced mainly by the intensity (duration and frequency) of interventions. Those containing education, social support and behaviour management appeared most effective. These interventions reflect emergent patterns of home support. Research is required to identify effective interventions linked to the stage of dementia, which can be applied as part of routine clinical care. © 2017 John Wiley & Sons Ltd.

  19. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review.

    Directory of Open Access Journals (Sweden)

    Hannah L Parke

    Full Text Available There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients.Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services.We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings.From 12,400 titles we selected 13 systematic reviews (published 2003-2012 representing 101 individual trials. Although the term 'self-management' was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death. There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community.Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship.

  20. Online Peer-to-Peer Support for Young People With Mental Health Problems: A Systematic Review.

    Science.gov (United States)

    Ali, Kathina; Farrer, Louise; Gulliver, Amelia; Griffiths, Kathleen M

    2015-01-01

    Adolescence and early adulthood are critical periods for the development of mental disorders. Online peer-to-peer communication is popular among young people and may improve mental health by providing social support. Previous systematic reviews have targeted Internet support groups for adults with mental health problems, including depression. However, there have been no systematic reviews examining the effectiveness of online peer-to-peer support in improving the mental health of adolescents and young adults. The aim of this review was to systematically identify available evidence for the effectiveness of online peer-to peer support for young people with mental health problems. The PubMed, PsycInfo, and Cochrane databases were searched using keywords and Medical Subject Headings (MeSH) terms. Retrieved abstracts (n=3934) were double screened and coded. Studies were included if they (1) investigated an online peer-to-peer interaction, (2) the interaction discussed topics related to mental health, (3) the age range of the sample was between 12 to 25 years, and (4) the study evaluated the effectiveness of the peer-to-peer interaction. Six studies satisfied the inclusion criteria for the current review. The studies targeted a range of mental health problems including depression and anxiety (n=2), general psychological problems (n=1), eating disorders (n=1), and substance use (tobacco) (n=2). The majority of studies investigated Internet support groups (n=4), and the remaining studies focused on virtual reality chat sessions (n=2). In almost all studies (n=5), the peer support intervention was moderated by health professionals, researchers or consumers. Studies employed a range of study designs including randomized controlled trials (n=3), pre-post studies (n=2) and one randomized trial. Overall, two of the randomized controlled trials were associated with a significant positive outcome in comparison to the control group at post-intervention. In the remaining four

  1. Organizing in a National Sacrifice Area: the radioactive waste campaign in New Mexico

    International Nuclear Information System (INIS)

    Colombo, L.J.

    1981-01-01

    Organizing in a National Sacrifice Area concerns a citizens' campaign to affect the development of a Federal radioactive waste disposal facility in New Mexico. This facility, called the Waste Isolation Pilot Plant (WIPP), is intended to be the first permanent radioactive waste disposal facility in the United States. The three principal elements of this work are: (1) demographic, economic and attitudinal information providing the social context for the citizens' campaign; (2) the theory and practice of community organizing with respect to the New Mexico radioactive waste disposal project; and (3) the history of citizen activities to affect the New Mexico state legislature on this issue. The demographic and attitudinal information include: survey research conducted previously concerning nuclear waste and nuclear power; demographic and economic data for New Mexico principally from the 1970 Census; a secondary analysis of a base-line survey concerning nuclear development in New Mexico; and original qualitative and survey research dealing with public attitudes in the state on the WIPP project. The attitude change and maintenance literature are also reviewed. This dissertation covers the events constituting the establishment of the WIPP project in New Mexico and citizen activities both opposed to and in support of the radioactive waste disposal project. In addition, citizen activity to influence the New Mexico state legislature in 1979 with regard to radioactive waste disposal is reviewed. An analysis of the New Mexico state legislature in terms of this issue is made also

  2. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review.

    Science.gov (United States)

    Wang, Jingyi; Mann, Farhana; Lloyd-Evans, Brynmor; Ma, Ruimin; Johnson, Sonia

    2018-05-29

    The adverse effects of loneliness and of poor perceived social support on physical health and mortality are established, but no systematic synthesis is available of their relationship with the outcomes of mental health problems over time. In this systematic review, we aim to examine the evidence on whether loneliness and closely related concepts predict poor outcomes among adults with mental health problems. We searched six databases and reference lists for longitudinal quantitative studies that examined the relationship between baseline measures of loneliness and poor perceived social support and outcomes at follow up. Thirty-four eligible papers were retrieved. Due to heterogeneity among included studies in clinical populations, predictor measures and outcomes, a narrative synthesis was conducted. We found substantial evidence from prospective studies that people with depression who perceive their social support as poorer have worse outcomes in terms of symptoms, recovery and social functioning. Loneliness has been investigated much less than perceived social support, but there is some evidence that greater loneliness predicts poorer depression outcome. There is also some preliminary evidence of associations between perceived social support and outcomes in schizophrenia, bipolar disorder and anxiety disorders. Loneliness and quality of social support in depression are potential targets for development and testing of interventions, while for other conditions further evidence is needed regarding relationships with outcomes.

  3. Spinal cord blood flow and ischemic injury after experimental sacrifice of thoracic and abdominal segmental arteries.

    Science.gov (United States)

    Etz, Christian D; Homann, Tobias M; Luehr, Maximilian; Kari, Fabian A; Weisz, Donald J; Kleinman, George; Plestis, Konstadinos A; Griepp, Randall B

    2008-06-01

    Spinal cord blood flow (SCBF) after sacrifice of thoracoabdominal aortic segmental arteries (TAASA) during thoracoabdominal aortic aneurysm (TAAA) repair remains poorly understood. This study explored SCBF for 72 h after sacrifice of all TAASA. Fourteen juvenile Yorkshire pigs underwent complete serial TAASA sacrifice (T4-L5). Six control pigs underwent anesthesia and cooling to 32 degrees C with no TAASA sacrifice. In the experimental animals, spinal cord function was continuously monitored using motor evoked potentials (MEPs) until 1h after clamping the last TAASA. Fluorescent microspheres enabled segmental measurement of SCBF along the entire spinal cord before, and 5 min, 1 h, 5 h, 24 h and 72 h after complete TAASA sacrifice. A modified Tarlov score was obtained for 3 days after surgery. All the pigs with complete TAASA sacrifice retained normal cord function (MEP) until 1h after TAASA ligation. Seven pigs (50%) with complete TAASA sacrifice recovered after 72 h; seven pigs suffered paraparesis or paraplegia. Intraoperatively, and until 1h postoperatively, SCBF was similar among the three groups along the entire cord. Postoperatively, SCBF did not decrease in any group, but significant hyperemia occurred at 5h in controls and recovery animals, but did not occur in pigs that developed paraparesis or paraplegia in the T8-L2 segments (p=0.0002) and L3-S segments (p=0.0007). At 24h, SCBF remained marginally lower from T8 caudally; at 72h, SCBF was similar among all groups along the entire cord. SCBF in the segments T8-L2 at 5h predicted functional recovery (p=0.003). This study suggests that critical spinal cord ischemia after complete TAASA sacrifice does not occur immediately (intraoperatively), but is delayed 1-5h or longer after clamping, and represents failure to mount a hyperemic response to rewarming and awakening. The short duration of low SCBF associated with spinal cord injury suggests that hemodynamic and metabolic manipulation lasting only 24-72 h may

  4. A Systematic Mapping on Supporting Approaches for Requirements Traceability in the Context of Software Projects

    Directory of Open Access Journals (Sweden)

    MALCHER, P R.C.

    2015-12-01

    Full Text Available The Requirements Traceability is seen as a quality factor with regard to software development, being present in standards and quality models. In this context, several techniques, models, frameworks and tools have been used to support it. Thus, the purpose of this paper is to present a systematic mapping carried out in order to find in the literature approaches to support the requirements traceability in the context of software projects and make the categorization of the data found in order to demonstrate, by means of a reliable, accurate and auditable method, how this area has developed and what are the main approaches are used to implement it.

  5. Employer-Based Programs to Support Breastfeeding Among Working Mothers: A Systematic Review.

    Science.gov (United States)

    Dinour, Lauren M; Szaro, Jacalyn M

    2017-04-01

    Many mothers experience barriers to maintaining a breastfeeding relationship with their infants upon returning to work and, consequently, terminate breastfeeding earlier than recommended or intended. As such, employers are in a unique position to help further increase breastfeeding rates, durations, and exclusivity. The purpose of this review is to examine the literature regarding employer-based programs, policies, and interventions to support breastfeeding among working mothers. A systematic literature search was conducted for peer-reviewed articles published before April 2016. Studies were included if they focused on workplace-based lactation/breastfeeding support programs, policies, or interventions to promote breastfeeding among employees. For inclusion, articles must have measured at least one outcome, such as breastfeeding duration, breastfeeding exclusivity, or employee satisfaction. Twenty-two articles were included, representing 10 different countries and both public- and private-sector employers, including governmental offices, schools, hospitals, manufacturing/industrial companies, and financial settings, among others. Providing a lactation space was the most common employer-based support accommodation studied, followed by breastfeeding breaks and comprehensive lactation support programs. The majority of studies analyzing these three support types found at least one positive breastfeeding and/or nonbreastfeeding outcome. This review suggests that maintaining breastfeeding while working is not only possible but also more likely when employers provide the supports that women need to do so. Although some employers may have more extensive breastfeeding support policies and practices than others, all employers can implement a breastfeeding support program that fits their company's budget and resources.

  6. Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Collins, Peter F; Stratton, Rebecca J; Elia, Marinos

    2012-06-01

    The efficacy of nutritional support in the management of malnutrition in chronic obstructive pulmonary disease (COPD) is controversial. Previous meta-analyses, based on only cross-sectional analysis at the end of intervention trials, found no evidence of improved outcomes. The objective was to conduct a meta-analysis of randomized controlled trials (RCTs) to clarify the efficacy of nutritional support in improving intake, anthropometric measures, and grip strength in stable COPD. Literature databases were searched to identify RCTs comparing nutritional support with controls in stable COPD. Thirteen RCTs (n = 439) of nutritional support [dietary advice (1 RCT), oral nutritional supplements (ONS; 11 RCTs), and enteral tube feeding (1 RCT)] with a control comparison were identified. An analysis of the changes induced by nutritional support and those obtained only at the end of the intervention showed significantly greater increases in mean total protein and energy intakes with nutritional support of 14.8 g and 236 kcal daily. Meta-analyses also showed greater mean (±SE) improvements in favor of nutritional support for body weight (1.94 ± 0.26 kg, P groups. This systematic review and meta-analysis showed that nutritional support, mainly in the form of ONS, improves total intake, anthropometric measures, and grip strength in COPD. These results contrast with the results of previous analyses that were based on only cross-sectional measures at the end of intervention trials.

  7. Clinical decision support systems in child and adolescent psychiatry: a systematic review.

    Science.gov (United States)

    Koposov, Roman; Fossum, Sturla; Frodl, Thomas; Nytrø, Øystein; Leventhal, Bennett; Sourander, Andre; Quaglini, Silvana; Molteni, Massimo; de la Iglesia Vayá, María; Prokosch, Hans-Ulrich; Barbarini, Nicola; Milham, Michael Peter; Castellanos, Francisco Xavier; Skokauskas, Norbert

    2017-11-01

    Psychiatric disorders are amongst the most prevalent and impairing conditions in childhood and adolescence. Unfortunately, it is well known that general practitioners (GPs) and other frontline health providers (i.e., child protection workers, public health nurses, and pediatricians) are not adequately trained to address these ubiquitous problems (Braddick et al. Child and Adolescent mental health in Europe: infrastructures, policy and programmes, European Communities, 2009; Levav et al. Eur Child Adolesc Psychiatry 13:395-401, 2004). Advances in technology may offer a solution to this problem with clinical decision support systems (CDSS) that are designed to help professionals make sound clinical decisions in real time. This paper offers a systematic review of currently available CDSS for child and adolescent mental health disorders prepared according to the PRISMA-Protocols (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols). Applying strict eligibility criteria, the identified studies (n = 5048) were screened. Ten studies, describing eight original clinical decision support systems for child and adolescent psychiatric disorders, fulfilled inclusion criteria. Based on this systematic review, there appears to be a need for a new, readily available CDSS for child neuropsychiatric disorder which promotes evidence-based, best practices, while enabling consideration of national variation in practices by leveraging data-reuse to generate predictions regarding treatment outcome, addressing a broader cluster of clinical disorders, and targeting frontline practice environments.

  8. Supporting public involvement in interview and other panels: a systematic review.

    Science.gov (United States)

    Baxter, Susan; Clowes, Mark; Muir, Delia; Baird, Wendy; Broadway-Parkinson, Andrea; Bennett, Carole

    2017-10-01

    Members of the public are increasingly being invited to become members of a variety of different panels and boards. This study aimed to systematically search the literature to identify studies relating to support or training provided to members of the public who are asked to be members of an interview panel. A systematic search for published and unpublished studies was carried out from June to September 2015. The search methods included electronic database searching, reference list screening, citation searching and scrutinizing online sources. We included studies of any design including published and unpublished documents which outlined preparation or guidance relating to public participants who were members of interview panels or representatives on other types of panels or committees. Results were synthesised via narrative methods. Thirty-six documents were included in the review. Scrutiny of this literature highlighted ten areas which require consideration when including members of the public on interview panels: financial resources; clarity of role; role in the interview process; role in evaluation; training; orientation/induction; information needs; terminology; support; and other public representative needs such as timing, accessibility and support with information technology. The results of the review emphasize a range of elements that need to be fully considered when planning the involvement of public participants on interview panels. It highlights potential issues relating to the degree of involvement of public representatives in evaluating/grading decisions and the need for preparation and on-going support. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  9. Were women, too, allowed to offer sacrifice in Israel? Observations on the meaning and festive form of sacrifice in Deuteronomy1

    Directory of Open Access Journals (Sweden)

    Georg Braulik

    1999-12-01

    Full Text Available Although the question whether women in Israel were also allowed to present offerings stands in accordance with modern ways of thought and speech, it is not self-evident at all. This is immediately proved in the example of the sacrificial hermeneutics of the early church and of a precise semantics of biblical statements on sacrifice. The view on sacrifices and their presenters thus gained, is then illustrated by means of the pilgrimage feast which was conducted by the family of Elkanah at the sanctuary in Shiloh (1 Sm 1. The function which was given to women in the ancient Israelite sacrificial cult was also taken up by the centralisation of the cult by king Josiah and by Deuteronomy. It is now to be found in the pilgrimage schema of the Deuteronomic festal theory. Moreover, the meal proves itself to be the structure of meaning of the sacrifice. The right of women, too, can only be determined within the framework of this liturgical communal meal.

  10. It's the Motive That Counts: Perceived Sacrifice Motives and Gratitude in Romantic Relationships.

    Science.gov (United States)

    Visserman, Mariko L; Righetti, Francesca; Impett, Emily A; Keltner, Dacher; Van Lange, Paul A M

    2017-06-12

    Gratitude is robustly linked to many positive outcomes for individuals and relationships (e.g., greater life and relationship satisfaction). However, little is known about how romantic partners come to feel grateful for each other's pro-relational acts, such as when a partner makes a sacrifice. The present research examines how perceptions of partner sacrifice motives evoke gratitude. We distinguish between partner, relationship, and self-focused motives, and how they are guided by approach or avoidance orientations. We expected that perceiving a partner to sacrifice for partner-focused approach motives (i.e., to promote the partner's well-being) should evoke gratitude, as this type of motive may signal a genuine departure from self-interest. Moreover, we expected these motives to provoke greater perceptions of partner responsiveness, which should partially explain why they elicit gratitude. In contrast, perceiving a partner to sacrifice for relationship-focused motives (e.g., to promote the well-being of the relationship), or self-focused motives (e.g., to feel good about oneself), should not evoke gratitude-irrespective of an approach or avoidance orientation-as these motives may, to some extent, be perceived as tainted by self-interest. Two studies of romantic couples (N = 413), using diary methods (Studies 1 and 2) and having couples converse about a major sacrifice in the laboratory (Study 2), consistently showed that perceived partner-focused approach motives promote gratitude and that this association is partly mediated by perceived partner responsiveness. In contrast, relationship and self-focused motives (approach and avoidance oriented) were not associated with gratitude. Implications regarding perceiving and displaying sacrifice motives are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

    2017-09-01

    Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

  12. Preliminary remarks on the Roman military equipment from the war booty sacrifice of Viemose, Denmark

    DEFF Research Database (Denmark)

    Pauli Jensen, Xenia

    2007-01-01

    The article deals with the war booty sacrifice of Vimose, Denmark, where a vast amount of Roman military equipment was found. The Ring Pommel swords are discussed, especially the possible (or not so possible) link with the Marcomannic Wars 166-180 AD.......The article deals with the war booty sacrifice of Vimose, Denmark, where a vast amount of Roman military equipment was found. The Ring Pommel swords are discussed, especially the possible (or not so possible) link with the Marcomannic Wars 166-180 AD....

  13. Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review.

    Science.gov (United States)

    Zhang, Qi; Jin, Xin; Yu, Mengliu; Ou, Guoming; Matsui, Hiroyuki; Liang, Xing; Sasaki, Keiichi

    Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients. The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature. Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective. Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures.

  14. Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

    Science.gov (United States)

    Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

    2014-01-01

    Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

  15. A systematic review of decision support needs of parents making child health decisions

    Science.gov (United States)

    Jackson, Cath; Cheater, Francine M.; Reid, Innes

    2008-01-01

    Abstract Objective  To identify the decision support needs of parents attempting to make an informed health decision on behalf of a child. Context  The first step towards implementing patient decision support is to assess patients’ information and decision‐making needs. Search strategy  A systematic search of key bibliographic databases for decision support studies was performed in 2005. Reference lists of relevant review articles and key authors were searched. Three relevant journals were hand searched. Inclusion criteria  Non‐intervention studies containing data on decision support needs of parents making child health decisions. Data extraction and synthesis  Data were extracted on study characteristics, decision focus and decision support needs. Studies were quality assessed using a pre‐defined set of criteria. Data synthesis used the UK Evidence for Policy and Practice Information and Co‐ordinating Centre approach. Main results  One‐hundred and forty nine studies were included across various child health decisions, settings and study designs. Thematic analysis of decision support needs indicated three key issues: (i) information (including suggestions about the content, delivery, source, timing); (ii) talking to others (including concerns about pressure from others); and (iii) feeling a sense of control over the process that could be influenced by emotionally charged decisions, the consultation process, and structural or service barriers. These were consistent across decision type, study design and whether or not the study focused on informed decision making. PMID:18816320

  16. I gave too much: Low self-esteem and the regret of sacrifices.

    NARCIS (Netherlands)

    Righetti, F.; Visserman, M.L.

    2017-01-01

    Low self-esteem is often related to interpersonal difficulties. In fact, low self-esteem people fear rejection and tend to adopt self-protection goals. In the present work, we tested the idea that when low self-esteem individuals decide to sacrifice personal preferences for their relationship, they

  17. Against dichotomies: on mature care and self-sacrifice in care ethics

    NARCIS (Netherlands)

    Nistelrooij, A.A.M. van; Leget, C.J.W.

    2016-01-01

    Introduction: In previous issues of this journal Carol Gilligan’s original concept of mature care has been conceptualized by several (especially Norwegian) contributors. This has resulted in a dichotomous view of self and other, and of self-care and altruism, in which any form of self-sacrifice is

  18. Sacrifice zones: the front lines of toxic chemical exposure in the United States

    National Research Council Canada - National Science Library

    Lerner, Steve

    2010-01-01

    ... States of America. Library of Congress Cataloging-in-Publication Data Lerner, Steve. Sacrifice zones: the front lines of toxic chemical exposure in the United States / Steve Lerner. p. cm. Includes bibliographical references and index. ISBN 978-0-262-01440-3 (hardcover : alk. paper) 1. Environmental toxicology- United States- Case studies. 2. Che...

  19. Feature engineering and a proposed decision-support system for systematic reviewers of medical evidence.

    Directory of Open Access Journals (Sweden)

    Tanja Bekhuis

    Full Text Available Evidence-based medicine depends on the timely synthesis of research findings. An important source of synthesized evidence resides in systematic reviews. However, a bottleneck in review production involves dual screening of citations with titles and abstracts to find eligible studies. For this research, we tested the effect of various kinds of textual information (features on performance of a machine learning classifier. Based on our findings, we propose an automated system to reduce screeing burden, as well as offer quality assurance.We built a database of citations from 5 systematic reviews that varied with respect to domain, topic, and sponsor. Consensus judgments regarding eligibility were inferred from published reports. We extracted 5 feature sets from citations: alphabetic, alphanumeric(+, indexing, features mapped to concepts in systematic reviews, and topic models. To simulate a two-person team, we divided the data into random halves. We optimized the parameters of a Bayesian classifier, then trained and tested models on alternate data halves. Overall, we conducted 50 independent tests.All tests of summary performance (mean F3 surpassed the corresponding baseline, P<0.0001. The ranks for mean F3, precision, and classification error were statistically different across feature sets averaged over reviews; P-values for Friedman's test were .045, .002, and .002, respectively. Differences in ranks for mean recall were not statistically significant. Alphanumeric(+ features were associated with best performance; mean reduction in screening burden for this feature type ranged from 88% to 98% for the second pass through citations and from 38% to 48% overall.A computer-assisted, decision support system based on our methods could substantially reduce the burden of screening citations for systematic review teams and solo reviewers. Additionally, such a system could deliver quality assurance both by confirming concordant decisions and by naming

  20. Circles of Support and Accountability for Sex Offenders: A Systematic Review of Outcomes.

    Science.gov (United States)

    Clarke, Martin; Brown, Susan; Völlm, Birgit

    2017-08-01

    We conducted a systematic review of studies reporting on the effectiveness of Circles of Support and Accountability (Circles). Circles use volunteers to provide support for sex offenders living in the community. We searched 10 databases up to the end of 2013 and identified 3 relevant outcome studies. An additional 12 papers or reports were identified by searching reference lists, Google, and contacting key authors and Circles providers to obtain unpublished data. These 15 studies comprised one randomized controlled trial, three retrospective cohorts with matched controls, and 11 case series. The majority reported measures of recidivism, particularly reconviction. The 4 studies with controls generally reported that participation in Circles was associated with lower recidivism although there were few statistically significant differences. Few studies examined changes in risk or psychosocial outcomes. A number of methodological issues are discussed. Longer term, prospective follow-up studies with control groups are required to address these issues.

  1. The Impact on Informal Supporters of Domestic Violence Survivors: A Systematic Literature Review.

    Science.gov (United States)

    Gregory, Alison Clare; Williamson, Emma; Feder, Gene

    2017-12-01

    Domestic violence (DV) is experienced by 1 in 4 women in the United Kingdom during their lifetime, and most survivors will seek informal support from the people around them, even if they choose not to access help from professionals. Support from these relatives, friends, neighbors, and colleagues can provide a buffer against effects on the survivor's physical health, mental health, and quality of life, and has been shown to be protective against future abuse. There has been an absence of research studying members of survivors' networks and, in particular, investigating how the impact of DV might diffuse to affect them. A systematic literature review of reported research (either in peer-reviewed journals or in gray literature) was undertaken to explore the impacts of DV on survivor networks. Of the articles found, 24 had data relating to the topic area, though no study addressed the question directly. Framework analysis and meta-ethnography generated the following themes: physical health impacts, negative impacts on psychological well-being, direct impacts from the perpetrator, and beneficial impacts on psychological well-being. The studies in this review indicated that informal supporters may be experiencing substantial impact, including vicarious trauma and the risk of physical harm. Currently, there is little support available which is directly aimed at informal supporters of DV survivors, thus these findings have practical and policy implications, in order to acknowledge and meet their needs.

  2. Pengaruh Perceived Quality, Perceived Sacrifice Dan Perceived Value Terhadap Customer Satisfaction Di Informa Innovative Furnishing Pakuwon City Surabaya

    OpenAIRE

    Saputro, Daniel Krisno

    2013-01-01

    Penelitian ini bertujuan untuk menganalisa pengaruh dari Perceived Quality, Perceived Sacrifice dan Perceived Value terhadap Customer Satisfaction di Informa Innovative Furnishing Pakuwon City Surabaya. Variabel yang digunakan dalam penelitian ini adalah perceived quality, perceived sacrifice dan perceived value. Penelitian ini dilaksanakan dengan menyebarkan kuesioner kepada 100 orang konsumen di Informa Pakuwon City. Alat analisa yang digunakan adalah analisa regresi linear berganda.Hasil d...

  3. Pengaruh Perceived Quality, Perceived Sacrifice, Perceived Value, Dan Price Fairness Terhadap Customer Satisfaction Taman Sari Rasa Waterpark Cilacap

    OpenAIRE

    Rifqi, Viola Amdya; Endratno, Hermin

    2015-01-01

    Penelitian ini bertujuan untuk mengetahui dan menganalisis pengaruh perceived quality, perceived sacrifice, perceived value, dan price fairness terhadap customer satisfaction Taman Sari Rasa Waterpark Cilacap. Dimana variabel independen dalam penelitian ini adalah perceived quality, perceived sacrifice, perceived value, dan price fairness, sedangkan variabel dependen dalam penelitian ini adalah customer satisfaction.Analisis yang digunakan dalam penelitian ini menggunakan uji v...

  4. The role of short messaging service in supporting the delivery of healthcare: An umbrella systematic review.

    Science.gov (United States)

    Househ, Mowafa

    2016-06-01

    Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes. © The Author(s) 2014.

  5. Masculinity, Racism, Social Support, and Colorectal Cancer Screening Uptake Among African American Men: A Systematic Review.

    Science.gov (United States)

    Rogers, Charles R; Mitchell, Jamie A; Franta, Gabriel J; Foster, Margaret J; Shires, Deirdre

    2017-09-01

    Colorectal cancer (CRC) is highly preventable when CRC screening is utilized, yet CRC screening completion among African American men is relatively low and their mortality rates remain 50% higher juxtaposed to their White counterparts. Since a growing body of literature indicates masculinity, racism, and social support each have strong influences on CRC screening uptake, this systematic review examined the connections between these three sociocultural factors and CRC screening uptake among African American men. Potential studies were retrieved from MEDLINE, CINAHL, EMBASE, and PsycINFO. Cited reference searching for the final sample was employed to identify and assess additional studies for inclusion using Scopus. The methodological quality of the reviewed evidence was also evaluated. Nineteen studies met inclusion/exclusion criteria. Thirteen studies employed nonexperimental research designs; a quasi-experimental design was present in four, and two utilized experimental designs. Studies were published between 2000 and 2014; the majority between 2009 and 2013. Social support was most frequently addressed (84%) while masculinity and racism were equally studied with paucity (11%) for their influence on CRC screening. After evaluating conceptual and methodological characteristics of the studies, 42% fell below average in quality and rigor. The need for increased attention to the sociocultural correlates of CRC screening for African American men are highlighted in this systematic review, and important recommendations for research and practice are provided. Alongside a call for more rigorous research, further research examining the influence of masculinity and racism on CRC screening completion among African American men is warranted.

  6. Multi-scale ancient DNA analyses confirm the western origin of Michelsberg farmers and document probable practices of human sacrifice.

    Directory of Open Access Journals (Sweden)

    Alice Beau

    Full Text Available In Europe, the Middle Neolithic is characterized by an important diversification of cultures. In northeastern France, the appearance of the Michelsberg culture has been correlated with major cultural changes and interpreted as the result of the settlement of new groups originating from the Paris Basin. This cultural transition has been accompanied by the expansion of particular funerary practices involving inhumations within circular pits and individuals in "non-conventional" positions (deposited in the pits without any particular treatment. If the status of such individuals has been highly debated, the sacrifice hypothesis has been retained for the site of Gougenheim (Alsace. At the regional level, the analysis of the Gougenheim mitochondrial gene pool (SNPs and HVR-I sequence analyses permitted us to highlight a major genetic break associated with the emergence of the Michelsberg in the region. This genetic discontinuity appeared to be linked to new affinities with farmers from the Paris Basin, correlated to a noticeable hunter-gatherer legacy. All of the evidence gathered supports (i the occidental origin of the Michelsberg groups and (ii the potential implication of this migration in the progression of the hunter-gatherer legacy from the Paris Basin to Alsace / Western Germany at the beginning of the Late Neolithic. At the local level, we noted some differences in the maternal gene pool of individuals in "conventional" vs. "non-conventional" positions. The relative genetic isolation of these sub-groups nicely echoes both their social distinction and the hypothesis of sacrifices retained for the site. Our investigation demonstrates that a multi-scale aDNA study of ancient communities offers a unique opportunity to disentangle the complex relationships between cultural and biological evolution.

  7. Sacrifice and Commitment: American Volunteers in the Spanish Civil War

    Directory of Open Access Journals (Sweden)

    Anders Greenspan

    2013-06-01

    Full Text Available The Spanish Civil War (1936-1939 was the last European war before the start of World War II. The war, an ideological struggle between Francisco Franco and his nationalist supporters, aided by the Germans and Italians, sought to remove from power the Spanish Republic, which was aided by the Soviet Union. On both sides of the conflict were volunteers from many countries, including the United States of America. American volunteers fought on both sides of the war, yet more chose the side of the Republicans. Many, but not all, were motivated by political beliefs. Others wanted the perceived romance and excitement of battle, or the sense that they were being of help. The volunteers discussed in this study came from all of these categories, with the ones having political motivation the largest group. They detailed their experiences and their views of the war to their friends, families and comrades back home in the United States. These letters, which come from the Abraham Lincoln Brigade Archives at New York University, form the main part of the study and provide a deeper insight into what these men and women were thinking, as well as providing insight into their desire to fight in Spain. Through their eyes it is possible to gain a deeper understanding of their experiences and their motivations. For many of them, their experiences in Spain formed an important part of their journey in life. Some of them remained loyal to the Communist ideology throughout their lives, while others changed their views as the ruthlessness of Stalin became better known. A modern audience can benefit from a chance to read their thoughts and ideas in an attempt to better understand the events that helped drive the world into the Second World War.

  8. Sacrifice and Commitment: American Volunteers in the Spanish Civil War

    Directory of Open Access Journals (Sweden)

    Anders Greenspan

    2013-06-01

    Full Text Available The Spanish Civil War (1936-1939 was the last European war before the start of World War II. The war, an ideological struggle between Francisco Franco and his nationalist supporters, aided by the Germans and Italians, sought to remove from power the Spanish Republic, which was aided by the Soviet Union. On both sides of the conflict were volunteers from many countries, including the United States of America. American volunteers fought on both sides of the war, yet more chose the side of the Republicans.  Many, but not all, were motivated by political beliefs. Others wanted the perceived romance and excitement of battle, or the sense that they were being of help. The volunteers discussed in this study came from all of these categories, with the ones having political motivation the largest group. They detailed their experiences and their views of the war to their friends, families and comrades back home in the United States.  These letters, which come from the Abraham Lincoln Brigade Archives at New York University, form the main part of the study and provide a deeper insight into what these men and women were thinking, as well as providing insight into their desire to fight in Spain. Through their eyes it is possible to gain a deeper understanding of their experiences and their motivations.  For many of them, their experiences in Spain formed an important part of their journey in life.  Some of them remained loyal to the Communist ideology throughout their lives, while others changed their views as the ruthlessness of Stalin became better known.  A modern audience can benefit from a chance to read their thoughts and ideas in an attempt to better understand the events that helped drive the world into the Second World War.

  9. Systematic review on Internet Support Groups (ISGs) and depression (2): What is known about depression ISGs?

    Science.gov (United States)

    Griffiths, Kathleen M; Calear, Alison L; Banfield, Michelle; Tam, Ada

    2009-09-30

    Internet support groups (ISGs) are a popular means by which consumers with depression communicate online. A number of studies have evaluated the nature and impact of depression-specific ISGs. However, to date there have been no published systematic reviews of this evidence. The aim was to systematically identify and summarize the available evidence concerning the scope and findings of studies of depression ISGs. Three databases (PubMed, PsycINFO, Cochrane) were searched using over 150 search terms extracted from relevant papers, abstracts, and a thesaurus. Papers were included if they employed an online peer-to-peer depression-specific support group and reported either quantitative or qualitative empirical data. The objective of each study was coded according to a 20-category classification system, which included the effect on depression and other outcomes, including help seeking; user characteristics, activity, satisfaction, perceived benefits, perceived disadvantages; the reason for using the ISG; the nature of ISG posts; characteristics of depression ISGs compared to other ISG types, face-to-face groups, and face-to-face counseling; ISG structure and longitudinal changes; and predictors of ISG adherence. Thirteen papers satisfied the inclusion criteria from an initial pool of 12,692 abstracts. Of these, three collected data using survey questionnaires, nine analyzed samples of posts, and one both collected survey data and analyzed a sample of posts. The quality of most studies was not high, and little data were collected on most key aspects of depression ISGs. The most common objective of the studies was to analyze the nature of the posts (eight studies) and to describe site usage (six studies) and user characteristics (five studies). The most prevalent types of social support were emotional, informational, and social companionship. Given the popularity of depression ISGs and the paucity of available evidence about them, there is a need for high

  10. INVESTIGATING THE RELATIONSHIP BETWEEN PERCEIVED SACRIFICE AND B TO B CUSTOMER SATISFACTION IN THE INSURANCE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Petrisoaia Carmen

    2012-07-01

    Full Text Available The Romanian insurance market expanded rapidly during the last two decades. Presently, the Insurance Supervisory Commission (CSA reports 43 insurance companies and 567 insurance brokers. In this extremely dynamic and competitive environment, it is compulsory to control key elements that generate and maintain customer satisfaction. Therefore, the hereto paper concentrates on the influence exerted by perceived sacrifice over the business to business customer satisfaction in the insurance industry. More precisely, the objective is to investigate the impact of effort, time and money spent by the business to business customer over satisfaction. The concept of satisfaction has been intensively explored in the literature due to the fact that both practitioners and academics understood that it held a great significance in determining and preserving customer relationships and therefore, long-term profitability. In the service sector, much research has been conducted in the business to consumer context, especially concentrated on the relationship between service quality and satisfaction, whereas the business to business setting received less attention. In order to explore the relationship between perceived sacrifice and satisfaction, a descriptive research design was used. A questionnaire was created using multiple items for measuring satisfaction and perceived sacrifice and also a number of identification variables. The survey concerned companies that had had benefitted from the services of an insurance broker at least once. Copies of the questionnaire were sent by email to company managers from all the main industries. A total of 85 answers were collected. With the help of SPSS tool, the two measurement scales were tested for reliability and validity and a factor analysis was performed. The next step was to calculate the composite scores for each of the two variables and to carry out the simple linear regression analysis. Our linear model considers that

  11. Definitions of apical vaginal support loss: a systematic review.

    Science.gov (United States)

    Meister, Melanie R L; Sutcliffe, Siobhan; Lowder, Jerry L

    2017-03-01

    We sought to identify and summarize definitions of apical support loss utilized for inclusion, success, and failure in surgical trials for treatment of apical vaginal prolapse. Pelvic organ prolapse is a common condition affecting more than 3 million women in the US, and the prevalence is increasing. Prolapse may occur in the anterior compartment, posterior compartment or at the apex. Apical support is considered paramount to overall female pelvic organ support, yet apical support loss is often underrecognized and there are no guidelines for when an apical support procedure should be performed or incorporated into a procedure designed to address prolapse. A systematic literature search was performed in 8 search engines: PubMed 1946-, Embase 1947-, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Review Effects, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Proquest Dissertations and Theses, and FirstSearch Proceedings, using key words for apical pelvic organ prolapse and apical suspension procedures through April 2016. Searches were limited to human beings using human filters and articles published in English. Study authors (M.R.L.M., J.L.L.) independently reviewed publications for inclusion based on predefined variables. Articles were eligible for inclusion if they satisfied any of the following criteria: (1) apical support loss was an inclusion criterion in the original study, (2) apical support loss was a surgical indication, or (3) an apical support procedure was performed as part of the primary surgery. A total of 4469 publications were identified. After review, 35 articles were included in the analysis. Prolapse-related inclusion criteria were: (1) apical prolapse (n = 20, 57.1%); (2) overall prolapse (n = 8, 22.8%); or (3) both (n = 6, 17.1%). Definitions of apical prolapse (relative to the hymen) included: (1) apical prolapse >-1 cm (n = 13, 50.0%); (2) apical prolapse >+1 cm (n = 7, 26.9%); (3) apical

  12. [A qualitative analysis of spelling mistakes and a systematic supportive learning instruction of spelling disorder].

    Science.gov (United States)

    Corvacho Del Toro, Irene M

    2016-09-01

    This paper explains how a qualitative analysis of spelling mistakes (Oldenburger Fehleranalyse, Thomé & Thomé, 2014) may be used to select learning materials according to individual needs. The pre-post design with control group serves to evaluate the effects of an intervention that is systematic and learning supportive for pupils with a diagnosed spelling disorder (ages 12 to 14; 6th-8th grade). Therapists of the experimental group were instructed to apply a series of linguistic and psycholinguistic criteria when creating the material for instruction and when carrying out the therapy. Therapists of the control group carried out the intervention without attending to these criteria, although they did have knowledge about the pupil’s profile in spelling mistakes. The intervention included 20 sessions. The ANOVA shows improvement for both groups (HSP, May 2012): (F(1, 14) = 15,05, p = .002, η2 = .518). For the experimental group it is stronger, and the difference in achievement gain is significant (F(1, 14) = 4,70, p = .048; η2 = .25). These results support a combination of qualitative analysis and a high qualification for therapists that relates specifically to orthography and its instruction. For some pupils the changes in the qualitative profiles reveal persistent support requirements in phonology or grammar instruction.

  13. Visualizing risks in cancer communication: A systematic review of computer-supported visual aids.

    Science.gov (United States)

    Stellamanns, Jan; Ruetters, Dana; Dahal, Keshav; Schillmoeller, Zita; Huebner, Jutta

    2017-08-01

    Health websites are becoming important sources for cancer information. Lay users, patients and carers seek support for critical decisions, but they are prone to common biases when quantitative information is presented. Graphical representations of risk data can facilitate comprehension, and interactive visualizations are popular. This review summarizes the evidence on computer-supported graphs that present risk data and their effects on various measures. The systematic literature search was conducted in several databases, including MEDLINE, EMBASE and CINAHL. Only studies with a controlled design were included. Relevant publications were carefully selected and critically appraised by two reviewers. Thirteen studies were included. Ten studies evaluated static graphs and three dynamic formats. Most decision scenarios were hypothetical. Static graphs could improve accuracy, comprehension, and behavioural intention. But the results were heterogeneous and inconsistent among the studies. Dynamic formats were not superior or even impaired performance compared to static formats. Static graphs show promising but inconsistent results, while research on dynamic visualizations is scarce and must be interpreted cautiously due to methodical limitations. Well-designed and context-specific static graphs can support web-based cancer risk communication in particular populations. The application of dynamic formats cannot be recommended and needs further research. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review.

    Science.gov (United States)

    O'Brien, O A; McCarthy, M; Gibney, E R; McAuliffe, F M

    2014-07-01

    Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women.

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

    Science.gov (United States)

    Faggion, Clovis Mariano

    2012-09-01

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

  16. A Systematic Review of Unmet Information and Psychosocial Support Needs of Adults Diagnosed with Thyroid Cancer.

    Science.gov (United States)

    Hyun, Yong Gyu; Alhashemi, Ahmad; Fazelzad, Rouhi; Goldberg, Alyse S; Goldstein, David P; Sawka, Anna M

    2016-09-01

    Patient education and psychosocial support to patients are important elements of comprehensive cancer care, but the needs of thyroid cancer survivors are not well understood. The published English-language quantitative literature on (i) unmet medical information and (ii) psychosocial support needs of thyroid cancer survivors was systematically reviewed. A librarian information specialist searched seven electronic databases and a hand search was conducted. Two reviewers independently screened citations from the electronic search and reviewed relevant full-text papers. There was consensus between reviewers on the included papers, and duplicate independent abstraction was performed. The results were summarized descriptively. A total of 1984 unique electronic citations were screened, and 51 full-text studies were reviewed (three from the hand search). Seven cross-sectional, single-arm, survey studies were included, containing data from 6215 thyroid cancer survivor respondents. The respective study sizes ranged from 57 to 2398 subjects. All of the studies had some methodological limitations. Unmet information needs were variable relating to the disease, diagnostic tests, treatments, and co-ordination of medical care. There were relatively high unmet information needs related to aftercare (especially long-term effects of the disease or its treatment and its management) and psychosocial concerns (including practical and financial matters). Psychosocial support needs were incompletely met. Patient information on complementary and alternative medicine was very limited. In conclusion, thyroid cancer survivors perceive many unmet information needs, and these needs extend to aftercare. Psychosocial information and supportive care needs may be insufficiently met in this population. More work is needed to improve knowledge translation and psychosocial support for thyroid cancer survivors.

  17. A Systematic Review of the Economic Evidence for Home Support Interventions in Dementia.

    Science.gov (United States)

    Clarkson, Paul; Davies, Linda; Jasper, Rowan; Loynes, Niklas; Challis, David

    2017-09-01

    Recent evidence signals the need for effective forms of home support to people with dementia and their carers. The cost-effectiveness evidence of different approaches to support is scant. To appraise economic evidence on the cost-effectiveness of home support interventions for dementia to inform future evaluation. A systematic literature review of full and partial economic evaluations was performed using the British National Health Service Economic Evaluation Database supplemented by additional references. Study characteristics and findings, including incremental cost-effectiveness ratios, when available, were summarized narratively. Study quality was appraised using the National Health Service Economic Evaluation Database critical appraisal criteria and independent ratings, agreed by two reviewers. Studies were located on a permutation matrix describing their mix of incremental costs/effects to aid decision making. Of the 151 articles retrieved, 14 studies met the inclusion criteria: 8 concerning support to people with dementia and 6 to carers. Five studies were incremental cost-utility analyses, seven were cost-effectiveness analyses, and two were cost consequences analyses. Five studies expressed incremental cost-effectiveness ratios as cost per quality-adjusted life-year (£6,696-£207,942 per quality-adjusted life-year). In four studies, interventions were dominant over usual care. Two interventions were more costly but more beneficial and were favorable against current acceptability thresholds. Occupational therapy, home-based exercise, and a carers' coping intervention emerged as cost-effective approaches for which there was better evidence. These interventions used environmental modifications, behavior management, physical activity, and emotional support as active components. More robust evidence is needed to judge the value of these and other interventions across the dementia care pathway. Copyright © 2017 International Society for Pharmacoeconomics and

  18. Robots and ICT to support play in children with severe physical disabilities: a systematic review.

    Science.gov (United States)

    van den Heuvel, Renée J F; Lexis, Monique A S; Gelderblom, Gert Jan; Jansens, Rianne M L; de Witte, Luc P

    2015-09-02

    Play is an essential part of children's lives. Children with physical disabilities experience difficulties in play, especially those with severe physical disabilities. With the progress of innovative technology, the possibilities to support play are increasing. The purpose of this literature study is to gain insight into the aims, control options and commercial availability of information and communication technology (ICT) and robots to support play (especially play for the sake of play) in children with severe physical disabilities. A systematic literature search in the databases PubMed, CINAHL, IEEE and ERIC was carried out. Titles and abstracts were assessed independently by three reviewers. In addition, studies were selected using Google Scholar, conference proceedings and reference lists. Three main groups of technology for play could be distinguished: robots (n = 8), virtual reality systems (n = 15) and computer systems (n = 4). Besides, ICT and robots developed for specific therapy or educational goals using play-like activities, five of the in total 27 technologies in this study described the aim of "play for play's sake". Many ICT systems and robots to support play in children with physical disabilities were found. Numerous technologies use play-like activities to achieve therapeutic or educational goals. Robots especially are used for "play for play's sake". Implications for Rehabilitation This study gives insight into the aims, control options and commercial availability for application of robots and ICT to support play in children with severe physical disabilities. This overview can be used in both the fields of rehabilitation and special education to search for new innovative intervention options and it can stimulate them to use these innovative play materials. Especially robots may have great potential in supporting "play for play's sake".

  19. 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

  20. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  1. 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

  2. Disinflation in a DSGE Perspective: Sacrifice Ratio or Welfare Gain Ratio?

    OpenAIRE

    Guido Ascari; Tiziano Ropele

    2009-01-01

    When used to examine disinflation monetary policies, the current workhorse dynamic stochastic general equilibrium model of business cycle fluctuations is able to quantitatively account for the main stylized facts in terms of recessionary effects and sacrifice ratio. We complement the transitional analysis of the short-run costs with a rigorous welfare evaluation and show that, despite the long-lasting economic downturn, disinflation entails non-zero overall welfare gains.

  3. Religion and Displacement in Africa: Compassion and Sacrifice in Congolese Churches in Kampala, Uganda

    DEFF Research Database (Denmark)

    Lauterbach, Karen

    2014-01-01

    This article is about the role of religion in contexts of displacement. The article looks at the role churches and church leaders play in the lives of refugees and more particularly the assistance that these actors provide. The analytical approach is to take into consideration both religious idea...... to refugees, how this is conceptualised as well as the practices in a perspective that includes the intersection between religious ideas (compassion and sacrifice) and ideas around social relationships, gift-giving and reciprocity....

  4. Involving people with dementia in the development of supportive IT applications: a systematic review.

    Science.gov (United States)

    Span, Marijke; Hettinga, Marike; Vernooij-Dassen, Myrra; Eefsting, Jan; Smits, Carolien

    2013-03-01

    Involving people with dementia in research is not self-evident. Inclusion of people with dementia in the development process of user-friendly, supportive IT applications may be especially useful to improve the quality of these applications and may be beneficial to the person with dementia. The aim of this study was to gain insight into the involvement of people with dementia in developing supportive IT applications. The focus of involvement was on phase, methods, role and impact on the quality of the IT application and on the person with dementia. A systematic search was undertaken using Cochrane Library, PubMED, PsycInfo, EMBASE, and CINAHL. Publications were selected using the following inclusion criteria: publications had to address a development process of an IT application involving people with dementia. The BMJ checklist was used to assess the quality of the included publications. Twenty-six publications relating to 15 IT programs met the inclusion criteria. People with dementia were mainly involved in the exploratory and technical development phases. The methods most frequently used to involve the participants were interviews, observations and usability try-outs. In most studies, participants were objects of study and informants. People with dementia provided useful feedback and gave valuable recommendations for researchers and designers regarding the development of user-friendly, supportive, IT applications. Involvement in all phases may have empowering effects on people with dementia. To develop valuable, user-friendly, supportive IT applications that increase the quality of life of people with dementia involvement in all phases of the development process is of great importance. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Dying for the group: Towards a general theory of extreme self-sacrifice.

    Science.gov (United States)

    Whitehouse, Harvey

    2018-02-07

    Whether upheld as heroic or reviled as terrorism, throughout history people have been willing to lay down their lives for the sake of their groups. Why? Previous theories of extreme self-sacrifice have highlighted a range of seemingly disparate factors such as collective identity, outgroup hostility, and kin psychology. This paper attempts to integrate many of these factors into a single overarching theory based on several decades of collaborative research with a range of special populations, from tribes in Papua New Guinea to Libyan insurgents, and from Muslim fundamentalists in Indonesia to Brazilian football hooligans. These studies suggest that extreme self-sacrifice is motivated by 'identity fusion', a visceral sense of oneness with the group resulting from intense collective experiences (e.g. painful rituals or the horrors of frontline combat) or from perceptions of shared biology. In ancient foraging societies, fusion would have enabled warlike bands to stand united despite strong temptations to scatter and flee. The fusion mechanism has often been exploited in cultural rituals, not only by tribal societies but also in specialized cells embedded in armies, cults, and terrorist organizations. With the rise of social complexity and the spread of states and empires, fusion has also been extended to much larger groups, including doctrinal religions, ethnicities, and ideological movements. Explaining extreme self-sacrifice is not only a scientific priority but also a practical challenge as we seek a collective response to suicide terrorism and other extreme expressions of outgroup hostility that continue to bedevil humanity today.

  6. Facial reanimation by muscle-nerve neurotization after facial nerve sacrifice. Case report.

    Science.gov (United States)

    Taupin, A; Labbé, D; Babin, E; Fromager, G

    2016-12-01

    Recovering a certain degree of mimicry after sacrifice of the facial nerve is a clinically recognized finding. The authors report a case of hemifacial reanimation suggesting a phenomenon of neurotization from muscle-to-nerve. A woman benefited from a parotidectomy with sacrifice of the left facial nerve indicated for recurrent tumor in the gland. The distal branches of the facial nerve, isolated at the time of resection, were buried in the masseter muscle underneath. The patient recovered a voluntary hémifacial motricity. The electromyographic analysis of the motor activity of the zygomaticus major before and after block of the masseter nerve showed a dependence between mimic muscles and the masseter muscle. Several hypotheses have been advanced to explain the spontaneous reanimation of facial paralysis. The clinical case makes it possible to argue in favor of muscle-to-nerve neurotization from masseter muscle to distal branches of the facial nerve. It illustrates the quality of motricity that can be obtained thanks to this procedure. The authors describe a simple implantation technique of distal branches of the facial nerve in the masseter muscle during a radical parotidectomy with facial nerve sacrifice and recovery of resting tone but also a quality voluntary mimicry. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Approaches that use software to support the prevention of pressure ulcer: A systematic review.

    Science.gov (United States)

    Marchione, F G; Araújo, L M Q; Araújo, L V

    2015-10-01

    The incidence and costs for pressure ulcer (PU) treatment remain high even though preventive methods are applied. Approaches that use software to support the prevention of PU are presented in the literature to make it more effective. Identify the state of art of the approaches that use software to support the prevention of PUs. A systematic literature review was performed to analyze approaches that use software to support the prevention of PU. ACM, IEEE, PubMed, Scopus, CINAHL and Embase databases have been searched with a predetermined search string to identify primary studies. We selected the ones that met the established inclusion criteria. Thirty-six articles met the inclusion criteria. To support prevention, most approaches monitor the patient to provide information about exposure to pressure, temperature level, humidity level and estimated body position in bed providing risk factor intensity charts and intensity maps. The main method to perform patient's monitoring is using sensors installed on the mattress, but recently, alternative methods have been proposed such as electronic sensors and tactile sensory coils. Part of the approaches performs automated management of the risk factors using ventilation tubes and mattresses with porous cells to decrease body's temperature and movable cells to automatically redistribute the pressure over the body. Matters as cost of the approach, patient comfort and hygiene of the monitoring equipment is only briefly discussed in the selected articles. No experiments have been conducted to evidence the approached may reduce PU incidence. Currently, approaches that use software to support the prevention of PU provide relevant information to health professionals such as risk factor intensity charts and intensity maps. Some of them can even automatically manage risk factors in a limited way. Yet, the approaches are based on risk factor monitoring methods that require patient's contact with the monitoring equipment. Therefore, some

  8. Social Support and Symptom Severity Among Patients With Obsessive-Compulsive Disorder or Panic Disorder With Agoraphobia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Véronique Palardy

    2018-03-01

    Full Text Available Panic disorder with or without agoraphobia (PD/A and obsessive-compulsive disorder (OCD are characterized by major behavioral dysruptions that may affect patients’ social and marital functioning. The disorders’ impact on interpersonal relationships may also affect the quality of support patients receive from their social network. The main goal of this systematic review is to determine the association between social or marital support and symptom severity among adults with PD/A or OCD. A systematic search of databases was executed and provided 35 eligible articles. Results from OCD studies indicated a negative association between marital adjustment and symptom severity, and a positive association between accommodation from relatives and symptom severity. However, results were inconclusive for negative forms of social support (e.g. criticism, hostility. Results from PD/A studies indicated a negative association between perceived social support and symptom severity. Also, results from studies using an observational measure of marital adjustment indicated a negative association between quality of support from the spouse and PD/A severity. However, results were inconclusive for perceived marital adjustment and symptom severity. In conclusion, this systematic review generally suggests a major role of social and marital support in PD/A and OCD symptomatology. However, given diversity of results and methods used in studies, more are needed to clarify the links between support and symptom severity among patients with PD/A and OCD.

  9. Development and impact of computerised decision support systems for clinical management of depression: A systematic review.

    Science.gov (United States)

    Triñanes, Yolanda; Atienza, Gerardo; Louro-González, Arturo; de-las-Heras-Liñero, Elena; Alvarez-Ariza, María; Palao, Diego J

    2015-01-01

    One of the proposals for improving clinical practice is to introduce computerised decision support systems (CDSS) and integrate these with electronic medical records. Accordingly, this study sought to systematically review evidence on the effectiveness of CDSS in the management of depression. A search was performed in Medline, EMBASE and PsycInfo, in order to do this. The quality of quantitative studies was assessed using the SIGN method, and qualitative studies using the CASPe checklist. Seven studies were identified (3 randomised clinical trials, 3 non-randomised trials, and one qualitative study). The CDSS assessed incorporated content drawn from guidelines and other evidence-based products. In general, the CDSS had a positive impact on different aspects, such as the screening and diagnosis, treatment, improvement in depressive symptoms and quality of life, and referral of patients. The use of CDSS could thus serve to optimise care of depression in various scenarios by providing recommendations based on the best evidence available and facilitating decision-making in clinical practice. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  10. Systematic development and optimization of chemically defined medium supporting high cell density growth of Bacillus coagulans.

    Science.gov (United States)

    Chen, Yu; Dong, Fengqing; Wang, Yonghong

    2016-09-01

    With determined components and experimental reducibility, the chemically defined medium (CDM) and the minimal chemically defined medium (MCDM) are used in many metabolism and regulation studies. This research aimed to develop the chemically defined medium supporting high cell density growth of Bacillus coagulans, which is a promising producer of lactic acid and other bio-chemicals. In this study, a systematic methodology combining the experimental technique with flux balance analysis (FBA) was proposed to design and simplify a CDM. The single omission technique and single addition technique were employed to determine the essential and stimulatory compounds, before the optimization of their concentrations by the statistical method. In addition, to improve the growth rationally, in silico omission and addition were performed by FBA based on the construction of a medium-size metabolic model of B. coagulans 36D1. Thus, CDMs were developed to obtain considerable biomass production of at least five B. coagulans strains, in which two model strains B. coagulans 36D1 and ATCC 7050 were involved.

  11. Technologies and decision support systems to aid solid-waste management: a systematic review.

    Science.gov (United States)

    Vitorino de Souza Melaré, Angelina; Montenegro González, Sahudy; Faceli, Katti; Casadei, Vitor

    2017-01-01

    Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Do brain image databanks support understanding of normal ageing brain structure? A systematic review

    International Nuclear Information System (INIS)

    Dickie, David Alexander; Job, Dominic E.; Wardlaw, Joanna M.; Poole, Ian; Ahearn, Trevor S.; Staff, Roger T.; Murray, Alison D.

    2012-01-01

    To document accessible magnetic resonance (MR) brain images, metadata and statistical results from normal older subjects that may be used to improve diagnoses of dementia. We systematically reviewed published brain image databanks (print literature and Internet) concerned with normal ageing brain structure. From nine eligible databanks, there appeared to be 944 normal subjects aged ≥60 years. However, many subjects were in more than one databank and not all were fully representative of normal ageing clinical characteristics. Therefore, there were approximately 343 subjects aged ≥60 years with metadata representative of normal ageing, but only 98 subjects were openly accessible. No databank had the range of MR image sequences, e.g. T2*, fluid-attenuated inversion recovery (FLAIR), required to effectively characterise the features of brain ageing. No databank supported random subject retrieval; therefore, manual selection bias and errors may occur in studies that use these subjects as controls. Finally, no databank stored results from statistical analyses of its brain image and metadata that may be validated with analyses of further data. Brain image databanks require open access, more subjects, metadata, MR image sequences, searchability and statistical results to improve understanding of normal ageing brain structure and diagnoses of dementia. (orig.)

  13. Technique for systematic bone reduction for fixed implant-supported prosthesis in the edentulous maxilla.

    Science.gov (United States)

    Bidra, Avinash S

    2015-06-01

    Bone reduction for maxillary fixed implant-supported prosthodontic treatment is often necessary to either gain prosthetic space or to conceal the prosthesis-tissue junction in patients with excessive gingival display (gummy smile). Inadequate bone reduction is often a cause of prosthetic failure due to material fractures, poor esthetics, or inability to perform oral hygiene procedures due to unfavorable ridge lap prosthetic contours. Various instruments and techniques are available for bone reduction. It would be helpful to have an accurate and efficient method for bone reduction at the time of surgery and subsequently create a smooth bony platform. This article presents a straightforward technique for systematic bone reduction by transferring the patient's maximum smile line, recorded clinically, to a clear radiographic smile guide for treatment planning using cone beam computed tomography (CBCT). The patient's smile line and the amount of required bone reduction are transferred clinically by marking bone with a sterile stationery graphite wood pencil at the time of surgery. This technique can help clinicians to accurately achieve the desired bone reduction during surgery, and provide confidence that the diagnostic and treatment planning goals have been achieved. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  14. A systematic review of peer-supported interventions for health promotion and disease prevention.

    Science.gov (United States)

    Ramchand, Rajeev; Ahluwalia, Sangeeta C; Xenakis, Lea; Apaydin, Eric; Raaen, Laura; Grimm, Geoffrey

    2017-08-01

    Prior research has examined peer programs with respect to specific peer roles (e.g.; peer support) or specific health/wellness domains (e.g.; exercise/diet), or have aggregated effects across roles and domains. We sought to conduct a systematic review that categorizes and assesses the effects of peer interventions to promote health and wellness by peer role, intervention type, and outcomes. We use evidence mapping to visually catalog and synthesize the existing research. We searched PubMed and WorldCat databases (2005 to 2015) and New York Academy of Medicine Grey Literature Report (1999 to 2016) for English-language randomized control trials. We extracted study design, study participants, type of intervention(s), peer role(s), outcomes assessed and measures used, and effects from 116 randomized controlled trials. Maps were created to provide a visual display of the evidence by intervention type, peer role, outcome type, and significant vs null or negative effects. There are more null than positive effects across peer interventions, with notable exceptions: group-based interventions that use peers as educators or group facilitators commonly improve knowledge, attitudes, beliefs, and perceptions; peer educators also commonly improved social health/connectedness and engagement. Dyadic peer support influenced behavior change and peer counseling shows promising effects on physical health outcomes. Programs seeking to use peers in public health campaigns can use evidence maps to identify interventions that have previously demonstrated beneficial effects. Those seeking to produce health outcomes may benefit from identifying the mechanisms by which they expect their program to produce these effects and associated proximal outcomes for future evaluations. Although we attempted to register our protocol with PROSPERO, we did not meet eligibility criteria because we were past the data collection phase. The full PROSPERO-aligned protocol is available from the authors

  15. Supporting Well-Being in Retirement through Meaningful Social Roles: Systematic Review of Intervention Studies

    Science.gov (United States)

    Heaven, Ben; Brown, Laura Je; White, Martin; Errington, Linda; Mathers, John C; Moffatt, Suzanne

    2013-01-01

    Context The marked demographic change toward greater proportions of older people in developed nations poses significant challenges for health and social care. Several studies have demonstrated an association between social roles in later life and positive health and well-being outcomes. After retiring from work, people may lose roles that provide purpose and social contacts. The outcomes of interventions to promote social roles in retirement have not been systematically reviewed. Methods We examined three research questions: (1) What kinds of intervention have been developed to promote social roles in retirement? (2) How much have they improved perceived roles? (3) Have these roles improved health or well-being? We included those studies that evaluated the provision of social roles; used a control or comparison group; targeted healthy retirement-transition adults who were living in the community; provided an abstract written in English; took place in a highly developed nation; and reported social role, health, or well-being outcomes. We searched eight electronic databases and combined the results with hand searches. Findings Through our searches, we identified 9,062 unique publications and eleven evaluative studies of acceptable quality, which reported seven interventions that met our inclusion criteria. These interventions varied in year of inception and scope, but only two were based outside North America. The studies rarely reported the quality or meaning of roles. Only three studies used random allocation, thus limiting inferences of causality from these studies. Interventions providing explicit roles and using supportive group structures were somewhat effective in improving one or more of the following: life satisfaction, social support and activity, physical health and activity, functional health, and cognition. Conclusions Social role interventions may improve health and well-being for people in retirement transition. Future research should improve the

  16. In search of standards to support circularity in product policies: A systematic approach.

    Science.gov (United States)

    Tecchio, Paolo; McAlister, Catriona; Mathieux, Fabrice; Ardente, Fulvio

    2017-12-01

    The aspiration of a circular economy is to shift material flows toward a zero waste and pollution production system. The process of shifting to a circular economy has been initiated by the European Commission in their action plan for the circular economy. The EU Ecodesign Directive is a key policy in this transition. However, to date the focus of access to market requirements on products has primarily been upon energy efficiency. The absence of adequate metrics and standards has been a key barrier to the inclusion of resource efficiency requirements. This paper proposes a framework to boost sustainable engineering and resource use by systematically identifying standardization needs and features. Standards can then support the setting of appropriate material efficiency requirements in EU product policy. Three high-level policy goals concerning material efficiency of products were identified: embodied impact reduction, lifetime extension and residual waste reduction. Through a lifecycle perspective, a matrix of interactions among material efficiency topics (recycled content, re-used content, relevant material content, durability, upgradability, reparability, re-manufacturability, reusability, recyclability, recoverability, relevant material separability) and policy goals was created. The framework was tested on case studies for electronic displays and washing machines. For potential material efficiency requirements, specific standardization needs were identified, such as adequate metrics for performance measurements, reliable and repeatable tests, and calculation procedures. The proposed novel framework aims to provide a method by which to identify key material efficiency considerations within the policy context, and to map out the generic and product-specific standardisation needs to support ecodesign. Via such an approach, many different stakeholders (industry, academics, policy makers, non-governmental organizations etc.) can be involved in material efficiency

  17. Supporting well-being in retirement through meaningful social roles: systematic review of intervention studies.

    Science.gov (United States)

    Heaven, Ben; Brown, Laura J E; White, Martin; Errington, Linda; Mathers, John C; Moffatt, Suzanne

    2013-06-01

    The marked demographic change toward greater proportions of older people in developed nations poses significant challenges for health and social care. Several studies have demonstrated an association between social roles in later life and positive health and well-being outcomes. After retiring from work, people may lose roles that provide purpose and social contacts. The outcomes of interventions to promote social roles in retirement have not been systematically reviewed. We examined three research questions: (1) What kinds of intervention have been developed to promote social roles in retirement? (2) How much have they improved perceived roles? (3) Have these roles improved health or well-being? We included those studies that evaluated the provision of social roles; used a control or comparison group; targeted healthy retirement-transition adults who were living in the community; provided an abstract written in English; took place in a highly developed nation; and reported social role, health, or well-being outcomes. We searched eight electronic databases and combined the results with hand searches. Through our searches, we identified 9,062 unique publications and eleven evaluative studies of acceptable quality, which reported seven interventions that met our inclusion criteria. These interventions varied in year of inception and scope, but only two were based outside North America. The studies rarely reported the quality or meaning of roles. Only three studies used random allocation, thus limiting inferences of causality from these studies. Interventions providing explicit roles and using supportive group structures were somewhat effective in improving one or more of the following: life satisfaction, social support and activity, physical health and activity, functional health, and cognition. Social role interventions may improve health and well-being for people in retirement transition. Future research should improve the quality of intervention and assessment and

  18. A Systematic Review of the Literature on Mathematics Manipulatives to Support Students with Disabilities

    Science.gov (United States)

    Bouck, Emily C.; Park, Jiyoon

    2018-01-01

    Manipulatives are considered a common tool for mathematics teaching and learning, for both students with and without disabilities. Yet, a systematic review of the current state of research regarding manipulatives for students with disabilities did not exist prior to this article. This manuscript presents a systematic review of the literature…

  19. Hair and Sacrifice in the Andean World, as deduced by biomolecular approaches

    Directory of Open Access Journals (Sweden)

    Andrew Wilson

    2016-11-01

    Full Text Available An individual’s first haircut is considered to be a major milestone in many world cultures and religions even today. It is interesting to note therefore that children placed as Inca child sacrifices in shrines on a number of the principal mountains in the Andes were found with many offerings, including small bags made of animal intestines containing cut human hair. The exceptional preservation of these young individuals offers huge potential for us to gain insight into the ritual process, given that most have remained in permafrost conditions since they were left on the mountain as part of the state-sanctioned Capacocha ceremony practised by the Inca.

  20. Parochial Altruists or Ideologues? An Agent Based Model of Commitment to Self Sacrifice

    Directory of Open Access Journals (Sweden)

    Giti Zahedzadeh

    2015-09-01

    Full Text Available 'What motivates suicide attackers remains an open question. From an evolutionary perspective, commitment to suicide missions is puzzling since such behavior is fitness reducing. We model suicide terrorism by drawing on two fundamental human motivations: altruism and selfishness. Martyrdom can be viewed as altruistic- benefiting group members at a cost to oneself, as well as selfish- ideological belief in a profitable afterlife. Our simulations identify that some degree of both behaviors are essential in order to facilitate a commitment to sacrifice. Thus, manipulations of ideology and altruism can tip the threshold and set the agents on the path of martyrdom. '

  1. Archaeological, radiological, and biological evidence offer insight into Inca child sacrifice

    DEFF Research Database (Denmark)

    Wilson, Andrew S.; Brown, Emma L.; Villa, Chiara

    2013-01-01

    Examination of three frozen bodies, a 13-y-old girl and a girl and boy aged 4 to 5 y, separately entombed near the Andean summit of Volcán Llullaillaco, Argentina, sheds new light on human sacrifice as a central part of the Imperial Inca capacocha rite, described by chroniclers writing after...... of final placement on the mountain top. We argue that the individuals were treated differently according to their age, status, and ritual role. Finally, we relate our findings to questions of consent, coercion, and/or compliance, and the controversial issues of ideological justification and strategies...

  2. Healing Through States of Consciousness: Animal Sacrifice and Christian Prayer Among the Kachin in Southwest China.

    Science.gov (United States)

    Zhang, Wenyi

    2016-01-01

    Healing rituals can be understood in terms of configurations of two states of consciousness-a culturally elaborated everyday waking consciousness, and an enhanced and culturally elaborated state of consciousness. Two healing rituals performed by the ethnic Kachin in Southwest China differentiate these two states of consciousness in their theories of life and death. The first ritual, animal sacrifice, employs the ordinary consciousness, including will and expectation, of participants through the enhanced state of consciousness of the ritual officiant. The second, Christian prayer, utilizes the enhanced consciousness of Christian Congregation to achieve psychic transformation. These two rituals maneuver different configurations of the two states of consciousness in achieving healing efficacy.

  3. Impact on process results of clinical decision support systems (CDSSs) applied to medication use: overview of systematic reviews.

    Science.gov (United States)

    Reis, Wálleri C; Bonetti, Aline F; Bottacin, Wallace E; Reis, Alcindo S; Souza, Thaís T; Pontarolo, Roberto; Correr, Cassyano J; Fernandez-Llimos, Fernando

    2017-01-01

    The purpose of this overview (systematic review of systematic reviews) is to evaluate the impact of clinical decision support systems (CDSS) applied to medication use in the care process. A search for systematic reviews that address CDSS was performed on Medline following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane recommendations. Terms related to CDSS and systematic reviews were used in combination with Boolean operators and search field tags to build the electronic search strategy. There was no limitation of date or language for inclusion. We included revisions that investigated, as a main or secondary objective, changes in process outcomes. The Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) score was used to evaluate the quality of the studies. The search retrieved 954 articles. Five articles were added through manual search, totaling an initial sample of 959 articles. After screening and reading in full, 44 systematic reviews met the inclusion criteria. In the medication-use processes where CDSS was used, the most common stages were prescribing (n=38 (86.36%) and administering (n=12 (27.27%)). Most of the systematic reviews demonstrated improvement in the health care process (30/44 - 68.2%). The main positive results were related to improvement of the quality of prescription by the physicians (14/30 - 46.6%) and reduction of errors in prescribing (5/30 - 16.6%). However, the quality of the studies was poor, according to the score used. CDSSs represent a promising technology to optimize the medication-use process, especially related to improvement in the quality of prescriptions and reduction of prescribing errors, although higher quality studies are needed to establish the predictors of success in these systems.

  4. Advancing clinical decision support using lessons from outside of healthcare: an interdisciplinary systematic review

    Directory of Open Access Journals (Sweden)

    Wu Helen W

    2012-08-01

    Full Text Available Abstract Background Greater use of computerized decision support (DS systems could address continuing safety and quality problems in healthcare, but the healthcare field has struggled to implement DS technology. This study surveys DS experience across multiple non-healthcare disciplines for new insights that are generalizable to healthcare provider decisions. In particular, it sought design principles and lessons learned from the other disciplines that could inform efforts to accelerate the adoption of clinical decision support (CDS. Methods Our systematic review drew broadly from non-healthcare databases in the basic sciences, social sciences, humanities, engineering, business, and defense: PsychINFO, BusinessSource Premier, Social Sciences Abstracts, Web of Science, and Defense Technical Information Center. Because our interest was in DS that could apply to clinical decisions, we selected articles that (1 provided a review, overview, discussion of lessons learned, or an evaluation of design or implementation aspects of DS within a non-healthcare discipline and (2 involved an element of human judgment at the individual level, as opposed to decisions that can be fully automated or that are made at the organizational level. Results Clinical decisions share some similarities with decisions made by military commanders, business managers, and other leaders: they involve assessing new situations and choosing courses of action with major consequences, under time pressure, and with incomplete information. We identified seven high-level DS system design features from the non-healthcare literature that could be applied to CDS: providing broad, system-level perspectives; customizing interfaces to specific users and roles; making the DS reasoning transparent; presenting data effectively; generating multiple scenarios covering disparate outcomes (e.g., effective; effective with side effects; ineffective; allowing for contingent adaptations; and facilitating

  5. Should community health workers offer support healthcare services to survivors of sexual violence? a systematic review.

    Science.gov (United States)

    Gatuguta, Anne; Katusiime, Barbra; Seeley, Janet; Colombini, Manuela; Mwanzo, Isaac; Devries, Karen

    2017-10-12

    Sexual violence is widespread, yet relatively few survivors receive healthcare or complete treatment. In low and middle-income countries, community health workers (CHWs) have the potential to provide support services to large numbers of survivors. The aim of this review was to document the role of CHWs in sexual violence services. We aimed to: 1) describe existing models of CHWs services including characteristics of CHWs, services delivered and populations served; 2) explore acceptability of CHWs' services to survivors and feasibility of delivering such services; and 3) document the benefits and challenges of CHW-provided sexual violence services. Quantitative and qualitative studies reporting on CHWs and other community-level paraprofessional volunteer services for sexual violence were eligible for inclusion. CHWs and sexual violence were defined according to WHO criteria. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Quality of included studies was assessed using two quality assessment tools for quantitative, and, the methodology checklist by the National Institute for Health and Clinical Excellence for qualitative studies. Data were extracted and analysed separately for quantitative and qualitative studies and results integrated using a framework approach. Seven studies conducted in six countries (Democratic Republic of Congo, Rwanda, Burma, United States of America, Scotland, Israel) met the inclusion criteria. Different models of care had diverse CHWs roles including awareness creation, identifying, educating and building relationships with survivors, psychosocial support and follow up. Although sociocultural factors may influence CHWs' performance and willingness of survivors to use their services, studies often did not report on CHWs characteristics. Few studies assessed acceptability of CHWs' to survivors or feasibility of delivery of services. However, participants mentioned a range

  6. Advancing clinical decision support using lessons from outside of healthcare: an interdisciplinary systematic review.

    Science.gov (United States)

    Wu, Helen W; Davis, Paul K; Bell, Douglas S

    2012-08-17

    Greater use of computerized decision support (DS) systems could address continuing safety and quality problems in healthcare, but the healthcare field has struggled to implement DS technology. This study surveys DS experience across multiple non-healthcare disciplines for new insights that are generalizable to healthcare provider decisions. In particular, it sought design principles and lessons learned from the other disciplines that could inform efforts to accelerate the adoption of clinical decision support (CDS). Our systematic review drew broadly from non-healthcare databases in the basic sciences, social sciences, humanities, engineering, business, and defense: PsychINFO, BusinessSource Premier, Social Sciences Abstracts, Web of Science, and Defense Technical Information Center. Because our interest was in DS that could apply to clinical decisions, we selected articles that (1) provided a review, overview, discussion of lessons learned, or an evaluation of design or implementation aspects of DS within a non-healthcare discipline and (2) involved an element of human judgment at the individual level, as opposed to decisions that can be fully automated or that are made at the organizational level. Clinical decisions share some similarities with decisions made by military commanders, business managers, and other leaders: they involve assessing new situations and choosing courses of action with major consequences, under time pressure, and with incomplete information. We identified seven high-level DS system design features from the non-healthcare literature that could be applied to CDS: providing broad, system-level perspectives; customizing interfaces to specific users and roles; making the DS reasoning transparent; presenting data effectively; generating multiple scenarios covering disparate outcomes (e.g., effective; effective with side effects; ineffective); allowing for contingent adaptations; and facilitating collaboration. The article provides examples of

  7. International Monetary Fund sacrifices higher growth, employment, spending, and public investment in health systems in order to keep inflation unnecessarily low.

    Science.gov (United States)

    Rowden, Rick

    2010-01-01

    The International Monetary Fund's response to evidence on the impact of its programs on public health fails to address the fundamental criticisms about its policies. The IMF's demand for borrowers to achieve extremely low inflation targets is founded on very little empirical evidence in the peer-reviewed literature. The low-inflation policies privilege international creditors over domestic debtors and short-term priorities over long-term development goals, and contain high social costs, referred to by economists as a "sacrifice ratio." For example, governments' raising of interest rates to bring down inflation undermines the ability of domestic firms to expand production and employment and thus "sacrifices" higher economic growth and higher tax revenues and unnecessarily constrains domestic health spending. During financial crisis, most countries seek to lower interest rates to stimulate the economy, the opposite of the IMF's general advice. Perversely, compliance with IMF policies has become a prerequisite for receiving donor aid. Critiques of the IMF express significant concerns that IMF fiscal and monetary policies are unduly restrictive. Health advocates must weigh in on such matters and pressure their finance ministries, particularly in the G7, to take steps at the level of the IMF Executive Board to revisit and modify its policy framework on deficits and inflation. Such reforms are crucial to enable countries to generate more domestic resources while the global health community searches for ways to support strengthening health system capacity.

  8. Dalla caduta al deicidio: mito, sacrificio e letteratura - From fall to deicide: myth, sacrifice and literature

    Directory of Open Access Journals (Sweden)

    Manfredi Bortoluzzi

    2013-06-01

    Full Text Available This paper aims to offer a contribute to the anthropology of literature starting from Mario Vargas Llosa’s definition of fiction as deicide. The death of the author proclaimed by post-structuralism seems the last transformation of an ancient western mytheme. The fall into time and the desperate attempt to escape from it by the narrative plot leads the man-author to change himself into a deicide with the purpose to replace the divine creation with a literary one. From an anthropological point of view, the essay develops a mythography of literature that goes from the cosmogonic self-sacrifice to the death of the author which represents a further symbolic immolation to re-write the world. The myths of Tantalus, Prometheus and the Genesis offer a symbolic setting to understand the human need to tell stories. In this analysis, the concept of sacrifice represents a valuable heuristic tool to highlight the complex relation between the reality and the imaginary, the man and his self representation, which is expressed in the Jungian psychology by the terms Ego and Self.

  9. The meaningfulness of participating in support groups for informal caregivers of older adults with dementia: a qualitative systematic review

    DEFF Research Database (Denmark)

    Lauritzen, Jette; Pedersen, Preben Ulrich; Sørensen, Erik Elgaard

    Introduction: Support groups are considered an effective and economical way to relieve informal caregivers stress and burden. Research shows, that participating in support groups seems to be beneficial for the informal caregivers, but there are no significant improvements in feelings of stress...... and burden. It is unclear how support groups can produce a meaningful and optimal outcome for the informal caregivers. Aim: To identify the meaningfulness of participating in support groups for informal caregivers of older adults with dementia living in their own home. Method: A systematic literature review...... that through comparison and sharing positive and negative emotions, the members of the support group are able to take on and maintain the role as caregiver....

  10. Understanding persuasion contexts in health gamification: A systematic analysis of gamified health behavior change support systems literature.

    Science.gov (United States)

    Alahäivälä, Tuomas; Oinas-Kukkonen, Harri

    2016-12-01

    Gamification is increasingly used as a design strategy when developing behavior change support systems in the healthcare domain. It is commonly agreed that understanding the contextual factors is critical for successful gamification, but systematic analyses of the persuasive contexts have been lacking so far within gamified health intervention studies. Through a persuasion context analysis of the gamified health behavior change support systems (hBCSSs) literature, we inspect how the contextual factors have been addressed in the prior gamified health BCSS studies. The implications of this study are to provide the practitioners and researchers examples of how to conduct a systematic analysis to help guide the design and research on gamified health BCSSs. The ideas derived from the analysis of the included studies will help identify potential pitfalls and shortcomings in both the research and implementations of gamified health behavior change support systems. We systematically analyzed the persuasion contexts of 15 gamified health intervention studies. According to our results, gamified hBCSSs are implemented under different facets of lifestyle change and treatments compliance, and use a multitude of technologies and methods. We present a set of ideas and concepts to help improve endeavors in studying gamified health intervention through comprehensive understanding of the persuasive contextual factors. Future research on gamified hBCSSs should systematically compare the different combinations of contextual factors, related theories, chosen gamification strategies, and the study of outcomes to help understand how to achieve the most efficient use of gamification on the different aspects of healthcare. Analyzing the persuasion context is essential to achieve this. With the attained knowledge, those planning health interventions can choose the 'tried-and-tested' approaches for each particular situation, rather than develop solutions in an ad-hoc manner. Copyright © 2016

  11. Archaeological, radiological, and biological evidence offer insight into Inca child sacrifice.

    Science.gov (United States)

    Wilson, Andrew S; Brown, Emma L; Villa, Chiara; Lynnerup, Niels; Healey, Andrew; Ceruti, Maria Constanza; Reinhard, Johan; Previgliano, Carlos H; Araoz, Facundo Arias; Diez, Josefina Gonzalez; Taylor, Timothy

    2013-08-13

    Examination of three frozen bodies, a 13-y-old girl and a girl and boy aged 4 to 5 y, separately entombed near the Andean summit of Volcán Llullaillaco, Argentina, sheds new light on human sacrifice as a central part of the Imperial Inca capacocha rite, described by chroniclers writing after the Spanish conquest. The high-resolution diachronic data presented here, obtained directly from scalp hair, implies escalating coca and alcohol ingestion in the lead-up to death. These data, combined with archaeological and radiological evidence, deepen our understanding of the circumstances and context of final placement on the mountain top. We argue that the individuals were treated differently according to their age, status, and ritual role. Finally, we relate our findings to questions of consent, coercion, and/or compliance, and the controversial issues of ideological justification and strategies of social control and political legitimation pursued by the expansionist Inca state before European contact.

  12. True sacrifice on Hegel’s presentation of self-consciousness

    Directory of Open Access Journals (Sweden)

    Kobe Zdravko

    2015-01-01

    Full Text Available The paper provides a modest reading of Hegel’s treatment of self-consciousness in his Phenomenology of Spirit and tries to present it as an integral part of the overall project of the experience of consciousness leading from understanding to reason. Its immediate objective is, it is argued, to think the independence and dependence, that is the pure and empirical I within the same unity of self-consciousness. This implies a double movement of finding a proper existence for the pure I and at the same time a breaking down of the empirical I’s attachment to particularity. It is argued that the Hegelian struggle for recognition intends to show how the access to reason demands the subject’s renunciation of its attachment to particularity, that is to sacrifice not only its bare life but every thing indeed, including its particular identity, and yet, to go on living.

  13. Systematic review to support the development of nutrient reference intake values: challenges and solutions

    Science.gov (United States)

    Workshops sponsored by the Institute of Medicine (IOM) and the World Health Organization (WHO) suggested that incorporating systematic reviews into the process of updating nutrient reference values would enhance the transparency of the process. The IOM issues the Dietary Reference Intake values (DR...

  14. Why should nuclear power plant management support the systematic approach to training?

    International Nuclear Information System (INIS)

    Haber, S.B.; Yoder, J.A.

    1998-01-01

    The presentation shows the role of management in training of NPP personnel especially in training for technology transfer and training for transfer of the training capabilities. Systematic approach to training should be used to achieve standard among different industries; consistent, effective and efficient training

  15. Considerations for the Development of Mobile Phone Apps to Support Diabetes Self-Management: Systematic Review.

    Science.gov (United States)

    Adu, Mary D; Malabu, Usman H; Callander, Emily J; Malau-Aduli, Aduli Eo; Malau-Aduli, Bunmi S

    2018-06-21

    There is increased research interest in the use of mobile phone apps to support diabetes management. However, there are divergent views on what constitute the minimum standards for inclusion in the development of mobile phone apps. Mobile phone apps require an evidence-based approach to development which will consequently impact on their effectiveness. Therefore, comprehensive information on developmental considerations could help designers and researchers to develop innovative and effective patient-centered self-management mobile phone apps for diabetes patients. This systematic review examined the developmental considerations adopted in trials that engaged mobile phone applications for diabetes self-management. A comprehensive search strategy was implemented across 5 electronic databases; Medline, Scopus, Social Science Citation Index, the Cochrane Central Register of Controlled Trials and Cumulative Index of Nursing and Allied Health Literature (CINALHL) and supplemented by reference list from identified studies. Study quality was evaluated using the Joanna Briggs Critical appraisal checklist for trials. Information on developmental factors (health behavioral theory, functionality, pilot testing, user and clinical expert involvements, data privacy and app security) were assessed across experimental studies using a template developed for the review. A total of 11 studies (10 randomized controlled trials and 1 quasi-experimental trial) that fitted the inclusion criteria were identified. All the included studies had the functionality of self-monitoring of blood glucose. However, only some of them included functions for data analytics (7/11, 63.6%), education (6/11, 54.5%) and reminder (6/11, 54.5%). There were 5/11(45.5%) studies with significantly improved glycosylated hemoglobin in the intervention groups where educational functionality was present in the apps used in the 5 trials. Only 1 (1/11, 9.1%) study considered health behavioral theory and user involvement

  16. The effect of caregiver support interventions for informal caregivers of community-dwelling frail elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Maja Lopez Hartmann

    2012-08-01

    Full Text Available Introduction: Informal caregivers are important resources for community-dwelling frail elderly. But caring can be challenging. To be able to provide long-term care to the elderly, informal caregivers need to be supported as well. The aim of this study is to review the current best evidence on the effectiveness of different types of support services targeting informal caregivers of community-dwelling frail elderly. Methods: A systematic literature search was performed in Medline, PsychINFO, Ovid Nursing Database, Cinahl, Embase, Cochrane Central Register of Controlled Trials and British Nursing Index in september 2010. Results: Overall, the effect of caregiver support interventions is small and also inconsistent between studies. Respite care can be helpful in reducing depression, burden and anger. Interventions at the individual caregivers' level can be beneficial in reducing or stabilizing depression, burden, stress and role strain. Group support has a positive effect on caregivers' coping ability, knowledge, social support and reducing depression. Technology-based interventions can reduce caregiver burden, depression, anxiety and stress and improve the caregiver's coping ability. Conclusion: Integrated support packages where the content of the package is tailored to the individual caregivers' physical, psychological and social needs should be preferred when supporting informal caregivers of frail elderly. It requires an intense collaboration and coordination between all parties involved.

  17. Loneliness and social support of older people in China: a systematic literature review.

    Science.gov (United States)

    Chen, Yu; Hicks, Allan; While, Alison E

    2014-03-01

    Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources. © 2013 John Wiley & Sons Ltd.

  18. A new species of Cladotanytarsus (Lenziella) from Oregon supports the systematic concept of the subgenus (Diptera: Chironomidae).

    Science.gov (United States)

    Puchalski, Mateusz; Giłka, Wojciech

    2017-05-18

    A new species of the genus Cladotanytarsus Kieffer, 1921 and the small subgenus Lenziella Kieffer, 1922 is described from Southern Oregon, USA. The adult male of C. (L.) glaber Giłka et Puchalski, sp. nov., featuring tibial lobes armed with dense setae and a large globular swelling of the hypopygial inferior volsella, supports the recently defined systematic concept for Lenziella. This subgenus is known from seven species distributed in the Northern Hemisphere (1 European, 1 Palaearctic and 5 Nearctic), the males of which are included in an updated identification key.

  19. Systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing.

    Science.gov (United States)

    Jolly, Kate; Ingram, Lucy; Khan, Khalid S; Deeks, Jonathan J; Freemantle, Nick; MacArthur, Christine

    2012-01-25

    To examine the effect of setting, intensity, and timing of peer support on breast feeding. Systematic review and metaregression analysis of randomised controlled trials. Cochrane Library, Medline, CINAHL, the National Research Register, and British Nursing Index were searched from inception or from 1980 to 2011. Review methods Study selection, data abstraction, and quality assessment were carried out independently and in duplicate. Risk ratios and 95% confidence intervals were calculated for individual studies and pooled. Effects were estimated for studies grouped according to setting (high income countries, low or middle income countries, and the United Kingdom), intensity (services in high income countries need to undergo concurrent evaluation.

  20. Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania

    NARCIS (Netherlands)

    Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A.; Schulze, Alexander

    2016-01-01

    Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality

  1. When sustainability of a tourism destination is a requirement: Does the consumer perceive sacrifices in diving experiences?

    Directory of Open Access Journals (Sweden)

    Polyanna de Lourdes Saraiva do Nascimento

    2017-06-01

    Full Text Available Consumer behaviour refers to some subjective characteristics of individuals, their cultural principles and living experiences throughout their lives, aspects that awaken the individual’s desire to consume certain products and services and sometimes the tendency to give up some personal and discretionary resources to concretize this consumption, in other words, to make sacrifices. In this present study, the emphasis focuses on the understanding of the way Dutch and Brazilian consumers carry out the sacrifice in diving experiences, while the practice of sustainability is required. Therefore, the aspects that motivated this study are related to the need to explore the sacrifice theme in consumer relations, mainly when associated with products and services where the hedonic experience is felt, as it is through diving. The research is interpretative, considering that it captures objective results from the studied phenomenon, by using semi-structured interviews collected with divers, totalling twenty-three interviews in Brazil and Netherlands. The collected data was analysed according to content analysis. The results pointed out the relationship between sacrifices and sustainability, in diving experiences associated with the abdication of resources such as: recreation, time, comfort and money. Moreover, the predisposition to sacrifice something is directly related to living experiences during the practice of the activity, considering that it awakens positive feelings and generates a strong individual affective commitment. These aspects emphasize the provision of the individuals to follow the rules for sustainability determined by tourist destinations for diving, as well as the desire to explore without destroying, aiming to keep practicing that activity are that location.

  2. The role of the family in supporting the self-management of chronic conditions: A qualitative systematic review.

    Science.gov (United States)

    Whitehead, Lisa; Jacob, Elisabeth; Towell, Amanda; Abu-Qamar, Ma'en; Cole-Heath, Amanda

    2018-01-01

    To explore the contribution of family members in promoting and supporting the self-management of chronic conditions amongst adult family members. The prevalence of chronic disease continues to grow globally. The role of the family in chronic condition management and support for self-management has received little attention. A systematic review of qualitative literature using the Joanna Briggs Institute approach for qualitative systematic reviews. Ovid (MEDLINE, CINAHL and PsycINFO) were searched for the period of database inception-2016. The QARI (Qualitative Assessment and Review Instrument) critical appraisal instrument was used to assess the quality of each study. Using the Joanna Briggs Institute-QARI data extraction tool, findings related to the family role in the self-management of chronic conditions were extracted and each finding rated according to Joanna Briggs Institute-QARI levels of credibility. Findings were categorised and synthesised to produce a final set of aggregated findings. Families were key in constructing an environment that was conducive to family engagement and support. Adaptation within the family included maintaining cohesion between family members, normalisation and contextualisation of the chronic condition. Whilst evidence on the value of the family in promoting positive health outcomes is clear, research on how families can specifically support the self-management of chronic conditions is emerging. Family adaptability has been found to be the most powerful predictor of carer depression. Families may need support to change their home and family organisation to adapt to the challenges they face overtime. Change in roles and subsequent adaptation can be stressful, even for those family members at a distance. Nurses working in hospital and community settings can play an important role in assessing how families are adapting to living with chronic illness and to explore strategies to cope with challenges in the home setting. © 2017 John

  3. Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

    Science.gov (United States)

    Heinen, Maud M; Bartholomew, L Kay; Wensing, Michel; van de Kerkhof, Peter; van Achterberg, Theo

    2006-05-01

    The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process. Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made. Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures. Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.

  4. A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Rian Adi Pamungkas

    2017-09-01

    Full Text Available The rate of type-2 diabetes mellitus (T2D is dramatically increasing worldwide. Continuing diabetes mellitus (DM care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were “type 2 diabetes,” “self-management,” “diabetes self-management education (DSME,” “family support,” “social support,” and “uncontrolled glycaemia.” Joanna Briggs Institute (JBI guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.

  5. A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients.

    Science.gov (United States)

    Pamungkas, Rian Adi; Chamroonsawasdi, Kanittha; Vatanasomboon, Paranee

    2017-09-15

    The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were "type 2 diabetes," "self-management," "diabetes self-management education (DSME)," "family support," "social support," and "uncontrolled glycaemia." Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.

  6. A systematic review of supportive supervision as a strategy to improve primary healthcare services in Sub-Saharan Africa.

    Science.gov (United States)

    Bailey, Claire; Blake, Carolyn; Schriver, Michael; Cubaka, Vincent Kalumire; Thomas, Tisa; Martin Hilber, Adriane

    2016-01-01

    It may be assumed that supportive supervision effectively builds capacity, improves the quality of care provided by frontline health workers, and positively impacts clinical outcomes. Evidence on the role of supervision in Sub-Saharan Africa has been inconclusive, despite the critical need to maximize the workforce in low-resource settings. To review the published literature from Sub-Saharan Africa on the effects of supportive supervision on quality of care, and health worker motivation and performance. A systematic review of seven databases of both qualitative and quantitative studies published in peer-reviewed journals. Selected studies were based in primary healthcare settings in Sub-Saharan Africa and present primary data concerning supportive supervision. Thematic synthesis where data from the identified studies were grouped and interpreted according to prominent themes. Supportive supervision can increase job satisfaction and health worker motivation. Evidence is mixed on whether this translates to increased clinical competence and there is little evidence of the effect on clinical outcomes. Results highlight the lack of sound evidence on the effects of supportive supervision owing to limitations in research design and the complexity of evaluating such interventions. The approaches required a high level of external inputs, which challenge the sustainability of such models. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Gender differences in computer-mediated communication: a systematic literature review of online health-related support groups.

    Science.gov (United States)

    Mo, Phoenix K H; Malik, Sumaira H; Coulson, Neil S

    2009-04-01

    Previous research has contended that the unique characteristics of the Internet might remove some of the gender differences that exist in face-to-face healthcare. The aims of the present study were to systematically review studies that have examined gender differences in communication within online health communities. A literature search was conducted to identify studies addressing gender differences in messages posted to online health-related support groups. Out of the 1186 articles identified, twelve were retrieved for review. Half of the studies examined gender differences by comparing male and female cancer discussion boards. The literature review revealed that some gender differences were observed in these studies. However, for studies that analysed mixed-gender communities, gender differences were less evident. Results seemed to reveal gender differences in communications in single-sex online health support groups, and similarities in communication patterns in mixed-sex online health support groups. However, findings should be treated with caution due to the diversity in studies and methodological issues highlighted in the present review. There is a need for health care professionals to take into account a range of situational and contextual factors that may affect how men and women use online health support groups. However, more robust research is needed before concrete guidelines can be developed to help health care professionals develop effective online support interventions.

  8. MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

    Science.gov (United States)

    Pavela, James; Suresh, Rahul; Blue, Rebecca S; Mathers, Charles H; Belalcazar, L Maria

    2018-02-01

    Individuals with diabetes are increasingly seeking pretravel advice, but updated professional recommendations remain scant. We performed a systematic review on diabetes management during air travel to summarize current recommendations, assess supporting evidence, and identify areas of future research. A systematic review of the English literature on diabetes management during air travel was undertaken utilizing PubMed and MEDLINE. Publications regarding general travel advice; adjustment of insulin and noninsulin therapies; and the use of insulin pumps, glucometers and subcutaneous glucose sensors at altitude were included. Gathered information was used to create an updated summary of glucose-lowering medication adjustment during air travel. Sixty-one publications were identified, most providing expert opinion and few offering primary data (47 expert opinion, 2 observational studies, 2 case reports, 10 device studies). General travel advice was uniform, with increasing attention to preflight security. Indications for oral antihyperglycemic therapy adjustments varied. There were few recommendations on contemporary agents and on nonhypoglycemic adverse events. There was little consensus on insulin adjustment protocols, many antedating current insulin formulations. Most publications advocated adjusting insulin pump time settings after arrival; however, there was disagreement on timing and rate adjustments. Glucometers and subcutaneous glucose sensors were reported to be less accurate at altitude, but not to an extent that would preclude their clinical use. Recommendations for diabetes management during air travel vary significantly and are mostly based on expert opinion. Data from systematic investigation on glucose-lowering medication adjustment protocols may support the development of a future consensus statement. CSII = continuous subcutaneous insulin infusion (device) DPP-4 = dipeptidyl peptidase 4 EGA = error grid analysis GDH = glucose dehydrogenase GOX = glucose

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

    DEFF Research Database (Denmark)

    Loving, Sys; Nordling, Jørgen; Jaszczak, Poul

    2012-01-01

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

  10. Reaching out to Ebola victims: Coercion, persuasion or an appeal for self-sacrifice?

    Science.gov (United States)

    Calain, Philippe; Poncin, Marc

    2015-12-01

    The 2014-2015 Ebola crisis in West Africa has highlighted the practical limits of upholding human rights and common ethical principles when applying emergency public-health measures. The role of medical teams in the implementation of quarantine and isolation has been equivocal, particularly when such measures are opposed by communities who are coerced by the temporary suspension of civil liberties. In their encounters with Ebola victims, outreach teams face moral dilemmas, where the boundaries are unclear between coercion, persuasion and appeals for self-sacrifice. For those teams, we propose a set of practical recommendations aimed at respecting the autonomy of epidemic victims and easing tensions within communities. We recognize that some of these recommendations are progressively achievable, depending on the specific stage or setting of an outbreak. Yet with the increasing availability of experimental treatments and research interventions, weighing patients' autonomy against the common good will become an even more pressing ethical obligation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Frozen Mummies from Andean Mountaintop Shrines: Bioarchaeology and Ethnohistory of Inca Human Sacrifice.

    Science.gov (United States)

    Ceruti, Maria Constanza

    2015-01-01

    This study will focus on frozen mummies of sacrificial victims from mounts Llullaillaco (6739 m), Quehuar (6130 m), El Toro (6160 m), and the Aconcagua massif. These finds provide bioarchaeological data from mountaintop sites that has been recovered in scientifically controlled excavations in the northwest of Argentina, which was once part of the southern province of the Inca Empire. Numerous interdisciplinary studies have been conducted on the Llullaillaco mummies, including radiological evaluations by conventional X-rays and CT scans, which provided information about condition and pathology of the bones and internal organ, as well as dental studies oriented to the estimation of the ages of the three children at the time of death. Ancient DNA studies and hair analysis were also performed in cooperation with the George Mason University, the University of Bradford, and the Laboratory of Biological Anthropology at the University of Copenhagen. Ethnohistorical sources reveal interesting aspects related to the commemorative, expiatory, propitiatory, and dedicatory aspects of human sacrifice performed under Inca rule. The selection of the victims along with the procedures followed during the performance of the capacocha ceremony will be discussed, based on the bioarchaeological evidences from frozen mummies and the accounts recorded by the Spanish chroniclers.

  12. Frozen Mummies from Andean Mountaintop Shrines: Bioarchaeology and Ethnohistory of Inca Human Sacrifice

    Directory of Open Access Journals (Sweden)

    Maria Constanza Ceruti

    2015-01-01

    Full Text Available This study will focus on frozen mummies of sacrificial victims from mounts Llullaillaco (6739 m, Quehuar (6130 m, El Toro (6160 m, and the Aconcagua massif. These finds provide bioarchaeological data from mountaintop sites that has been recovered in scientifically controlled excavations in the northwest of Argentina, which was once part of the southern province of the Inca Empire. Numerous interdisciplinary studies have been conducted on the Llullaillaco mummies, including radiological evaluations by conventional X-rays and CT scans, which provided information about condition and pathology of the bones and internal organ, as well as dental studies oriented to the estimation of the ages of the three children at the time of death. Ancient DNA studies and hair analysis were also performed in cooperation with the George Mason University, the University of Bradford, and the Laboratory of Biological Anthropology at the University of Copenhagen. Ethnohistorical sources reveal interesting aspects related to the commemorative, expiatory, propitiatory, and dedicatory aspects of human sacrifice performed under Inca rule. The selection of the victims along with the procedures followed during the performance of the capacocha ceremony will be discussed, based on the bioarchaeological evidences from frozen mummies and the accounts recorded by the Spanish chroniclers.

  13. Stunning method effect on the most important parameters which influence sacrifice and quality of pork

    Directory of Open Access Journals (Sweden)

    José Guadalupe Gamboa-Alvarado

    2011-12-01

    Full Text Available The effect of captive bolt pistol (PP and knocked down by hammer (NM on sensibility and pork quality was evaluated employing 28 commercial porks considering as co-variables the ante mortem rest (REP, and environmental moisture (HUM and temperature (TEMP during sacrifice. PSE carcasses presence was higher (P0.05 was observed in the pH and TEMP at 45 min (pH45 and T45, nor at 24 h (pH24 and T24 post mortem in luminosity (L*, yellowness (b* and drip loss (PG, probably because the muscles were already affected by the ante mortem handling. The pH24 showed a negative relationship (P<0.05 with REP and, when REP was superior to 43h, pH24 were characteristics of PSE carcasses. The increase in HUM and REP provoked higher (P<0.01 T24, where carcass cooling required more attention. The knocked down by hammer (NM provoked a higher (P<0.01 redness and CRA by the accumulate stress during ante mortem handling and stunning.

  14. EUGENICS, THE GIRARDIAN THEORY OF SACRIFICE, AND THE NEW DARWINIAN ETHICS

    Directory of Open Access Journals (Sweden)

    THOMAS RYBA

    2011-11-01

    Full Text Available In this paper I argue that, though many ethical systems recognizesacrifice as moral action, the utilitarian appropriation of Neo-Darwinian theory especially as it justifies eugenics as a “winnowing of the human stock” is in Girardian terms analogous to the sacrificial scapegoating of innocents. This argument is accomplished in four steps. (1 I show that within some ethical systems sacrifice is recognized as moral behavior driven by a specific axiology (or theory of value (2 I discuss some of the meta-ethical problems connected with Neo-Darwinian naturalism and naturalism, in general. (3 I show how modern varieties of naturalism and Darwinian naturalism, inparticular are especially inclined to lead to a moral justification of eugenic scapegoating and how Girardian theory is helpful in identifying the moral disorder connected with eugenics. (4 Finally, I conclude by arguing that Darwin’s thought is susceptible to another kind of interpretation, one that need not lead to the valorization of eugenics.

  15. Needs for everyday life support for brain tumour patients' relatives: systematic literature review

    DEFF Research Database (Denmark)

    Madsen, Karina; Poulsen, H S

    2011-01-01

    The purpose of this paper is to undertake a review of the everyday lives and the need for support felt by relatives of adults with malignant cerebral glioma. Through electronic literature searches we identified studies with qualitative, quantitative or mixed method designs. Fourteen studies were....... The relatives lacked information about how to provide day-to-day care and how to manage psychoses and neuropsychiatric problems at home. Likewise, they needed help from the professionals to talk with each other about potentially reduced life expectancy. Most relatives appeared to value specialist nurse support...... highly, and they found support groups helpful. Relatively few studies were identified, and extant research was found to be diverse in purpose, study design and study population. The majority of the studies focused only on the parts of the relatives' everyday lives in which they were taking care...

  16. Maxillary complete denture outcome with two-implant supported mandibular overdentures. A systematic review.

    Science.gov (United States)

    Rutkunas, Vygandas; Mizutani, Hiroshi; Peciuliene, Vytaute; Bendinskaite, Ruta; Linkevicius, Tomas

    2008-01-01

    Research data regarding maxillary complete denture outcome with two-implant supported mandibular overdentures are not consistent. Considering multiple publications on implant supported mandibular overdentures, it was decided to summarize currently present evidence on the maxillary complete dentures opposed by implant-supported mandibular overdentures, and analyze factors that could potentially influence the outcomes. The articles from 1985 to 2007 related to the topic were identified in the online MEDLINE/Pubmed and other databases and manually. Primary articles were scanned, and irrelevant studies were excluded from the further review process. Potentially relevant titles and abstracts were provisionally included for consideration on the basis of full text articles. Full text articles were obtained from on-line and printed sources. The data from the studies were extracted and reviewed. The study has failed to identify any prospective satisfying inclusion/exclusion criteria RCT reporting on maxillary bone resorption. The number of maxillary complete denture relining incidences per patient was constantly increasing during the 10-year period. Maxillary complete denture remake incidences comprised 16-33 % of the number of patients followed during the 10-year period. Comparing patient satisfaction with upper dentures at the baseline and after two years, no decrease in satisfaction was noticed. There is no evidence that maxillary ridge resorption is accelerated with certain types of two-implant supported mandibular overdenture attachments. Most common complication for the maxilla - prosthetic maintenance. There is a risk of decreased patient satisfaction with bar-supported mandibular overdenture. Further studies are needed to provide evidence for the maxillary complete denture outcome with two-implant supported mandibular overdentures.

  17. Phase behavior of supported lipid bilayers: A systematic study by coarse-grained molecular dynamics simulations

    DEFF Research Database (Denmark)

    Poursoroush, Asma; Sperotto, Maria Maddalena; Laradji, Mohamed

    2017-01-01

    Solid-supported lipid bilayers are utilized by experimental scientists as models for biological membranes because of their stability. However, compared to free standing bilayers, their close proximity to the substrate may affect their phase behavior. As this is still poorly understood, and few co...

  18. Involving people with dementia in the development of supportive IT applications: A systematic review

    NARCIS (Netherlands)

    Span, M.; Hettinga, M.; Vernooij-Dassen, M.J.F.J.; Eefsting, J.; Smits, C.

    2013-01-01

    BACKGROUND: Involving people with dementia in research is not self-evident. Inclusion of people with dementia in the development process of user-friendly, supportive IT applications may be especially useful to improve the quality of these applications and may be beneficial to the person with

  19. Involving people with dementia in the development of supportive IT applications: A systematic review

    NARCIS (Netherlands)

    Span, M.; Hettinga, M.; Vernooij-Dassen, M.; Eefsting, J.A.; Smits, C.

    2013-01-01

    Background: Involving people with dementia in research is not self-evident. Inclusion of people with dementia in the development process of user-friendly, supportive IT applications may be especially useful to improve the quality of these applications and may be beneficial to the person with

  20. Community-Based Organisations and How to Support Their Use of Systematic Reviews: A Qualitative Study

    Science.gov (United States)

    Wilson, Michael G.; Lavis, John N.

    2011-01-01

    Unlike for other health system stakeholders, there have been few visible efforts to support the use of research evidence in community-based organisations (CBOs). To begin to address this gap, we conducted focus groups and interviews with executive directors and programme managers of CBOs from the HIV/AIDS, diabetes and mental health and addictions…

  1. Peer and Professional Parenting Support on the Internet: A Systematic Review

    NARCIS (Netherlands)

    dr. Christa C.C. Nieuwboer; Prof.Dr. Ruben G. Fukkink; Prof.Dr. Jo M.A. Hermanns

    2013-01-01

    The Internet offers many opportunities to provide parenting support. An overview of empirical studies in this domain is lacking, and little is known about the design of web based parenting resources and their evaluations, raising questions about its position in the context of parenting intervention

  2. Peer and professional parenting support on the Internet : a systematic review (versie: Dissertatie 2014)

    NARCIS (Netherlands)

    dr. Christa C.C. Nieuwboer

    2014-01-01

    The Internet offers many opportunities to provide parenting support. An overview of empirical studies in this domain is lacking, and little is known about the design of webbased parenting resources and their evaluations, raising questions about its position in the context of parenting intervention

  3. Decision support systems for incurable non-small cell lung cancer : a systematic review

    NARCIS (Netherlands)

    Révész, D; Engelhardt, E G; Tamminga, J J; Schramel, Franz M N H; Onwuteaka-Philipsen, B.D.; van de Garde, E M W; Steyerberg, E.W.; Jansma, E P; de Vet, Henrica C W; Coupé, V.M.H.

    2017-01-01

    BACKGROUND: Individually tailored cancer treatment is essential to ensure optimal treatment and resource use. Treatments for incurable metastatic non-small cell lung cancer (NSCLC) are evolving rapidly, and decision support systems (DSS) for this patient population have been developed to balance

  4. Decision support systems for incurable non-small cell lung cancer: A systematic review

    NARCIS (Netherlands)

    Révész, D. (D.); Engelhardt, E.G. (E. G.); Tamminga, J.J. (J. J.); F.M.N.H. Schramel (Franz); B.D. Onwuteaka-Philipsen (Bregje); E.M.W. van de Garde (Ewoudt); E.W. Steyerberg (Ewout); Jansma, E.P. (E. P.); H.C. de Vet (Henrica C); V.M.H. Coupé (Veerle)

    2017-01-01

    textabstractBackground: Individually tailored cancer treatment is essential to ensure optimal treatment and resource use. Treatments for incurable metastatic non-small cell lung cancer (NSCLC) are evolving rapidly, and decision support systems (DSS) for this patient population have been developed to

  5. Improving Communicative Competence through Synchronous Communication in Computer-Supported Collaborative Learning Environments: A Systematic Review

    Science.gov (United States)

    Huang, Xi

    2018-01-01

    Computer-supported collaborative learning facilitates the extension of second language acquisition into social practice. Studies on its achievement effects speak directly to the pedagogical notion of treating communicative practice in synchronous computer-mediated communication (SCMC): real-time communication that takes place between human beings…

  6. Improving Communicative Competence through Synchronous Communication in Computer-Supported Collaborative Learning Environments: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Xi Huang

    2018-01-01

    Full Text Available Computer-supported collaborative learning facilitates the extension of second language acquisition into social practice. Studies on its achievement effects speak directly to the pedagogical notion of treating communicative practice in synchronous computer-mediated communication (SCMC: real-time communication that takes place between human beings via the instrumentality of computers in forms of text, audio and video communication, such as live chat and chatrooms as socially-oriented meaning construction. This review begins by considering the adoption of social interactionist views to identify key paradigms and supportive principles of computer-supported collaborative learning. A special focus on two components of communicative competence is then presented to explore interactional variables in synchronous computer-mediated communication along with a review of research. There follows a discussion on a synthesis of interactional variables in negotiated interaction and co-construction of knowledge from psycholinguistic and social cohesion perspectives. This review reveals both possibilities and disparities of language socialization in promoting intersubjective learning and diversifying the salient use of interactively creative language in computer-supported collaborative learning environments in service of communicative competence.

  7. Designing Integrated Approaches to Support People with Multimorbidity: Key Messages from Systematic Reviews, Health System Leaders and Citizens.

    Science.gov (United States)

    Wilson, Michael G; Lavis, John N; Gauvin, Francois-Pierre

    2016-11-01

    Living with multiple chronic conditions (multimorbidity) - and facing complex, uncoordinated and fragmented care - is part of the daily life of a growing number of Canadians. We undertook: a knowledge synthesis; a "gap analysis" of existing systematic reviews; an issue brief that synthesized the available evidence about the problem, three options for addressing it and implementation considerations; a stakeholder dialogue involving key health-system leaders; and a citizen panel. We identified several recommendations for actions that can be taken, including: developing evidence-based guidance that providers can use to help achieve goals set by patients; embracing approaches to supporting self-management; supporting greater communication and collaboration across healthcare providers as well as between healthcare providers and patients; and investing more efforts in health promotion and disease prevention. Our results point to the need for health system decision-makers to support bottom-up, person-centred approaches to developing models of care that are tailored for people with multimorbidity and support a research agenda to address the identified priorities. Copyright © 2016 Longwoods Publishing.

  8. Service user experiences of specialist mental health supported accommodation: A systematic review of qualitative studies and narrative synthesis.

    Science.gov (United States)

    Krotofil, Joanna; McPherson, Peter; Killaspy, Helen

    2018-04-02

    Specialist supported accommodation services have become a key component of most community-based mental healthcare systems. While mental health policies highlight the importance of service user involvement in service development and care planning, there are no comprehensive literature reviews synthesising services users' perspectives on, or experiences of, supported accommodation services. This systematic review was undertaken to fill this gap. We searched electronic databases (January 2015, updated June 2017), conducted hand searches and used forward-backward snowballing to identify 13,678 papers. We inspected the full-text of 110 papers and included 50 of these in the final review. Data extraction and quality assessments were conducted. We used narrative synthesis to develop a conceptual model of service users' experiences that included structural, process, relational and contextual factors, such as the characteristics of the service, relationships with staff and other service users, the intensity and nature of support, the physical environment, and social and community integration. The review highlights the complex interplay of individual, service-level and community factors in shaping the lived experience of service users and their impact on personal identity and recovery. Our approach addressed some of the widely reported limitations of the quantitative research in this field, providing a conceptual model relevant to service user experiences across supported accommodation service types, population groups and countries. © 2018 John Wiley & Sons Ltd.

  9. Characteristics of efficacy evidence supporting approval of supplemental indications for prescription drugs in United States, 2005-14: systematic review.

    Science.gov (United States)

    Wang, Bo; Kesselheim, Aaron S

    2015-09-23

    To characterize the types of comparators and endpoints used in efficacy trials for approvals of supplemental indications, compared with the data supporting these drugs' originally approved indications. Systematic review. Publicly accessible data on supplemental indications approved by the US Food and Drug Administration from 2005 to 2014. Types of comparators (active, placebo, historical, none) and endpoints (clinical outcomes, clinical scales, surrogate) in the efficacy trials for these drugs' supplemental and original indication approvals. The cohort included 295 supplemental indications. Thirty per cent (41/136) of supplemental approvals for new indications were supported by efficacy trials with active comparators, compared with 51% (47/93) of modified use approvals and 11% (7/65) of approvals expanding the patient population (Pindications, 30% (28/93) of modified indication approvals, and 22% (14/65) of expanded population approvals (P=0.29). Orphan drugs had supplemental approvals for 40 non-orphan indications, which were supported by similar proportions of trials using active comparators (28% (11/40) for non-orphan supplemental indications versus 24% (10/42) for original orphan indications; P=0.70) and clinical outcome endpoints (25% (10/40) versus 31% (13/42); P=0.55). Wide variations were seen in the evidence supporting approval of supplemental indications, with the fewest active comparators and clinical outcome endpoints used in trials leading to supplemental approvals that expanded the patient population. © Wang et al 2015.

  10. Peer support interventions seeking to improve physical health and lifestyle behaviours among people with serious mental illness: A systematic review.

    Science.gov (United States)

    Stubbs, Brendon; Williams, Julie; Shannon, Jennifer; Gaughran, Fiona; Craig, Tom

    2016-12-01

    People with serious mental illness (SMI) experience a premature mortality gap of between 10 and 20 years. Interest is growing in the potential for peer support interventions (PSI) to improve the physical health of people with SMI. We conducted a systematic review investigating if PSI can improve the physical health, lifestyle factors, and physical health appointment attendance among people with SMI. A systematic search of major electronic databases was conducted from inception until February 2016 for any article investigating PSI seeking to improve physical health, lifestyle, or physical health appointment attendance. From 1347 initial hits, seven articles were eligible, including three pilot randomized, control trials (interventions: n = 85, controls: n = 81), and four pretest and post-test studies (n = 54). There was considerable heterogeneity in the type of PSI, and the role of the peer support workers (PSW) varied considerably. Three studies found that PSI resulted in insignificant reductions in weight. Evidence from three studies considering the impact of PSI on lifestyle changes was equivocal, with only one study demonstrating that PSI improved self-report physical activity and diet. Evidence regarding physical health appointment attendance was also unclear across four studies. In conclusion, there is inconsistent evidence to support the use of PSW to improve the physical health and promote lifestyle change among people with SMI. The small sample sizes, heterogeneity of interventions, outcome measures, and lack of clarity about the unique contribution of PSW means no definitive conclusions can be made about the benefits of PSW and physical health in SMI. © 2016 Australian College of Mental Health Nurses Inc.

  11. Mining unstructured data to support requirements elicitation by using controlled vocabularies: A systematic mapping study

    Directory of Open Access Journals (Sweden)

    José L. Barros-Justo

    2015-01-01

    Full Text Available This paper presents a work-in- progress that deals with the asse ssment of the use of controlled vocabularies during the process es of requirements engineering, as a m eans to mine data from differen t sources (interviews, contracts, schemas and diagrams. By doi ng this the requirements description, analy sis and comprehension is facilit ated for both developers and end users. As a research methodolo gy, we decided to use a systematic mapping study covering the last fou rteen years (2000 - 2014. As far as we know, such studies have not yet been done; however, the cost incurred from errors in the requir ements elicitation phase is one of the problems that is most co mmonly reported by the practitioners. Our study includes data on the p rocesses of building the controlled vocabulary and assesses the productivity and quality. We are also interes ted in tools and techniques to classify and retrieve information. Our first findings suggest t hat this is an under-research area.

  12. 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

  13. The effectiveness of interventions to enhance self-management support competencies in the nursing profession: a systematic review.

    Science.gov (United States)

    Duprez, Veerle; Vandecasteele, Tina; Verhaeghe, Sofie; Beeckman, Dimitri; Van Hecke, Ann

    2017-08-01

    The aim of this study was to explore the effectiveness and effective components of training interventions to enhance nurses' competencies in self-management support in chronic care. The growing burden of chronic diseases puts an increasing focus on nurses' self-management support of people living with a chronic illness. The most effective method to train nurses' competencies in self-management support remains unclear. Systematic literature review. PubMed, CINAHL, Cochrane CENTRAL, EMBASE, Web of Science, ERIC and PsycARTICLES databases were searched up to August 2015. Eligible studies reported on training interventions to enhance chronic care self-management support competencies in nurses. Outcomes were defined as trainees' reactions to the training (level 1), changes in trainees' competencies (level 2) or changes in trainees' performance in practice (level 3) concerning self-management support. Risk of bias was assessed. Level 1 outcomes were synthesized narratively. Standardized mean differences were calculated per study for level 2 and 3 outcomes. In total, 25 studies were included. Twelve of these studies included level 1 outcomes, eight studies included level 2 outcomes and 10 studies included level 3 outcomes. Effect sizes in favour of training ranged from -0·36 - 1·56 (level 2) and from 0·06 - 5·56 (level 3). Theory-driven training interventions with time to practice, (video) feedback and follow-up generated the most training effects. Caution is needed due to the inconsistent study quality. To date, there is a knowledge gap concerning the most effective method to train nurses' competencies in self-management support. More well-designed, longitudinal studies are needed. © 2016 John Wiley & Sons Ltd.

  14. A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

    Science.gov (United States)

    Fowler, G E; Baker, D M; Lee, M J; Brown, S R

    2017-11-01

    The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

  15. Bar versus ball attachments for implant-supported overdentures in complete edentulism: A systematic review.

    Science.gov (United States)

    Anas El-Wegoud, Marwah; Fayyad, Ahmed; Kaddah, Amal; Nabhan, Ashraf

    2018-04-01

    Implant-supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball attachments used to retain overdentures in terms of patient satisfaction and prosthesis retention. The purpose of this study is to compare the effectiveness of bar and ball attachments for conventionally loaded implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention. We conducted the review according to the Cochrane methods and following MECIR standards. We searched Cochrane Oral Health Group Trial register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO ICTRP (March 31, 2017). Two review authors assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals. We included 10 trials (465 participants). After 5 y, one trial reported higher patient satisfaction when bar attachment was used (MD 1.30, 95% CI 0.20-2.40), and reported no difference between both systems in prosthesis retention (MD -0.90, 95% CI -1.90 to 0.10). Two trials reported no implant failures after 1 and 5 y in both attachments. Downgrading of evidence was based on the unclear risk of bias of included studies and the wide CI crossing the line of no effect. There is insufficient evidence to support bar or ball attachment to be used with implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention (PROSPERO 2014:CRD42014014594). © 2017 Wiley Periodicals, Inc.

  16. Improving Communicative Competence through Synchronous Communication in Computer-Supported Collaborative Learning Environments: A Systematic Review

    OpenAIRE

    Xi Huang

    2018-01-01

    Computer-supported collaborative learning facilitates the extension of second language acquisition into social practice. Studies on its achievement effects speak directly to the pedagogical notion of treating communicative practice in synchronous computer-mediated communication (SCMC): real-time communication that takes place between human beings via the instrumentality of computers in forms of text, audio and video communication, such as live chat and chatrooms as socially-oriented meaning c...

  17. Support for reporting guidelines in surgical journals needs improvement: A systematic review.

    Science.gov (United States)

    Agha, Riaz A; Barai, Ishani; Rajmohan, Shivanchan; Lee, Seon; Anwar, Mohammed O; Fowler, Alexander J; Orgill, Dennis P; Altman, Douglas G

    2017-09-01

    Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047-8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the 73 (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

    International Nuclear Information System (INIS)

    Honma, George

    2015-01-01

    The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will be used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).

  19. Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

    Energy Technology Data Exchange (ETDEWEB)

    Honma, George [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-10-01

    The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will be used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).

  20. A SPDS Node to Support the Systematic Interpretation of Cosmic Ray Data

    Science.gov (United States)

    1997-01-01

    The purpose of this project was to establish and maintain a Space Physics Data System (SPDS) node that supports the analysis and interpretation of current and future galactic cosmic ray (GCR) measurements by (1) providing on-line databases relevant to GCR propagation studies; (2) providing other on-line services, such as anonymous FTP access, mail list service and pointers to e-mail address books, to support the cosmic ray community; (3) providing a mechanism for those in the community who might wish to submit similar contributions for public access; (4) maintaining the node to assure that the databases remain current; and (5) investigating other possibilities, such as CD-ROM, for public dissemination of the data products. Shortly after the original grant to support these activities was established at Louisiana State University a detailed study of alternate choices for the node hardware was initiated. The chosen hardware was an Apple Workgroup Server 9150/120 consisting of a 120 MHz PowerPC 601 processor, 32 MB of memory, two I GB disks and one 2 GB disk. This hardware was ordered and installed and has been operating reliably ever since. A preliminary version of the database server was available during the first year effort and was used as part of the very successful SPDS demonstration during the Rome, Italy International Cosmic Ray Conference. For this server version we were able to establish the html and anonymous FTP server software, develop a Web page structure which can be easily modified to include new items, provide an on-line database of charge changing total cross sections, include the cross section prediction software of Silberberg & Tsao as well as Webber, Kish and Schrier for download access, and provide an on-line bibliography of the cross section measurement references by the Transport Collaboration. The preliminary version of this SPDS Cosmic Ray node was examined by members of the C&H SPDS committee and returned comments were used to refine the

  1. Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review.

    Science.gov (United States)

    Banbury, Annie; Nancarrow, Susan; Dart, Jared; Gray, Leonard; Parkinson, Lynne

    2018-02-02

    Group therapy and education and support sessions are used within health care across a range of disciplines such as chronic disease self-management and psychotherapy interventions. However, there are barriers that constrain group attendance, such as mobility, time, and distance. Using videoconferencing may overcome known barriers and improve the accessibility of group-based interventions. The aim of this study was to review the literature to determine the feasibility, acceptability, effectiveness, and implementation of health professional-led group videoconferencing to provide education or social support or both, into the home setting. Electronic databases were searched using predefined search terms for primary interventions for patient education and/or social support. The quality of studies was assessed using the Mixed Methods Appraisal Tool. We developed an analysis framework using hierarchical terms feasibility, acceptability, effectiveness, and implementation, which were informed by subheadings. Of the 1634 records identified, 17 were included in this review. Home-based groups by videoconferencing are feasible even for those with limited digital literacy. Overall acceptability was high with access from the home highly valued and little concern of privacy issues. Some participants reported preferring face-to-face groups. Good information technology (IT) support and training is required for facilitators and participants. Communication can be adapted for the Web environment and would be enhanced by clear communication strategies and protocols. A range of improved outcomes were reported but because of the heterogeneity of studies, comparison of these across studies was not possible. There was a trend for improvement in mental health outcomes. Benefits highlighted in the qualitative data included engaging with others with similar problems; improved accessibility to groups; and development of health knowledge, insights, and skills. Videoconference groups were able to

  2. A systematic mapping review of effective interventions for communicating with, supporting and providing information to parents of preterm infants.

    Science.gov (United States)

    Brett, Jo; Staniszewska, Sophie; Newburn, Mary; Jones, Nicola; Taylor, Lesley

    2011-06-02

    Background and objective The birth of a preterm infant can be an overwhelming experience of guilt, fear and helplessness for parents. Provision of interventions to support and engage parents in the care of their infant may improve outcomes for both the parents and the infant. The objective of this systematic review is to identify and map out effective interventions for communication with, supporting and providing information for parents of preterm infants. Design Systematic searches were conducted in the electronic databases Medline, Embase, PsychINFO, the Cochrane library, the Cumulative Index to Nursing and Allied Health Literature, Midwives Information and Resource Service, Health Management Information Consortium, and Health Management and Information Service. Hand-searching of reference lists and journals was conducted. Studies were included if they provided parent-reported outcomes of interventions relating to information, communication and/or support for parents of preterm infants prior to the birth, during care at the neonatal intensive care unit and after going home with their preterm infant. Titles and abstracts were read for relevance, and papers judged to meet inclusion criteria were included. Papers were data-extracted, their quality was assessed, and a narrative summary was conducted in line with the York Centre for Reviews and Dissemination guidelines. Studies reviewed Of the 72 papers identified, 19 papers were randomised controlled trials, 16 were cohort or quasi-experimental studies, and 37 were non-intervention studies. Results Interventions for supporting, communicating with, and providing information to parents that have had a premature infant are reported. Parents report feeling supported through individualised developmental and behavioural care programmes, through being taught behavioural assessment scales, and through breastfeeding, kangaroo-care and baby-massage programmes. Parents also felt supported through organised support groups and

  3. Prevention of pressure ulcers with a static air support surface: A systematic review.

    Science.gov (United States)

    Serraes, Brecht; van Leen, Martin; Schols, Jos; Van Hecke, Ann; Verhaeghe, Sofie; Beeckman, Dimitri

    2018-03-05

    The aims of this study were to identify, assess, and summarise available evidence about the effectiveness of static air mattress overlays to prevent pressure ulcers. The primary outcome was the incidence of pressure ulcers. Secondary outcomes included costs and patient comfort. This study was a systematic review. Six electronic databases were consulted: Cochrane Library, EMBASE, PubMed (Medline), CINAHL (EBSCOhost interface), Science direct, and Web of Science. In addition, a hand search through reviews, conference proceedings, and the reference lists of the included studies was performed to identify additional studies. Potential studies were reviewed and assessed by 2 independent authors based on the title and abstract. Decisions regarding inclusion or exclusion of the studies were based on a consensus between the authors. Studies were included if the following criteria were met: reporting an original study; the outcome was the incidence of pressure ulcer categories I to IV when using a static air mattress overlay and/or in comparison with other pressure-redistribution device(s); and studies published in English, French, and Dutch. No limitation was set on study setting, design, and date of publication. The methodological quality assessment was evaluated using the Critical Appraisal Skills Program Tool. Results were reported in a descriptive way to reflect the exploratory nature of the review. The searches included 13 studies: randomised controlled trials (n = 11) and cohort studies (n = 2). The mean pressure ulcer incidence figures found in the different settings were, respectively, 7.8% pressure ulcers of categories II to IV in nursing homes, 9.06% pressure ulcers of categories I to IV in intensive care settings, and 12% pressure ulcers of categories I to IV in orthopaedic wards. Seven comparative studies reported a lower incidence in the groups of patients on a static air mattress overlay. Three studies reported a statistical (P pressure ulcers. There

  4. Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2014-05-01

    Full Text Available Objective: To systematically review the effects of omega-3 poly unsaturated fatty acids (FA enriched nutrition support on the mortality of critically illness patients. Methods: Databases of Medline, ISI, Cochrane Library, and Chinese Biomedicine Database were searched and randomized controlled trials (RCTs were identified. We enrolled RCTs that compared fish oil enriched nutrition support and standard nutrition support. Major outcome is mortality. Methodological quality assessment was conducted based on Modified Jadad’s score scale. For control heterogeneity, we developed a method that integrated I2 test, nutritional support route subgroup analysis and clinical condition of severity. RevMan 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark was used for meta-analysis. Results: Twelve trials involving 1208 patients that met all the inclusion criteria. Heterogeneity existed between the trials. A random model was used, there was no significant effect on mortality RR, 0.82, 95% confidence interval (CI (0.62, 1.09, p = 0.18. Knowing that the route of fish oil administration may affect heterogeneity, we categorized the trials into two sub-groups: parenteral administration (PN of omega-3 and enteral administration (EN of omega-3. Six trials administered omega-3 FA through PN. Pooled results indicated that omega-3 FA had no significant effect on mortality, RR 0.76, 95% CI (0.52, 1.10, p = 0.15. Six trials used omega-3 fatty acids enriched EN. After excluded one trial that was identified as source of heterogeneity, pooled data indicated omega-3 FA enriched EN significant reduce mortality, RR=0.69, 95% CI [0.53, 0.91] (p = 0.007. Conclusion: Omega-3 FA enriched nutrition support is safe. Due to the limited sample size of the included trials, further large-scale RCTs are needed.

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

    Science.gov (United States)

    Chambers, Duncan; Wilson, Paul

    2012-07-09

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

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

    Directory of Open Access Journals (Sweden)

    Chambers Duncan

    2012-07-01

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

  7. Service oriented architecture for clinical decision support: a systematic review and future directions.

    Science.gov (United States)

    Loya, Salvador Rodriguez; Kawamoto, Kensaku; Chatwin, Chris; Huser, Vojtech

    2014-12-01

    The use of a service-oriented architecture (SOA) has been identified as a promising approach for improving health care by facilitating reliable clinical decision support (CDS). A review of the literature through October 2013 identified 44 articles on this topic. The review suggests that SOA related technologies such as Business Process Model and Notation (BPMN) and Service Component Architecture (SCA) have not been generally adopted to impact health IT systems' performance for better care solutions. Additionally, technologies such as Enterprise Service Bus (ESB) and architectural approaches like Service Choreography have not been generally exploited among researchers and developers. Based on the experience of other industries and our observation of the evolution of SOA, we found that the greater use of these approaches have the potential to significantly impact SOA implementations for CDS.

  8. Supporting someone with an eating disorder: a systematic review of caregiver experiences of eating disorder treatment and a qualitative exploration of burnout management within eating disorder services

    OpenAIRE

    Fowler, Emma

    2016-01-01

    Aims: Eating disorder recovery is often supported by caregivers and mental health professionals. This research portfolio focuses on the experiences of supporting someone with an eating disorder from the perspective of the caregivers and also mental health professionals. The aims of this research portfolio are: Firstly, to systematically review the published qualitative literature relating to the experiences of caregivers supporting someone during eating disorder treatment; and ...

  9. A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change.

    Science.gov (United States)

    Northcott, Sarah; Moss, Becky; Harrison, Kirsty; Hilari, Katerina

    2016-08-01

    Identify what factors are associated with functional social support and social network post stroke; explore stroke survivors' perspectives on what changes occur and how they are perceived. The following electronic databases were systematically searched up to May 2015: Academic Search Complete; CINAHL Plus; E-journals; Health Policy Reference Centre; MEDLINE; PsycARTICLES; PsycINFO; and SocINDEX. PRISMA guidelines were followed in the conduct and reporting of this review. All included studies were critically appraised using the Critical Appraisal Skills Program tools. Meta-ethnographic techniques were used to integrate findings from the qualitative studies. Given the heterogeneous nature of the quantitative studies, data synthesis was narrative. Seventy research reports met the eligibility criteria: 22 qualitative and 48 quantitative reporting on 4,816 stroke survivors. The qualitative studies described a contraction of the social network, with non-kin contact being vulnerable. Although family were more robust network members, significant strain was observed within the family unit. In the quantitative studies, poor functional social support was associated with depression (13/14 studies), reduced quality of life (6/6 studies) and worse physical recovery (2/2 studies). Reduced social network was associated with depression (7/8 studies), severity of disability (2/2 studies) and aphasia (2/2 studies). Although most indicators of social network reduced post stroke (for example, contact with friends, 5/5 studies), the perception of feeling supported remained relatively stable (4/4 studies). Following a stroke non-kin contact is vulnerable, strain is observed within the family unit, and poor social support is associated with depressive symptoms. © The Author(s) 2015.

  10. Internet interventions to support lifestyle modification for diabetes management: a systematic review of the evidence.

    Science.gov (United States)

    Cotter, Alexander P; Durant, Nefertiti; Agne, April A; Cherrington, Andrea L

    2014-01-01

    The Internet presents a widely accessible, 24-h means to promote chronic disease management. The objective of this review is to identify studies that used Internet based interventions to promote lifestyle modification among adults with type 2 diabetes. We searched PubMed using the terms: [internet, computer, phone, smartphone, mhealth, mobile health, web based, telehealth, social media, text messages] combined with [diabetes management and diabetes control] through January 2013. Studies were included if they described an Internet intervention, targeted adults with type 2 diabetes, focused on lifestyle modification, and included an evaluation component with behavioral outcomes. Of the 2803 papers identified, nine met inclusion criteria. Two studies demonstrated improvements in diet and/or physical activity and two studies demonstrated improvements in glycemic control comparing web-based intervention with control. Successful studies were theory-based, included interactive components with tracking and personalized feedback, and provided opportunities for peer support. Website utilization declined over time in all studies that reported on it. Few studies focused on high risk, underserved populations. Web-based strategies provide a viable option for facilitating diabetes self-management. Future research is needed on the use of web-based interventions in underserved communities and studies examining website utilization patterns and engagement over time. © 2014 Elsevier Inc. All rights reserved.

  11. Technologies as Support Tools for Persons with Autistic Spectrum Disorder: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Nuria Aresti-Bartolome

    2014-08-01

    Full Text Available This study analyzes the technologies most widely used to work on areas affected by the Autistic Spectrum Disorder (ASD. Technologies can focus on the strengths and weaknesses of this disorder as they make it possible to create controlled environments, reducing the anxiety produced by real social situations. Extensive research has proven the efficiency of technologies as support tools for therapy and their acceptation by ASD sufferers and the people who are with them on a daily basis. This article is organized by the types of systems developed: virtual reality applications, telehealth systems, social robots and dedicated applications, all of which are classified by the areas they center on: communication, social learning and imitation skills and other ASD-associated conditions. 40.5% of the research conducted is found to be focused on communication as opposed to 37.8% focused on learning and social imitation skills and 21.6% which underlines problems associated with this disorder. Although most of the studies reveal how useful these tools are in therapy, they are generic tools for ASD sufferers in general, which means there is a lack of personalised tools to meet each person’s needs.

  12. Technologies as Support Tools for Persons with Autistic Spectrum Disorder: A Systematic Review

    Science.gov (United States)

    Aresti-Bartolome, Nuria; Garcia-Zapirain, Begonya

    2014-01-01

    This study analyzes the technologies most widely used to work on areas affected by the Autistic Spectrum Disorder (ASD). Technologies can focus on the strengths and weaknesses of this disorder as they make it possible to create controlled environments, reducing the anxiety produced by real social situations. Extensive research has proven the efficiency of technologies as support tools for therapy and their acceptation by ASD sufferers and the people who are with them on a daily basis. This article is organized by the types of systems developed: virtual reality applications, telehealth systems, social robots and dedicated applications, all of which are classified by the areas they center on: communication, social learning and imitation skills and other ASD-associated conditions. 40.5% of the research conducted is found to be focused on communication as opposed to 37.8% focused on learning and social imitation skills and 21.6% which underlines problems associated with this disorder. Although most of the studies reveal how useful these tools are in therapy, they are generic tools for ASD sufferers in general, which means there is a lack of personalised tools to meet each person’s needs. PMID:25093654

  13. Systematic maintenance analysis with decision support method and tool for optimizing maintenance programme

    International Nuclear Information System (INIS)

    Laakso, K.; Simola, K.; Dorrepaal, J.; Skogberg, P.

    1999-01-01

    This report describes an approach to evaluate the effectiveness of test and maintenance programs of technical systems used during several years. The method combines an analysis of the historical data on faults and repairs with an analysis of the history of periodic testing and preventive maintenance action programs. The application of the maintenance analysis from the methodological point of view in the reliability centered maintenance (RCM) project for Barsebaeck nuclear power plant is described. In order to limit the analysis resources, a method for ranking of objects for maintenance analysis is needed. Preliminary suggestions for changes in maintenance action programs are based on signals from simple maintenance indicators and qualitative analysis of underlying data on failures and maintenance. To facilitate generation of maintenance indicators, and make the maintenance analysis more efficient, a powerful and suitable data treatment tool is needed for analysis of the work order history. In the final maintenance decisions, additional decision criteria must be taken into account, and thus a more formal decision analysis is often needed for decision support. (au)

  14. Digital Support Interventions for the Self-Management of Low Back Pain: A Systematic Review.

    Science.gov (United States)

    Nicholl, Barbara I; Sandal, Louise F; Stochkendahl, Mette J; McCallum, Marianne; Suresh, Nithya; Vasseljen, Ottar; Hartvigsen, Jan; Mork, Paul J; Kjaer, Per; Søgaard, Karen; Mair, Frances S

    2017-05-21

    Low back pain (LBP) is a common cause of disability and is ranked as the most burdensome health condition globally. Self-management, including components on increased knowledge, monitoring of symptoms, and physical activity, are consistently recommended in clinical guidelines as cost-effective strategies for LBP management and there is increasing interest in the potential role of digital health. The study aimed to synthesize and critically appraise published evidence concerning the use of interactive digital interventions to support self-management of LBP. The following specific questions were examined: (1) What are the key components of digital self-management interventions for LBP, including theoretical underpinnings? (2) What outcome measures have been used in randomized trials of digital self-management interventions in LBP and what effect, if any, did the intervention have on these? and (3) What specific characteristics or components, if any, of interventions appear to be associated with beneficial outcomes? Bibliographic databases searched from 2000 to March 2016 included Medline, Embase, CINAHL, PsycINFO, Cochrane Library, DoPHER and TRoPHI, Social Science Citation Index, and Science Citation Index. Reference and citation searching was also undertaken. Search strategy combined the following concepts: (1) back pain, (2) digital intervention, and (3) self-management. Only randomized controlled trial (RCT) protocols or completed RCTs involving adults with LBP published in peer-reviewed journals were included. Two reviewers independently screened titles and abstracts, full-text articles, extracted data, and assessed risk of bias using Cochrane risk of bias tool. An independent third reviewer adjudicated on disagreements. Data were synthesized narratively. Of the total 7014 references identified, 11 were included, describing 9 studies: 6 completed RCTs and 3 protocols for future RCTs. The completed RCTs included a total of 2706 participants (range of 114

  15. Use of technology to support information needs for continuity of operations planning in public health: a systematic review.

    Science.gov (United States)

    Reeder, Blaine; Turner, Anne; Demiris, George

    2010-01-01

    Continuity of operations planning focuses on an organization's ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems. To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review. A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems. There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success.

  16. Molecular systematics and biodiversity of the Cryptotis mexicanus group (Eulipotyphla: Soricidae): two new species from Honduras supported

    Science.gov (United States)

    Baird, Amy B.; McCarthy, Timothy J.; Trujillo, Robert G.; Kang, Yuan Yuan; Esmaeiliyan, Mehdi; Valdez, Joselyn; Woodman, Neal; Bickham, John W.

    2018-01-01

    Small-eared shrews of the genus Cryptotis (Mammalia: Eulipotyphla: Soricidae) are widespread in the northern Neotropics. Systematic studies of these shrews over the past two decades have revealed previously undocumented morphological and species diversity, resulting in a quadrupling of the number of recognized species. Unfortunately, a small proportion of the species in the genus have been included in molecular phylogenetic studies, and evolutionary relationships within the genus are incompletely known. Traditionally, species have been assigned to four or five morphologically defined ‘species groups’, but tests of the monophyly of some of these groups show weak support and relationships amongst species groups remain somewhat speculative. The largest species group is the C. mexicanus group inhabiting Mexico and northern Central America. We studied sequences from mitochondrial cytochrome-b and 16S genes, as well as nuclear ApoB and BRCA1 genes from 22 species of Cryptotis, including 15 species in the C. mexicanus group. Our combined analysis shows that the C. goldmani subgroup is very weakly supported as monophyletic; however, the C. mexicanus group as a whole is not monophyletic. Our molecular phylogenetic analyses confirm the distinctiveness of two newly described species (C. celaque and C. mccarthyi) from isolated highlands of western Honduras and illustrate their relationship with other species formerly considered part of a widespread C. goodwini.

  17. Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence.

    Science.gov (United States)

    Modini, Matthew; Tan, Leona; Brinchmann, Beate; Wang, Min-Jung; Killackey, Eoin; Glozier, Nicholas; Mykletun, Arnstein; Harvey, Samuel B

    2016-07-01

    Individual placement and support (IPS) is a vocational rehabilitation programme that was developed in the USA to improve employment outcomes for people with severe mental illness. Its ability to be generalised to other countries and its effectiveness in varying economic conditions remains to be ascertained. To investigate whether IPS is effective across international settings and in different economic conditions. A systematic review and meta-analysis of randomised controlled trials comparing IPS with traditional vocational services was undertaken; 17 studies, as well as 2 follow-up studies, were included. Meta-regressions were carried out to examine whether IPS effectiveness varied according to geographic location, unemployment rates or gross domestic product (GDP) growth. The overall pooled risk ratio for competitive employment using IPS compared with traditional vocational rehabilitation was 2.40 (95% CI 1.99-2.90). Meta-regressions indicated that neither geographic area nor unemployment rates affected the overall effectiveness of IPS. Even when a country's GDP growth was less than 2% IPS was significantly more effective than traditional vocational training, and its benefits remained evident over 2 years. Individual placement and support is an effective intervention across a variety of settings and economic conditions and is more than twice as likely to lead to competitive employment when compared with traditional vocational rehabilitation. © The Royal College of Psychiatrists 2016.

  18. Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

    Science.gov (United States)

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

  19. Experiences of and support for nurses as second victims of adverse nursing errors: a qualitative systematic review.

    Science.gov (United States)

    Cabilan, C J; Kynoch, Kathryn

    2017-09-01

    Second victims are clinicians who have made adverse errors and feel traumatized by the experience. The current published literature on second victims is mainly representative of doctors, hence nurses' experiences are not fully depicted. This systematic review was necessary to understand the second victim experience for nurses, explore the support provided, and recommend appropriate support systems for nurses. To synthesize the best available evidence on nurses' experiences as second victims, and explore their experiences of the support they receive and the support they need. Participants were registered nurses who made adverse errors. The review included studies that described nurses' experiences as second victims and/or the support they received after making adverse errors. All studies conducted in any health care settings worldwide. The qualitative studies included were grounded theory, discourse analysis and phenomenology. A structured search strategy was used to locate all unpublished and published qualitative studies, but was limited to the English language, and published between 1980 and February 2017. The references of studies selected for eligibility screening were hand-searched for additional literature. Eligible studies were assessed by two independent reviewers for methodological quality using a standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI QARI). Themes and narrative statements were extracted from papers included in the review using the standardized data extraction tool from JBI QARI. Data synthesis was conducted using the Joanna Briggs Institute meta-aggregation approach. There were nine qualitative studies included in the review. The narratives of 284 nurses generated a total of 43 findings, which formed 15 categories based on similarity of meaning. Four synthesized findings were generated from the categories: (i) The error brings a considerable emotional burden to the

  20. Women’s experiences of personalised support for asthma care during pregnancy: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Graham R. Williamson

    2017-02-01

    Full Text Available Abstract Background Asthma and pregnancy are both sources of anxiety for women. Although there has been a focus on physiological management of asthma and pregnancy, there has been little research on the impact that personalised support can have on asthma care during pregnancy. This systematic review and narrative synthesis of the literature set out to answer the question ‘What are women’s experiences of asthma care, its management and education, during pregnancy?’ Methods This systematic review was carried out using accepted methodology from the York Centre for Reviews and Dissemination. Electronic database searches were conducted using PsycInfo, CINAHL, MedLine, Google Scholar and the Cochrane Library, using the combination search terms: ‘Asthma’ AND ‘Pregnancy’ AND ‘Care’ AND (‘Education OR Information OR Experience’. Hand searching of journals and searches for grey literature were also undertaken. Independent quality appraisal by the three authors took place using the criteria detailed by Kmet et al. (Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields, 2004. Results All papers scoring in excess of 60% were deemed to be of adequate quality for inclusion, of which there were five: two qualitative designs and three quantitative designs. The designs were too methodologically heterogeneous to permit statistical meta-analysis so narrative review and synthesis was undertaken. Despite an embryonic evidence bases, it is reasonable to conclude that personalised care has beneficial outcomes for pregnant asthmatic women. Conclusions Larger randomised controlled trials investigating personalised care are required to build an evidence base which can establish the efficacy of such interventions.

  1. Self-Management and Self-Management Support Outcomes: A Systematic Review and Mixed Research Synthesis of Stakeholder Views.

    Directory of Open Access Journals (Sweden)

    Emma Boger

    Full Text Available Self-management has received growing attention as an effective approach for long-term condition management. Little is known about which outcomes of supported self-management are valued by patients, their families, health professionals and those who commission self-management services. This study systematically reviewed published empirical evidence in accordance with PRISMA guidelines to determine the outcomes of self-management valued by these key stakeholder groups, using three prominent exemplar conditions: colorectal cancer, diabetes and stroke.To systematically review the literature to identify which generic outcomes of self-management have been targeted and are considered important using three exemplar conditions (colorectal cancer, diabetes and stroke, which collectively have a range of features that are likely to be representative of generic self-management issues.Systematic searching of nine electronic databases was conducted in addition to hand searches of review articles. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool. Synthesis of findings was conducted using mixed research synthesis.Over 20,536 abstracts were screened. 41 studies which met the review criteria were fully retrieved and appraised. The majority of evidence related to diabetes. Few studies directly focussed on stakeholders' views concerning desired self-management outcomes; the majority of evidence was derived from studies focusing upon the experience of self-management. The views of health care commissioners were absent from the literature. We identified that self-management outcomes embrace a range of indicators, from knowledge, skills, and bio-psychosocial markers of health through to positive social networks.Patients', families', health professionals' and commissioners' views regarding which outcomes of self-management are important have not been clearly elicited. The extent to which

  2. A systematic review of socio-economic assessments in support of coastal zone management (1992-2011).

    Science.gov (United States)

    Le Gentil, Eric; Mongruel, Rémi

    2015-02-01

    Cooperation between the social and natural sciences has become essential in order to encompass all the dimensions of coastal zone management. Socio-economic approaches are increasingly recommended to complement integrated assessment in support of these initiatives. A systematic review of the academic literature was carried out in order to analyze the main types of socio-economic assessments used to inform the coastal zone management process as well as their effectiveness. A corpus of 1682 articles published between 1992 and 2011 was identified by means of the representative coverage approach, from which 170 were selected by applying inclusion/exclusion criteria and then classified using a content analysis methodology. The percentage of articles that mention the use of socio-economic assessment in support of coastal zone management initiatives is increasing but remains relatively low. The review examines the links between the issues addressed by integrated assessments and the chosen analytical frameworks as well as the various economic assessment methods which are used in the successive steps of the coastal zone management process. The results show that i) analytical frameworks such as 'risk and vulnerability', 'DPSIR', 'valuation', 'ecosystem services' and 'preferences' are likely to lead to effective integration of social sciences in coastal zone management research while 'integration', 'sustainability' and 'participation' remain difficult to operationalize, ii) risk assessments are insufficiently implemented in developing countries, and iii) indicator systems in support of multi-criteria analyses could be used during more stages of the coastal zone management process. Finally, it is suggested that improved collaboration between science and management would require that scientists currently involved in coastal zone management processes further educate themselves in integrated assessment approaches and participatory methodologies. Copyright © 2014 Elsevier Ltd

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

    Directory of Open Access Journals (Sweden)

    Mickenautsch Steffen

    2012-01-01

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

  4. Web-Based Interventions Supporting Adolescents and Young People With Depressive Symptoms: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Välimäki, Maritta; Anttila, Katriina; Anttila, Minna; Lahti, Mari

    2017-12-08

    Although previous studies on information and communication technology (ICT)-based intervention on mental health among adolescents with depressive symptoms have already been combined in a number of systematic reviews, coherent information is still missing about interventions used, participants' engagement of these interventions, and how these interventions work. We conducted a systematic review and meta-analysis of trials to describe the effectiveness of Web-based interventions to support adolescents with depression or depressive symptoms, anxiety, and stress. We also explored the content of the interventions, as there has previously been a lack of coherent understanding of the detailed content of the Web-based interventions for these purposes. We included parallel randomized controlled trials targeted at adolescents, or young people in the age range of 10 and 24 years, with symptoms or diagnoses of depression and anxiety. The interventions were from original studies aimed to support mental health among adolescents, and they were delivered via Web-based information and communication technology. Out of 2087 records identified, 27 papers (22 studies) met the inclusion criteria. On the basis of a narrative analysis of 22 studies, a variety of Web-based interventions were found; the most commonly used intervention was based on cognitive behavioral therapy. Meta-analysis was further conducted with 15 studies (4979 participants). At the end of the intervention, a statistically significant improvement was found in the intervention group (10 studies) regarding depressive symptoms (P=.02, median 1.68, 95% CI 3.11-0.25) and after 6 months (3 studies; P=.01, median 1.78, 95% CI 3.20-0.37). Anxiety symptoms (8 studies; Pstress scores. However, adolescents in the intervention group left the study early more often, both in short-term studies (11 studies; P=.007, median 1.31, 95% CI 1.08-1.58) and mid-term studies (3 studies; P=.02, median 1.65, 95% CI 1.09-2.49). We did not find

  5. Lumbar Supports for Prevention and Treatment of Low Back Pain: A Systematic Review Within the Framework of the Cochrane Back Review Group

    DEFF Research Database (Denmark)

    Jellema, Petra; van Tulder, Maurits W; van Poppel, Mireille N M

    2001-01-01

    Study Design : A systematic review of randomized and nonrandomized controlled trials. Summary of Background Data : Lumbar supports are used in the treatment of low back pain, but also to prevent the onset (primary prevention) or recurrences of a low back pain episode (secondary prevention......). Objectives: To assess the effects of lumbar sup-ports for prevention and treatment of nonspecific low back pain. Methods: The Medline, Cinahl, and Current Contents databases; the Cochrane Controlled Trials Register up to September 1999; and the Embase database up to September 1998 were all searched...... are not effective for primary prevention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, whereas it is still unclear whether lumbar...

  6. Interventions to support effective communication between maternity care staff and women in labour: A mixed-methods systematic review.

    Science.gov (United States)

    Chang, Yan-Shing; Coxon, Kirstie; Portela, Anayda Gerarda; Furuta, Marie; Bick, Debra

    2018-04-01

    the objectives of this review were (1) to assess whether interventions to support effective communication between maternity care staff and healthy women in labour with a term pregnancy could improve birth outcomes and experiences of care; and (2) to synthesize information related to the feasibility of implementation and resources required. a mixed-methods systematic review. studies which reported on interventions aimed at improving communication between maternity care staff and healthy women during normal labour and birth, with no apparent medical or obstetric complications, and their family members were included. 'Maternity care staff' included medical doctors (e.g. obstetricians, anaesthetists, physicians, family doctors, paediatricians), midwives, nurses and other skilled birth attendants providing labour, birth and immediate postnatal care. Studies from all birth settings (any country, any facility including home birth, any resource level) were included. two papers met the inclusion criteria. One was a step wedge randomised controlled trial conducted in Syria, and the other a sub-analysis of a randomised controlled trial from the United Kingdom. Both studies aimed to assess effects of communication training for maternity care staff on women's experiences of labour care. The study from Syria reported that a communication skills training intervention for resident doctors was not associated with higher satisfaction reported by women. In the UK study, patient-actors' (experienced midwives) perceptions of safety and communication significantly improved for postpartum haemorrhage scenarios after training with patient-actors in local hospitals, compared with training using manikins in simulation centres, but no differences were identified for other scenarios. Both studies had methodological limitations. the review identified a lack of evidence on impact of interventions to support effective communication between maternity care staff and healthy women during labour and

  7. Does the scientific evidence support the advertising claims made for products containing Lactobacillus casei and Bifidobacterium lactis? A systematic review.

    Science.gov (United States)

    Meléndez-Illanes, Lorena; González-Díaz, Cristina; Chilet-Rosell, Elisa; Álvarez-Dardet, Carlos

    2016-09-01

    To analyse the scientific evidence that exists for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis and to conduct a comparison between the published literature and what is presented in the corporate website. Systematic review, using Medline through Pubmed and Embase. We included human clinical trials that exclusively measured the effect of Lactobacillus casei or Bifidobacterium lactis on a healthy population, and where the objective was related to the health claims made for certain products in advertising. We assessed the levels of evidence and the strength of the recommendation according to the classification criteria established by the Oxford Centre for Evidence Based Medicine (CEBM). We also assessed the outcomes of the studies published on the website that did not appear in the search. Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) of these presented a level of evidence of 1b and a recommendation grade of A, all corresponding to studies on product containing Bifidobacterium lactis, and only 12 of the 16 studies were published on the corporate website (47). There is insufficient scientific evidence to support the health claims made for these products, especially in the case of product containing Lactobacillus casei. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

    Science.gov (United States)

    Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

  9. Effectiveness of computerized clinical decision support systems for asthma and chronic obstructive pulmonary disease in primary care: a systematic review.

    Science.gov (United States)

    Fathima, Mariam; Peiris, David; Naik-Panvelkar, Pradnya; Saini, Bandana; Armour, Carol Lyn

    2014-12-02

    The use of computerized clinical decision support systems may improve the diagnosis and ongoing management of chronic diseases, which requires recurrent visits to multiple health professionals, disease and medication monitoring and modification of patient behavior. The aim of this review was to systematically review randomized controlled trials evaluating the effectiveness of computerized clinical decision systems (CCDSS) in the care of people with asthma and COPD. Randomized controlled trials published between 2003 and 2013 were searched using multiple electronic databases Medline, EMBASE, CINAHL, IPA, Informit, PsychINFO, Compendex, and Cochrane Clinical Controlled Trials Register databases. To be included, RCTs had to evaluate the role of the CCDSSs for asthma and/or COPD in primary care. Nineteen studies representing 16 RCTs met our inclusion criteria. The majority of the trials were conducted in patients with asthma. Study quality was generally high. Meta-analysis was not conducted because of methodological and clinical heterogeneity. The use of CCDSS improved asthma and COPD care in 14 of the 19 studies reviewed (74%). Nine of the nineteen studies showed statistically significant (p < 0.05) improvement in the primary outcomes measured. The majority of the studies evaluated health care process measures as their primary outcomes (10/19). Evidence supports the effectiveness of CCDSS in the care of people with asthma. However there is very little information of its use in COPD care. Although there is considerable improvement in the health care process measures and clinical outcomes through the use of CCDSSs, its effects on user workload and efficiency, safety, costs of care, provider and patient satisfaction remain understudied.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury : A systematic review

    NARCIS (Netherlands)

    Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja

    Objective: To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Methods: Cochrane, MEDLINE, EM BASE, CINAHL, PEDro, DocOnline

  12. Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury: a systematic review

    NARCIS (Netherlands)

    Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja

    2010-01-01

    To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Cochrane, MEDLINE, EMBASE, CINAHL, PEDro, DocOnline were searched and

  13. Autism Spectrum Disorder: Does Neuroimaging Support the DSM-5 Proposal for a Symptom Dyad? A Systematic Review of Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Studies

    Science.gov (United States)

    Pina-Camacho, Laura; Villero, Sonia; Fraguas, David; Boada, Leticia; Janssen, Joost; Navas-Sanchez, Francisco J.; Mayoral, Maria; Llorente, Cloe; Arango, Celso; Parellada, Mara

    2012-01-01

    A systematic review of 208 studies comprising functional magnetic resonance imaging and diffusion tensor imaging data in patients with "autism spectrum disorder" (ASD) was conducted, in order to determine whether these data support the forthcoming DSM-5 proposal of a social communication and behavioral symptom dyad. Studies consistently reported…

  14. Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis

    NARCIS (Netherlands)

    Verra, Wiebe C.; van den Boom, Lennard G. H.; Jacobs, Wilco; Clement, Darren J.; Wymenga, Ate A. B.; Nelissen, Rob G. H. H.

    2013-01-01

    Background The functional and clinical basis on which to choose whether or not to retain the posterior cruciate ligament during total knee arthroplasty surgery remained unclear after a Cochrane systematic review and meta-analysis in 2005, which contained eight clinical trials. Several new trials

  15. Protocol for a systematic review of evaluation research for adults who have participated in the 'SMART recovery' mutual support programme.

    Science.gov (United States)

    Beck, Alison K; Baker, Amanda; Kelly, Peter J; Deane, Frank P; Shakeshaft, Anthony; Hunt, David; Forbes, Erin; Kelly, John F

    2016-05-23

    Self-Management and Recovery Training (SMART Recovery) offers an alternative to predominant 12-step approaches to mutual aid (eg, alcoholics anonymous). Although the principles (eg, self-efficacy) and therapeutic approaches (eg, motivational interviewing and cognitive behavioural therapy) of SMART Recovery are evidence based, further clarity regarding the direct evidence of its effectiveness as a mutual aid package is needed. Relative to methodologically rigorous reviews supporting the efficacy of 12-step approaches, to date, reviews of SMART Recovery have been descriptive. We aim to address this gap by providing a comprehensive overview of the evidence for SMART Recovery in adults with problematic alcohol, substance and/or behavioural addiction, including a commentary on outcomes assessed, potential mediators, feasibility (including economic outcomes) and a critical evaluation of the methods used. Methods are informed by the Cochrane Guidelines for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. 6 electronic peer-reviewed and 4 grey literature databases have been identified. Preliminary searches have been conducted for SMART Recovery literature (liberal inclusion criteria, not restricted to randomised controlled trials (RCTs), qualitative-only designs excluded). Eligible 'evaluation' articles will be assessed against standardised criteria and checked by an independent assessor. The searches will be re-run just before final analyses and further studies retrieved for inclusion. A narrative synthesis of the findings will be reported, structured around intervention type and content, population characteristics, and outcomes. Where possible, 'summary of findings' tables will be generated for each comparison. When data are available, we will calculate a risk ratio and its 95% CI (dichotomous outcomes) and/or effect size according to Cohen's formula (continuous outcomes) for the primary outcome of each trial. No

  16. The Bible Student’s Sacrifice: Gender Fluidity and Consecrated Identity in Evangelical America, 1879-1916

    Directory of Open Access Journals (Sweden)

    Timothy Robert Noddings

    2012-11-01

    Full Text Available American feminist scholars have often represented gender in nineteenth-century evangelical Protestantism as a binary conflict between oppositional ‘male’ and ‘female’ categories of identity and experience. Drawing on the theoretical work of Jeanne Boydston, this article argues that gender within evangelical religion is better understood as a ‘system of distinctions’ that could be articulated in a variety of ways, some of which violated the gendered division of masculine/feminine. The American Bible Student movement, as a fervent millennialist organization, demanded that its members sacrifice their individuality to become ‘harvest workers’ for Christ. This sacrifice temporarily provided Students with a degree of freedom to construct spiritual identities that combined ‘masculine’ and ‘feminine’ signifiers, de-stabilizing the binary meaning of gender. After 1897, a series of internal challenges and schisms re-solidified the gender line, associating stability with the limiting of women’s power within both church and home.

  17. Bayesian approach to estimate AUC, partition coefficient and drug targeting index for studies with serial sacrifice design.

    Science.gov (United States)

    Wang, Tianli; Baron, Kyle; Zhong, Wei; Brundage, Richard; Elmquist, William

    2014-03-01

    The current study presents a Bayesian approach to non-compartmental analysis (NCA), which provides the accurate and precise estimate of AUC 0 (∞) and any AUC 0 (∞) -based NCA parameter or derivation. In order to assess the performance of the proposed method, 1,000 simulated datasets were generated in different scenarios. A Bayesian method was used to estimate the tissue and plasma AUC 0 (∞) s and the tissue-to-plasma AUC 0 (∞) ratio. The posterior medians and the coverage of 95% credible intervals for the true parameter values were examined. The method was applied to laboratory data from a mice brain distribution study with serial sacrifice design for illustration. Bayesian NCA approach is accurate and precise in point estimation of the AUC 0 (∞) and the partition coefficient under a serial sacrifice design. It also provides a consistently good variance estimate, even considering the variability of the data and the physiological structure of the pharmacokinetic model. The application in the case study obtained a physiologically reasonable posterior distribution of AUC, with a posterior median close to the value estimated by classic Bailer-type methods. This Bayesian NCA approach for sparse data analysis provides statistical inference on the variability of AUC 0 (∞) -based parameters such as partition coefficient and drug targeting index, so that the comparison of these parameters following destructive sampling becomes statistically feasible.

  18. Introduzione. Su Dio e i suoi uomini e i nostri sacrifici - Introduction. On God and His Men and Our Sacrifices

    Directory of Open Access Journals (Sweden)

    Antonio Luigi Palmisano

    2015-11-01

    Full Text Available Anthropology has maybe too often confined itself in an analysis of liturgies and rituals – ideal or actual behaviours which are acknowledged by the social actor as addressed to supernatural beings or agents –, providing extraordinarily precise descriptions but renouncing to comprehend and relate the discourse on Man about himself -and implicitly about God- which is nevertheless traceable in all societies. Anthropology has avoided confrontation with the theologies, although present in all societies and inscribed in cosmogonies, theogonies, anthropogonies, ethnogonies, of which amazingly rich mythologies bear much more than plain traces. Anthropology has done so because it has given way to tekhne which is rampant nowadays. It has surrendered to tekhne because tekhne allows the elision of doubt. And yet, no matter how much one technifies it, anthropology does only exist as complementary to theology and vice versa, at least since the beginning of history. This relation was very clear to scholars such as Bronislaw Malinowski, Maurice Leenhard, Marcel Mauss or Meyer Fortes. After all, has there ever been a liturgy without a theology, a ritual without a cosmology? A sacrifice without a God, no matter how small? Sacrifice is a ritual par excellence.

  19. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes

    Directory of Open Access Journals (Sweden)

    SL Wagner

    2015-10-01

    Full Text Available Background: There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. Objective: To determine the value of social support interventions for work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. Results: The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. Conclusion: There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

  20. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes.

    Science.gov (United States)

    Wagner, S L; White, M I; Schultz, I Z; Williams-Whitt, K; Koehn, C; Dionne, C E; Koehoorn, M; Harder, H G; Pasca, R; Wärje, O; Hsu, V; McGuire, L; Lama, I; Schulz, W; Kube, D; Wright, M D

    2015-10-01

    There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. To determine the value of social support interventions for work outcomes. Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

  1. Computerised clinical decision support systems to improve medication safety in long-term care homes: a systematic review.

    Science.gov (United States)

    Marasinghe, Keshini Madara

    2015-05-12

    Computerised clinical decision support systems (CCDSS) are used to improve the quality of care in various healthcare settings. This systematic review evaluated the impact of CCDSS on improving medication safety in long-term care homes (LTC). Medication safety in older populations is an important health concern as inappropriate medication use can elevate the risk of potentially severe outcomes (ie, adverse drug reactions, ADR). With an increasing ageing population, greater use of LTC by the growing ageing population and increasing number of medication-related health issues in LTC, strategies to improve medication safety are essential. Databases searched included MEDLINE, EMBASE, Scopus and Cochrane Library. Three groups of keywords were combined: those relating to LTC, medication safety and CCDSS. One reviewer undertook screening and quality assessment. Overall findings suggest that CCDSS in LTC improved the quality of prescribing decisions (ie, appropriate medication orders), detected ADR, triggered warning messages (ie, related to central nervous system side effects, drug-associated constipation, renal insufficiency) and reduced injury risk among older adults. CCDSS have received little attention in LTC, as attested by the limited published literature. With an increasing ageing population, greater use of LTC by the ageing population and increased workload for health professionals, merely relying on physicians' judgement on medication safety would not be sufficient. CCDSS to improve medication safety and enhance the quality of prescribing decisions are essential. Analysis of review findings indicates that CCDSS are beneficial, effective and have potential to improve medication safety in LTC; however, the use of CCDSS in LTC is scarce. Careful assessment on the impact of CCDSS on medication safety and further modifications to existing CCDSS are recommended for wider acceptance. Due to scant evidence in the current literature, further research on implementation and

  2. A systematic review of basic life support training targeted to family members of high-risk cardiac patients.

    Science.gov (United States)

    Cartledge, Susie; Bray, Janet E; Leary, Marion; Stub, Dion; Finn, Judith

    2016-08-01

    Targeting basic life support (BLS) training to bystanders who are most likely to witness an out of hospital cardiac arrest (OHCA) is an important public health intervention. We performed a systematic review examining the evidence of the effectiveness of providing BLS training to family members of high-risk cardiac patients. A search of Ovid MEDLINE, CINAL, EMBASE, Informit, Cochrane Library, Web of Science, Scopus, ERIC and ProQuest Dissertations and Theses Global was conducted. We included all studies training adult family members of high-risk cardiac patients regardless of methods used for cardiopulmonary resuscitation (CPR) or BLS training. Two reviewers independently extracted data and evaluated the quality of evidence using GRADE (Grades of Recommendation, Assessment, Development and Evaluation). We included 26 of the 1172 studies identified. The majority of studies were non-randomised controlled trials (n=18), of very low to moderate quality. Currently, there is insufficient evidence to indicate a benefit of this intervention for patients; largely because of low numbers of OHCA events and high loss to follow-up. However, the majority of trained individuals were able to competently perform BLS skills, reported a willingness to use these skills and experienced lower anxiety. Whilst there is no current evidence for improvement in patient outcomes from targeted BLS training for family members, this group are willing and capable to learn these skills. Future research may need to examine longer periods of follow-up using alternate methods (e.g. cardiac arrest registries), and examine the effectiveness of training in the modern era. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Workplace programmes for HIV and tuberculosis: a systematic review to support development of international guidelines for the health workforce.

    Science.gov (United States)

    Yassi, Annalee; O'Hara, Lyndsay M; Lockhart, Karen; Spiegel, Jerry M

    2013-01-01

    The health service sector has a vital role to play in delivering human immunodeficiency virus (HIV) and tuberculosis (TB) prevention, treatment and care, yet evidence indicates that healthcare workers (HCWs) themselves lack adequate access to HIV and TB services. HCWs are also at increased risk from TB and other infectious diseases at work, and therefore accessing HIV services is particularly important. A systematic review was therefore conducted to inform the development of World Health Organization (WHO) guidelines to improve access to HIV and TB services, and specifically, to assess the evidence regarding providing such services through workplace-based programmes. We identified any study published since 1984 that addressed outcomes of interest as defined through multi-stakeholder consultations, and were related to workplace interventions in (1) the healthcare workplace and (2) any workplace that included HIV and/or TB diagnosis and/or treatment. Interventions focusing solely on primary prevention with no diagnostic or treatment services were excluded, as they were the subject of other guidelines. A minimum of two reviewers independently extracted data and assessed the articles against pre-set selection criteria; studies were also profiled and quality assessed by a minimum of two reviewers. Three studies met these criteria specifically for HCWs; all showed a preponderance of positive benefits, with minimal negative outcome. Seven studies met these criteria regarding workplace HIV and/or TB diagnosis and/or treatment from other sectors, public or private. Again, all showed positive results. The paucity of high-quality evidence in this field of research was itself an important finding, beckoning further research on workplace-based programmes for health workers. Nonetheless, while more well-designed intervention studies are definitely desirable, providing programmes for HCWs to obtain HIV and TB diagnosis and treatment at the workplace is supported by the literature

  4. Nutritional support for patients sustaining traumatic brain injury: a systematic review and meta-analysis of prospective studies.

    Directory of Open Access Journals (Sweden)

    Xiang Wang

    Full Text Available BACKGROUND: In traumatic brain injury (TBI, the appropriate timing and route of feeding, and the efficacy of immune-enhancing formulae have not been well established. We performed this meta-analysis aiming to compare the effects of different nutritional support modalities on clinical outcomes of TBI patients. METHODS: We systematically searched Pubmed, Embase, and the Cochrane Library until October, 2012. All randomized controlled trials (RCTs and non-randomized prospective studies (NPSs that compared the effects of different routes, timings, or formulae of feeding on outcomes in TBI patients were selected. The primary outcomes included mortality and poor outcome. The secondary outcomes included the length of hospital stay, the length of ventilation days, and the rate of infectious or feeding-related complications. FINDINGS: 13 RCTs and 3 NPSs were included. The pooled data demonstrated that, compared with delayed feeding, early feeding was associated with a significant reduction in the rate of mortality (relative risk [RR] = 0.35; 95% CI, 0.24-0.50, poor outcome (RR = 0.70; 95% CI, 0.54-0.91, and infectious complications (RR = 0.77; 95% CI, 0.59-0.99. Compared with enteral nutrition, parenteral nutrition showed a slight trend of reduction in the rate of mortality (RR = 0.61; 95% CI, 0.34-1.09, poor outcome (RR = 0.73; 95% CI, 0.51-1.04, and infectious complications (RR = 0.89; 95% CI, 0.66-1.22, whereas without statistical significances. The immune-enhancing formula was associated with a significant reduction in infection rate compared with the standard formula (RR = 0.54; 95% CI, 0.35-0.82. Small-bowel feeding was found to be with a decreasing rate of pneumonia compared with nasogastric feeding (RR = 0.41; 95% CI, 0.22-0.76. CONCLUSION: After TBI, early initiation of nutrition is recommended. It appears that parenteral nutrition is superior to enteral nutrition in improving outcomes. Our results lend support to

  5. Data supporting the use of end-tidal carbon dioxide (ETCO2 measurement to guide management of cardiac arrest: A systematic review

    Directory of Open Access Journals (Sweden)

    Edison F. Paiva

    2018-06-01

    Full Text Available The data presented in this article are related to the research article, “The Use of End-Tidal Carbon Dioxide (ETCO2 Measurement to Guide Management of Cardiac Arrest: A Systematic Review” [1]. This article is a systematic review and meta-analysis of existing data on the subject of whether any level of end-tidal carbon dioxide (ETCO2 measured during cardiopulmonary resuscitation (CPR correlates with return of spontaneous circulation (ROSC or survival in adult patients experiencing cardiac arrest in any setting. These data are made publicly available to enable critical or extended analyses. Keywords: Cardiac arrest, End tidal carbon dioxide, Prognostication, Advanced cardiac life support, Capnography, Systematic review, Meta-analysis

  6. Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000-2015.

    Science.gov (United States)

    Hinsliff-Smith, Kathryn; McGarry, Julie

    2017-12-01

    To identify, review and critically evaluate published empirical studies concerned with the prevalence, management and support for survivors of domestic violence and abuse who present at emergency department. Domestic violence and abuse is a global phenomenon with a wealth of studies that explore the different aspects of the issue including the economic, social and health effects on survivors and on society as a whole. Emergency department is widely recognised as one healthcare facility where domestic violence and abuse survivors will often disclose domestic violence and abuse. In the UK, National Institute of Clinical Excellence produced guidelines in 2014 requiring all sectors of health care and those they work alongside to recognise support and manage survivors of domestic violence and abuse. Whilst there is an increasing body of research on domestic violence and abuse, limited synthesised work has been conducted in the context of domestic violence and abuse within emergency department. This review encompasses empirical studies conducted in emergency department for screening interventions, management and support for domestic violence and abuse patients including prevalence. This review included studies that included emergency department staff, emergency department service users and domestic violence and abuse survivors. A systematic approach across five electronic bibliographic databases found 35 studies meeting the inclusion criteria published between 2000-2015. From the 35 studies, four descriptive overarching themes were identified (i) prevalence of domestic violence and abuse in emergency department, (ii) use of domestic violence and abuse screening tools and emergency department interventions, (iii) current obstacles for staff working in emergency department and (iv) emergency department users and survivor perspectives. Having knowledgeable and supportive emergency department staff can have a positive benefit for the longer-term health of the domestic

  7. Roles of University Support for International Students in the United States: Analysis of a Systematic Model of University Identification, University Support, and Psychological Well-Being

    Science.gov (United States)

    Cho, Jaehee; Yu, Hongsik

    2015-01-01

    Unlike previous research on international students' social support, this current study applied the concept of organizational support to university contexts, examining the effects of university support. Mainly based on the social identity/self-categorization stress model, this study developed and tested a path model composed of four key…

  8. Computerized clinical decision support systems for therapeutic drug monitoring and dosing: A decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Weise-Kelly Lorraine

    2011-08-01

    Full Text Available Abstract Background Some drugs have a narrow therapeutic range and require monitoring and dose adjustments to optimize their efficacy and safety. Computerized clinical decision support systems (CCDSSs may improve the net benefit of these drugs. The objective of this review was to determine if CCDSSs improve processes of care or patient outcomes for therapeutic drug monitoring and dosing. Methods We conducted a decision-maker-researcher partnership systematic review. Studies from our previous review were included, and new studies were sought until January 2010 in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Inspec databases. Randomized controlled trials assessing the effect of a CCDSS on process of care or patient outcomes were selected by pairs of independent reviewers. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results Thirty-three randomized controlled trials were identified, assessing the effect of a CCDSS on management of vitamin K antagonists (14, insulin (6, theophylline/aminophylline (4, aminoglycosides (3, digoxin (2, lidocaine (1, or as part of a multifaceted approach (3. Cluster randomization was rarely used (18% and CCDSSs were usually stand-alone systems (76% primarily used by physicians (85%. Overall, 18 of 30 studies (60% showed an improvement in the process of care and 4 of 19 (21% an improvement in patient outcomes. All evaluable studies assessing insulin dosing for glycaemic control showed an improvement. In meta-analysis, CCDSSs for vitamin K antagonist dosing significantly improved time in therapeutic range. Conclusions CCDSSs have potential for improving process of care for therapeutic drug monitoring and dosing, specifically insulin and vitamin K antagonist dosing. However, studies were small and generally of modest quality, and effects on patient outcomes were uncertain, with no convincing

  9. A Systematic Review of the Processes Underlying the Main and the Buffering Effect of Social Support on the Experience of Pain.

    Science.gov (United States)

    Che, Xianwei; Cash, Robin; Ng, Sin Ki; Fitzgerald, Paul; Fitzgibbon, Bernadette M

    2018-04-24

    This review aimed to explore the processes that underlie the main and the buffering effect of social support on decreased pain experience. The systematic review was conducted according to the PRISMA guidelines. Online databases of PubMed and PsycINFO were searched for peer-reviewed articles using keywords (("social support", OR "interpersonal", OR "social presence", OR "spouse", OR "couple", OR "marriage") AND "pain"). Articles were included if they examined the cognitive or behavioural processes linking social support to any aspects of reduced pain experience. The database search identified 38 studies, of which 33 were cognitive-behavioural studies and 5 were neurobiological. Cognitive-behavioural studies generated a total of 57 findings of the analgesic influence of social support. This effect was further categorized as social support decreasing the adverse influence of pain-related stress (28/44 findings), reappraising pain-related stress (7/9 findings), and facilitating coping attempts (2/4 findings). Of the 5 neurobiological studies, the influence of social support on pain reduction was associated with reduced neural and physiological stress systems in response to painful stimuli. This review presents evidence that the stress-buffering effect is more often able to account for the relationship between social support and pain experience. Moreover, findings suggest the critical significance of stress appraisal and attenuated stress systems in linking social support to aspects of reduced pain experience. Findings implicate the role of integrating perceived support and intimacy in support-oriented interventional trials for chronic pain.

  10. The Tzu Chi Silent Mentor Program: Application of Buddhist Ethics to Teach Student Physicians Empathy, Compassion, and Self-Sacrifice.

    Science.gov (United States)

    Santibañez, Scott; Boudreaux, Debra; Tseng, Guo-Fang; Konkel, Kimberly

    2016-10-01

    The Buddhist Tzu Chi Silent Mentor Program promotes the donation of one's body to science as a selfless act by appealing to the Buddhist ethics of compassion and self-sacrifice. Together, faculty, families, and donors help medical students to learn the technical, spiritual, emotional, and psychological aspects of medicine. Students assigned to each "Silent Mentor" visit the family to learn about the donor's life. They see photos and hear family members' stories. Afterwards, students write a brief biography of the donor which is posted on the program website, in the medical school, and on the dissection table. In this paper, we: (1) summarize the Silent Mentor Program; (2) describe findings from an assessment of medical students who recently completed a new version of the program in Malaysia; and (3) explore how healthcare settings could benefit from this innovative program.

  11. Systematic literature review on effectiveness of self-management support interventions in patients with chronic conditions and low socio-economic status

    DEFF Research Database (Denmark)

    Van Hecke, Ann; Heinen, Maud; Fernández-Ortega, Paz

    2017-01-01

    of patients with a low socio-economic status. No differences were found for interventions developed based on health behaviour theoretical models. CONCLUSION: Limited evidence was found for self-management support interventions in chronically ill patients with low socio-economic status. Essential......AIM: To assess the quality of evidence and determine the effect of patient-related and economic outcomes of self-management support interventions in chronically ill patients with a low socio-economic status. BACKGROUND: Integrated evidence on self-management support interventions in chronically ill...... people with low socio-economic status is lacking. DESIGN: Systematic literature review. DATA SOURCES: Cochrane database of trials, PubMed, CINAHL, Web of Science, PsycINFO and Joanna Briggs Institute Library were searched (2000-2013). Randomized controlled trials addressing self-management support...

  12. Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

    Science.gov (United States)

    Janamian, Tina; Upham, Susan J; Crossland, Lisa; Jackson, Claire L

    2016-04-18

    To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility. Systematic review of the international published and grey literature. CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012. All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework. We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care. This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in

  13. The effectiveness of self-management support interventions for men with long-term conditions: a systematic review and meta-analysis.

    Science.gov (United States)

    Galdas, Paul; Fell, Jennifer; Bower, Peter; Kidd, Lisa; Blickem, Christian; McPherson, Kerri; Hunt, Kate; Gilbody, Simon; Richardson, Gerry

    2015-03-20

    To assess the effectiveness of self-management support interventions in men with long-term conditions. A quantitative systematic review with meta-analysis. The Cochrane Database of Systematic Reviews was searched to identify published reviews of self-management support interventions. Relevant reviews were screened to identify randomised controlled trials (RCTs) of self-management support interventions conducted in men alone, or which analysed the effects of interventions by sex. Data on relevant outcomes, patient populations, intervention type and study quality were extracted. Quality appraisal was conducted using the Cochrane Risk of Bias Tool. Meta-analysis was conducted to compare the effects of interventions in men, women, and mixed-sex sub-groups. 40 RCTs of self-management support interventions in men, and 20 eligible RCTs where an analysis by sex was reported, were included in the review. Meta-analysis suggested that physical activity, education, and peer support-based interventions have a positive impact on quality of life in men. However, there is currently insufficient evidence to make strong statements about whether self-management support interventions show larger, similar or smaller effects in men compared with women and mixed-sex groups. Clinicians may wish to consider whether certain types of self-management support (eg, physical activity, education, peer support) are particularly effective in men, although more research is needed to fully determine and explore this. 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.

  14. The Role of Decision Support System (DSS) in Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    R. Anchala (Raghupathy); M.P. Pinto (Maria); A. Shroufi (Amir); R. Chowdhury (Rajiv); J. Sanderson (Jean); L.A. Johnson (Laura); P. Blanco (Patricia); D. Prabhakaran (Dorairaj); O.H. Franco (Oscar)

    2012-01-01

    textabstractBackground: The potential role of DSS in CVD prevention remains unclear as only a few studies report on patient outcomes for cardiovascular disease. Methods and Results: A systematic review and meta-analysis of randomised controlled trials and observational studies was done using

  15. Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

    NARCIS (Netherlands)

    Heinen, M.M.; Bartholomew, L.K.; Wensing, M.J.P.; Kerkhof, P.C.M. van de; Achterberg, T. van

    2006-01-01

    OBJECTIVES: The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. METHODS: We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a

  16. Da religião do sacrifício à religião da fraternidade =From the religion of sacrifice to the religion of fraternity

    Directory of Open Access Journals (Sweden)

    Susin, Luiz Carlos

    2010-01-01

    Full Text Available Há uma relação entre religião e violência que consiste basicamente em sacralização da violência através da sublimação da mesma como sacrifício. Ora, o sacrifício está no coração de toda religião, de forma descarada nas religiões arcaicas e de forma metamorfoseada e mascarada na evolução histórica da religião. A Escritura testemunha as ambiguidades do sacrifício e o choque profético entre o sacrifício e a misericórdia. O Cristianismo, em sua fonte, é a superação radical do sacrifício, mas, ao longo da história, novas metamorfoses do sacrifício surgem no Cristianismo. É a volta às fontes e a renovação de sua experiência na confraternização universal, testada pelos excluídos, que legitimam a originalidade do Cristianismo e um sentido realmente cristão para a palavra sacrifício. There is a relation between religion and violence that consists basically in making violence sacred through its sublimation as a sacrifice. Therefore, sacrifice is at the heart of all religion, in a blatant way in archaic religions and in a metamorphosed and masked way in the historical evolution of religion. The Scriptures witness the ambiguities of sacrifice and the prophetic shock between sacrifice and mercy. Christianity, in its origin, is the radical overcoming of sacrifice, but throughout history new ways sacrifice has metamorphosed appear in Christianity. It’s the return to the sources and the renewal of this experience in universal fellowship, tested by those excluded, who legitimate the uniqueness of Christianity and a true Christian meaning to the word sacrifice.

  17. What keeps you strong? A systematic review identifying how primary health-care and aged-care services can support the well-being of older Indigenous peoples.

    Science.gov (United States)

    Davy, Carol; Kite, Elaine; Aitken, Graham; Dodd, Garth; Rigney, Janice; Hayes, Jenny; Van Emden, Jan

    2016-06-01

    The objective of this systematic review was to identify primary health-care or aged-care strategies that have or could support the well-being of older Indigenous peoples. A search was undertaken of primary databases including Medical Literature Analysis and Retrieval System Online and Cumulative Index to Nursing and Allied Health Literature. Papers which reported on the perspectives of older Indigenous peoples, community members and provider participants were included. Findings were pooled using a meta-aggregative approach. Three high-level synthesised findings - maintaining Indigenous identity, promoting independence and delivering culturally safe care - were believed to be important for supporting the well-being of older Indigenous peoples. As physical independence often diminishes with age, having the support of culturally safe primary health-care and aged-care services that understand the importance of maintaining an Indigenous identity and promoting independence will be crucial for the well-being of older Indigenous peoples. © 2016 AJA Inc.

  18. Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach

    Directory of Open Access Journals (Sweden)

    Helen Quirk

    2017-10-01

    Full Text Available Abstract Background People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients’ need and expectations. Methods This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will

  19. The Faith of Sacrifice: Leadership Trade-Offs in an Afro-Brazilian Religion.

    Science.gov (United States)

    Soler, Montserrat

    2016-12-01

    Despite secular trends in some countries, prestige-based authority in the form of religious leadership remains hugely influential in the everyday lives of millions of people around the world. Here, the costs and benefits of religious leadership are explored in an urban setting in northeastern Brazil. An economic game, within-group cooperation questionnaires, and social network analyses were carried out among adherents of an Afro-Brazilian religion. Results reveal that leaders display high levels of religious commitment and disproportionally provide cooperative services to group members. On the other hand, initiates cooperate less than leaders but do not differ in levels of received cooperation or social cohesion measures. This may indicate some level of exploitation or free-riding. Demographic and group variables also appear to play an important role in the degree of social cohesion a group achieves. These findings are discussed in the context of non-Western urban settings where religious leadership may represent both an alternative to social advancement and a crucial source of material aid, social support, and a strong sense of community.

  20. Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review.

    Science.gov (United States)

    Munns, Ailsa; Watts, Robin; Hegney, Desley; Walker, Roz

    2016-10-01

    Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support. The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors. Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program. Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies. Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors. The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered. Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate. Both quantitative and qualitative data were independently extracted by two reviewers

  1. Interventions to Support Social Interaction in Children with Autism Spectrum Disorders: A Systematic Review of Single Case Studies

    Science.gov (United States)

    Ozuna, Jennifer; Mavridis, Alexis; Hott, Brittany L.

    2015-01-01

    Social interaction is a core deficit in individuals with autism spectrum disorder (ASD). Therefore, parents and teachers need effective interventions to support students with ASD. This synthesis provides a quantitative analysis of single-subject studies that examine interventions to support social interactions in children with ASD. Results suggest…

  2. The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review.

    Science.gov (United States)

    Kelly, Michelle E; Duff, Hollie; Kelly, Sara; McHugh Power, Joanna E; Brennan, Sabina; Lawlor, Brian A; Loughrey, David G

    2017-12-19

    Social relationships, which are contingent on access to social networks, promote engagement in social activities and provide access to social support. These social factors have been shown to positively impact health outcomes. In the current systematic review, we offer a comprehensive overview of the impact of social activities, social networks and social support on the cognitive functioning of healthy older adults (50+) and examine the differential effects of aspects of social relationships on various cognitive domains. We followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, and collated data from randomised controlled trials (RCTs), genetic and observational studies. Independent variables of interest included subjective measures of social activities, social networks, and social support, and composite measures of social relationships (CMSR). The primary outcome of interest was cognitive function divided into domains of episodic memory, semantic memory, overall memory ability, working memory, verbal fluency, reasoning, attention, processing speed, visuospatial abilities, overall executive functioning and global cognition. Thirty-nine studies were included in the review; three RCTs, 34 observational studies, and two genetic studies. Evidence suggests a relationship between (1) social activity and global cognition and overall executive functioning, working memory, visuospatial abilities and processing speed but not episodic memory, verbal fluency, reasoning or attention; (2) social networks and global cognition but not episodic memory, attention or processing speed; (3) social support and global cognition and episodic memory but not attention or processing speed; and (4) CMSR and episodic memory and verbal fluency but not global cognition. The results support prior conclusions that there is an association between social relationships and cognitive function but the exact nature of this association remains unclear

  3. Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer.

    Science.gov (United States)

    Hanlon, Peter; Daines, Luke; Campbell, Christine; McKinstry, Brian; Weller, David; Pinnock, Hilary

    2017-05-17

    Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support. We performed a metareview (a systematic review of systematic reviews) of randomized controlled trials (RCTs) of telehealth interventions to support self-management in 6 exemplar long-term conditions. We searched 7 databases for reviews published from January 2000 to May 2016 and screened identified studies against eligibility criteria. We weighted reviews by quality (revised A Measurement Tool to Assess Systematic Reviews), size, and relevance. We then combined our results in a narrative synthesis and using harvest plots. We included 53 systematic reviews, comprising 232 unique RCTs. Reviews concerned diabetes (type 1: n=6; type 2, n=11; mixed, n=19), heart failure (n=9), asthma (n=8), COPD (n=8), and cancer (n=3). Findings varied between and within disease areas. The highest-weighted reviews showed that blood glucose telemonitoring with feedback and some educational and lifestyle interventions improved glycemic control in type 2, but not type 1, diabetes, and that telemonitoring and telephone interventions reduced mortality and hospital admissions in heart failure, but these findings were not consistent in all reviews. Results for the other conditions were mixed, although no reviews showed evidence of harm. Analysis of the mediating role of self-management, and of components of successful

  4. Peer support for parents of children with chronic disabling conditions: a systematic review of quantitative and qualitative studies.

    Science.gov (United States)

    Shilling, Val; Morris, Christopher; Thompson-Coon, Jo; Ukoumunne, Obioha; Rogers, Morwenna; Logan, Stuart

    2013-07-01

    To review the qualitative and quantitative evidence of the benefits of peer support for parents of children with disabling conditions in the context of health, well-being, impact on family, and economic and service implications. We comprehensively searched multiple databases. Eligible studies evaluated parent-to-parent support and reported on the psychological health and experience of giving or receiving support. There were no limits on the child's condition, study design, language, date, or setting. We sought to aggregate quantitative data; findings of qualitative studies were combined using thematic analysis. Qualitative and quantitative data were brought together in a narrative synthesis. Seventeen papers were included: nine qualitative studies, seven quantitative studies, and one mixed-methods evaluation. Four themes were identified from qualitative studies: (1) shared social identity, (2) learning from the experiences of others, (3) personal growth, and (4) supporting others. Some quantitative studies reported a positive effect of peer support on psychological health and other outcomes; however, this was not consistently confirmed. It was not possible to aggregate data across studies. No costing data were identified. Qualitative studies strongly suggest that parents perceive benefit from peer support programmes, an effect seen across different types of support and conditions. However, quantitative studies provide inconsistent evidence of positive effects. Further research should explore whether this dissonance is substantive or an artefact of how outcomes have been measured. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

  5. Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach.

    Science.gov (United States)

    Quirk, Helen; Crank, Helen; Harrop, Deborah; Hock, Emma; Copeland, Robert

    2017-10-25

    People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients' need and expectations. This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will be performed by two reviewers. Data will be

  6. Adherence support strategies for exercise interventions in people with mild cognitive impairment and dementia: A systematic review

    Directory of Open Access Journals (Sweden)

    Veronika van der Wardt

    2017-09-01

    Full Text Available Exercise-based therapy may improve health status for people with Mild Cognitive Impairment (MCI or dementia but cannot work without adherence, which has proven difficult. This review aimed to evaluate strategies to support adherence among people with MCI or Dementia and was completed in Nottingham/UK in 2017. A narrative synthesis was used to investigate the effectiveness or usefulness of adherence support strategies. Fifteen adherence support strategies were used including theoretical underpinning (programmes based on behavior change theories, individual tailoring, worksheets and exercise booklets, goal setting, phone calls or reminders, newsletters, support to overcome exercise barriers, information, adaptation periods, individual supervision, support for clinicians, group setting, music, accelerometers/pedometers and emphasis on enjoyable activities. Music was the only strategy that was investigated in a comparative design but was found to be effective only for those who were generally interested in participating in activities. A wide range of adherence support strategies are being included in exercise interventions for people with MCI or dementia, but the evidence regarding their effectiveness is limited.

  7. Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review.

    Science.gov (United States)

    Selick, Avra; Durbin, Janet; Vu, Nhi; O'Connor, Karen; Volpe, Tiziana; Lin, Elizabeth

    2017-10-01

    Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented. © 2017 John Wiley & Sons Australia, Ltd.

  8. Psychological and support interventions to reduce levels of stress, anxiety or depression on women's subsequent pregnancy with a history of miscarriage: an empty systematic review.

    Science.gov (United States)

    San Lazaro Campillo, Indra; Meaney, Sarah; McNamara, Karen; O'Donoghue, Keelin

    2017-09-07

    The aim of this systematic review was to assess the effect of interventions to reduce stress in pregnant women with a history of miscarriage. A systematic review of randomised controlled trials (RCTs). A total of 13 medical, psychological and social electronic databases were searched from January 1995 to April 2016 including PUBMED, CENTRAL, Web of Science and EMBASE. This review focused on women in their subsequent pregnancy following miscarriage. All published RCTs which assessed the effect of non-medical interventions such as counselling or support interventions on psychological and mental health outcomes such as stress, anxiety or depression when compared with a control group were included. Stress, anxiety or depression had to be measured at least preintervention and postintervention. This systematic review found no RCT which met our initial inclusion criteria. Of the 4140 titles screened, 17 RCTs were identified. All of them were excluded. One RCT, which implemented a caring-based intervention, included pregnant women in their subsequent pregnancy; however, miscarriage was analysed as a composite variable among other pregnancy losses such as stillbirth and neonatal death. Levels of perceived stress were measured by four RCTs. Different types of non-medical interventions, time of follow-up and small sample sizes were found. Cohort studies and RCTs in non-pregnant women suggest that support and psychological interventions may improve pregnant women's psychological well-being after miscarriage. This improvement may reduce adverse pregnancy-related outcomes in subsequent pregnancies. However, this review found no RCTs which met our criteria. There is a need for targeted RCTs that can provide reliable and conclusive results to determine effective interventions for this vulnerable group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  9. Systematic review

    DEFF Research Database (Denmark)

    Enggaard, Helle

    Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... and resources available. In order to incorporate evidence in clinical decisions, nursing students need to learn how to transfer knowledge in order to utilize evidence in clinical decisions. The method of systematic review can be one approach to achieve this in nursing education. Method: As an associate lecturer...... I have taken a Comprehensive Systematic Review Training course provide by Center of Clinical Guidelines in Denmark and Jonna Briggs Institute (JBI) and practice in developing a systematic review on how patients with ischemic heart disease experiences peer support. This insight and experience...

  10. Mothers' and health visitors' perceptions of the support provided to mothers who have experienced domestic violence: A systematic review.

    Science.gov (United States)

    Eynon, Julia; Carrier, Judith; Rees, Sally; Cartwright, Annie

    2012-01-01

    Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence. The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives. The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research. Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP. Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction tools from the Joanna Briggs Institute. Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings. Four

  11. The meaningfulness of participating in support groups for informal caregivers of older adults with dementia: a systematic review

    DEFF Research Database (Denmark)

    Lauritzen, Jette; Pedersen, Preben Ulrich; Sørensen, Erik Elgaard

    2015-01-01

    of participants: Informal caregivers of older adults aged 65 years and over with dementia. The informal caregiver was a family member, and care was performed at home. Phenomena of interest: How the informal caregivers perceived the meaningfulness of participating in support groups. The setting was all locations......BACKGROUND Informal caregivers who perform at-home care of older people with dementia might have feelings of a meaningless existence, burden, anxiety, stress and fatigue. Support groups are considered an especially effective and economical way to relieve informal caregivers’ stress and burden......, although it is unclear if participating in group meetings produces a meaningful outcome for the informal caregiver. OBJECTIVES To identify the meaningfulness of participating in support groups for informal caregivers of older adults with dementia living in their own home. INCLUSION CRITERIA Types...

  12. "Many miles to go …": a systematic review of the implementation of patient decision support interventions into routine clinical practice.

    Science.gov (United States)

    Elwyn, Glyn; Scholl, Isabelle; Tietbohl, Caroline; Mann, Mala; Edwards, Adrian G K; Clay, Catharine; Légaré, France; van der Weijden, Trudy; Lewis, Carmen L; Wexler, Richard M; Frosch, Dominick L

    2013-01-01

    Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings. An electronic search strategy was devised and adapted for the following databases: ASSIA, CINAHL, Embase, HMIC, Medline, Medline-in-process, OpenSIGLE, PsycINFO, Scopus, Social Services Abstracts, and the Web of Science. In addition, we used snowballing techniques. Studies were included after dual independent assessment. After assessment, 5322 abstracts yielded 51 articles for consideration. After examining full-texts, 17 studies were included and subjected to data extraction. The approach used in all studies was one where clinicians and their staff used a referral model, asking eligible patients to use decision support. The results point to significant challenges to the implementation of patient decision support using this model, including indifference on the part of health care professionals. This indifference stemmed from a reported lack of confidence in the content of decision support interventions and concern about disruption to established workflows, ultimately contributing to organizational inertia regarding their adoption. It seems too early to make firm recommendations about how best to implement patient decision support into routine practice because approaches that use a 'referral model' consistently report difficulties. We sense that the underlying issues that militate against the use of

  13. The Relation between the two Phenomenological Categories Initiation and Sacrifice as Exemplified by the Norse Myth of Óðinn on the Tree

    Directory of Open Access Journals (Sweden)

    Jens Peter Schjødt

    1993-01-01

    Full Text Available Many articles have been devoted to the Old Norse myth which relates how Odin was hanging from a tree for nine nights without being offered food or drink. The question we are going to investigate here is, as mentioned, whether we are facing a sacrifice or an initiation. Both possibilities have been proposed, and some scholars have even believed that the strophes deal with an exemplary myth which has served directly as a model for some ritual.

  14. Instructional Strategies Used in Direct AAC Interventions with Children to Support Graphic Symbol Learning: A Systematic Review

    Science.gov (United States)

    Lynch, Yvonne; McCleary, Muireann; Smith, Martine

    2018-01-01

    Augmentative and alternative communication (AAC) refers to a wide range of aided and unaided modes that are employed with a diverse group of people to support a range of language and communication outcomes. Children whose comprehension of spoken language greatly exceeds their ability to express themselves within that modality can be described as…

  15. Supportive psychotherapy or client education alongside surgical procedures to correct complications of female genital mutilation: A systematic review.

    Science.gov (United States)

    Abayomi, Olukayode; Chibuzor, Moriam T; Okusanya, Babasola O; Esu, Ekpereonne; Odey, Edward; Meremikwu, Martin M

    2017-02-01

    Supportive psychotherapy, in individual or group settings, may help improve surgical outcomes for women and girls living with female genital mutilation (FGM). To assess whether supportive psychotherapy given alongside surgical procedures to correct complications of FGM improves clinical outcomes. We searched major databases including CENTRAL, Medline, African Index Medicus, SCOPUS, PsycINFO, and others. There were no language restrictions. We checked the reference lists of retrieved studies for additional reports of relevant studies. We included studies of girls and women living with any type of FGM who received supportive psychotherapy or client education sessions alongside any surgical procedure to correct health complications from FGM. Two team members independently screened studies for eligibility. There were no eligible studies identified. There is no direct evidence for the benefits or harms of supportive psychotherapy alongside surgical procedures for women and girls living with FGM. Research evidence is urgently needed to guide clinical practice. 42015024639. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  16. Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta-analysis

    NARCIS (Netherlands)

    Durand, M.A.; Carpenter, L.; Dolan, H.; Bravo, P.; Mann, M.; Bunn, F.; Elwyn, G.

    2014-01-01

    BACKGROUND: Increasing patient engagement in healthcare has become a health policy priority. However, there has been concern that promoting supported shared decision-making could increase health inequalities. OBJECTIVE: To evaluate the impact of SDM interventions on disadvantaged groups and health

  17. Narrating health and scarcity: Guyanese healthcare workers, development reformers, and sacrifice as solution from socialist to neoliberal governance.

    Science.gov (United States)

    Walker, Alexis

    2017-08-01

    In oral history interviews, Guyanese healthcare workers emphasize continuity in public health governance throughout the late twentieth century, despite major shifts in broader systems of governance during this period. I argue that these healthcare workers' recollections reflect long-term scarcities and the discourses through which both socialist politicians and neoliberal reformers have narrated them. I highlight the striking similarities in discourses of responsibility and efficiency advanced by socialist politicians in 1970s Guyana and by World Bank representatives designing the country's market transition in the late 1980s, and the ways these discourses have played out in Guyana's health system. Across diverging ideologies, politicians and administrators have promoted severe cost-control as the means to a more prosperous future, presenting short-term pains as necessary to creating new, better, leaner ways of life. In the health sector this has been enacted through a focus on self-help, and on nutrition as a tool available without funds dedicated for pharmaceuticals, advanced medical technologies, or a fully staffed public health system. I argue that across these periods Guyanese citizens have been offered a very similar recipe of ongoing sacrifice. I base my analysis on oral histories with forty-six healthcare workers conducted between 2013 and 2015 in Guyana in Regions 3, 4, 5, 9, and 10, as well as written records from World Bank and Guyanese national archives; I analyze official discourses as well as recollections and experiences of public health governance by those working in Guyana's health system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury: a systematic review.

    Science.gov (United States)

    Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja

    2010-06-01

    To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Cochrane, MEDLINE, EMBASE, CINAHL, PEDro, DocOnline were searched and identified studies were assessed for eligibility and methodological quality and described regarding population, training protocol, and effects on walking ability, activities of daily living and quality of life. A descriptive and quantitative synthesis was conducted. Eighteen articles (17 studies) were included. Two randomized controlled trials showed that subjects with injuries of less than one year duration reached higher scores on the locomotor item of the Functional Independence Measure (range 1-7) in the over-ground training group compared with the body weight-supported treadmill training group. Only for persons with an American Spinal Injury Association Impairment Scale C or D was the mean difference significant, with 0.80 (95% confidence interval 0.04-1.56). No differences were found regarding walking velocity, activities of daily living or quality of life. Subjects with subacute motor incomplete spinal cord injury reached a higher level of independent walking after over-ground training, compared with body weight-supported treadmill training. More randomized controlled trials are needed to clarify the effectiveness of body weight-supported gait training on walking, activities of daily living, and quality of life for subgroups of persons with an incomplete spinal cord injury.

  19. How can multi criteria decision analysis support value assessment of pharmaceuticals? - Findings from a systematic literature review.

    Science.gov (United States)

    Kolasa, Katarzyna; Zah, Vladimir; Kowalczyk, Marta

    2018-04-29

    As budget constraints become more and more visible, there is growing recognition for greater transparency and greater stakeholders' engagement in the pharmaceuticals' pric-ing&reimbursement (P&R) decision making. New frameworks of drugs' value assessments are searched for. Among them, the multi-criteria decision analysis (MCDA) receives more and more attention. In 2014, ISPOR established Task Force to provide methodological recommendations for MCDA utilization in the health care decision making. Still, there is not so much knowledge about the real life experience with MCDA's adaptation to the P&R processes. Areas covered: A systematic literature review was performed to understand the rationale for MCDA adaptation, methodology used as well as its impact on P&R outcomes. Expert commentary: In total 102 hits were found through the search of databases, out of which 18 publications were selected. Although limited in scope, the review highlighted how MCDA can im-prove the decision making processes not only regarding pricing & reimbursement but also contribute to the the risk benefit assessment as well as optimization of treatment outcomes. Still none of re-viewed studies did report how MCDA results actually impacted the real life settings.

  20. Trends Supporting the In-Field Use of Wearable Inertial Sensors for Sport Performance Evaluation: A Systematic Review.

    Science.gov (United States)

    Camomilla, Valentina; Bergamini, Elena; Fantozzi, Silvia; Vannozzi, Giuseppe

    2018-03-15

    Recent technological developments have led to the production of inexpensive, non-invasive, miniature magneto-inertial sensors, ideal for obtaining sport performance measures during training or competition. This systematic review evaluates current evidence and the future potential of their use in sport performance evaluation. Articles published in English (April 2017) were searched in Web-of-Science, Scopus, Pubmed, and Sport-Discus databases. A keyword search of titles, abstracts and keywords which included studies using accelerometers, gyroscopes and/or magnetometers to analyse sport motor-tasks performed by athletes (excluding risk of injury, physical activity, and energy expenditure) resulted in 2040 papers. Papers and reference list screening led to the selection of 286 studies and 23 reviews. Information on sport, motor-tasks, participants, device characteristics, sensor position and fixing, experimental setting and performance indicators was extracted. The selected papers dealt with motor capacity assessment (51 papers), technique analysis (163), activity classification (19), and physical demands assessment (61). Focus was placed mainly on elite and sub-elite athletes (59%) performing their sport in-field during training (62%) and competition (7%). Measuring movement outdoors created opportunities in winter sports (8%), water sports (16%), team sports (25%), and other outdoor activities (27%). Indications on the reliability of sensor-based performance indicators are provided, together with critical considerations and future trends.

  1. Trends Supporting the In-Field Use of Wearable Inertial Sensors for Sport Performance Evaluation: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Valentina Camomilla

    2018-03-01

    Full Text Available Recent technological developments have led to the production of inexpensive, non-invasive, miniature magneto-inertial sensors, ideal for obtaining sport performance measures during training or competition. This systematic review evaluates current evidence and the future potential of their use in sport performance evaluation. Articles published in English (April 2017 were searched in Web-of-Science, Scopus, Pubmed, and Sport-Discus databases. A keyword search of titles, abstracts and keywords which included studies using accelerometers, gyroscopes and/or magnetometers to analyse sport motor-tasks performed by athletes (excluding risk of injury, physical activity, and energy expenditure resulted in 2040 papers. Papers and reference list screening led to the selection of 286 studies and 23 reviews. Information on sport, motor-tasks, participants, device characteristics, sensor position and fixing, experimental setting and performance indicators was extracted. The selected papers dealt with motor capacity assessment (51 papers, technique analysis (163, activity classification (19, and physical demands assessment (61. Focus was placed mainly on elite and sub-elite athletes (59% performing their sport in-field during training (62% and competition (7%. Measuring movement outdoors created opportunities in winter sports (8%, water sports (16%, team sports (25%, and other outdoor activities (27%. Indications on the reliability of sensor-based performance indicators are provided, together with critical considerations and future trends.

  2. Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: a systematic review protocol.

    Science.gov (United States)

    Mrklas, Kelly J; MacDonald, Shannon; Shea-Budgell, Melissa A; Bedingfield, Nancy; Ganshorn, Heather; Glaze, Sarah; Bill, Lea; Healy, Bonnie; Healy, Chyloe; Guichon, Juliet; Colquhoun, Amy; Bell, Christopher; Richardson, Ruth; Henderson, Rita; Kellner, James; Barnabe, Cheryl; Bednarczyk, Robert A; Letendre, Angeline; Nelson, Gregg S

    2018-03-02

    Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples. Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive

  3. Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review.

    Science.gov (United States)

    Fearnley, Rachel; Boland, Jason W

    2017-03-01

    Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family's needs would help ensure appropriate support. To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals' communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents' feelings of supporting their children. A systematic literature review and narrative synthesis. Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent's illness. There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents' illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent's illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise.

  4. Short-term mechanical circulatory support as a bridge to durable left ventricular assist device implantation in refractory cardiogenic shock: a systematic review and meta-analysis.

    Science.gov (United States)

    den Uil, Corstiaan A; Akin, Sakir; Jewbali, Lucia S; Dos Reis Miranda, Dinis; Brugts, Jasper J; Constantinescu, Alina A; Kappetein, Arie Pieter; Caliskan, Kadir

    2017-07-01

    Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016. Using Cochrane Register of Trials, Embase and Medline, a systematic review was performed on patients with cardiogenic shock from acute myocardial infarction, end-stage cardiomyopathy, or acute myocarditis, receiving short-term MCS. Studies on periprocedural, post-cardiotomy and cardiopulmonary resuscitation support were excluded. Thirty-nine studies, mainly registries of heterogeneous patient populations (n = 4151 patients), were identified. Depending on the device used (intra-aortic balloon pump, TandemHeart, Impella 2.5, Impella 5.0, CentriMag and peripheral veno-arterial extracorporeal membrane oxygenation), mean support duration was (range) 1.6-25 days and the mean proportion of short-term MCS patients discharged was (range) 45-66%. The mean proportion of bridge to durable LVAD was (range) 3-30%. Bridge to durable LVAD was most frequently performed in patients with end-stage cardiomyopathy (22 [12-35]%). We conclude that temporary MCS can be used to bridge patients with cardiogenic shock towards durable LVAD. Clinicians are encouraged to share their results in a large multicentre registry in order to investigate optimal device selection and best duration of support. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  5. De novo aortic insufficiency during long-term support on a left ventricular assist device: a systematic review and meta-analysis.

    Science.gov (United States)

    Deo, Salil V; Sharma, Vikas; Cho, Yang Hyun; Shah, Ishan K; Park, Soon J

    2014-01-01

    Aortic insufficiency (AI) may occur while supported on a left ventricular assist device (LVAD). We conducted a systematic review to determine the incidence, predictors, and consequences of AI during LVAD support. MEDLINE was searched for original studies presenting clinical data regarding patients who developed AI during LVAD implant. Seven observational studies (657 patients) were selected for review; 65% of patients underwent implantation with a continuous-flow device (Cf-LVAD). The incidence of AI was 25% (11-42%) (Support period: 412 ± 281 days). AI increased by 4% (1-6%) per month of support (p < 0.01). AI-positive patients were older at implant (weighted mean difference, 7.7 [4.3; 11.1]; p < 0.01). Female sex (0.002 ± 0.001; p = 0.01) and smaller body surface area (-0.003 ± 0.001 per m; p < 0.01) correlated with progressive AI. Destination therapy patients (odds ratio [OR], 5.3 [1.2, 24]; p = 0.02) and those with Cf-LVAD pumps were likely to develop AI (hazard ratio [HR], 2.2 [1.2, 3.8]; p < 0.01). A closed aortic valve was associated with AI (OR, 4.7 [1.9, 11.8]; p < 0.01). Survival was comparable in both cohorts (HR, 1.5 [0.81, 2.8]; p = 0.2). A significant number of patients develop de novo AI during LVAD support. Advanced age, longer support duration, continuous-flow pumps, and a closed aortic valve are associated with AI. Large cohort studies would improve our understanding of this condition.

  6. Perspectives of self-direction: a systematic review of key areas contributing to service users' engagement and choice-making in self-directed disability services and supports.

    Science.gov (United States)

    Lakhani, Ali; McDonald, Donna; Zeeman, Heidi

    2018-05-01

    Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research

  7. The meaningfulness of participating in Support Groups for informal caregives of older adults with dementia: A Systematic Review Protocol

    DEFF Research Database (Denmark)

    Lauritzen, Jette; Pedersen, Preben Ulrich; Bjerrum, Merete Bender

    2013-01-01

    of the disease and the duration of care. The informal caregiver is mainly seen as a family member and care must be performed at home. The review will not differentiate between studies involving subsets of informal caregivers (e.g. based on specific ethnicity, gender and/or specific morbidities of dementia among......Review question/objective The objective of this review is to identify the meaningfulness of participating in support groups for informal caregivers of older adults with dementia living in their own home. More specifically, the review question is: How do informal caregivers of older adults...... with dementia, living in urban and rural settings, perceive the meaningfulness of participating in support groups? Inclusion Criteria Types of participant(s) This review will consider studies that include informal caregivers of older adults aged 65 years and older with dementia, regardless of the severity...

  8. Partial ventilatory support modalities in acute lung injury and acute respiratory distress syndrome-a systematic review.

    Directory of Open Access Journals (Sweden)

    Sarah M McMullen

    Full Text Available The efficacy of partial ventilatory support modes that allow spontaneous breathing in patients with acute lung injury (ALI and acute respiratory distress syndrome (ARDS is unclear. The objective of this scoping review was to assess the effects of partial ventilatory support on mortality, duration of mechanical ventilation, and both hospital and intensive care unit (ICU lengths of stay (LOS for patients with ALI and ARDS; the secondary objective was to describe physiologic effects on hemodynamics, respiratory system and other organ function.MEDLINE (1966-2009, Cochrane, and EmBase (1980-2009 databases were searched using common ventilator modes as keywords and reference lists from retrieved manuscripts hand searched for additional studies. Two researchers independently reviewed and graded the studies using a modified Oxford Centre for Evidence-Based Medicine grading system. Studies in adult ALI/ARDS patients were included for primary objectives and pre-clinical studies for supporting evidence.Two randomized controlled trials (RCTs were identified, in addition to six prospective cohort studies, one retrospective cohort study, one case control study, 41 clinical physiologic studies and 28 pre-clinical studies. No study was powered to assess mortality, one RCT showed shorter ICU length of stay, and the other demonstrated more ventilator free days. Beneficial effects of preserved spontaneous breathing were mainly physiological effects demonstrated as improvement of gas exchange, hemodynamics and non-pulmonary organ perfusion and function.The use of partial ventilatory support modalities is often feasible in patients with ALI/ARDS, and may be associated with short-term physiological benefits without appreciable impact on clinically important outcomes.

  9. A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients

    OpenAIRE

    Pamungkas, Rian Adi; Chamroonsawasdi, Kanittha; Vatanasomboon, Paranee

    2017-01-01

    The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose moni...

  10. Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis.

    Science.gov (United States)

    Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos; Bonfante, Estevam Augusto; Santiago Júnior, Joel Ferreira; Pellizzer, Eduardo Piza

    2018-03-01

    The systematic review and meta-analysis aimed to answer the PICO question: "Do patients that received external connection implants show similar marginal bone loss, implant survival and complication rates as internal connection implants?". Meta-analyses of marginal bone loss, survival rates of implants and complications rates were performed for the included studies. Study eligibility criteria included (1) randomized controlled trials (RCTs) and/or prospective, (2) studies with at least 10 patients, (3) direct comparison between connection types and (4) publications in English language. The Cochrane risk of bias tool was used to assess the quality and risk of bias in RCTs, while Newcastle-Ottawa scale was used for non-RCTs. A comprehensive search strategy was designed to identify published studies on PubMed/MEDLINE, Scopus, and The Cochrane Library databases up to October 2017. The search identified 661 references. Eleven studies (seven RCTs and four prospective studies) were included, with a total of 530 patients (mean age, 53.93 years), who had received a total of 1089 implants (461 external-connection and 628 internal-connection implants). The internal-connection implants exhibited lower marginal bone loss than external-connection implants (PInternal connections had lower marginal bone loss when compared to external connections. However, the implant-abutment connection had no influence on the implant's survival and complication rates. Based on the GRADE approach the evidence was classified as very low to moderate due to the study design, inconsistency, and publication bias. Thus, future research is highly encouraged. Internal connection implants should be preferred over external connection implants, especially when different risk factors that may contribute to increased marginal bone loss are present. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Investigating the empirical support for therapeutic targets proposed by the temporal experience of pleasure model in schizophrenia: A systematic review.

    Science.gov (United States)

    Edwards, Clementine J; Cella, Matteo; Tarrier, Nicholas; Wykes, Til

    2015-10-01

    Anhedonia and amotivation are substantial predictors of poor functional outcomes in people with schizophrenia and often present a formidable barrier to returning to work or building relationships. The Temporal Experience of Pleasure Model proposes constructs which should be considered therapeutic targets for these symptoms in schizophrenia e.g. anticipatory pleasure, memory, executive functions, motivation and behaviours related to the activity. Recent reviews have highlighted the need for a clear evidence base to drive the development of targeted interventions. To review systematically the empirical evidence for each TEP model component and propose evidence-based therapeutic targets for anhedonia and amotivation in schizophrenia. Following PRISMA guidelines, PubMed and PsycInfo were searched using the terms "schizophrenia" and "anhedonia". Studies were included if they measured anhedonia and participants had a diagnosis of schizophrenia. The methodology, measures and main findings from each study were extracted and critically summarised for each TEP model construct. 80 independent studies were reviewed and executive functions, emotional memory and the translation of motivation into actions are highlighted as key deficits with a strong evidence base in people with schizophrenia. However, there are many relationships that are unclear because the empirical work is limited by over-general tasks and measures. Promising methods for research which have more ecological validity include experience sampling and behavioural tasks assessing motivation. Specific adaptations to Cognitive Remediation Therapy, Cognitive Behavioural Therapy and the utilisation of mobile technology to enhance representations and emotional memory are recommended for future development. Copyright © 2015. Published by Elsevier B.V.

  12. Interpreters’ Experiences of Transferential Dynamics, Vicarious Traumatisation, and Their Need for Support and Supervision: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Emma Darroch

    2016-08-01

    Full Text Available Using thematic analysis, this systematic review aimed to explore sign language interpreters’ experiences of transferential dynamics and vicarious trauma. The notion of transferential dynamics, such as transference and countertransference, originate from psychodynamic therapy and refer to the mutual impact that client and therapist have on one another (Chessick, 1986. Psychodynamic models of therapy are predominantly concerned with unconscious processes and theorise that such processes have a powerful influence over an individuals’ thoughts, feelings and behaviours (Howard, 2011. In contrast to countertransference, which is a immediate response to a particular client, vicarious trauma is thought to develop as a result of continuous exposure to, and engagement across, many therapeutic interactions (Pearlman & Saakvitne, 1995a. A search of the available literature uncovered a striking lack of literature into the experiences of sign language interpreters, and in all, only two of the 11 identified empirical studies addressed sign language interpreters. The vast majority of the literature analysed reflected the experiences of spoken language interpreters. The results indicate that interpreters experience transferential dynamics as part of their work as well as suggesting the presence of vicarious trauma among interpreters. Additionally, a unique contribution to the fields of interpreting and psychology is offered, as it is consistently demonstrated that ‘service providers’ and ‘mental health workers’, which are umbrella terms for psychologists, immensely under-estimate the role of interpreters, as they fail to consider the emotional impact of their work and ignore the linguistic complexities of translation by failing to appreciate their need for information in order to ensure an effective translation.

  13. Educating professionals to support self-management in people with asthma or diabetes: protocol for a systematic review and scoping exercise.

    Science.gov (United States)

    McCleary, Nicola; Andrews, Amanda; Morrow, Susan; Wiener-Ogilvie, Sharon; Fletcher, Monica; Steed, Liz; Taylor, Stephanie J C; Pinnock, Hilary

    2016-10-28

    Supported self-management for asthma helps people adjust their treatment in response to symptom changes. This improves day-to-day control and reduces the risk of asthma attacks and the need for emergency healthcare. However, implementation remains poor in routine clinical practice. This systematic review is part of a programme of work developing an intervention to help primary care practice teams embed self-management support into routine asthma care. The aim of the review is to synthesise the evidence regarding the effectiveness of educational interventions for professionals supporting self-management in people with asthma or diabetes (type 1 and type 2). These two conditions have the most robust evidence base for the effectiveness of implementing supported self-management. Electronic searches will be conducted in CENTRAL, MEDLINE, EMBASE, ISI Web of Science, CINAHL, PsycINFO, AMED, Global Health, WHO Global Health Library, ERIC, BNI, RDRB/CME and Google Scholar. Eligible studies are randomised controlled trials or controlled clinical trials published between 1990 and 2016 which evaluated professional education interventions facilitating asthma or diabetes supported self-management. Further relevant work will be identified from trial registries, citation searching and through contact with authors of included studies. This will be supplemented by scoping potentially relevant educational packages described in English language policy literature or health service websites. Screening, data extraction and risk of bias assessment (using the Cochrane Risk of Bias Tool) will be completed by two independent reviewers, with a third reviewer arbitrating where necessary. We plan a theoretically informed narrative synthesis of the aggregated data as heterogeneity is likely to preclude meta-analysis. Ethical approval is not required for this systematic review. The results will be described in a paper submitted for peer-reviewed publication and will inform the development of an

  14. Spouses of patients with a stoma lack information and support and are restricted in their social and sexual life: a systematic review.

    Science.gov (United States)

    Danielsen, Anne Kjaergaard; Burcharth, Jakob; Rosenberg, Jacob

    2013-12-01

    A permanent stoma has a large impact on everyday life with several physical, mental, and social impairments for the individual. It seems obvious that if persons with stomas are affected socially by the stoma creation, it is likely that the family and/or relatives will be affected as well. The objective of this systematic review was to explore how stoma creation may affect spouses of patients with stomas. A systematic review was undertaken based on database searches including studies published from 1950 to 2012. We applied a method of synthesis based on narrative summaries of both qualitative and quantitative results being assessed in parallel processes and finally included in a joint synthesis of results on a study level. We identified 17 studies and included 6 studies. Spouses wanted to be more involved in the stoma education and specifically wanted more focus on the psychosocial aspects of stoma creation. Furthermore, spouses' sexual life was seriously affected, and their social life was restricted. In general, spouses wished for more support from the health care sector as well as from family and friends. There is a need for further research focusing on spouses or relatives. Talking about worries and concerns regarding the new life situation may alleviate suffering and reduce uncertainty. Stoma nurses and other health professionals play an important role in the care of patients as well as spouses, and a greater insight into the worries and concerns affecting spouses is warranted to improve postoperative counseling and education.

  15. A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems.

    Science.gov (United States)

    Simpao, Allan F; Tan, Jonathan M; Lingappan, Arul M; Gálvez, Jorge A; Morgan, Sherry E; Krall, Michael A

    2017-10-01

    Anesthesia information management systems (AIMS) are sophisticated hardware and software technology solutions that can provide electronic feedback to anesthesia providers. This feedback can be tailored to provide clinical decision support (CDS) to aid clinicians with patient care processes, documentation compliance, and resource utilization. We conducted a systematic review of peer-reviewed articles on near real-time and point-of-care CDS within AIMS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Studies were identified by searches of the electronic databases Medline and EMBASE. Two reviewers screened studies based on title, abstract, and full text. Studies that were similar in intervention and desired outcome were grouped into CDS categories. Three reviewers graded the evidence within each category. The final analysis included 25 articles on CDS as implemented within AIMS. CDS categories included perioperative antibiotic prophylaxis, post-operative nausea and vomiting prophylaxis, vital sign monitors and alarms, glucose management, blood pressure management, ventilator management, clinical documentation, and resource utilization. Of these categories, the reviewers graded perioperative antibiotic prophylaxis and clinical documentation as having strong evidence per the peer reviewed literature. There is strong evidence for the inclusion of near real-time and point-of-care CDS in AIMS to enhance compliance with perioperative antibiotic prophylaxis and clinical documentation. Additional research is needed in many other areas of AIMS-based CDS.

  16. Effect of peer support interventions on cardiovascular disease risk factors in adults with diabetes: a systematic review and meta-analysis.

    Science.gov (United States)

    Patil, Sonal J; Ruppar, Todd; Koopman, Richelle J; Lindbloom, Erik J; Elliott, Susan G; Mehr, David R; Conn, Vicki S

    2018-03-23

    Peer support by persons affected with diabetes improves peer supporter's diabetes self-management skills. Peer support interventions by individuals who have diabetes or are affected by diabetes have been shown to improve glycemic control; however, its effects on other cardiovascular disease risk factors in adults with diabetes are unknown. We aimed to estimate the effect of peer support interventions on cardiovascular disease risk factors other than glycemic control in adults with diabetes. We conducted a systematic review and meta-analysis of randomized controlled trials comparing peer support interventions to a control condition in adults affected by diabetes that measured any cardiovascular disease risk factors [Body Mass Index, smoking, diet, physical activity, cholesterol level, glucose control and blood pressure]. Quality was assessed by Cochrane's risk of bias tool. We calculated standardized mean difference effect sizes using random effects models. We retrieved 438 citations from multiple databases including OVID MEDLINE, Cochrane database and Scopus, and author searches. Of 233 abstracts reviewed, 16 articles met inclusion criteria. A random effects model in a total of 3243 participants showed a positive effect of peer support interventions on systolic BP with a pooled effect size of 2.07 mmHg (CI 0.35 mmHg to 3.79 mmHg, p = 0.02); baseline pooled systolic blood pressure was 137 mmHg. There was a non-significant effect of peer support interventions on diastolic blood pressure, cholesterol, body mass index, diet and physical activity. Cardiovascular disease risk factors other than glycemic control outcomes were secondary outcomes in most studies and baseline values were normal or mildly elevated. Only one study reported smoking outcomes. We found a small (2 mmHg) positive effect of peer support interventions on systolic blood pressure in adults with diabetes whose baseline blood pressure was on average minimally elevated. Additional studies need to

  17. A Systematic Scoping Literature Review of Publications Supporting Treatment Guidelines for Pediatric Atopic Dermatitis in Contrast to Clinical Practice Patterns.

    Science.gov (United States)

    Siegfried, Elaine C; Jaworski, Jennifer C; Mina-Osorio, Paola

    2018-06-01

    Treatment guidelines endorse a variety of strategies for atopic dermatitis (AD) which may vary from published data and clinical practice patterns. The objective of this review was to quantify the volume of available medical literature supporting pediatric AD treatments and compare these patterns to those recommended by published guidelines and/or clinical practice patterns. Searches of Embase (2005-2016) and abstracts from selected meetings (2014-2016) related to AD treatment in patients younger than 17 years of age yielded references that were assessed by study design, primary treatment, age groups, and AD severity. Published literature partially supports clinical guidelines, with emollients and topical medications being the most investigated. There were disproportionately more publications for topical calcineurin inhibitors (TCI) compared with topical corticosteroids (TCS); however, the search interval may have biased the results toward treatments approved near the beginning of the time frame. In contrast, publications documenting clinical practice patterns reflect greater use of emollients and TCS (over TCI), as well as systemic corticosteroids. Data is relatively limited for long-term and combination treatment, treatment of severe AD, and patients younger than 2 years of age, and completely lacking for systemic corticosteroids. This scoping review demonstrates that available medical literature largely supports published guidelines for topical therapy; however, clinical practice patterns are less aligned. There is a lack of data for older, more frequently used generic treatments, including oral antihistamines, oral antibiotics, and systemic corticosteroids. Overall, literature is lacking for long-term treatment, treatment for patients younger than 2 years of age, and for systemic treatment for severe disease. Regeneron Pharmaceuticals Inc.

  18. Effectiveness of universal parental support interventions addressing children's dietary habits, physical activity and bodyweight: A systematic review.

    Science.gov (United States)

    Kader, Manzur; Sundblom, Elinor; Elinder, Liselotte Schäfer

    2015-08-01

    The evidence regarding effectiveness of parental support interventions targeting children's health behaviours is weak. We aimed to review: 1) effectiveness of universal parental support interventions to promote dietary habits, physical activity (PA) or prevent overweight and obesity among children 2-18years and 2) effectiveness in relation to family socio-economic position. Thirty five studies from 1990 to 2013 were identified from major databases. Quality was assessed by four criteria accounting for selection and attrition bias, fidelity to intervention, and outcome measurement methodology, categorizing studies as strong, moderate or weak. Four intervention types were identified: face-to-face counselling, group education, information sent home, and telephone counselling. Face-to-face or telephone counselling was effective in changing children's diet, while there was only weak evidence for improvement in PA. Sending home information was not effective. Concerning body weight, group education seemed more promising than counselling. Intervention effectiveness was generally higher in younger compared to older children. In groups with low socio-economic position, group-based approaches appeared promising. In the future efforts should be made to improve reporting of intervention content, include a power calculation for the main outcome, the use of high quality outcome assessment methodology, and a follow-up period of at least 6months. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Evidence from prospective cohort studies did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review.

    Science.gov (United States)

    Harcombe, Zoë; Baker, Julien S; Davies, Bruce

    2017-12-01

    National dietary guidelines were introduced in 1977 and 1983, by the USA and UK governments to reduce coronary heart disease (CHD) mortality by reducing dietary fat intake. Our 2015 systematic review examined randomised controlled trial (RCT) evidence available to the dietary committees at the time; we found no support for the recommendations to restrict dietary fat. What epidemiological evidence was available to the dietary guideline committees in 1983? A systematic review of prospective cohort studies, published prior to 1983, which examined the relationship between dietary fat, serum cholesterol and the development of CHD. Across 6 studies, involving 31 445 participants, there were 1521 deaths from all-causes and 360 deaths from CHD during the mean follow-up of 7.5±6.2 years. The death rates were 4.8% and 1.1% from all-causes and CHD respectively. One study included men with previous heart disease. The death rate from CHD for those with, and without previous myocardial infarction was 20.9% and 1.0% respectively. None of the six studies found a significant relationship between CHD deaths and total dietary fat intake. One of the six studies found a correlation between CHD deaths and saturated dietary fat intake across countries; none found a relationship between CHD deaths and saturated dietary fat in the same population. 1983 dietary recommendations for 220 million US and 56 million UK citizens lacked supporting evidence from RCT or prospective cohort studies. The extant research had been undertaken exclusively on males, so lacked generalisability for population-wide guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Systematic Review of Methods in Low-Consensus Fields: Supporting Commensuration through `Construct-Centered Methods Aggregation' in the Case of Climate Change Vulnerability Research.

    Science.gov (United States)

    Delaney, Aogán; Tamás, Peter A; Crane, Todd A; Chesterman, Sabrina

    2016-01-01

    There is increasing interest in using systematic review to synthesize evidence on the social and environmental effects of and adaptations to climate change. Use of systematic review for evidence in this field is complicated by the heterogeneity of methods used and by uneven reporting. In order to facilitate synthesis of results and design of subsequent research a method, construct-centered methods aggregation, was designed to 1) provide a transparent, valid and reliable description of research methods, 2) support comparability of primary studies and 3) contribute to a shared empirical basis for improving research practice. Rather than taking research reports at face value, research designs are reviewed through inductive analysis. This involves bottom-up identification of constructs, definitions and operationalizations; assessment of concepts' commensurability through comparison of definitions; identification of theoretical frameworks through patterns of construct use; and integration of transparently reported and valid operationalizations into ideal-type research frameworks. Through the integration of reliable bottom-up inductive coding from operationalizations and top-down coding driven from stated theory with expert interpretation, construct-centered methods aggregation enabled both resolution of heterogeneity within identically named constructs and merging of differently labeled but identical constructs. These two processes allowed transparent, rigorous and contextually sensitive synthesis of the research presented in an uneven set of reports undertaken in a heterogenous field. If adopted more broadly, construct-centered methods aggregation may contribute to the emergence of a valid, empirically-grounded description of methods used in primary research. These descriptions may function as a set of expectations that improves the transparency of reporting and as an evolving comprehensive framework that supports both interpretation of existing and design of future

  1. Systematic Review of Methods in Low-Consensus Fields: Supporting Commensuration through `Construct-Centered Methods Aggregation’ in the Case of Climate Change Vulnerability Research

    Science.gov (United States)

    Crane, Todd A.; Chesterman, Sabrina

    2016-01-01

    There is increasing interest in using systematic review to synthesize evidence on the social and environmental effects of and adaptations to climate change. Use of systematic review for evidence in this field is complicated by the heterogeneity of methods used and by uneven reporting. In order to facilitate synthesis of results and design of subsequent research a method, construct-centered methods aggregation, was designed to 1) provide a transparent, valid and reliable description of research methods, 2) support comparability of primary studies and 3) contribute to a shared empirical basis for improving research practice. Rather than taking research reports at face value, research designs are reviewed through inductive analysis. This involves bottom-up identification of constructs, definitions and operationalizations; assessment of concepts’ commensurability through comparison of definitions; identification of theoretical frameworks through patterns of construct use; and integration of transparently reported and valid operationalizations into ideal-type research frameworks. Through the integration of reliable bottom-up inductive coding from operationalizations and top-down coding driven from stated theory with expert interpretation, construct-centered methods aggregation enabled both resolution of heterogeneity within identically named constructs and merging of differently labeled but identical constructs. These two processes allowed transparent, rigorous and contextually sensitive synthesis of the research presented in an uneven set of reports undertaken in a heterogenous field. If adopted more broadly, construct-centered methods aggregation may contribute to the emergence of a valid, empirically-grounded description of methods used in primary research. These descriptions may function as a set of expectations that improves the transparency of reporting and as an evolving comprehensive framework that supports both interpretation of existing and design of future

  2. Mobile Phone and Tablet Apps to Support Young People's Management of Their Physical Long-Term Conditions: A Systematic Review Protocol.

    Science.gov (United States)

    Majeed-Ariss, Rabiya; Hall, Andrew G; McDonagh, Janet; Fallon, Deborah; Swallow, Veronica

    2015-04-07

    The prevalence of long-term or chronic conditions that limit activity and reduce quality of life in young people aged 10-24 years is rising. This group has distinct health care needs and requires tailored support strategies to facilitate increasing personal responsibility for the management of their condition wherever possible, as they mature. Mobile phone and tablet mobile technologies featuring software program apps are already well used by young people for social networking or gaming. They have also been utilized in health care to support personal condition management, using condition-specific and patient-tailored software. Such apps have much potential, and there is an emerging body of literature on their use in a health context making this review timely. The objective of this paper is to develop a systematic review protocol focused on identifying and assessing the effectiveness of mobile phone and tablet apps that support young people's management of their chronic conditions. The search strategy will include a combination of standardized indexed search terms and free-text terms related to the key concepts of young people; long-term conditions and mobile technology. Peer-reviewed journal articles published from 2003 that meet the inclusion and exclusion criteria will be identified through searching the generated hits from 5 bibliographical databases. Two independent reviewers will screen the titles and abstracts to determine which articles focus on testing interventions identified as a mobile phone or tablet apps, and that have been designed and delivered to support the management of long-term conditions in young people aged 10-24 years. Data extraction and quality assessment tools will be used to facilitate consistent analysis and synthesis. It is anticipated that several studies will meet the selection criteria but that these are likely to be heterogeneous in terms of study design, reported outcomes, follow-up times, participants' age, and health condition

  3. Self-management of health care: multimethod study of using integrated health care and supportive housing to address systematic barriers for people experiencing homelessness.

    Science.gov (United States)

    Parsell, Cameron; Ten Have, Charlotte; Denton, Michelle; Walter, Zoe

    2017-04-07

    Objectives The aims of the present study were to examine tenants' experiences of a model of integrated health care and supportive housing and to identify whether integrated health care and supportive housing improved self-reported health and healthcare access. Methods The present study used a mixed-method survey design (n=75) and qualitative interviews (n=20) performed between September 2015 and August 2016. Participants were tenants of permanent supportive housing in Brisbane (Qld, Australia). Qualitative data were analysed thematically. Results Integrated health care and supportive housing were resources for tenants to overcome systematic barriers to accessing mainstream health care experienced when homeless. When homeless, people did not have access to resources required to maintain their health. Homelessness meant not having a voice to influence the health care people received; healthcare practitioners treated symptoms of poverty rather than considering how homelessness makes people sick. Integrated healthcare and supportive housing enabled tenants to receive treatment for health problems that were compounded by the barriers to accessing mainstream healthcare that homelessness represented. Conclusions Extending the evidence about housing as a social determinant of health, the present study shows that integrated health care and supportive housing enabled tenants to take control to self-manage their health care. In addition to homelessness directly contributing to ill health, the present study provides evidence of how the experience of homelessness contributes to exclusions from mainstream healthcare. What is known about the topic? People who are homeless experience poor physical and mental health, have unmet health care needs and use disproportionate rates of emergency health services. What does the paper add? The experience of homelessness creates barriers to accessing adequate health care. The provision of onsite multidisciplinary integrated health care in

  4. A systematic review of interventions to promote social support and parenting skills in parents with an intellectual disability.

    Science.gov (United States)

    Wilson, S; McKenzie, K; Quayle, E; Murray, G

    2014-01-01

    The family support needs of parents with an intellectual disability (ID) are relatively unknown. This paper reviewed two types of intervention for parents with ID: those designed to strengthen social relationships and those teaching parenting skills. A literature search was conducted using electronic databases and a limited number of evaluative studies were found. The evidence for interventions aimed at strengthening social relationships was inconclusive; although positive changes were observed, there were limitations in study design which restricted the generalizability of the results. The evidence for parental skills teaching suggested that behavioural based interventions are more effective than less intensive forms such as lesson booklets and the provision of normal services, although these studies also had limitations. There is a need for further large scale controlled studies in this area to provide clearer evidence and to explore additional factors relating to child, parent and family which may impact on outcomes. © 2013 John Wiley & Sons Ltd.

  5. Computer and telephone delivered interventions to support caregivers of people with dementia: a systematic review of research output and quality

    Directory of Open Access Journals (Sweden)

    Amy Waller

    2017-11-01

    Full Text Available Abstract Background To assess the scope, volume and quality of research on the acceptability, utilisation and effectiveness of telephone- and computer-delivered interventions for caregivers of people living with dementia. Methods Medline, EMBASE, CINAHL and Cochrane databases were searched (Jan 1990 – Dec 2016. Eligible papers were classified as data-based descriptive, measurement or intervention studies. Intervention studies were first categorised according to mode of delivery (e.g. telephone, computer; then assessed against the Effective Practice and Organisation of Care (EPOC methodological criteria for research design. Impact on health-related outcomes; and the acceptability, feasibility and utilisation of interventions were also assessed. Results The number of publications increased by 13% each year (p < 0.001. Half were descriptive studies (n = 92, 50% describing caregiver views on acceptability, access or utilization of technology. The remainder (n = 89, 48% reported on interventions designed to improve caregiver outcomes. Only 34 met EPOC design criteria. Interventions were delivered via computer (n = 10, multiple modalities (n = 9 or telephone (n = 15. Interventions that incorporated various elements of psycho-education, peer support, skills training and health assessments led to improvements in caregiver wellbeing. While largely acceptable, utilisation of computer-based interventions was variable, with use often decreasing over time. Conclusion Interventions delivered via telephone and computer have the potential to augment existing dementia care. High-quality trials are required to make clear recommendations about the types of interventions that are most effective. Those that provide caregivers with: access to practical strategies to manage care of the person with dementia and their own wellbeing, advice and support from peers and/or clinicians; and that target the dyad should be explored.

  6. Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews.

    Science.gov (United States)

    Fisher, Edwin B; Boothroyd, Renée I; Elstad, Emily A; Hays, Laura; Henes, Amy; Maslow, Gary R; Velicer, Clayton

    2017-01-01

    Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000-7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000-12/31/2015. In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.

  7. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

    Science.gov (United States)

    Haynes, R Brian; Wilczynski, Nancy L

    2010-02-05

    Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions

  8. Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

    Science.gov (United States)

    Souza, Nathan M; Sebaldt, Rolf J; Mackay, Jean A; Prorok, Jeanette C; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Evidence supports the effectiveness of CCDSSs for screening and

  9. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2010-02-01

    Full Text Available Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. Methods The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Results Data will be summarized

  10. Supporting same-sex mothers in the Nordic child health field: a systematic literature review and meta-synthesis of the most gender equal countries.

    Science.gov (United States)

    Wells, Michael B; Lang, Sarah N

    2016-12-01

    To explore the needs of and support given to lesbian, gay, bisexual, transgendered and inter-sex parents within the Nordic child health field. The number of lesbian, gay, bisexual, transgendered and inter-sex parents is growing around the world. However, they face fear, discrimination and heteronormativity within the child health field. The Nordic countries (Sweden, Norway, Denmark, Finland and Iceland) rank as the most gender equal countries in the world; therefore, they may support lesbian, gay, bisexual, transgendered and inter-sex parents to a greater extent. Systematic literature review and meta-synthesis. A systematic search was conducted for lesbian, gay, bisexual, transgendered and inter-sex parents' experiences in the child health field, which consists of prenatal, labour and birth, postnatal and child health clinics, using PubMed, PsychInfo, Sociological Abstracts and CINAHL, as well as searching the grey literature, from 2000-2015. Ten articles were included. A quality assessment and a meta-synthesis of the articles were performed. Nearly all studies were qualitative, and most articles had at least one area of insufficient reporting. Only two countries, Sweden and Norway, had lesbian, gay, bisexual, transgendered and inter-sex parents reporting on the child health field. However, gay, bisexual, transgender and inter-sex parents' perspectives were nonexistent in the literature; therefore, the results all relate to same-sex mothers. Five themes were found: Acceptance of Same-sex Mothers, Disclosing Sexual Orientation, Heteronormative Obstacles, Co-mothers are Not Fathers, and Being the Other Parent. Same-sex mothers are generally accepted within the Nordic child health field, but they still face overt and covert heteronormative obstacles, resulting in forms of discrimination and fear. Co-mothers feel invisible and secondary if they are not treated like an equal parent, but feel noticed and important when they are given equal support. Changes at the

  11. Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2011-08-01

    Full Text Available Abstract Background Computerized clinical decision support systems (CCDSSs are claimed to improve processes and outcomes of primary preventive care (PPC, but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63% RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34% trials assessed patient outcomes, and four (29% reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15% and two (5% trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Conclusions

  12. Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Kondo, Yutaka; Fukuda, Tatsuma; Uchimido, Ryo; Hifumi, Toru; Hayashida, Kei

    2017-10-22

    Advanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature. We will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ 2 test of homogeneity, and any observed heterogeneity will be quantified using the I 2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence. Our study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information. PROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Emergency Support Function 15: Communication Synchronization during Defense Support of Civil Authorities Operations

    Science.gov (United States)

    2015-06-12

    for the future. I would like to thank my parents Juan and Helen for their love, support, and guidance; your hard work and sacrifices have given me...required support to civil authortities during emergency relief operations.9 Once civil authorites are capable of resuming responsibility for the...Freeman posit the researcher has an understanding of the cognitive styles of the program stakeholders which will increase access and comprehension of

  14. Evidence supporting see-and-treat management of cervical intraepithelial neoplasia: a systematic review and meta-analysis.

    Science.gov (United States)

    Ebisch, R M F; Rovers, M M; Bosgraaf, R P; van der Pluijm-Schouten, H W; Melchers, W J G; van den Akker, P A J; Massuger, L F A G; Bekkers, R L M

    2016-01-01

    Studies of see-and-treat management of cervical intraepithelial neoplasia (CIN) vary in their inclusion criteria, resulting in a broad range of overtreatment rates. To determine overtreatment rates in see-and-treat management of women referred for colposcopy because of suspected CIN, in order to define circumstances supporting see-and-treat management. MEDLINE, EMBASE, and the Cochrane Library were searched from inception up to 12 May 2014. Studies of see-and-treat management in women with a reported cervical smear result, colposcopic impression, and histology result were included. Methodological quality was assessed with the Newcastle-Ottawa scale. We used the inverse variance method for pooling incidences, and a random-effects model was used to account for heterogeneity between studies. Overtreatment was defined as treatment in patients with no CIN or CIN1. Thirteen studies (n = 4611) were included. The overall overtreatment rate in women with a high-grade cervical smear and a high-grade colposcopic impression was 11.6% (95% CI 7.8-15.3%). The overtreatment rate in women with a high-grade cervical smear and low-grade colposcopic impression was 29.3% (95% CI 16.7-41.9%), and in the case of a low-grade smear and high-grade colposcopic impression it was 46.4% (95% CI 15.7-77.1%). In women with a low-grade smear and low-grade colposcopic impression, the overtreatment rate was 72.9% (95% CI 68.1-77.7%). The pooled overtreatment rate in women with a high-grade smear and high-grade colposcopic impression is at least comparable with the two-step procedure, which supports the use of see-and-treat management in this subgroup of women. See-and-treat management is justified in the case of a high-grade smear and a high-grade colposcopic impression. © 2015 Royal College of Obstetricians and Gynaecologists.

  15. Secondary use of data from hospital electronic prescribing and pharmacy systems to support the quality and safety of antimicrobial use: a systematic review.

    Science.gov (United States)

    Micallef, Christianne; Chaudhry, Navila T; Holmes, Alison H; Hopkins, Susan; Benn, Jonathan; Franklin, Bryony Dean

    2017-07-01

    Electronic prescribing (EP) and electronic hospital pharmacy (EHP) systems are increasingly common. A potential benefit is the extensive data in these systems that could be used to support antimicrobial stewardship, but there is little information on how such data are currently used to support the quality and safety of antimicrobial use. To summarize the literature on secondary use of data (SuD) from EP and EHP systems to support quality and safety of antimicrobial use, to describe any barriers to secondary use and to make recommendations for future work in this field. We conducted a systematic search within four databases; we included original research studies that were (1) based on SuD from hospital EP or EHP systems and (2) reported outcomes relating to quality and/or safety of antimicrobial use and/or qualitative findings relating to SuD in this context. Ninety-four full-text articles were obtained; 14 met our inclusion criteria. Only two described interventions based on SuD; seven described SuD to evaluate other antimicrobial stewardship interventions and five described descriptive or exploratory studies of potential applications of SuD. Types of data used were quantitative antibiotic usage data ( n  =   9 studies), dose administration data ( n  =   4) and user log data from an electronic dashboard ( n  = 1). Barriers included data access, data accuracy and completeness, and complexity when using data from multiple systems or hospital sites. The literature suggests that SuD from EP and EHP systems is potentially useful to support or evaluate antimicrobial stewardship activities; greater system functionality would help to realize these benefits. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Effect of Pharmacy-Supported Transition-of-Care Interventions on 30-Day Readmissions: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Rodrigues, Claire R; Harrington, Amanda R; Murdock, Nicole; Holmes, John T; Borzadek, Eliza Z; Calabro, Kristin; Martin, Jennifer; Slack, Marion K

    2017-10-01

    To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov , and relevant websites were searched from January 1, 1995, to December 31, 2015. PICOS+E criteria were utilized. Eligible studies reported pharmacy-supported TOC interventions compared with usual care in adult patients discharged to home within the United States. Studies were required to evaluate postdischarge outcomes (eg, rate of readmissions, hospital utilization). Randomized controlled trials, cohort studies, or controlled before-and-after studies were included. Two reviewers independently extracted data and evaluated study quality. A total of 56 articles were included in the systematic review (n = 61 858), of which 32 reported 30-day all-cause readmissions and were included in the meta-analysis. A taxonomy was developed to categorize targeted patients, intervention types, and pharmacy personnel as sole intervener. The meta-analysis demonstrated about a 32% reduction in the odds of readmission (odds ratio [OR] = 0.68; 95% CI = 0.61 to 0.75) observed for pharmacy-supported TOC interventions compared with usual care. Heterogeneity was identified ( I 2 = 55%; P < 0.001). A stratified meta-analysis showed that interventions with patient-centered follow-up reduced 30-day readmissions relative to studies without follow-up (OR = 0.70; CI = 0.63 to 0.78). Pharmacy-supported TOC programs were associated with a significant reduction in the odds of 30-day readmissions.

  17. A systematic surveillance programme for infectious salmon anaemia virus supports its absence in the Pacific Northwest of the United States

    Science.gov (United States)

    Gustafson, Lori L.; Creekmore, Lynn H.; Snekvik, Kevin R.; Ferguson, Jayde A.; Warg, Janet V.; Blair, Marilyn; Meyers, Theodore R.; Stewart, Bruce; Warheit, Kenneth I.; Kerwin, John; Goodwin, Andrew E.; Rhodes, Linda D.; Whaley, Janet E.; Purcell, Maureen K.; Bentz, Collette; Shasa, Desiree; Bader, Joel; Winton, James R.

    2018-01-01

    In response to reported findings of infectious salmon anaemia virus (ISAV) in British Columbia (BC), Canada, in 2011, U.S. national, state and tribal fisheries managers and fish health specialists developed and implemented a collaborative ISAV surveillance plan for the Pacific Northwest region of the United States. Accordingly, over a 3-1/2-year period, 4,962 salmonids were sampled and successfully tested by real-time reverse-transcription PCR. The sample set included multiple tissues from free-ranging Pacific salmonids from coastal regions of Alaska and Washington and farmed Atlantic salmon (Salmo salar L.) from Washington, all representing fish exposed to marine environments. The survey design targeted physiologically compromised or moribund animals more vulnerable to infection as well as species considered susceptible to ISAV. Samples were handled with a documented chain of custody and testing protocols, and criteria for interpretation of test results were defined in advance. All 4,962 completed tests were negative for ISAV RNA. Results of this surveillance effort provide sound evidence to support the absence of ISAV in represented populations of free-ranging and marine-farmed salmonids on the northwest coast of the United States.

  18. Cost and economic benefit of clinical decision support systems for cardiovascular disease prevention: a community guide systematic review.

    Science.gov (United States)

    Jacob, Verughese; Thota, Anilkrishna B; Chattopadhyay, Sajal K; Njie, Gibril J; Proia, Krista K; Hopkins, David P; Ross, Murray N; Pronk, Nicolaas P; Clymer, John M

    2017-05-01

    This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSSs) to prevent cardiovascular disease (CVD). Methods developed for the Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSSs to prevent CVD from the available studies ( n  = 12) due to considerable heterogeneity. Several studies ( n  = 11) indicated that health care costs were averted by using CDSSs but many were partial assessments that did not consider all components of health care. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSSs based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Intervention costs were not negligible, but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted health care cost could not be determined with confidence because many studies did not fully account for all components of health care. We were unable to conclude whether CDSSs for CVD prevention is either cost-beneficial or cost-effective. Several evidence gaps are identified, most prominently a lack of information about major drivers of cost and benefit, a lack of standard metrics for the cost of CDSSs, and not allowing for useful life of a CDSS that generally extends beyond one accounting period. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

  19. Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health.

    Science.gov (United States)

    Shaw, Elizabeth; Levitt, Cheryl; Wong, Sharon; Kaczorowski, Janusz

    2006-09-01

    Postpartum support is recommended to prevent infant and maternal morbidity. This review examined the published evidence of the effectiveness of postpartum support programs to improve maternal knowledge, attitudes, and skills related to parenting, maternal mental health, maternal quality of life, and maternal physical health. MEDLINE, Cinahl, PsycINFO, and the Cochrane Library were searched for randomized controlled trials of interventions initiated from immediately after birth to 1 year in postnatal women. The initial literature search was done in 1999 and was enhanced in 2003 and 2005. Studies were categorized based on the the above outcomes. Data were extracted in a systematic manner, and the quality of each study was reviewed. In the 1999 search, 9 studies met the inclusion criteria. The 2003 and 2005 searches identified 13 additional trials for a total of 22 trials. Universal postpartum support to unselected women at low risk did not result in statistically significant improvements for any outcomes examined. Educational visits to a pediatrician showed statistically significant improvements in maternal-infant parenting skills in low-income primiparous women. In women at high risk for family dysfunction and child abuse, nurse home visits combined with case conferencing produced a statistically significant improvement in home environment quality using the HOME (Home Observation for Measurement of the Environment) program. Similarly, in women at high risk for either family dysfunction or postpartum depression, home visitation or peer support, respectively, produced a statistically significant reduction in Edinburgh Postnatal Depression Scale scores (difference - 2.23, 95% CI -3.72 to -0.74, p= 0.004; and 15.0% vs 52.4%, OR 6.23, 95% CI 1.40 to 27.84, p= 0.01, respectively). Educational programs reduced repeat unplanned pregnancies (12.0% vs 28.3%, p= 0.003) and increased effective contraceptive use (RR 1.35, 95% CI 1.09 to 1.68, p= 0.007). Maternal satisfaction was

  20. Supporting 'work-related goals' rather than 'return to work' after cancer? A systematic review and meta-synthesis of 25 qualitative studies.

    Science.gov (United States)

    Wells, Mary; Williams, Brian; Firnigl, Danielle; Lang, Heidi; Coyle, Joanne; Kroll, Thilo; MacGillivray, Steve

    2013-06-01

    This study aimed to systematically review and synthesise qualitative studies of employment and cancer. A rigorous systematic review and meta-synthesis process was followed. A total of 13,233 papers were retrieved from eight databases; 69 were deemed relevant following title and abstract appraisal. Four further publications were identified via contact with key authors. Screening of full texts resulted in the retention of 25 publications from six countries, which were included in the synthesis. Studies consistently indicate that for people with cancer, 'work' forms a central basis for self-identity and self-esteem, provides financial security, forms and maintains social relationships, and represents an individual's abilities, talents and health. Work is therefore more than paid employment. Its importance to individuals rests on the relative value survivors place on these constituent functions. The desirability, importance and subsequent interpretation of individuals' experience of 'return to work' appears to be influenced by the ways in which cancer affects these functions or goals of 'work'. Our synthesis draws these complex elements into a heuristic model to help illustrate and communicate these inter-relationships. The concept of 'return to work' may be overly simplistic, and as a result, misleading. The proposed benefits previously ascribed to 'return to work' may only be achieved through consideration of the specific meaning and role of work to the individual. Interventions to address work-related issues need to be person-centred, acknowledging the work-related outcomes that are important to the individual. A conceptual and operational shift towards supporting survivors to identify and achieve their 'work-related goals' may be more appropriate. Copyright © 2012 John Wiley & Sons, Ltd.

  1. Psychological Impact of Deploying in Support of the U.S. Response to Ebola: A Systematic Review and Meta-Analysis of Past Outbreaks.

    Science.gov (United States)

    Vyas, Kartavya J; Delaney, Eileen M; Webb-Murphy, Jennifer A; Johnston, Scott L

    2016-11-01

    To examine the potential psychological impact of deploying in support of the U.S. response to Ebola in west Africa by systematic review and meta-analysis. Peer-reviewed articles published between January 2000 and December 2014 were identified using PubMed, PsycINFO, and Web of Science. Thirty-two studies involving 26,869 persons were included in the systematic review; 13 studies involving 7,785 persons were included in the meta-analysis. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Reflecting the sociodemographics of the military, those who are younger, single, not living with family, have fewer years of work experience, lower education, and lower income are at increased risk for psychological distress, alcohol/drug misuse, post-traumatic stress disorder (PTSD), depression, and/or anxiety as a result of their perceived risk of infection. Effect sizes for post-traumatic stress disorder, depressive, and anxiety symptoms were considered small (SMD = 0.12, 95% CI = -0.23 to 0.47), moderate (SMD = 0.40, 95% CI = 0.24-0.51), and small (SMD = 0.08, 95% CI = -0.09 to 0.25), respectively; however, only the effect size for depressive symptoms was statistically significant. Deployed service members may return with clinically significant problems, the most notable of which is depression. Delivering resilience training and fostering altruistic acceptance may protect service members from developing mental health disorders. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  2. Interventions to support people with dementia and their caregivers during the transition from home care to nursing home care: A systematic review.

    Science.gov (United States)

    Müller, Christian; Lautenschläger, Sindy; Meyer, Gabriele; Stephan, Astrid

    2017-06-01

    During the transition of people with dementia from home to nursing home family caregivers often feel burdened. We aimed to 1) identify interventions which support people with dementia and their caregivers in the transition from home care to nursing home care, 2) synthesize the evidence for efficacy of these interventions, and 3) examine whether the identified interventions have been systematically developed, evaluated and implemented according to the Medical Research Council guidance on complex interventions. A systematic review of randomised controlled trials was conducted according to the recommendations specified in the Cochrane Handbook for Intervention Reviews. The review protocol was registered in PROSPERO (2015: CRD42015019839). Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. MEDLINE, CENTRAL, PsycINFO, CINAHL, OTseeker, and PEDro, were searched. Other sources included Google Scholar, and ALOIS. Two reviewers independently assessed the eligibility of the articles. Data extraction was performed by one reviewer and verified independently by another. The Cochrane Risk of Bias tool was used for critical appraisal. Development and evaluation of the identified interventions were assessed, taking the Medical Research Council guidance into account. Review findings were synthesized narratively. The search yielded 1278 records. Five studies were included, all conducted in the United States (4 RCTs and 1 cRCT with a total of 695 participants). The psychosocial interventions were individual and family counseling via telephone or ad hoc all of which addressed only informal caregivers. The intervention components, content and mode of delivery differed widely with inconsistent results. Significant intervention effects were found for the reduction of caregivers' depressive symptoms, burden, feeling of guilt, emotional distress, overload, and interactions with staff. Other outcomes, i.e. stress, placement

  3. The Usability and Effectiveness of Mobile Health Technology–Based Lifestyle and Medical Intervention Apps Supporting Health Care During Pregnancy: Systematic Review

    Science.gov (United States)

    Rosman, Ageeth N; van Beukering, Monique DM; Kok, Marjolein

    2018-01-01

    Background A growing number of mobile health (mHealth) technology–based apps are being developed for personal lifestyle and medical health care support, of which several apps are related to pregnancy. Evidence on usability and effectiveness is limited but crucial for successful implementation. Objective This study aimed to evaluate the usability, that is, feasibility and acceptability, as well as effectiveness of mHealth lifestyle and medical apps to support health care during pregnancy in high-income countries. Feasibility was defined as the actual use, interest, intention, and continued use; perceived suitability; and ability of users to carry out the activities of the app. Acceptability was assessed by user satisfaction, appreciation, and the recommendation of the app to others. Methods We performed a systematic review searching the following electronic databases for studies on mHealth technology–based apps in maternal health care in developed countries: EMBASE, MEDLINE Epub (Ovid), Cochrane Library, Web of Science, and Google Scholar. All included studies were scored on quality, using the ErasmusAGE Quality Score or the consolidated criteria for reporting qualitative research. Main outcome measures were usability and effectiveness of mHealth lifestyle and medical health care support apps related to pregnancy. All studies were screened by 2 reviewers individually, and the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement were followed. Results Our search identified 4204 titles and abstracts, of which 2487 original studies remained after removing duplicates. We performed full-text screening of 217 studies, of which 29 were included in our study. In total, 19 out of 29 studies reported on mHealth apps to adopt healthy lifestyles and 10 out of 29 studies to support medical care. The lifestyle apps evaluated in 19 studies reported on usability and effectiveness: 10 studies reported positive on acceptability, and 14

  4. Online Training and Support Programs Designed to Improve Mental Health and Reduce Burden Among Caregivers of People With Dementia: A Systematic Review.

    Science.gov (United States)

    Egan, Kieren J; Pinto-Bruno, Ángel C; Bighelli, Irene; Berg-Weger, Marla; van Straten, Annemieke; Albanese, Emiliano; Pot, Anne-Margriet

    2018-03-01

    Dementia poses a considerable socioeconomic burden to society. On a global scale, family and other unpaid care predominates. Supporting caregivers is crucial, but scalable interventions are currently lacking. Because a growing number of studies have suggested that online training and support programs hold considerable promise for scaling up, we reviewed existing literature. We systematically searched 6 databases to identify studies of Internet-based interventions designed to train and support caregivers of people with dementia, and we formally assessed risk of bias. Our prespecified primary outcomes of interest included both mental health and caregiver burden/perceived stress. Our secondary outcomes of interest included knowledge, quality of life of caregivers, quality of care, caregiver response to challenging behaviors, coping, and self-efficacy. Eight randomized control trials met our inclusion criteria involving over 900 participants. The content and structure of Internet-based interventions, outcome measures, and duration differed markedly, and selection, performance, and reporting biases were varied and on occasion of concern. Six studies reported outcomes in caregivers' mental health outcomes, 3 studies reported burden outcomes. Three studies reported knowledge skills, quality of life and reaction to challenging behaviours, whereas 2 studies reported changes in coping outcomes and self-efficacy. No studies reported outcomes on quality of care. Although there is some evidence that Internet-based interventions can improve mental health outcomes for informal caregivers of people with dementia, marked methodological diversity across studies prevented the robust pooling of the results. A concerted and cohesive approach from all stakeholders is now required to help realize the full potential of this emerging field. Copyright © 2017. Published by Elsevier Inc.

  5. The sacrifice of animals in Afro-Brasilian religions: analysis of a recent controversy in the Brazilian state of Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Ari Pedro Oro

    2006-01-01

    Full Text Available The paper analyses a controversy in Rio Grande do Sul, involving the local Afro-religious community, after the State Assembly approved a State Code for the Protection of Animals, which could jeopardize the ritual practice of sacrificing animals in "terreiros". We examine the different standpoints on animal sacrifice in Afro-religious rituals on the part of the main actors and institutions involved, as well as the repercussions of such debates in Brazil and abroad. The controversy is an opportunity for discussing the limits of religious freedom in Brazil.

  6. The Impacts of Business Support Services for Small and Medium Enterprises on Firm Performance in Low-and Middle-Income Countries: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Piza C

    2016-01-01

    Full Text Available BACKGROUND AND OBJECTIVES OF THE REVIEW Business support interventions in low and middle-income countries (LMICs direct a large amount of resources to SMEs, with the assumption that institutional constraints impede small and medium-sized enterprises (SMEs from generating profits and employment at the firm level, which in turn is thought to impede economic growth and poverty reduction. Yet despite this abundance of resources, very little is known about the impact of such interventions. To address this gap, this systematic review analyses evaluations of SME support services in LMICs to help inform policy debates pertaining to SMEs and business support services. This review examines the available evidence on the effects of SME support services in LMICs on firm-level performance indicators (such as revenues, profits, and productivity, employment generation, and labour productivity. METHODS We systematically searched for available literature. To identify relevant papers for this review, we conducted electronic searches on key platforms; snowball sampling of references from relevant papers and book chapters, and suggestions from recognized experts in the field. We focused on LMICs as defined by the World Bank classifications, and on evidence published since the year 2000, so as to include more sophisticated evaluation techniques. The references retrieved for this review are up-to-date as of December 2014. We included studies that evaluated the effectiveness of business support services on firm level outcomes of SMEs in low- and middle-income countries. We defined SMEs as firms with between two and 250 employees, but also included studies that used annual revenue to classify firms as SMEs instead of employee count. We examined interventions involving tax simplification, exports and access to external markets; support for innovation policies; support to local production systems; training and technical assistance, and SME financing and credit guarantee

  7. Perceived Organizational Support, Organizational Commitment and Psychological Well-Being: A Longitudinal Study

    Science.gov (United States)

    Panaccio, Alexandra; Vandenberghe, Christian

    2009-01-01

    Using longitudinal data (N=220), we examined the contribution of perceived organizational support and four mindsets of organizational commitment (affective, normative, perceived sacrifice associated with leaving and perceived lack of alternatives) to employee psychological well-being. In order to assess the contribution of support and commitment…

  8. The role of family and friends in providing social support towards enhancing the wellbeing of postpartum women: a comprehensive systematic review.

    Science.gov (United States)

    Ni, Phang Koh; Siew Lin, Serena Koh

    2011-01-01

    Maternal postpartum health is a neglected area both in research and practice. This aspect warrants more attention as the health of postpartum mothers has a considerable influence on her infant and also other family members. Social support provided by family and friends has been identified as a buffer against the many stressors faced by the women. Outcomes such as self-esteem, stress, postnatal depression, breastfeeding levels, infant care, and maternal adaptation have been studied and found to be significantly related to social support. The need to understand the role of social support provided by family and friends provide the impetus for conducting this review. The objective of this systematic review was to appraise and synthesise the best available evidence which discusses the impact of social support from family and friends on enhancing the wellbeing of postpartum women. This review includes women who were within their first year postpartum period, with any number of children, and had given birth to healthy infants. Mothers who had co-existing morbidities such as depression were excluded. Mothers from low socio-economic groups were excluded.This review considered any study that involved the provision of social support by family and/or friends. Interventions provided by peer counsellors were also considered.The six outcomes were stress, self esteem, breastfeeding levels, mental health in relation to postnatal depression, infant care and maternal adaptation.Quantitative This review considered any randomised controlled trials that examined the effectiveness of social support from family and friends on the well being of the postpartum women. As it was not likely to find RCTs on this topic, this review also considered observational studies (cohort, case control, quantitative descriptive studies such as surveys).Qualitative This review considered any interpretive studies that drew on the experiences of social support from family and friends in postpartum women

  9. Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania.

    Science.gov (United States)

    Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A; Schulze, Alexander

    2016-10-13

    Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff. An electronic Tool to Improve Quality of Healthcare (e-TIQH) was developed to assess the quality of primary healthcare provision. The e-TIQH contains six sub-tools, each covering one quality dimension: infrastructure and equipment of the facility, its management and administration, job expectations, clinical skills of the staff, staff motivation and client satisfaction. As part of supportive supervision, council health staff conduct quality assessments in all primary healthcare facilities in a given council, including observation of clinical consultations and exit interviews with clients. Using a hand-held device, assessors enter data and view results in real time through automated data analysis, permitting immediate feedback to health workers. Based on the results, quality gaps and potential measures to address them are jointly discussed and actions plans developed. For illustrative purposes, preliminary findings from e-TIQH application are presented from eight councils of Tanzania for the period 2011-2013, with a quality score quality dimensions at baseline. Clinical practice was unsatisfactory in six councils, with more mixed results for availability of infrastructure and equipment, and for administration and management. In contrast, client satisfaction scored surprisingly high. Over time, each council showed a significant overall increase of 3-7 % in mean score, with the most pronounced improvements in staff motivation and job expectations. Given its comprehensiveness, convenient handling and automated statistical reports, e-TIQH enables

  10. Are community-based nurse-led self-management support interventions effective in chronic patients? Results of a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Azzurra Massimi

    Full Text Available The expansion of primary care and community-based service delivery systems is intended to meet emerging needs, reduce the costs of hospital-based ambulatory care and prevent avoidable hospital use by the provision of more appropriate care. Great emphasis has been placed on the role of self-management in the complex process of care of patient with long-term conditions. Several studies have determined that nurses, among the health professionals, are more recommended to promote health and deliver preventive programs within the primary care context. The aim of this systematic review and meta-analysis is to assess the efficacy of the nurse-led self-management support versus usual care evaluating patient outcomes in chronic care community programs. Systematic review was carried out in MEDLINE, CINAHL, Scopus and Web of Science including RCTs of nurse-led self-management support interventions performed to improve observer reported outcomes (OROs and patients reported outcomes (PROs, with any method of communication exchange or education in a community setting on patients >18 years of age with a diagnosis of chronic diseases or multi-morbidity. Of the 7,279 papers initially retrieved, 29 met the inclusion criteria. Meta-analyses on systolic (SBP and diastolic (DBP blood pressure reduction (10 studies-3,881 patients and HbA1c reduction (7 studies-2,669 patients were carried-out. The pooled MD were: SBP -3.04 (95% CI -5.01--1.06, DBP -1.42 (95% CI -1.42--0.49 and HbA1c -0.15 (95% CI -0.32-0.01 in favor of the experimental groups. Meta-analyses of subgroups showed, among others, a statistically significant effect if the interventions were delivered to patients with diabetes (SBP or CVD (DBP, if the nurses were specifically trained, if the studies had a sample size higher than 200 patients and if the allocation concealment was not clearly defined. Effects on other OROs and PROs as well as quality of life remain inconclusive.

  11. The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence.

    Science.gov (United States)

    Brooks, Helen Louise; Rushton, Kelly; Lovell, Karina; Bee, Penny; Walker, Lauren; Grant, Laura; Rogers, Anne

    2018-02-05

    There is increasing recognition of the therapeutic function pets can play in relation to mental health. However, there has been no systematic review of the evidence related to the comprehensive role of companion animals and how pets might contribute to the work associated with managing a long-term mental health condition. The aim of this study was to explore the extent, nature and quality of the evidence implicating the role and utility of pet ownership for people living with a mental health condition. A systematic search for studies exploring the role of companion animals in the management of mental health conditions was undertaken by searching 9 databases and undertaking a scoping review of grey literature from the earliest record until March 2017. To be eligible for inclusion, studies had to be published in English and report on primary data related to the relationship between domestic animal ownership and the management of diagnosable mental health conditions. Synthesis of qualitative and quantitative data was undertaken in parallel using a narrative synthesis informed by an illness work theoretical framework. A total of 17 studies were included in the review. Quantitative evidence relating to the benefits of pet ownership was mixed with included studies demonstrating positive, negative and neutral impacts of pet ownership. Qualitative studies illuminated the intensiveness of connectivity people with companion animals reported, and the multi-faceted ways in which pets contributed to the work associated with managing a mental health condition, particularly in times of crisis. The negative aspects of pet ownership were also highlighted, including the practical and emotional burden of pet ownership and the psychological impact that losing a pet has. This review suggests that pets provide benefits to those with mental health conditions. Further research is required to test the nature and extent of this relationship, incorporating outcomes that cover the range of

  12. Systematic review automation technologies

    Science.gov (United States)

    2014-01-01

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

  13. The Triple P-Positive Parenting Program: a systematic review and meta-analysis of a multi-level system of parenting support.

    Science.gov (United States)

    Sanders, Matthew R; Kirby, James N; Tellegen, Cassandra L; Day, Jamin J

    2014-06-01

    This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family outcomes. Multiple search strategies identified 116 eligible studies conducted over a 33-year period, with 101 studies comprising 16,099 families analyzed quantitatively. Moderator analyses were conducted using structural equation modeling. Risk of bias within and across studies was assessed. Significant short-term effects were found for: children's social, emotional and behavioral outcomes (d=0.473); parenting practices (d=0.578); parenting satisfaction and efficacy (d=0.519); parental adjustment (d=0.340); parental relationship (d=0.225) and child observational data (d=0.501). Significant effects were found for all outcomes at long-term including parent observational data (d=0.249). Moderator analyses found that study approach, study power, Triple P level, and severity of initial child problems produced significant effects in multiple moderator models when controlling for other significant moderators. Several putative moderators did not have significant effects after controlling for other significant moderators. The positive results for each level of the Triple P system provide empirical support for a blending of universal and targeted parenting interventions to promote child, parent and family wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Neither property right nor heroic gift, neither sacrifice nor aporia: the benefit of the theoretical lens of sharing in donation ethics.

    Science.gov (United States)

    Zeiler, Kristin

    2014-05-01

    Two ethical frameworks have dominated the discussion of organ donation for long: that of property rights and that of gift-giving. However, recent years have seen a drastic rise in the number of philosophical analyses of the meaning of giving and generosity, which has been mirrored in ethical debates on organ donation and in critical sociological, anthropological and ethnological work on the gift metaphor in this context. In order to capture the flourishing of this field, this article distinguishes between four frameworks for thinking about bodily exchanges in medicine: those of property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. These frameworks represent four different ways of making sense of donation of organs as well as tissue, gametes and blood, draw on different conceptions of the relations between the self and the other, and bring out different ethical issues as core ones. The article presents these frameworks, argues that all of them run into difficulties when trying to make sense of reciprocity and relational interdependence in donation, and shows how the three gift-giving frameworks (of heroism, sacrifice and aporia) hang together in a critical discussion about what is at stake in organ donation. It also presents and argues in favour of an alternative intercorporeal framework of giving-through-sharing that more thoroughly explicates the gift metaphor in the context of donation, and offers tools for making sense of relational dimensions of live and post mortem donations.

  15. Apps and Adolescents: A Systematic Review of Adolescents' Use of Mobile Phone and Tablet Apps That Support Personal Management of Their Chronic or Long-Term Physical Conditions.

    Science.gov (United States)

    Majeed-Ariss, Rabiya; Baildam, Eileen; Campbell, Malcolm; Chieng, Alice; Fallon, Debbie; Hall, Andrew; McDonagh, Janet E; Stones, Simon R; Thomson, Wendy; Swallow, Veronica

    2015-12-23

    The prevalence of physical chronic or long-term conditions in adolescents aged 10-24 years is rising. Mobile phone and tablet mobile technologies featuring software program apps are widely used by these adolescents and their healthy peers for social networking or gaming. Apps are also used in health care to support personal condition management and they have considerable potential in this context. There is a growing body of literature on app use in health contexts, thereby making a systematic review of their effectiveness very timely. To systematically review the literature on the effectiveness of mobile apps designed to support adolescents' management of their physical chronic or long-term conditions. We conducted a review of the English-language literature published since 2003 in five relevant bibliographical databases using key search terms. Two independent reviewers screened titles and abstracts using data extraction and quality assessment tools. The search returned 1120 hits. Of the 19 eligible full-text papers, four met our review criteria, reporting one pilot randomized controlled trial and three pretest/post-test studies. Samples ranged from 4 to 18 participants, with a combined sample of 46 participants. The apps reported were targeted at type 1 diabetes, asthma, and cancer. Two papers provided data for calculating effect size. Heterogeneity in terms of study design, reported outcomes, follow-up times, participants' ages, and health conditions prevented meta-analyses. There was variation in whether adolescents received guidance in using the app or were solely responsible for navigating the app. Three studies reported some level of patient involvement in app design, development, and/or evaluation. Health professional involvement in the modelling stages of apps was reported in all studies, although it was not always clear whether specific clinical (as opposed to academic) expertise in working with adolescents was represented. The dearth of studies and the

  16. Systematic review

    DEFF Research Database (Denmark)

    Bager, Palle; Chauhan, Usha; Greveson, Kay

    2017-01-01

    of evidence is needed and the aim of this article was to systematically review the evidence of IBD advice lines. MATERIALS AND METHODS: A broad systematic literature search was performed to identify relevant studies addressing the effect of advice lines. The process of selection of the retrieved studies...... was undertaken in two phases. In phase one, all abstracts were review by two independent reviewers. In phase two, the full text of all included studies were independently reviewed by two reviewers. The included studies underwent quality assessment and data synthesis. RESULTS: Ten published studies and 10...... congress abstracts were included in the review. The studies were heterogeneous both in scientific quality and in the focus of the study. No rigorous evidence was found to support that advice lines improve disease activity in IBD and correspondingly no studies reported worsening in disease activity. Advice...

  17. GnRH Agonist Trigger and LH Activity Luteal Phase Support versus hCG Trigger and Conventional Luteal Phase Support in Fresh Embryo Transfer IVF/ICSI Cycles—A Systematic PRISMA Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Thor Haahr

    2017-06-01

    Full Text Available IntroductionThe use of GnRH agonist (GnRHa for final oocyte maturation trigger in oocyte donation and elective frozen embryo transfer cycles is well established due to lower ovarian hyperstimulation syndrome (OHSS rates as compared to hCG trigger. A recent Cochrane meta-analysis concluded that GnRHa trigger was associated with reduced live birth rates (LBRs in fresh autologous IVF cycles compared to hCG trigger. However, the evidence is not unequivocal, and recent trials have found encouraging reproductive outcomes among couples undergoing GnRHa trigger and individualized luteal LH activity support. Thus, the aim was to compare GnRHa trigger followed by luteal LH activity support with hCG trigger in IVF patients undergoing fresh embryo transfer.Material and methodsWe conducted a systematic review and meta-analysis of randomized trials published until December 14, 2016. The population was infertile patients submitted to IVF/ICSI cycles with GnRH antagonist cotreatment who underwent fresh embryo transfer. The intervention was GnRHa trigger followed by LH activity luteal phase support (LPS. The comparator was hCG trigger followed by a standard LPS. The critical outcome measures were LBR and OHSS rate. The secondary outcome measures were number of oocytes retrieved, clinical and ongoing pregnancy rates, and miscarriage rates.ResultsA total of five studies met the selection criteria comprising a total of 859 patients. The LBR was not significantly different between the GnRHa and hCG trigger groups (OR 0.84, 95% CI 0.62, 1.14. OHSS was reported in a total of 4/413 cases in the GnRHa group compared to 7/413 in the hCG group (OR 0.48, 95% CI 0.15, 1.60. We observed a slight, but non-significant increase in miscarriage rate in the GnRHa triggered group compared to the hCG group (OR 1.85; 95% CI 0.97, 3.54.ConclusionGnRHa trigger with LH activity LPS resulted in comparable LBRs compared to hCG trigger. The most recent trials reported LBRs close to unity

  18. Effectiveness of training workplace managers to understand and support the mental health needs of employees: a systematic review and meta-analysis.

    Science.gov (United States)

    Gayed, Aimée; Milligan-Saville, Josie S; Nicholas, Jennifer; Bryan, Bridget T; LaMontagne, Anthony D; Milner, Allison; Madan, Ira; Calvo, Rafael A; Christensen, Helen; Mykletun, Arnstein; Glozier, Nicholas; Harvey, Samuel B

    2018-06-01

    Managers are in an influential position to make decisions that can impact on the mental health and well-being of their employees. As a result, there is an increasing trend for organisations to provide managers with training in how to reduce work-based mental health risk factors for their employees. A systematic search of the literature was conducted to identify workplace interventions for managers with an emphasis on the mental health of employees reporting directing to them. A meta-analysis was performed to calculate pooled effect sizes using the random effects model for both manager and employee outcomes. Ten controlled trials were identified as relevant for this review. Outcomes evaluating managers' mental health knowledge (standardised mean difference (SMD)=0.73; 95% CI 0.43 to 1.03; pmental health (SMD=0.36; 95% CI 0.18 to 0.53; pemployees experiencing mental health problems (SMD=0.59; 95% CI 0.14 to 1.03; p=0.01) were found to have significant pooled effect sizes favouring the intervention. A significant pooled effect was not found for the small number of studies evaluating psychological symptoms in employees (p=0.28). Our meta-analysis indicates that training managers in workplace mental health can improve their knowledge, attitudes and self-reported behaviour in supporting employees experiencing mental health problems. At present, any findings regarding the impact of manager training on levels of psychological distress among employees remain preliminary as only a very limited amount of research evaluating employee outcomes is available. Our review suggests that in order to understand the effectiveness of manager training on employees, an increase in collection of employee level data is required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns (SCs).

    Science.gov (United States)

    Sailer, Irena; Makarov, Nikolay Alexandrovich; Thoma, Daniel Stefan; Zwahlen, Marcel; Pjetursson, Bjarni Elvar

    2015-06-01

    To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported single crowns (SCs) and to describe the incidence of biological, technical and esthetic complications. Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported fixed dental prostheses (FDPs) with a mean follow-up of at least 3 years. This was complimented by an additional hand search and the inclusion of 34 studies from a previous systematic review [1,2]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. Sixty-seven studies reporting on 4663 metal-ceramic and 9434 all-ceramic SCs fulfilled the inclusion criteria. Seventeen studies reported on metal-ceramic crowns, and 54 studies reported on all-ceramic crowns. Meta-analysis of the included studies indicated an estimated survival rate of metal-ceramic SCs of 94.7% (95% CI: 94.1-96.9%) after 5 years. This was similar to the estimated 5-year survival rate of leucit or lithium-disilicate reinforced glass ceramic SCs (96.6%; 95% CI: 94.9-96.7%), of glass infiltrated alumina SCs (94.6%; 95% CI: 92.7-96%) and densely sintered alumina and zirconia SCs (96%; 95% CI: 93.8-97.5%; 92.1%; 95% CI: 82.8-95.6%). In contrast, the 5-year survival rates of feldspathic/silica-based ceramic crowns were lower (pceramic and zirconia crowns exhibited significantly lower survival rates in the posterior region (pceramic fractures than metal-ceramic SCs (pceramic SCs than for metal-ceramic SCs. Survival rates of most types of all-ceramic SCs were similar to those reported for metal-ceramic SCs, both in anterior and posterior regions. Weaker feldspathic/silica-based ceramics should be limited to applications in the anterior region. Zirconia-based SCs should not be considered as primary option due to their high incidence of technical problems. Copyright © 2015 Academy

  20. A systematic review of structured versus non-structured breastfeeding programmes to support the initiation and duration of exclusive breastfeeding in acute and primary healthcare settings.

    Science.gov (United States)

    Beake, Sarah; Pellowe, Carol; Dykes, Fiona; Schmied, Virginia; Bick, Debra

    2011-01-01

    Joanna Briggs Institute. Two independent reviewers conducted critical appraisal and data extraction. Twenty-six articles were included; one randomised controlled trial, two non randomised trials, one cross-sectional study, five systematic reviews, 15 cohort studies and two descriptive studies. Due to the poor quality of evidence presented and clinical and methodological heterogeneity of study designs, including definitions of breastfeeding and duration of follow-up, it was not possible to combine studies or individual outcomes in meta-analyses, therefore findings are presented in a narrative form.In most studies the structured programme of interest reflected some or all of the Baby Friendly Hospital Initiative 'Ten Steps'. Most studies found a statistically significant improvement in initiation of breastfeeding following introduction of a structured breastfeeding programme, although effect sizes varied widely.The impact of introducing a structured programme on the duration of exclusive breastfeeding and duration of any breastfeeding was also evident, although not all studies found statistically significant differences. At hospital discharge or within the first week post-birth, implementation of a structured programme appeared to increase duration of exclusive breastfeeding and the duration of any breastfeeding compared with usual care. After hospital discharge and up to six months post-birth, use of structured programmes also appeared to support continued duration of exclusive and any breastfeeding although differences in outcomes were not reported across all included studies. At six months, three of five studies which included data on longer-term outcomes showed women were statistically significantly more likely to be exclusively breastfeeding. Only one of these studies compared outcomes following implementation of BFHI. Despite the poor overall quality of studies, structured programmes, regardless of content, compared with standard care appear to influence the uptake

  1. Do Postoperative Psychotherapeutic Interventions and Support Groups Influence Weight Loss Following Bariatric Surgery? A Systematic Review and Meta-analysis of Randomized and Nonrandomized Trials

    DEFF Research Database (Denmark)

    Beck, Nina N.; Johannsen, Maja; Støvring, René K.

    2012-01-01

    Bariatric surgery is currently considered the most effective treatment of severe obesity, but considerable individual variations in weight loss results have been reported. We therefore conducted a systematic review and meta-analysis of studies investigating the effect of psychotherapeutic...

  2. Supported exercise improves controlled eating and weight through its effects on psychosocial factors: extending a systematic research program toward treatment development.

    Science.gov (United States)

    Annesi, James J

    2012-01-01

    Behavioral weight-loss treatments have been overwhelmingly unsuccessful. Many inadequately address both behavioral theory and extant research--especially in regard to the lack of viability of simply educating individuals on improved eating and exercise behaviors. The aim was to synthesize research on associations of changes in exercise behaviors, psychosocial factors, eating behaviors, and weight; and then conduct further direct testing to inform the development of an improved treatment approach. A systematic program of health behavior-change research based on social cognitive theory, and extensions of that theory applied to exercise and weight loss, was first reviewed. Then, to extend this research toward treatment development and application, a field-based study of obese adults was conducted. Treatments incorporated a consistent component of cognitive-behaviorally supported exercise during 26 weeks that was paired with either standard nutrition education (n = 183) or cognitive-behavioral methods for controlled eating that emphasized self-regulatory methods such as goal setting and caloric tracking, cognitive restructuring, and eating cue awareness (n = 247). Both treatment conditions were associated with improved self-efficacy, self-regulation, mood, exercise, fruit and vegetable consumption, weight, and waist circumference; with improvements in self-regulation for eating, fruit and vegetable consumption, weight, and waist circumference significantly greater in the cognitive-behavioral nutrition condition. Changes in exercise- and eating-related self-efficacy and self-regulation were associated with changes in exercise and eating (R(2) = 0.40 and 0.17, respectively), with mood change increasing the explanatory power to R(2) = 0.43 and 0.20. Improved self-efficacy and self-regulation for exercise carried over to self-efficacy and self-regulation for controlled eating (β= 0.53 and 0.68, respectively). Development and longitudinal testing of a new and different

  3. Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae. A systematic review

    NARCIS (Netherlands)

    Schuurhuis, Jennifer M.; Stokman, Monique A.; Witjes, Max J. H.; Dijkstra, Pieter U.; Vissink, Arjan; Spijkervet, Frederik K. L.

    Pre-radiation dental screening of head-neck cancer patients aims to identify and eliminate oral foci of infection to prevent post-radiation oral problems. The evidence for the efficacy of dental screening is unclear. In this systematic review, we analyzed available evidence on the efficacy of

  4. Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: systematic reviews of the effects and cost-effectiveness of systems.

    Science.gov (United States)

    Main, C; Moxham, T; Wyatt, J C; Kay, J; Anderson, R; Stein, K

    2010-10-01

    Order communication systems (OCS) are computer applications used to enter diagnostic and therapeutic patient care orders and to view test results. Many potential benefits of OCS have been identified including improvements in clinician ordering patterns, optimisation of clinical time, and aiding communication processes between clinicians and different departments. Many OCS now include computerised decision support systems (CDSS), which are information systems designed to improve clinical decision-making. CDSS match individual patient characteristics to a computerised knowledge base, and software algorithms generate patient-specific recommendations. To investigate which CDSS in OCS are in use within the UK and the impact of CDSS in OCS for diagnostic, screening or monitoring test ordering compared to OCS without CDSS. To determine what features of CDSS are associated with clinician or patient acceptance of CDSS in OCS and what is known about the cost-effectiveness of CDSS in diagnostic, screening or monitoring test OCS compared to OCS without CDSS. A generic search to identify potentially relevant studies for inclusion was conducted using MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), CINAHL (Cumulative Index to Nursing and Allied Health Literature), DARE (Database of Abstracts of Reviews of Effects), Health Technology Assessment (HTA) database, IEEE (Institute of Electrical and Electronic Engineers) Xplore digital library, NHS Economic Evaluation Database (NHS EED) and EconLit, searched between 1974 and 2009 with a total of 22,109 titles and abstracts screened for inclusion. CDSS for diagnostic, screening and monitoring test ordering OCS in use in the UK were identified through contact with the 24 manufacturers/suppliers currently contracted by the National Project for Information Technology (NpfIT) to provide either national or specialist decision support. A generic search to identify potentially relevant studies for inclusion in the review was

  5. Gap Balancing Sacrifices Joint-Line Maintenance to Improve Gap Symmetry: 5-Year Follow-Up of a Randomized Controlled Trial.

    Science.gov (United States)

    Babazadeh, Sina; Dowsey, Michelle M; Vasimalla, Michael G; Stoney, James D; Choong, Peter F M

    2018-01-01

    Gap balancing (GB) has been noted to sacrifice joint-line maintenance to improve gap symmetry. This study aims to determine whether this change affects function or quality of life in the midterm. A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or GB (n = 51). Primary outcome measured was femoral component rotation. Secondary outcomes measured were joint-line change, gap symmetry, and function and quality-of-life outcomes. At 5 years, 83 of 103 patients (85%) were assessed. There was no significant difference between groups in terms of functional or quality of life outcomes. A subgroup analysis revealed that there was no significant association between those with asymmetrical flexion and/or extension or medial and/or lateral gaps during knee replacement and subsequent functional outcomes. No significant difference was detected with those with an elevated joint line and postoperative function. In the midterm, the resultant change in joint-line and maintained gap symmetry noted with GB does not result in significant change to function or quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Community health workers' experiences of mobile device-enabled clinical decision support systems for maternal, newborn and child health in developing countries: a qualitative systematic review protocol.

    Science.gov (United States)

    Dzabeng, Francis; Enuameh, Yeetey; Adjei, George; Manu, Grace; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2016-09-01

    The objective of this review is to synthesize evidence on the experiences of community health workers (CHWs) of mobile device-enabled clinical decision support systems (CDSSs) interventions designed to support maternal newborn and child health (MNCH) in low-and middle-income countries.Specific objectives.

  7. An overview of systematic review.

    Science.gov (United States)

    Baker, Kathy A; Weeks, Susan Mace

    2014-12-01

    Systematic review is an invaluable tool for the practicing clinician. A well-designed systematic review represents the latest and most complete information available on a particular topic or intervention. This article highlights the key elements of systematic review, what it is and is not, and provides an overview of several reputable organizations supporting the methodological development and conduct of systematic review. Important aspects for evaluating the quality of a systematic review are also included. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  8. The implementation of mindfulness-based interventions and educational interventions to support family caregivers of patients with cancer: A systematic review.

    Science.gov (United States)

    Al Daken, Laila I; Ahmad, Muayyad M

    2018-05-10

    This review aims to determine the effectiveness of mindfulness-based interventions (MBIs) and educational interventions (EIs) as supportive care for family caregivers (FCs) of patients with cancer. Review was conducted following PRISMA guidelines. The search protocol was performed using EBSCO, Google Scholar, and Science Direct for the studies published between 2007 and 2017. Little evidence is available on the usefulness of MBIs among FCs of patients with cancer. However, the available evidence supports that MBIs have the potential to enhance overall well-being and reduce the burden for FCs. EIs have shown positive outcomes on some aspects of well-being and reducing the burden. The findings provide preliminary support for effectiveness of MBIs and EIs as a supportive care for FCs. © 2018 Wiley Periodicals, Inc.

  9. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    OpenAIRE

    Wilczynski Nancy L; Haynes R Brian

    2010-01-01

    Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this...

  10. In Intergroup Conflict, Self-sacrifice is Stronger among Pro-social Individuals and Parochial Altruism Emerges specially among Cognitively Taxed Individuals

    Directory of Open Access Journals (Sweden)

    Carsten K.W. De Dreu

    2015-05-01

    Full Text Available Parochial altruism is decomposed in a tendency to benefit the in-group along with a tendency to ignore, derogate, and harm rivaling out-groups. Building off recent work suggesting that decisions to cooperate can be relatively fast and intuitive, we examine parochial altruism in intergroup conflict when cognitive deliberation is rendered difficult or not. Predictions were tested in an experiment using an incentivized Intergroup Prisoner’s Dilemma—Maximizing Differences Game (IPD-MD with ninety-five subjects classified as either pro-social or pro-self being randomly allocated to high vs. low impulse-control conditions. Results showed, first of all, that decisions to contribute and self-sacrifice were made faster than decisions not to contribute, and that longer decision time associated with less positive expectations of in-group members. Second, we observed that lowering impulse control with a difficult rather than easy Stroop Task increased the amount contributed to a pool that benefited in-group members while harming out-group members; thus reducing deliberation increased parochial altruism. Finally, results replicated earlier work showing that especially pro-social (versus pro-self individuals contributed more to the in-group and did not lower their contributions to the between-group pool that benefitted their in-group and, simultaneously, hurt the out-group. This pattern emerged independent of their impulse control. Thus, (in-group bounded cooperation is more prominent among individuals with strong rather than weak other-regarding preferences. Moreover, the intuitive tendency to cooperate may have evolved in the context of intergroup conflict and therefore is sharp-edged—in-group bounded and including willingness to aggress out-groups.

  11. On the Discovery of Eastern Hellenistic Initiatory Altar of the 3rd – 1st Centuries BC Depicting the Plot of Bull Sacrifice in the City of Stavropol

    Directory of Open Access Journals (Sweden)

    Prokopenko Yuriy A.

    2016-10-01

    Full Text Available The article is devoted to the semantic and chronological analysis of the images on the plate of white tuff discovered in the city of Stavropol. The central part of the relief is occupied with the image of table – an altar with hoisted bull head (in the background and the hanging part of bull skin (in the foreground. Between the protruding edges of the hanging skin and lower to the ground (between the legs of the altar an ancient Greek phrase carved in three lines. The composition is completed by flanking images of two figures in long robes depicted in profile, symmetrically turned to the head of the bull. The figure at the right is an image of a man with a long beard, the lower edge of which is bent forward (priest or king. The figure at the left is a female (queen. Both the man and the woman are holding ritual vessels in hands. The plot of bull sacrifice is typical for the cultural traditions of ancient Greece as well as for ancient eastern states. The fact of combining images and inscriptions peculiar of the Hellenistic culture and ancient Iranian mythology on the Stavropol altar should be associated with the religious policy pursued by the Pontic kings since the second half of the 3rd century BC till the Common Era. This policy was focused on the gradual replacement of local cults by Greek ones in the official pantheon. The reasons for the Asia Minor altar existence in the Stavropol Upland include: 1 the military expeditions of the Sarmatians to Asia Minor in 2nd – 1st centuries BC; 2 the establishment of political and economic ties by the North Caucasus population with the state of Seleucids in the 2nd century BC, with Parthia in the 2nd – 1st centuries BC, and especially with the kingdom of Pontus in the 1st century BC.

  12. Adaptation and obtainment of evidence for the validity of the “Scale of Perceived Sacrifices Associated with Leaving (the organization” in the Brazilian context: a study among teachers of basic, technical, and technological education

    Directory of Open Access Journals (Sweden)

    Renata Gomes de Jesus

    Full Text Available Abstract The most widely-used model in studies of organizational commitment is the three-dimensional model developed by Meyer and Allen in 1991. This model understands the construct as being composed of instrumental, affective, and normative dimensions. However, it has been criticized by researchers who do not view instrumental commitment as related to the concept of commitment, but instead as a possible organizational link. In order to address the conceptual and empirical problems of the instrument, Powell and Meyer perfected the sub-scale of instrumental commitment and recommended that a new scale, named Perceived Sacrifices Associated with Leaving, be used in future research. This article aims to adapt and obtain evidence of the validity of the new scale, and analyze how teachers perceive the sacrifices associated with leaving a Federal Institute of Education, Science, and Technology. The scale has undergone cross-cultural adaptation and the adapted version was applied to teachers. Exploratory Factor Analysis and Confirmatory Factor Analysis were applied, displaying evidence of the validity of the construct for the Brazilian version. The results revealed that teachers agree on the high intensity level of the sacrifices associated with leaving, and that teachers who occupy management positions perceive it to a higher degree than others. The proposed changes in the scale should be evaluated in future research, and other studies are important to confirm the results found.

  13. Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews.

    Science.gov (United States)

    Lewin, Simon; Lavis, John N; Oxman, Andrew D; Bastías, Gabriel; Chopra, Mickey; Ciapponi, Agustín; Flottorp, Signe; Martí, Sebastian García; Pantoja, Tomas; Rada, Gabriel; Souza, Nathan; Treweek, Shaun; Wiysonge, Charles S; Haines, Andy

    2008-09-13

    Strengthening health systems is a key challenge to improving the delivery of cost-effective interventions in primary health care and achieving the vision of the Alma-Ata Declaration. Effective governance, financial and delivery arrangements within health systems, and effective implementation strategies are needed urgently in low-income and middle-income countries. This overview summarises the evidence from systematic reviews of health systems arrangements and implementation strategies, with a particular focus on evidence relevant to primary health care in such settings. Although evidence is sparse, there are several promising health systems arrangements and implementation strategies for strengthening primary health care. However, their introduction must be accompanied by rigorous evaluations. The evidence base needs urgently to be strengthened, synthesised, and taken into account in policy and practice, particularly for the benefit of those who have been excluded from the health care advances of recent decades.

  14. Toward intrinsic graphene surfaces: a systematic study on thermal annealing and wet-chemical treatment of SiO2-supported graphene devices.

    Science.gov (United States)

    Cheng, Zengguang; Zhou, Qiaoyu; Wang, Chenxuan; Li, Qiang; Wang, Chen; Fang, Ying

    2011-02-09

    By combining atomic force microscopy and trans-port measurements, we systematically investigated effects of thermal annealing on surface morphologies and electrical properties of single-layer graphene devices fabricated by electron beam lithography on silicon oxide (SiO(2)) substrates. Thermal treatment above 300 °C in vacuum was required to effectively remove resist residues on graphene surfaces. However, annealing at high temperature was found to concomitantly bring graphene in close contact with SiO(2) substrates and induce increased coupling between them, which leads to heavy hole doping and severe degradation of mobilities in graphene devices. To address this problem, a wet-chemical approach employing chloroform was developed in our study, which was shown to enable both intrinsic surfaces and enhanced electrical properties of graphene devices. Upon the recovery of intrinsic surfaces of graphene, the adsorption and assisted fibrillation of amyloid β-peptide (Aβ1-42) on graphene were electrically measured in real time.

  15. Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae. A systematic review.

    Science.gov (United States)

    Schuurhuis, Jennifer M; Stokman, Monique A; Witjes, Max J H; Dijkstra, Pieter U; Vissink, Arjan; Spijkervet, Frederik K L

    2015-03-01

    Pre-radiation dental screening of head-neck cancer patients aims to identify and eliminate oral foci of infection to prevent post-radiation oral problems. The evidence for the efficacy of dental screening is unclear. In this systematic review, we analyzed available evidence on the efficacy of pre-radiation elimination of oral foci of infection in preventing oral sequelae. A search was conducted (MEDLINE/EMBASE) for papers published up to May 2014. Papers on head-neck cancer patients subjected to pre-radiation dental screening, (chemo)radiation and oral follow-up were included. Of the 1770 identified papers, 20 studies fulfilled the inclusion criteria of which 17 were retrospective. A great heterogeneity in patient groups, dental screening techniques, definitions of oral foci of infection and techniques for eliminating foci was found. Most papers lacked essential details on how dental screening was performed and a clear definition of an oral focus of infection. The evidence for efficacy of elimination of oral foci of infection to prevent post-radiotherapy oral sequelae was inconclusive. Consequently, the efficacy of pre-radiation elimination of oral foci of infection remains unclear. No conclusions can be drawn about a definition of an oral focus of infection and whether pre-radiation elimination of these foci should be mandatory. We therefore suggest prospective studies with well-defined criteria for oral foci of infection, a clear description of which foci were eliminated and how, a detailed description of pre-radiation dental screening, clearly described patient and tumor characteristics, and a detailed dental history and dental status. Subsequently, oral problems that occur post-radiation should be systematically recorded. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Self-controlled technologies to support skill attainment in persons with an autism spectrum disorder and/or an intellectual disability: a systematic literature review.

    NARCIS (Netherlands)

    den Brok, W.L.J.E.; Sterkenburg, P.S.

    2015-01-01

    Persons with an autism spectrum disorder and/or intellectual disability have difficulties in processing information, which impedes the learning of daily living skills and cognitive concepts. Technological aids support learning, and if used temporarily and in a self-controlled manner, they may

  17. Sensor monitoring to measure and support daily functioning for independently living older people: A systematic review and road map for further development

    NARCIS (Netherlands)

    Pol, M.C.; Poerbodipoero, S.; Robben, S.; Daams, J.; van Hartingsveldt, M.; de Vos, R.; de Rooij, S.E.; Kröse, B.; Buurman, B.M.

    2013-01-01

    Objectives To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently

  18. Online Training and Support Programs Designed to Improve Mental Health and Reduce Burden Among Caregivers of People With Dementia: A Systematic Review

    NARCIS (Netherlands)

    Egan, Kieren J.; Pinto-Bruno, Ángel C.; Bighelli, Irene; Berg-Weger, Marla; van Straten, Annemieke; Albanese, Emiliano; Pot, Anne Margriet

    Introduction: Dementia poses a considerable socioeconomic burden to society. On a global scale, family and other unpaid care predominates. Supporting caregivers is crucial, but scalable interventions are currently lacking. Because a growing number of studies have suggested that online training and

  19. Sensor monitoring to measure and support daily functioning for independently living older people: a systematic review and road map for further development

    NARCIS (Netherlands)

    Pol, Margriet C.; Poerbodipoero, Soemitro; Robben, Saskia; Daams, Joost; van Hartingsveldt, Margo; de Vos, Rien; de Rooij, Sophia E.; Kröse, Ben; Buurman, Bianca M.

    2013-01-01

    To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently at home.

  20. A systematic review on immediate loading of implants used to support overdentures opposed by conventional prostheses : factors that might influence clinical outcomes

    NARCIS (Netherlands)

    Zygogiannis, K.; Wismeijer, D.; Aartman, I.H.A.; Osman, R.B.

    2016-01-01

    Purpose: Different treatment protocols in terms of number, diameter, and suprastructure design have been proposed for immediately loaded implants that are used to support mandibular overdentures opposed by maxillary conventional dentures. The aim of this study was to investigate the influence of

  1. Attitudes of oncology healthcare practitioners towards smoking cessation: A systematic review of the facilitators, barriers and recommendations for delivery of advice and support to cancer patients

    International Nuclear Information System (INIS)

    Conlon, K.; Pattinson, L.; Hutton, D.

    2017-01-01

    Objectives: A systematic review of the literature was conducted. The review was conducted using a search of the literature for all years up to October 2016. Statements that identified facilitators, barriers or recommendations surrounding smoking cessation delivery were extracted and analogous statements aggregated to enable thematic analysis. After searching multiple databases and the application of exclusion and inclusion criteria, a total of 19 acceptable studies were identified. Key findings: Delivery of cessation by oncology professionals was impacted by their own knowledge and views, their perception of the benefits to patient health and by the workplace procedures within their institution. Conclusion: Oncology practitioners worldwide face similar issues in delivering smoking cessation advice. By improving training programs that address the attitudes and beliefs which facilitate or block delivery of smoking cessation and by implementing systemic changes within cancer centres, delivery of smoking cessation should be enabled. - Highlights: • Oncology professional attitudes towards smoking cessation are relatively ubiquitous. • Lack of training is frequently reported to be a barrier to smoking interventions. • Oncology healthcare practitioners have a desire to be trained in smoking cessation. • Required improvements to training programs to facilitate delivery are addressed. • Integration of smoking assessment and advice into workplace policy is required.

  2. How to support patients with severe mental illness in their parenting role with children aged over 1 year? A systematic review of interventions.

    Science.gov (United States)

    Schrank, Beate; Moran, Katherine; Borghi, Cristiana; Priebe, Stefan

    2015-12-01

    There are well-established risks for parents with severe mental illness (i.e. psychotic and bipolar disorders), both for their children and themselves. Interventions to help parents fulfil their role should therefore be a public health objective, but their implementation needs to be underpinned by research evidence. This systematic review determines what is known about the nature and effectiveness of interventions for parents with severe mental illness. We conducted a narrative synthesis of controlled and uncontrolled studies reporting interventions for this patient group after the post-natal period (i.e. after the child has turned 1 year old). Eighteen publications reported data from 15 studies. All but two studies were rated as low quality studies. Interventions included home visiting programmes, complex community programmes, residential treatments, and online interventions. Interventions targeted diverse areas, with parenting skills and understanding the impact of mental illness on parenting most frequently addressed. Both parent and child-related outcomes improved, but children were only assessed via observers and follow-up times were short. Interventions were diverse with respect to their nature and effectiveness. Future interventions should combine different intervention strategies to target multiple areas in a flexible manner. The addition of positively focussed and resource-oriented components should be investigated. Trials should include direct assessments of both parents and children, outcomes that are relevant from a public health perspective, and establish the long-term effects ideally until children have reached 18 years of age.

  3. A Systematic Review of Human Bat Rabies Virus Variant Cases: Evaluating Unprotected Physical Contact with Claws and Teeth in Support of Accurate Risk Assessments.

    Science.gov (United States)

    Dato, Virginia M; Campagnolo, Enzo R; Long, Jonah; Rupprecht, Charles E

    2016-01-01

    In the United States and Canada, the most recent documented cases of rabies have been attributed to bat rabies viruses (RABV). We undertook this systematic review in an effort to summarize and enhance understanding of the risk of infection for individuals who have been potentially exposed to a suspect or confirmed rabid bat. United States rabies surveillance summaries documented a total of 41 human bat-rabies virus variant verified non-transplant cases between 1990 and 2015. All cases were fatal. Seven (17.1%) of 41 cases reported a bite from a bat. Ten (24.3%) cases had unprotected physical contact (UPC); these included seven cases that had a bat land or crawl on them (contact with claws) and one case that touched a bat's teeth. Seven (17.1%) cases had probable UPC. Insectivorous bat teeth are extremely sharp and highly efficient for predation upon arthropod prey. Bats also have sharp claws on the end of their thumbs and feet. One of the most common bat RABV variants has an ability to replicate in non-neural cells. Questioning individuals about unprotected contact with bat teeth and claws (including a bat landing or crawling on a person) may help identify additional exposures.

  4. Sacrifícios, sonhos, indústria cultural: retratos da educação do corpo no esporte escolar Sacrifices, dreams, culture industry: portraits of bodily education in school sports

    Directory of Open Access Journals (Sweden)

    Danielle Torri

    2007-12-01

    Full Text Available O artigo apresenta resultados de uma pesquisa que procurou investigar aspectos da educação do corpo, focando um programa de Esporte Escolar para meninos e meninas de uma escola pública de Florianópolis. Foram realizadas observações sistemáticas do contexto das sessões de treinamento e das competições, além de entrevistas narrativas e levantamento de alguns dados da instituição. Os resultados foram organizados em três grandes categorias de análise. Nomeamos a primeira de Castigos, punições e sacrifícios. Ela diz respeito à forma encontrada pelos treinadores para lidar com a dinâmica de repreensão e emulação de sua equipe. A segunda categoria, batizada de Formação humana X sonho de profissionalização, discorre sobre o papel das representações e expectativas sobre o futebol para as crianças em contraposição à formação que a escola e o esporte prometem lhes proporcionar. A escolha da terceira categoria se deu pela presença constante dos rituais nas práticas corporais organizadas, com especial atenção, nesse caso, ao esporte. Ela foi denominada Rituais como técnica. As considerações finais sugerem uma interpenetração entre rituais, expectativas de futuro e questões moralistas envolvidas no esporte, apontando a prevalência do interesse de controle como central. Além disso, sugerem o mimetismo das práticas do esporte convencional pela mediação da indústria cultural.This article presents results of a research that sought to investigate aspects of bodily education, focusing in a program of School Sports for boys and girls from a public school in Florianópolis, Brazil. Systematic observations were made of the contexts of training sessions and competitions, apart from discursive interviews and some data gathering about the institution. Results were organized in three major analysis categories. The first of them was called Punishments, penalties and sacrifices. It relates to the way found by coaches to

  5. [Systematic review and meta-analysis on the effect of implant supported overdentures on the oral health related quality of life of edentulous patients].

    Science.gov (United States)

    Zhang, S S; Zhang, Y; Di, P; Lin, Y

    2017-05-09

    Objective: To evaluate the effect of implant related treatment on the oral health related quality of life (OHRQoL) of edentulous patients. Methods: The CNKI, Wanfang database and Medline, EMBASE, Cochrane Library databases that include randomized clinical trials comparing implant supported overdentures with conventional complete denture for edentulous patients were retrived. Nine studies involving 769 cases were included and meta-analysis was conducted. Results: The standardized mean difference (SMD) of oral health impact profile (OHIP) score was 1.63 (95% CI: 1.25-2.02) and improved after implant related treatment, which was significantly better than the conventional complete denture (0.87, 95% CI: 0.54-1.20). Conclusions: Implant supported overdentures improved patient's OHRQoL and showed better performance compared to the overdentures complete dentures.

  6. Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.

    Science.gov (United States)

    Mehrholz, J; Harvey, L A; Thomas, S; Elsner, B

    2017-08-01

    Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI). The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI. Systematic review conducted by researchers from Germany and Australia. An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s -1 ) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model. Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s -1 (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s -1 (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training. BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.

  7. What is the existing evidence supporting the efficacy of compression bandage systems containing both elastic and inelastic components (mixed-component systems)? A systematic review.

    Science.gov (United States)

    Welsh, Lynn

    2017-05-01

    To analyse current evidence on the efficacy of bandage systems containing both elastic and inelastic components (mixed-component systems). International consensus on the efficacy of types of compression systems is difficult to achieve; however, mixed-component systems are being promoted as combining the best properties of both elastic and inelastic bandage systems and increasingly being used to treat venous leg ulcers in practice. A systematic literature review. Search terms such as venous leg ulcer, varicose ulcer, leg ulcer, compression, bandage, elastic, inelastic, short stretch, healing rate, interface pressure, mixed component, two-layer, four-layer and multi-layer were used in database and hand searches in several combinations. Limits were set for years 2005-March 2015 and English-language publications. A total of 475 studies were identified at initial search, and following elimination from abstract and title, this was reduced to 7. A further study was identified on Google Scholar, bringing the final number of studies fitting inclusion criteria to 8. The following subgroups relating to outcomes of efficacy were identified: ulcer healing, maintenance of interface pressure, slippage, ease of application and patient quality of life. Mixed-component systems were found to have comparable ulcer healing rates to alternative compression systems and be easy to apply; have similar abilities to maintain pressure as four-layer bandages and better abilities than short-stretch bandages; have less slippage than alternative systems; and to be significantly associated with several favourable quality of life outcomes. Clinician skill in bandage application was an uncontrolled variable in all eight papers included in the review, which may limit reliability of findings. This review synthesises existing evidence on the efficacy of mixed-component systems and encourages clinicians to regard them as an effective alternative to purely elastic or inelastic compression systems

  8. The Efficacy of Supportive Peri-Implant Therapies in Preventing Peri-Implantitis and Implant Loss: a Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ausra Ramanauskaite

    2016-09-01

    Full Text Available Objectives: To study the efficacy of supportive peri-implant therapies in preventing clinical and radiological signs of peri-implantitis and implant loss. Material and Methods: Longitudinal human studies, published between January 1, 2006, and February 1, 2016, were included based on an electronic search using MEDLINE and EMBASE databases and complemented by a manual search. Articles were included only if 1 they comprised a group of patients involved in/adhering to regular supportive peri-implant therapies (SPTs and a control group without such therapies or with poor adherence to them, 2 the protocol of the SPTs was clearly described and 3 the outcome was indicated by means of clinical/radiological changes or implant loss. Results: After initially identifying a total of 710 titles and abstracts, 12 full text articles were selected for eligibility assessment. Seven studies, three prospective and four retrospective, fulfilled the inclusion criteria for this review. The frequency of recall visits varied between the studies from a minimum of one visit every three months to an individually tailored regimen. In all the studies a lack of SPTs or poor adherence to them resulted in significantly higher frequencies of sites with mucosal bleeding, deepened peri-implant pockets or alveolar bone loss. In line with the above, a lack of/poor adherence to SPTs was associated with higher implant loss. Conclusions: To prevent peri-implantitis, an individually tailored supportive programme based on patient motivation and re-instruction in oral hygiene measures combined with professional implant cleaning seem to be crucial.

  9. Economic, Labor, and Regulatory Moderators of the Effect of Individual Placement and Support Among People With Severe Mental Illness: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Metcalfe, Justin D; Drake, Robert E; Bond, Gary R

    2018-01-13

    As Individual Placement and Support (IPS) has become the international standard for vocational rehabilitation of adults with serious mental illness, researchers must consider the relationship between IPS and local environments. This meta-analysis used mixed-effects meta-regressions to assess the impact of site-level moderators on the likelihood that IPS recipients, compared with recipients of alternative vocational services, achieved competitive employment. Potential moderators included change in gross domestic product (GDP), local unemployment and unionization rates, and indices describing employment protection regulations, level of disability benefits compensation, and efforts to integrate people with disabilities into the workforce. Regulatory moderators represent facilitators and barriers to employment that may reinforce or detract from the effectiveness of IPS. Across 30 sites drawn from 21 randomized controlled trials in 12 countries (33% in the United States), IPS recipients were 2.31 (95% CI 1.99-2.69) times more likely to find competitive employment than recipients of alternative vocational rehabilitation services. The significant competitive-employment rate advantage of IPS over control services increased in the presence of weaker employment protection legislation and integration efforts, and less generous disability benefits. Policy makers should recognize and account for the fact that labor and disability regulations can create an arrangement of incentives that reduces the relative efficacy of supported employment. © The Author(s) 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis

    Science.gov (United States)

    Xing, Fei; Lu, Bin; Kuang, Ming-jie; Wang, Ying; Zhao, Yun-long; Zhao, Jie; Sun, Lei; Wang, Yan; Ma, Jian-xiong; Ma, Xin-long

    2017-01-01

    Abstract Objective: The aim of this study was to evaluate the immediate effects of lateral wedge arch support insoles (LWAS) on reducing the knee joint load in patients with medial knee osteoarthritis (OA) compared with an appropriate control. Methods: Databases including Medline, EMBASE, Web of Science, Wiley Online Library, Cochrane library, and Google Scholar were searched with no limits on study date or language, from the earliest available date to October 31, 2016. The included studies had to have the aim of reducing knee load and have an appropriate control. The main measured values were the first and second peak external knee adduction moments (EKAM) and the knee adduction angular impulse (KAAI). The random-effects model was used for analyzing the eligible studies. Results: Nine studies met the inclusion criteria with a total of 356 participants of whom 337 received LWAS treatment. The risk of methodological bias scores (quality index) ranged from 21 to 27 of 32. Treatment with LWAS resulted in statistically significant reductions in the first peak EKAM (P = .005), the second peak EKAM (P = .01), and the KAAI (P = .03). However, among trials in which the control treatment was control shoes, the LWAS showed no associations on the first peak EKAM (P = .10) or the KAAI (P =  .06); among trials in which the control treatment was neutral insoles, the LWAS showed no associations on the second peak EKAM (P = .21) or the KAAI (P = .23). At the same time, the LWAS showed no statistically significant reduction on the first peak EKAM (P = .39) when compared with flat insoles. Conclusion: Although meta-analysis outcomes of all studies indicated statistically significant associations between LWAS and reductions of the first peak EKAM, second peak EKAM and KAAI in people with medial knee OA while walking, different results existed in subgroups using various control conditions for comparison. These findings do not support the use of LWAS

  11. Development of an intervention to support patients and clinicians with advanced lung cancer when considering systematic anticancer therapy: protocol for the PACT study.

    Science.gov (United States)

    Anagnostou, Despina; Sivell, Stephanie; Noble, Simon; Lester, Jason; Byrne, Anthony; Sampson, Catherine; Longo, Mirella; Nelson, Annmarie

    2017-07-12

    Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options. PACT is a five-stage, multimethod and multicentre study. Participants : Patients and health professionals will be recruited from three health boards. Methods : Non-participant observation of multidisciplinary team meetings (n=12) will be used to determine patients' allocation to treatment pathways (stage I). Non-participant observation of patient-clinician consultations (n=20-30) will be used to explore communication of treatment options and decision-making. Extent of participation in decision-making will be assessed using the Observing Patient Involvement in Shared Decision-Making tool. Interviews with patients (stage III) and their clinicians (stage IV) will explore the perception of treatment options and involvement in decision-making. Based on stages I-IV, an expert consensus meeting will finalise the content and format of the intervention. Cognitive interviews with patients will then determine the face validity of the intervention (stage V). Analysis : analysis will be according to data type and research question and will include mediated discourse analysis, thematic analysis, framework analysis and interpretative phenomenological analysis. Ethical approval has been granted. The study findings will contribute to and promote shared and informed decision-making in the best interest

  12. A Systematic Review on Immediate Loading of Implants Used to Support Overdentures Opposed by Conventional Prostheses: Factors That Might Influence Clinical Outcomes.

    Science.gov (United States)

    Zygogiannis, Kostas; Wismeijer, Daniel; Aartman, Irene Ha; Osman, Reham B

    2016-01-01

    Different treatment protocols in terms of number, diameter, and suprastructure design have been proposed for immediately loaded implants that are used to support mandibular overdentures opposed by maxillary conventional dentures. The aim of this study was to investigate the influence of these protocols on survival rates as well as clinical and prosthodontic outcomes. Several electronic databases were searched for all relevant articles published from 1966 to June 2014. Only randomized controlled trials and prospective studies with a minimum follow-up of 12 months were selected. The primary outcomes of interest were the success and survival rates of the implants. Prosthodontic complications were also evaluated. Fourteen studies fulfilled the inclusion criteria. Of the studies identified, nine were randomized controlled trials and five were prospective studies. The mean follow-up period was 3 years or less for the vast majority of the studies. The reported survival and success rates were comparable to that of conventional loading for most of the included studies. No specific immediate loading protocol seemed to perform better in terms of clinical and prosthodontic outcomes. Immediate loading protocols of mandibular overdentures seem to be a viable alternative to conventional loading. It was not possible to recommend a specific treatment protocol related to the number, diameter of the implants, and attachment system used. Long-term, well-designed studies comparing different immediate loading modalities could help to establish a protocol that delivers the most clinically predictable, efficient, and cost-effective outcome for edentulous patients in need of implant overdentures.

  13. Systematic care management: a comprehensive approach to catastrophic injury management applied to a catastrophic burn injury population--clinical, utilization, economic, and outcome data in support of the model.

    Science.gov (United States)

    Kucan, John; Bryant, Ernest; Dimick, Alan; Sundance, Paula; Cope, Nathan; Richards, Reginald; Anderson, Chris

    2010-01-01

    The new standard for successful burn care encompasses both patient survival and the burn patient's long-term quality of life. To provide optimal long-term recovery from catastrophic injuries, including catastrophic burns, an outcome-based model using a new technology called systematic care management (SCM) has been developed. SCM provides a highly organized system of management throughout the spectrum of care that provides access to outcome data, consistent oversight, broader access to expert providers, appropriate allocation of resources, and greater understanding of total costs. Data from a population of 209 workers' compensation catastrophic burn cases with a mean TBSA of 27.9% who were managed under the SCM model of care were analyzed. The data include treatment type, cost, return to work, and outcomes achieved. Mean duration of management to achieve all guaranteed outcomes was 20 months. Of the 209 injured workers, 152 (72.7%) achieved sufficient recovery to be released to return to work, of which 97 (46.8%) were both released and competitively employed. Assessment of 10 domains of functional independence indicated that 47.2% of injured workers required total assistance at initiation of SCM. However, at termination of SCM, 84% of those injured workers were fully independent in the 10 functional activities. When compared with other burn research outcome data, the results support the value of the SCM model of care.

  14. Systematic review

    DEFF Research Database (Denmark)

    Lødrup, Anders Bergh; Reimer, Christina; Bytzer, Peter

    2013-01-01

    in getting off acid-suppressive medication and partly explain the increase in long-term use of PPI. A number of studies addressing this issue have been published recently. The authors aimed to systematically review the existing evidence of clinically relevant symptoms caused by acid rebound following PPI...

  15. Systematic review

    DEFF Research Database (Denmark)

    Christensen, Troels Dreier; Spindler, Karen-Lise Garm; Palshof, Jesper Andreas

    2016-01-01

    to earlier diagnosis and improved survival. Method: In this paper, we describe the incidence as well as characteristics associated with BM based on a systematic review of the current literature, following the PRISMA guidelines. Results: We show that the incidence of BM in CRC patients ranges from 0.6 to 3...

  16. Systematic Avocating

    Directory of Open Access Journals (Sweden)

    Jan Green

    2014-12-01

    Full Text Available Feeling obliged to undertake complex research tasks outside core working hours is a common occurrence in academia. Detailed and timely research projects are expected; the creation and defence of sufficient intervals within a crowded working schedule is one concern explored in this short version paper. Merely working longer hours fails to provide a satisfactory solution for individuals experiencing concerns of this nature. Personal effort and drive are utilised and requires the application of mental mustering and systematic procedures. The attitude to research work is treating the task as a hobby conceptualised as avocating. Whilst this provides a personal solution through immersion in the task, this approach should raise concerns for employers. The flexibility of grounded theory is evident and the freedom to draw on various bodies of knowledge provides fresh insight into a problem that occurs in organizations in many sectors experiencing multiple priorities. The application of the core category, systematic avocating, may prove beneficial.

  17. Tantalus, restraint theory, and the low-sacrifice diet: the art of reverse abstraction: 10th International Congress on Obesity; September 4, 2006; Sydney,Australia - Symposium: obesity management: adding art to the science, invited presentation.

    Science.gov (United States)

    Blair-West, George W

    2007-10-24

    This paper argues that clinicians face the unique artistic challenge of taking concrete pieces of data - scientific findings - and abstracting them into effective therapeutic interventions. Moreover, this abstraction has to be modified for different personality types. The process of therapeutic change and how it can be impeded by the traditional medical model are briefly explored. The doctor-patient dyadic treatment relationship, while appropriate and necessary for many medical interventions, can disavow the source of change when it comes to lifestyle conditions such as obesity. Restraint theory and its origins in Greek mythology are briefly reviewed and integrated with Bowlby's attachment theory as precepts in developing a psychologically based dietary approach. By retaining in people's diets foods they have a deep emotional attachment to, the low-sacrifice diet attempts to encourage caloric restriction in a way that does not trigger rebound overeating.

  18. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs.

    Science.gov (United States)

    Pjetursson, Bjarni Elvar; Sailer, Irena; Makarov, Nikolay Alexandrovich; Zwahlen, Marcel; Thoma, Daniel Stefan

    2015-06-01

    To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported fixed dental prostheses (FDPs) and to describe the incidence of biological, technical and esthetic complications. Medline (PubMed), Embase and Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported FDPs with a mean follow-up of at least 3 years. This was complemented by an additional hand search and the inclusion of 10 studies from a previous systematic review [1]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. Forty studies reporting on 1796 metal-ceramic and 1110 all-ceramic FDPs fulfilled the inclusion criteria. Meta-analysis of the included studies indicated an estimated 5-year survival rate of metal-ceramic FDPs of 94.4% (95% CI: 91.2-96.5%). The estimated survival rate of reinforced glass ceramic FDPs was 89.1% (95% CI: 80.4-94.0%), the survival rate of glass-infiltrated alumina FDPs was 86.2% (95% CI: 69.3-94.2%) and the survival rate of densely sintered zirconia FDPs was 90.4% (95% CI: 84.8-94.0%) in 5 years of function. Even though the survival rate of all-ceramic FDPs was lower than for metal-ceramic FDPs, the differences did not reach statistical significance except for the glass-infiltrated alumina FDPs (p=0.05). A significantly higher incidence of caries in abutment teeth was observed for densely sintered zirconia FDPs compared to metal-ceramic FDPs. Significantly more framework fractures were reported for reinforced glass ceramic FDPs (8.0%) and glass-infiltrated alumina FDPs (12.9%) compared to metal-ceramic FDPs (0.6%) and densely sintered zirconia FDPs (1.9%) in 5 years in function. However, the incidence of ceramic fractures and loss of retention was significantly (p=0.018 and 0.028 respectively) higher for densely sintered zirconia FDPs compared to all other types of FDPs. Survival rates of all

  19. Promoting and supporting self-management for adults living in the community with physical chronic illness: A systematic review of the effectiveness and meaningfulness of the patient-practitioner encounter.

    Science.gov (United States)

    Rees, Sally; Williams, Anne

    example, people with diabetes, asthma, arthritis, coronary disease, lung disease, heart failure, epilepsy, kidney disease and inflammatory bowel disease. Since patients meet various professionals in a variety of community settings regarding their care, a practitioner in this review included doctors (physicians and General Practitioners), nurses, nurse specialists, dieticians, podiatrists and community health workers.A variety of outcomes measures was used to evaluate effective self-care management. These included physiological measurements such as: HbA1c, blood pressure, body weight, lipids; lifestyle measurements, for example physical activity; and self-care determinants such as knowledge, attitude; and self-care behaviours regarding, for example, diet and physical exercise, and medication. The outcome measures used to explore the meaningfulness of the patient-practitioner encounter, concerned patients', physicians' and nurses' views and perceptions of self-care management and support.The review considered all types of quantitative and qualitative evidence regarding the patient-practitioner encounter where self-care in chronic illness was the focus. The quantitative studies reviewed included systematic reviews, randomised controlled trials (RCTs), quasi-experimental studies, and survey studies.Qualitative studies reviewed included interview designs, vignette technique, qualitative evaluation, grounded theory, and exploratory descriptive design. The search sought to find both published and unpublished studies between 1990 and 2005. The year 1990 was deemed appropriate since it precedes the development of the Chronic Care Model in which self-management support for people living with chronic illness is heralded as an important part of care-management. An initial search of CINAHL and MEDLINE databases was undertaken to identify appropriate search terms regarding self-care and chronic illness. A search strategy was then developed using all identified MeSH headings and key

  20. Fungal Systematics and Evolution: FUSE 3

    Czech Academy of Sciences Publication Activity Database

    Krisai-Greilhuber, I.; Chen, Y.; Jabeen, S.; Madrid, H.; Marincowitz, S.; Razaq, A.; Ševčíková, H.; Voglmayr, H.; Yazici, K.; Aptroot, A.; Aslan, A.; Boekhout, T.; Borovička, Jan; Crous, P.W.; Ilyas, S.; Jami, F.; Jiang, Y. L.; Khalid, A. N.; Kolecká, A.; Konvalinková, T.; Norphanphoun, C.; Shaheen, S.; Wang, Y.; Wingfield, M. J.; Wu, S. P.; Wu, Y. M.; Yu, J. Y.

    2017-01-01

    Roč. 36, 29 December 2017 (2017), s. 229-264 ISSN 0082-0598 Institutional support: RVO:67985831 Keywords : biodiversity * ITS varcodes * phylogeny * systematics Subject RIV: EF - Botanics OBOR OECD: Mycology Impact factor: 0.896, year: 2016

  1. Systematization of best practices for ecodesign implementation

    DEFF Research Database (Denmark)

    Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.; Rozenfeld, Henrique

    2014-01-01

    Despite the recognition of ecodesign potential benefits, its application has not reached companies over the last decades mainly due to difficulties in ecodesign implementation and management and lack of a systematization of existing practices. In order to support companies in dealing with those...... challenges and provide a structured classification of ecodesign practices, a systematic literature review was performed for the identification and classification of the existing practices, supporting the selection of the most suitable ones according to companies’ specific needs and characteristics....

  2. [Detection of Toxoplasma gondii infection of sheep slaughtered in the governorate of Sousse on the occasion of the Muslim sacrifice feast (Eid Al-Adha) and analysis of risk factors].

    Science.gov (United States)

    Khayeche, M; Mhadhbi, M; Gharbi, M; Nasfi, I; Darghouth, M A

    2014-02-01

    During the Muslim feast of Sacrifice (Eid Al-Adha), DNA of Toxoplasma gondii was screened in the heart apex of 70 sheep belonging to different households in Sousse region (North-East of Tunisia) by nested PCR.DNA of T. gondii was identified in 5.7% of the samples. To study different risk factors of Toxoplasma gondii transmission that can be present especially for this occasion, a questionnaire was established. It revealed that the majority of households (92.9%) slaughtered a sheep aged less than 1 year old. Moreover, 2% of the study population consumed undercooked meat. This study showed also that the majority of meat handlers did not respect the hygiene rules, since 91% of them did not wash their hands after handling and before preparing or consuming food. The presence of the definitive host (cats) is considered among the factors that increase the risk of Toxoplasma infection. It was recorded in 14% of the households with the presence of elements that increases the risk as defecating in the house and eating raw meat during Eid Al-Adha feast. Our results show that the risk factors of Toxoplasma infection increase during this occasion; it requires the establishment of a sanitary education programme during this feast.

  3. How can policy strengthen community support for children in military families?

    Science.gov (United States)

    Boberiene, Liepa V; Hornback, Bradley J

    2014-09-01

    The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.

  4. Telerheumatology: A Systematic Review.

    Science.gov (United States)

    McDougall, John A; Ferucci, Elizabeth D; Glover, Janis; Fraenkel, Liana

    2017-10-01

    To identify and summarize the published and gray literature on the use of telemedicine for the diagnosis and management of inflammatory and/or autoimmune rheumatic disease. We performed a registered systematic search (CRD42015025382) for studies using MEDLINE (1946 to July 2015), Embase (1974 to July 2015), Web of Science (1900 to July 2015), and Scopus (1946 to July 2015) databases. We included studies that demonstrated the use of telemedicine for diagnosis and/or management of inflammatory/autoimmune rheumatic disease. Following data extraction, we performed a descriptive analysis. Our literature search identified 1,468 potentially eligible studies. Of these studies, 20 were ultimately included in this review. Studies varied significantly in publication type, quality of evidence, and the reporting of methods. Most demonstrated a high risk of bias. Rheumatoid arthritis was the most commonly studied rheumatic disease (42% of patients). Studies demonstrated conflicting results regarding the effectiveness of telemedicine (18 found it effective, 1 found it effective but possibly harmful, and 1 found it ineffective). A limited number of studies included some component of a cost analysis (n = 6; 16% of patients); all of these found telemedicine to be cost-effective. Studies identified by this systematic review generally found telemedicine to be effective for the diagnosis and management of autoimmune/inflammatory rheumatic disease; however, there is limited evidence to support this conclusion. Further studies are needed to determine the best uses of telemedicine for the diagnosis and management of these conditions. © 2016, American College of Rheumatology.

  5. Iridology: A systematic review.

    Science.gov (United States)

    Ernst, E

    1999-02-01

    Iridologists claim to be able to diagnose medical conditions through abnormalities of pigmentation in the iris. This technique is popular in many countries. Therefore it is relevant to ask whether it is valid. To systematically review all interpretable tests of the validity of iridology as a diagnostic tool. DATA SOURCE AND EXTRACTION: Three independent literature searches were performed to identify all blinded tests. Data were extracted in a predefined, standardized fashion. Four case control studies were found. The majority of these investigations suggests that iridology is not a valid diagnostic method. The validity of iridology as a diagnostic tool is not supported by scientific evaluations. Patients and therapists should be discouraged from using this method.

  6. Self-sacrifice Template Formation of Hollow Hetero-Ni7S6/Co3S4 Nanoboxes with Intriguing Pseudo-capacitance for High-performance Electrochemical Capacitors

    Science.gov (United States)

    Hua, Hui; Liu, Sijia; Chen, Zhiyi; Bao, Ruiqi; Shi, Yaoyao; Hou, Linrui; Pang, Gang; Hui, Kwun Nam; Zhang, Xiaogang; Yuan, Changzhou

    2016-02-01

    Herein, we report a simple yet efficient self-sacrifice template protocol to smartly fabricate hollow hetero-Ni7S6/Co3S4 nanoboxes (Ni-Co-S NBs). Uniform nickel cobalt carbonate nanocubes are first synthesized as the precursor via solvothermal strategy, and subsequently chemically sulfidized into hollow heter-Ni-Co-S NBs through anion-exchange process. When evaluated as electrode for electrochemical capacitors (ECs), the resultant hetero-Ni-Co-S NBs visually exhibit attractive pesudo-capacitance in KOH just after continuously cyclic voltammetry (CV) scanning for 100 cycles. New insights into the underlying energy-storage mechanism of the hollow hetero-Ni-Co-S electrode, based on physicochemical characterizations and electrochemical evaluation, are first put forward that the electrochemically induced phase transformation gradually occurrs during CV sweep from the hetero-Ni-Co-S to bi-component-active NiOOH and CoOOH, which are the intrinsic charge-storage phases for the appealing Faradaic capacitance (~677 F g-1 at 4 A g-1) of hollow Ni-Co-S NBs at high rates after cycling. When further coupled with negative activated carbon (AC), the AC//hetero-Ni-Co-S asymmetric device with extended electrochemical window of 1.5 V demonstrates high specific energy density of ~31 Wh kg-1. Of significance, we strongly envision that hollow design concept and new findings here hold great promise for enriching synthetic methodologies, and electrochemistry of complex metal sulfides for next-generation ECs.

  7. Birds sacrifice oxidative protection for reproduction

    NARCIS (Netherlands)

    Wiersma, P; Selman, C; Speakman, [No Value; Verhulst, S; Speakman, John R.

    2004-01-01

    Oxidative metabolism has reactive oxygen species (ROS) as unavoidable by-products, and the damage ROS inflicts on DNA, proteins and lipids is considered to be a major agent of senescence. Increasing reproductive effort accelerates senescence, but whether reproductive effort is increased at the

  8. Sacrifice and dystopia: imagining Karachi through Edhi

    NARCIS (Netherlands)

    Jaffri, Y.; Verkaaik, O.; Anjaria, J.S.; McFarlane, C.

    2011-01-01

    Introduction : conceptualising the city in South Asia / Jonathan Shapiro Anjaria and Colin McFarlane -- pt. 1. Contested landscapes. The nuisance of slums : environmental law and the production of slum illegality in India / D. Asher Ghertner ; Poverty as geography : motility, stoppage and circuits

  9. 'Living' sacrifice and shame: Phenomenological insights into ...

    African Journals Online (AJOL)

    This article is contextualised within the field of post-graduate, continuing teacher education in South Africa, through an essentially 'distanced', that is, part-time, mixedmode teaching and learning model. It draws on a broader phenomenological research study into the experiences of students taking a one semester module, ...

  10. The difficulties of systematic reviews.

    Science.gov (United States)

    Westgate, Martin J; Lindenmayer, David B

    2017-10-01

    The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently

  11. The systematization of practice

    DEFF Research Database (Denmark)

    Vidal, Rene Victor Valqui

    2002-01-01

    this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark.......this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark....

  12. Sacrificio cortoplacista adaptativo 2opt (SCA_2opt: Una heurística inspirada en el pensamiento sistémico Sacrifice short-term adaptive 2-opt (SCA_2opt: A heuristic inspired by systems thinking

    Directory of Open Access Journals (Sweden)

    Jorge Pérez Rave

    2013-01-01

    Full Text Available Se detalla el origen de dos noveles heurísticas para el TSP simétrico, inspiradas en el pensamiento sistémico: Sacrificio Cortoplacista Adaptativo 2-opt (SCA_2opt y SCA_2_opt_r. Estas surgen del análisis sistémico de la regla de decisión Vecino más cercano, identificándosele el arquetipo "Soluciones contraproducentes". El SCA se basa en que el agente viajero renuncie en un momento dado a una ciudad inmediatamente cercana, y se traslade hacia la segunda ciudad más cercana disponible. A partir de ello, se continúa con la regla del vecino más cercano. Cada que se realiza el SCA (búsqueda global se efectúa una búsqueda local 2_opt. Considerando el binomio eficacia y eficiencia, las dos heurísticas se muestran prometedoras en comparación multicriterio contra 19 metaheurísticas. Se evidencia que el pensamiento sistémico es un campo de inspiración viable para el desarrollo de métodos de optimización combinatoria; se plasman preguntas emergentes para desarrollos futuros, que permitan continuar integrando elementos de la optimización clásica con el pensamiento sistémico; áreas tradicionalmente vistas como antagónicas, pero cuyo diálogo se muestra favorable en este artículo.Outlining two novice heuristics for the symmetric TSP, inspired systemic thinking: Sacrifice short-term adaptive 2-opt (SCA2opt and SCA_2opt_r. These arise from the systemic analysis of the rule of decision, nearest neighbour, identifying the archetype "Counterproductive solutions". SCA relies on that agent traveler, renounces at any given time immediately to a nearby city, and moves towards the second nearest available city. From there, it continues with the nearest neighbour rule. Each is the SCA (global search operates a local search 2opt. Where as the binomial effectiveness and efficiency, the two new heuristics are shown promising in comparison multicriteria against 19 metaheuristics. It is evident that systemic thinking is a field of inspiration viable

  13. Tech Support.

    Science.gov (United States)

    Beem, Kate

    2002-01-01

    Discusses technology-support issues, including staff training, cost, and outsourcing. Describes how various school districts manage technology-support services. Features the Technology Support Index, developed by the International Society for Technology in Education, to gauge the operation of school district technology-support programs. (PKP)

  14. Corporate social responsibility: the role of public policy: a systematic literature review of the effects of government supported interventions on the corporate social responsibility (CSR) behaviour of enterprises in developing countries

    NARCIS (Netherlands)

    Ingram, V.; de Grip, K.; de Ruyter de Wildt, M.; Ton, G.; Douma, M.; Boone, K.; van Hoeven, H.

    2013-01-01

    Corporate social responsibility (CSR) focuses on creating social and environmental value in addition to economic performance: people, planet and profit (or Triple P). Public authorities are increasingly supporting companies that choose to do so. What has become of the Dutch government’s efforts to

  15. Supporting analyses and assessments

    Energy Technology Data Exchange (ETDEWEB)

    Ohi, J. [National Renewable Energy Lab., Golden, CO (United States)

    1995-09-01

    Supporting analysis and assessments can provide a sound analytic foundation and focus for program planning, evaluation, and coordination, particularly if issues of hydrogen production, distribution, storage, safety, and infrastructure can be analyzed in a comprehensive and systematic manner. The overall purpose of this activity is to coordinate all key analytic tasks-such as technology and market status, opportunities, and trends; environmental costs and benefits; and regulatory constraints and opportunities-within a long-term and systematic analytic foundation for program planning and evaluation. Within this context, the purpose of the project is to help develop and evaluate programmatic pathway options that incorporate near and mid-term strategies to achieve the long-term goals of the Hydrogen Program. In FY 95, NREL will develop a comprehensive effort with industry, state and local agencies, and other federal agencies to identify and evaluate programmatic pathway options to achieve the long-term goals of the Program. Activity to date is reported.

  16. Nutritional Support

    Science.gov (United States)

    Nutritional support is therapy for people who cannot get enough nourishment by eating or drinking. You may need ... absorb nutrients through your digestive system You receive nutritional support through a needle or catheter placed in your ...

  17. Aromatherapy: a systematic review.

    Science.gov (United States)

    Cooke, B; Ernst, E

    2000-01-01

    Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials. PMID:10962794

  18. Support Systems for Treatment Integrity

    NARCIS (Netherlands)

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately

  19. A systematic review of systematic reviews of homeopathy

    Science.gov (United States)

    Ernst, E

    2002-01-01

    Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice. PMID:12492603

  20. Supporting Families to Support Students

    Science.gov (United States)

    Kelly, John; Rossen, Eric; Cowan, Katherine C.

    2018-01-01

    Collaboration between students' families and the school is an essential component to promoting student mental and behavioral health. Many schools structure their mental health services using a Multi-Tiered System of Supports that offers three different tiers of support from universal supports to personalized help for students with serious…

  1. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India.

    Science.gov (United States)

    Maulik, Pallab K; Tewari, Abha; Devarapalli, Siddhardha; Kallakuri, Sudha; Patel, Anushka

    2016-01-01

    Common mental disorders (CMD) such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India's vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS) to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign. The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre. The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers. A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen's behavioural model of health services use. The findings assisted with refining the intervention prior to large-scale implementation and evaluation.

  2. The Systematic Medical Appraisal, Referral and Treatment (SMART Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India.

    Directory of Open Access Journals (Sweden)

    Pallab K Maulik

    Full Text Available Common mental disorders (CMD such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India's vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign.The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre.The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers.A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen's behavioural model of health services use.The findings assisted with refining the intervention prior to large-scale implementation and evaluation.

  3. Pancreatectomy for metastatic disease: a systematic review.

    LENUS (Irish Health Repository)

    Adler, H

    2014-04-01

    Tumours rarely metastasise to the pancreas. While surgical resection of such metastases is believed to confer a survival benefit, there is limited data to support such management. We present a systematic review of case series of pancreatic metastasectomy and analysis of survival outcomes.

  4. Surgically facilitated orthodontic treatment : A systematic review

    NARCIS (Netherlands)

    Hoogeveen, Eelke J.; Jansma, Johan; Ren, Yijin

    INTRODUCTION: Corticotomy and dental distraction have been proposed as effective and safe methods to shorten orthodontic treatment duration in adolescent and adult patients. A systematic review was performed to evaluate the evidence supporting these claims. METHODS: PubMed, Embase, and Cochrane

  5. Fungal Systematics and Evolution: FUSE 3

    Czech Academy of Sciences Publication Activity Database

    Krisai-Greilhuber, I.; Chen, Y.; Jabeen, S.; Madrid, H.; Marincowitz, S.; Razaq, A.; Ševčíková, H.; Voglmayr, H.; Yazici, K.; Aptroot, A.; Aslan, A.; Boekhout, T.; Borovička, Jan; Crous, P. W.; Ilyas, S.; Jami, F.; Jiang, Y. L.; Khalid, A. N.; Kolecká, A.; Konvalinková, Tereza; Norphanphoun, C.; Shaheen, S.; Wang, Y.; Wingfield, M. J.; Wu, S. P.; Wu, Y. M.; Yu, J. Y.

    2017-01-01

    Roč. 69, č. 12 (2017), s. 229-264 ISSN 0082-0598 Institutional support: RVO:61389005 ; RVO:61388971 Keywords : biodiversity * ITS varcodes * phylogeny * systematics Subject RIV: CB - Analytical Chemistry, Separation; EE - Microbiology, Virology (MBU-M) OBOR OECD: Analytical chemistry; Mycology (MBU-M) Impact factor: 0.896, year: 2016

  6. Roadway supports

    Energy Technology Data Exchange (ETDEWEB)

    Stassen, P

    1980-01-01

    Support systems in stone drifts and tunnels are discussed. Timber supports, steel arches, cold-bent sheet-metal arches, shotcrete and combined support arrangements are described. Brickwork and reinforced concrete are also covered. Supports in roadways leading to the face and in-seam roads are discussed including timber supports, steel arches, articulated arches on timber chocks, support accessories and the withdrawal and reshaping of arches. The subject of strata bolting, the aims of strata bolting, methods of strata bolting, systems of rock-bolting, end plates and wire mesh, and bolt and anchorage monitoring are also discussed. Injection techniques, injection parameters, injection methods, grouts, includes an example of the application of injection techniques are covered and combined injection/dowelling arrangements are examined. (55 refs.) (In French)

  7. Systematic text condensation

    DEFF Research Database (Denmark)

    Malterud, Kirsti

    2012-01-01

    To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies.......To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies....

  8. The Importance of Systematics

    Indian Academy of Sciences (India)

    1999-02-18

    Feb 18, 1999 ... Similarly, the work of Nathan Charles Rothschild, a taxonomic authority on flea species, was responsible for the discovery ... The use of genetic data for taxonomic purposes also brings systematics closer to realizing Darwin's desire that classification should reflect evolutionary relationships. Systematics is.

  9. A systematic review of systematic reviews on interventions for caregivers of people with chronic conditions.

    Science.gov (United States)

    Corry, Margarita; While, Alison; Neenan, Kathleen; Smith, Valerie

    2015-04-01

    To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear. A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions. The electronic databases of PubMed, CINAHL, British Nursing Index, PsycINFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions. Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R-AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results. Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers. Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings. © 2014 John Wiley & Sons Ltd.

  10. Application of systematic review methodology to the field of nutrition

    Science.gov (United States)

    Systematic reviews represent a rigorous and transparent approach of synthesizing scientific evidence that minimizes bias. They evolved within the medical community to support development of clinical and public health practice guidelines, set research agendas and formulate scientific consensus state...

  11. An examination of the role of perceived support and employee commitment in employee-customer encounters.

    Science.gov (United States)

    Vandenberghe, Christian; Bentein, Kathleen; Michon, Richard; Chebat, Jean-Charles; Tremblay, Michel; Fils, Jean-François

    2007-07-01

    The authors examined the relationships between perceived organizational support, organizational commitment, commitment to customers, and service quality in a fast-food firm. The research design matched customer responses with individual employees' attitudes, making this study a true test of the service provider-customer encounter. On the basis of a sample of matched employee-customer data (N = 133), hierarchical linear modeling analyses revealed that perceived organizational support had both a unit-level and an employee-level effect on 1 dimension of service quality: helping behavior. Contrary to affective organizational commitment, affective commitment to customers enhanced service quality. The 2 sub-dimensions of continuance commitment to the organization--perceived high sacrifice and perceived lack of alternatives--exerted effects opposite in sign: The former fostered service quality, whereas the latter reduced it. The implications of these findings are discussed within the context of research on employee-customer encounters.

  12. Using systematic review in occupational safety and health.

    Science.gov (United States)

    Howard, John; Piacentino, John; MacMahon, Kathleen; Schulte, Paul

    2017-11-01

    Evaluation of scientific evidence is critical in developing recommendations to reduce risk. Healthcare was the first scientific field to employ a systematic review approach for synthesizing research findings to support evidence-based decision-making and it is still the largest producer and consumer of systematic reviews. Systematic reviews in the field of occupational safety and health are being conducted, but more widespread use and adoption would strengthen assessments. In 2016, NIOSH asked RAND to develop a framework for applying the traditional systematic review elements to the field of occupational safety and health. This paper describes how essential systematic review elements can be adapted for use in occupational systematic reviews to enhance their scientific quality, objectivity, transparency, reliability, utility, and acceptability. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  13. Supporting Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is the supporting information for the journal article. This dataset is associated with the following publication: Rankin, K., S. Mabury, T. Jenkins, and J....

  14. Supporting Info

    Data.gov (United States)

    U.S. Environmental Protection Agency — Supporting Info. This dataset is associated with the following publication: Washington , J., and T. Jenkins. Abiotic Hydrolysis of Fluorotelomer-Based Polymers as a...

  15. Supporting Info

    Data.gov (United States)

    U.S. Environmental Protection Agency — Supporting Information. This dataset is associated with the following publication: Washington , J., T. Jenkins, and E. Weber. Identification of Unsaturated and 2H...

  16. Human Resources practices and workplace environmental support

    Directory of Open Access Journals (Sweden)

    Noel Ngwenya

    2014-01-01

    Full Text Available The key to retaining employees lies on the organization’s capability of supporting employees by understanding and answering to their intrinsic motivators. It is important for employees to perceive a positive and valuing attitude of the organization toward them in order to have greater motivation for staying in the organization. Such condition for employee retention is based on the social exchange theory which holds that the exchange relationship between employer and employee goes beyond exchange of impersonal resources such as money, information, and service. One of the leading challenges in creating attractive and supporting working environment has be implementing effective human development strategies to enhance organizational performance and employee commitment. Therefore, managing human resources plays a crucial role in a process of increasing organization, starting from line managers who need to be aware of factors that motivate their subordinates to make them perform well, ending up with human resources professionals who have to understand motivation to effectively design and implement reward structure and systems. In employment situation, as in personal relationships, commitment is a tow-away street. If employers want committed employees, they need to be committed employers. Committed employees do better work than uncommitted ones and organizations with committed workers do better financially than organizations with uncommitted ones. Employers need to determine what is responsible for this disparity. Many employees perceive that employers do not value loyalty and are willing to sacrifice workers to maintain the financial bottom line. Employees points to decades of downsizing, rightsizing, and re-engineering as the evidence that employers treat them as expendable commodities when times get tough (Bragg, 2002.

  17. Pedagogical Support Components of Students' Social Adaptation

    Science.gov (United States)

    Vlasova, Vera K.; Simonova, Galina I.; Soleymani, Nassim

    2016-01-01

    The urgency of the problem stated in the article is caused by the need of pedagogical support of students' social adaptation on the basis of systematicity, which is achieved if we correctly define the components of the process. The aim of the article is to determine the pedagogical support components of students' social adaptation. The leading…

  18. Pipe support

    International Nuclear Information System (INIS)

    Pollono, L.P.

    1979-01-01

    A pipe support for high temperature, thin-walled piping runs such as those used in nuclear systems is described. A section of the pipe to be suppported is encircled by a tubular inner member comprised of two walls with an annular space therebetween. Compacted load-bearing thermal insulation is encapsulated within the annular space, and the inner member is clamped to the pipe by a constant clamping force split-ring clamp. The clamp may be connected to pipe hangers which provide desired support for the pipe

  19. Supporting ATLAS

    CERN Multimedia

    maximilien brice

    2003-01-01

    Eighteen feet made of stainless steel will support the barrel ATLAS detector in the cavern at Point 1. In total, the ATLAS feet system will carry approximately 6000 tons, and will give the same inclination to the detector as the LHC accelerator.

  20. Supporting Transition

    Science.gov (United States)

    Qureshi, Asima; Petrucco, James

    2018-01-01

    Meadowbrook Primary School has explored the use of The Teacher Assessment in Primary Science (TAPS) to support transition, initially for transfer to secondary school and now for transition from Early Years Foundation Stage (EYFS) into Key Stage 1 (ages 5-7). This article will consider an example of a secondary transition project and discuss the…

  1. Using Explicit and Systematic Instruction to Support Working Memory

    Science.gov (United States)

    Smith, Jean Louise M.; Sáez, Leilani; Doabler, Christian T.

    2016-01-01

    Students are frequently expected to complete multistep tasks within a range of academic or classroom routines and to do so independently. Students' ability to complete these tasks successfully may vary as a consequence of both their working-memory capacity and the conditions under which they are expected to learn. Crucial features in the design or…

  2. 450 Perceived Supervisor's Support and Job Insecurity as Predictors ...

    African Journals Online (AJOL)

    efforts and sacrifices toward organizational processes. For employees ... employee's negative reaction to the changes concerning their jobs”. (Sverke & Hellen, 2002) .... the continuance commitment is encouraged by leader member exchange ...

  3. Sistema de informação para apoio à Sistematização da Assistência de Enfermagem Sistema de información para apoyo a la Sistematización de la Asistencia de Enfermería Information system for supporting the Nursing Care Systematization

    Directory of Open Access Journals (Sweden)

    Andreia Malucelli

    2010-08-01

    Full Text Available A importância, pertinência e necessidade de implantação da Sistematização da Assistência de Enfermagem nos diferentes ambientes da prática profissional é fato inquestionável. Tendo isso como princípio, objetivou-se elaborar um sistema de informação para apoio à Sistematização da Assistência de Enfermagem, baseado nas etapas do Processo de Enfermagem, nas Necessidades Humanas e utilizando a linguagem de diagnósticos, intervenções e resultados de enfermagem para documentação da prática profissional. Neste artigo, são descritas as etapas metodológicas e os resultados do desenvolvimento do referido sistema de informação - levantamento de requisitos, modelagem, mapeamento objeto-relacional, implementação e validação do sistema.La importancia, pertinencia y necesidad de implantación de la Sistematización de la Asistencia de Enfermería en los diferentes ambientes de la práctica profesional es facto incuestionable. Así se objetivó elaborar un sistema de información para apoyo a Sistematización de la Asistencia de Enfermería, basado en las etapas del Proceso de Enfermería, en las Necesidades Humanas e utilizando la lenguaje de diagnósticos, intervenciones y resultados de enfermería para documentación de la práctica profesional. En este artículo, son descriptos las etapas metodológicas y los resultados del desarrollo del referido sistema de información levantamiento de requisitos, modelaje, mapeamento objeto-intencional, implementación y validación del sistema.It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional

  4. Estimation of population mean under systematic sampling

    Science.gov (United States)

    Noor-ul-amin, Muhammad; Javaid, Amjad

    2017-11-01

    In this study we propose a generalized ratio estimator under non-response for systematic random sampling. We also generate a class of estimators through special cases of generalized estimator using different combinations of coefficients of correlation, kurtosis and variation. The mean square errors and mathematical conditions are also derived to prove the efficiency of proposed estimators. Numerical illustration is included using three populations to support the results.

  5. Systematic Approach for Development of Innovative Infrastructure

    Directory of Open Access Journals (Sweden)

    Zarema Muhamedova

    2014-07-01

    Full Text Available The necessity for development of innovative infrastructure is proved. Its nature, reasonability of systematic approach use and purpose has been identified. The author suggests considering the regime of infrastructural provision aimed at offering horizontal and vertical integration of institutions. This model is designed to create and integral complex for innovative support. The grounds of establishment the state politics are identified. The conceptual recommendations on its development and formation of relevant model, strategy and regulatory mechanism are outlined.

  6. A SYSTEMATIC STUDY OF SOFTWARE QUALITY MODELS

    OpenAIRE

    Dr.Vilas. M. Thakare; Ashwin B. Tomar

    2011-01-01

    This paper aims to provide a basis for software quality model research, through a systematic study ofpapers. It identifies nearly seventy software quality research papers from journals and classifies paper asper research topic, estimation approach, study context and data set. The paper results combined withother knowledge provides support for recommendations in future software quality model research, toincrease the area of search for relevant studies, carefully select the papers within a set ...

  7. Swaddling: A Systematic Review

    NARCIS (Netherlands)

    van Sleuwen, Bregje E.; Engelberts, Adèle C.; Boere-Boonekamp, Magdalena M.; Kuis, Wietse; Schulpen, Tom W.J.

    2007-01-01

    Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and the Netherlands to curb excessive crying. We have systematically reviewed all articles on

  8. Systematic, Cooperative Evaluation.

    Science.gov (United States)

    Nassif, Paula M.

    Evaluation procedures based on a systematic evaluation methodology, decision-maker validity, new measurement and design techniques, low cost, and a high level of cooperation on the part of the school staff were used in the assessment of a public school mathematics program for grades 3-8. The mathematics curriculum was organized into Spirals which…

  9. Swaddling : A systematic review

    NARCIS (Netherlands)

    van Sleuwen, Bregje E.; Engelberts, Adele C.; Boere-Boonekamp, Magda M.; Kuis, Wietse; Schulpen, Tom W. J.; L'Hoir, Monique P.

    2007-01-01

    Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and the Netherlands to curb excessive crying. We have systematically reviewed all articles on

  10. Serbia : Systematic Country Diagnostic

    OpenAIRE

    World Bank Group

    2015-01-01

    This Systematic Country Diagnostic (SCD) aims to identify the major constraints on and opportunities for sustaining poverty reduction and shared prosperity in Serbia. The SCD serves as the analytic foundation on which the World Bank Group and the Government of Serbia will define a new Country Partnership Framework for FY2016 to FY2020. It is based on the best possible analysis, drawing on ...

  11. The quality of systematic reviews about interventions for refractive error can be improved: a review of systematic reviews.

    Science.gov (United States)

    Mayo-Wilson, Evan; Ng, Sueko Matsumura; Chuck, Roy S; Li, Tianjing

    2017-09-05

    Systematic reviews should inform American Academy of Ophthalmology (AAO) Preferred Practice Pattern® (PPP) guidelines. The quality of systematic reviews related to the forthcoming Preferred Practice Pattern® guideline (PPP) Refractive Errors & Refractive Surgery is unknown. We sought to identify reliable systematic reviews to assist the AAO Refractive Errors & Refractive Surgery PPP. Systematic reviews were eligible if they evaluated the effectiveness or safety of interventions included in the 2012 PPP Refractive Errors & Refractive Surgery. To identify potentially eligible systematic reviews, we searched the Cochrane Eyes and Vision United States Satellite database of systematic reviews. Two authors identified eligible reviews and abstracted information about the characteristics and quality of the reviews independently using the Systematic Review Data Repository. We classified systematic reviews as "reliable" when they (1) defined criteria for the selection of studies, (2) conducted comprehensive literature searches for eligible studies, (3) assessed the methodological quality (risk of bias) of the included studies, (4) used appropriate methods for meta-analyses (which we assessed only when meta-analyses were reported), (5) presented conclusions that were supported by the evidence provided in the review. We identified 124 systematic reviews related to refractive error; 39 met our eligibility criteria, of which we classified 11 to be reliable. Systematic reviews classified as unreliable did not define the criteria for selecting studies (5; 13%), did not assess methodological rigor (10; 26%), did not conduct comprehensive searches (17; 44%), or used inappropriate quantitative methods (3; 8%). The 11 reliable reviews were published between 2002 and 2016. They included 0 to 23 studies (median = 9) and analyzed 0 to 4696 participants (median = 666). Seven reliable reviews (64%) assessed surgical interventions. Most systematic reviews of interventions for

  12. Quality of systematic reviews in pediatric oncology - A systematic review

    NARCIS (Netherlands)

    Lundh, Andreas; Knijnenburg, Sebastiaan L.; Jørgensen, Anders W.; van Dalen, Elvira C.; Kremer, Leontien C. M.

    2009-01-01

    Background: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. Methods: We identified eligible systematic reviews

  13. Supporting ATLAS

    CERN Multimedia

    2003-01-01

    Eighteen feet made of stainless steel will support the barrel ATLAS detector in the cavern at Point 1. In total, the ATLAS feet system will carry approximately 6000 tons, and will give the same inclination to the detector as the LHC accelerator. The installation of the feet is scheduled to finish during January 2004 with an installation precision at the 1 mm level despite their height of 5.3 metres. The manufacture was carried out in Russia (Company Izhorskiye Zavody in St. Petersburg), as part of a Russian and JINR Dubna in-kind contribution to ATLAS. Involved in the installation is a team from IHEP-Protvino (Russia), the ATLAS technical co-ordination team at CERN, and the CERN survey team. In all, about 15 people are involved. After the feet are in place, the barrel toroid magnet and the barrel calorimeters will be installed. This will keep the ATLAS team busy for the entire year 2004.

  14. Analytic Theology as Systematic Theology

    OpenAIRE

    Crisp Oliver D.

    2017-01-01

    It is often said that analytic theology is not really systematic theology; it is something else entirely. However, specifying what this “something else” amounts to has proven a little more difficult. In this article I argue that analytic theology may be a species of systematic theology. I show that there is no agreed view on the nature of systematic theology amongst several leading practitioners of systematic theology by comparing the work of John Webster, Brian Gerrish, and Gordon Kaufman. I...

  15. Computational aspects of systematic biology.

    Science.gov (United States)

    Lilburn, Timothy G; Harrison, Scott H; Cole, James R; Garrity, George M

    2006-06-01

    We review the resources available to systematic biologists who wish to use computers to build classifications. Algorithm development is in an early stage, and only a few examples of integrated applications for systematic biology are available. The availability of data is crucial if systematic biology is to enter the computer age.

  16. Systematic Quality Work in Preschool

    Science.gov (United States)

    Sheridan, Sonja; Williams, Pia; Sandberg, Anette

    2013-01-01

    The purpose of this study was to investigate the meaning that Swedish preschool teachers ascribe to systematic quality work. In Sweden, all preschools are required to work systematically with quality issues. This involves several interdependent steps that follow each other in a specific order. Although the concept of systematic quality work might…

  17. Systematic Approach for Decommissioning Planning and Estimating

    International Nuclear Information System (INIS)

    Dam, A. S.

    2002-01-01

    Nuclear facility decommissioning, satisfactorily completed at the lowest cost, relies on a systematic approach to the planning, estimating, and documenting the work. High quality information is needed to properly perform the planning and estimating. A systematic approach to collecting and maintaining the needed information is recommended using a knowledgebase system for information management. A systematic approach is also recommended to develop the decommissioning plan, cost estimate and schedule. A probabilistic project cost and schedule risk analysis is included as part of the planning process. The entire effort is performed by a experienced team of decommissioning planners, cost estimators, schedulers, and facility knowledgeable owner representatives. The plant data, work plans, cost and schedule are entered into a knowledgebase. This systematic approach has been used successfully for decommissioning planning and cost estimating for a commercial nuclear power plant. Elements of this approach have been used for numerous cost estimates and estimate reviews. The plan and estimate in the knowledgebase should be a living document, updated periodically, to support decommissioning fund provisioning, with the plan ready for use when the need arises

  18. Support facilities

    International Nuclear Information System (INIS)

    Williamson, F.S.; Blomquist, J.A.; Fox, C.A.

    1977-01-01

    Computer support is centered on the Remote Access Data Station (RADS), which is equipped with a 1000 lpm printer, 1000 cpm reader, and a 300 cps paper tape reader with 500-foot spools. The RADS is located in a data preparation room with four 029 key punches (two of which interpret), a storage vault for archival magnetic tapes, card files, and a 30 cps interactive terminal principally used for job inquiry and routing. An adjacent room provides work space for users, with a documentation library and a consultant's office, plus file storage for programs and their documentations. The facility has approximately 2,600 square feet of working laboratory space, and includes two fully equipped photographic darkrooms, sectioning and autoradiographic facilities, six microscope cubicles, and five transmission electron microscopes and one Cambridge scanning electron microscope equipped with an x-ray energy dispersive analytical system. Ancillary specimen preparative equipment includes vacuum evaporators, freeze-drying and freeze-etching equipment, ultramicrotomes, and assorted photographic and light microscopic equipment. The extensive physical plant of the animal facilities includes provisions for holding all species of laboratory animals under controlled conditions of temperature, humidity, and lighting. More than forty rooms are available for studies of the smaller species. These have a potential capacity of more than 75,000 mice, or smaller numbers of larger species and those requiring special housing arrangements. There are also six dog kennels to accommodate approximately 750 dogs housed in runs that consist of heated indoor compartments and outdoor exercise areas

  19. Multidimensional Classroom Support to Inclusive Education Teachers in Beijing, China

    Science.gov (United States)

    Wang, Yan; Mu, Guanglun Michael; Wang, Zhiqing; Deng, Meng; Cheng, Li; Wang, Hongxia

    2015-01-01

    Classroom support plays a salient role in successful inclusive education, hence it has been widely debated in the literature. Much extant work has only focused on a particular aspect of classroom support. A comprehensive, systematic discussion of classroom support is sporadic in the literature. Relevant research concerning the Chinese context is…

  20. Nutritional supportive care in children with cancer

    International Nuclear Information System (INIS)

    Riha, P.; Smisek, P.

    2013-01-01

    Appropriate nutritional support is an important part of comprehensive oncology treatment. The aim is to decrease the incidence of malnutrition. Malnourished patients are in higher risk of infectious and toxic complications, experience worse quality of life. Systematic survey of nutritional status and early nutritional intervention can eventually lead to better results of oncology treatment. We review the definitions, etiology and epidemiology of malnutrition, practical approaches to nutritional support of children with cancer. (author)

  1. Numerical support, information processing and attitude change

    OpenAIRE

    de Dreu, C.K.W.; de Vries, N.K.

    1993-01-01

    In two experiments we studied the prediction that majority support induces stronger convergent processing than minority support for a persuasive message, the more so when recipients are explicitly forced to pay attention to the source's point of view; this in turn affects the amount of attitude change on related issues. Convergent processing is the systematic elaboration on the sources position, but with a stronger focus on verification and justification rather than falsification. In Exp 1 wi...

  2. Sport supporting act: terminology issues

    Directory of Open Access Journals (Sweden)

    Petr Vlček

    2013-01-01

    Full Text Available BACKGROUND: The text deals with terminology issues from an interdisciplinary point of view. It is based on two different disciplines, law and kinanthropology, in an area of their overlap. AIM: The aim of the author is to point out some possible legislative problems, which could arise due to the current reading of the sport supporting act (Act no. 115/2001. The second aim of the author is to contribute to the discussion of kinantropologists (possibly also the educational researchers and lawyers and to stress the importance of the systematic approach to terminology formulation. METHODS: The author uses the method of language interpretation. We also use the basic analytical methods, induction and deduction, while we stress the systematic approach to the term formulation. RESULTS: The analysis of the sport supporting act terminology shows some specific legislative problems, which could arise due to the definition of sport in the sport supporting act. The author discusses a possible alternative solution. CONCLUSION: According to the opinion of the author, clear, obvious and unified terminology of kinantropologists as specialists in their discipline should represent a source, from which other sciences could derive their terminology. Defined and inexpert terminology used in other disciplines should not be used as an argument for its adopting in kinanthropology.

  3. Systematic literature review

    DEFF Research Database (Denmark)

    Barnard, K. D.; Lloyd, C. E.; Skinner, T. C.

    2007-01-01

    mixed results, with one study reporting quality of life benefits and one reporting no evidence of quality of life benefits. Conclusions: There is conflicting evidence reported in the various studies on the quality of life benefits of CSII in Type 1 diabetes. Existing research is flawed, making......Aim: To review systematically the published literature addressing whether continuous subcutaneous insulin infusion (CSII) provides any quality of life benefits to people with Type 1 diabetes. Methods: Electronic databases and published references were searched and a consultation with two...

  4. Systematic Equation Formulation

    DEFF Research Database (Denmark)

    Lindberg, Erik

    2007-01-01

    A tutorial giving a very simple introduction to the set-up of the equations used as a model for an electrical/electronic circuit. The aim is to find a method which is as simple and general as possible with respect to implementation in a computer program. The “Modified Nodal Approach”, MNA, and th......, and the “Controlled Source Approach”, CSA, for systematic equation formulation are investigated. It is suggested that the kernel of the P Spice program based on MNA is reprogrammed....

  5. Peer support: helping to influence cultural change.

    Science.gov (United States)

    Whitmore, Mary

    2015-02-01

    Breastfeeding peer support schemes in Blackpool and Lancashire work closely with midwifery and other partners to offer additional support and encouragement to breastfeeding mothers. Employed and volunteer peer supporters deliver a systematic service in target areas delivering workshops to pregnant mothers, supporting new mothers in hospital, including in the neonatal units, in mothers' homes and in groups at children's centres. Working with health, children's centres, public health and councils, the peer supporters were instrumental in Fleetwood town agreeing to always welcome breastfeeding. They worked with teachers, public health and infant feeding coordinators to deliver a month-long breastfeeding campaign at a local college and, working with health visitors, have engaged with grandmothers to find out how they feel they can help support new mothers. Skilled supervision is essential to ensuring peer supporters work safely and continue to develop their skills and knowledge. Volunteer coordinators play a key role in valuing and organising volunteers.

  6. Gynecomastia: A systematic review.

    Science.gov (United States)

    Fagerlund, Anders; Lewin, Richard; Rufolo, Guglielmo; Elander, Anna; Santanelli di Pompeo, Fabio; Selvaggi, Gennaro

    2015-01-01

    Gynecomastia is a common medical problem presenting in nearly a third of the male population. Treatment for gynecomastia can be either pharmacological or surgical. Patients with gynecomastia often experience affected quality-of-life. The aim of this systematic review was to analyze the quality of evidence of the current literature in relation to different treatment modalities and Quality-of-Life in patients with gynecomastia. A systematic search of the literature was performed in PubMed, Medline, Scopus, The Cochrane Library, and SveMed+ in accordance with the PRISMA statement. All searches were undertaken between September-November 2014. The PICOS (patients, intervention, comparator, outcomes, and study design) approach was used to specify inclusion criteria. Methodological quality was graded according to MINORS. Quality of evidence was rated according to GRADE. Data from the included studies were extracted based on study characteristics, participants specifics, type of intervention/treatment, and type of outcome measures into data extraction forms. A total of 134 abstracts were identified in the literature search. Seventeen studies met inclusion criteria, 14 concerning treatment and three concerning Quality-of-Life. All studies were non-randomised with a high risk of bias and very low quality of evidence according to GRADE. Several different surgical methods have been described with good results, minimal scars, and various levels of complications. Traditional surgical excision of glandular tissue combined with liposuction provides most consistent results and a low rate of complications. Pubertal gynecomastia may safely be managed by pharmacological anti-oestrogen treatment.

  7. Haematological factors in the management of adult epistaxis: systematic review.

    Science.gov (United States)

    Williams, A; Biffen, A; Pilkington, N; Arrick, L; Williams, R J; Smith, M E; Smith, M; Birchall, J

    2017-12-01

    The management of epistaxis requires an understanding of haematological factors that may complicate its treatment. This systematic review includes six distinct reviews examining the evidence supporting epistaxis-specific management strategies relating to warfarin, direct oral anticoagulants, heparin, antiplatelet agents, tranexamic acid and transfusion. A systematic review of the literature was performed using a standardised methodology and search strategy. Limited numbers of articles were identified in each systematic review, with level 1 evidence only regarding the use of tranexamic acid. No studies met the inclusion criteria within the heparin, direct oral anticoagulants or transfusion systematic reviews. Many studies were limited by small sample sizes and significant risk of bias. The management of major bleeding and transfusion practice is well documented in national guidance from multiple sources. The guidelines include advice on anticoagulants, antiplatelet agents and tranexamic acid. In the absence of more specific evidence, these guidelines should be applied in the management of epistaxis.

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

    Science.gov (United States)

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

    2017-10-01

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

  9. Personal resource questionnaire: a systematic review.

    Science.gov (United States)

    Tawalbeh, Loai I; Ahmad, Muayyad M

    2013-09-01

    Social support is a key nursing variable. No review has yet systematically assessed the effectiveness of the personal resource questionnaire (PRQ) as a measure of perceived social support. This article reviewed nine previous studies that used the PRQ (Brandt & Weinert, 1981). Completed studies were identified through searches of indexes that included PubMed, the Cumulative Index for Nursing and EBSCO host, and Ovid. Studies that reported PRQ scores, sample descriptions, and sample sizes and that tested the relationship between the PRQ and study variables were included in the present review. Three other studies were included that did not report on PRQ correlations with other health variables. The included studies addressed a variety of health problems and different population in different settings. Cronbach's alphas for the included studies ranged from .87 to .93, supporting the internal consistency of the PRQ. Hypothesized relationships between the PRQ and study variables including health promotion behavior, self-care behavior, self-efficacy, self-esteem, stress, depression, loneliness, pain, and disability were supported, providing positive evidence for PRQ construct validity. Included studies used the PRQ to address disparate populations in terms of age, socioeconomic status, ethnicity, and educational background. This review found the PRQ to be a reliable and valid tool for measuring perceived social support across a wide range of populations. Further studies are necessary to examine the relationship between social support and selected demographics among populations with different cultural backgrounds.

  10. Systematic Software Development

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Méndez Fernández, Daniel

    2015-01-01

    The speed of innovation and the global allocation of resources to accelerate development or to reduce cost put pressure on the software industry. In the global competition, especially so-called high-price countries have to present arguments why the higher development cost is justified and what...... makes these countries an attractive host for software companies. Often, high-quality engineering and excellent quality of products, e.g., machinery and equipment, are mentioned. Yet, the question is: Can such arguments be also found for the software industry? We aim at investigating the degree...... of professionalism and systematization of software development to draw a map of strengths and weaknesses. To this end, we conducted as a first step an exploratory survey in Germany, presented in this paper. In this survey, we focused on the perceived importance of the two general software engineering process areas...

  11. Broadening Public Participation in Systematic Reviews: A Case Example Involving Young People in Two Configurative Reviews

    Science.gov (United States)

    Oliver, Kathryn; Rees, Rebecca; Brady, Louca-Mai; Kavanagh, Josephine; Oliver, Sandy; Thomas, James

    2015-01-01

    Background: Arguments supporting the involvement of users in research have even more weight when involving the public in systematic reviews of research. We aimed to explore the potential for public involvement in systematic reviews of observational and qualitative studies. Methods: Two consultative workshops were carried out with a group of young…

  12. Use of Evidence from Systematic Reviews to Inform Commissioning Decisions: A Case Study

    Science.gov (United States)

    Chambers, Duncan; Grant, Rod; Warren, Erica; Pearson, Sally-Anne; Wilson, Paul

    2012-01-01

    Systematic reviews provide high-level evidence but there are barriers to their use by policy makers. This paper reports the preparation and evaluation of an evidence briefing, using systematic reviews and other existing sources of synthesised evidence, to support a possible reorganisation of services for young people with eating disorders in an…

  13. Neuroprotection in Parkinson's disease: A systematic review of the preclinical data

    NARCIS (Netherlands)

    Douna, H.; Bavelaar, B.M.; Pellikaan, H.; Olivier, B.; Pieters, T.

    2012-01-01

    Aim: This study aimed to systematically review the preclinical data of neuroprotective agents for Parkinson's disease (PD) to support the translation of these compounds. Methods: The study consisted of two phases. In phase I, Pubmed and Scopus were systematically searched for neuroprotective agents

  14. Is bruxism a risk factor for dental implants? A systematic review of the literature

    NARCIS (Netherlands)

    Manfredini, D.; Poggio, C.E.; Lobbezoo, F.

    2014-01-01

    Purpose To systematically review the literature on the role of bruxism as a risk factor for the different complications on dental implant-supported rehabilitations. Material and Methods A systematic search in the National Library of Medicine's Medline Database was performed to identify all

  15. Systematic review of N-acetylcysteine in cystic fibrosis

    NARCIS (Netherlands)

    Duijvestijn, YCM; Brand, PLP

    A systematic review was carried out to evaluate whether the use of N-acetylcysteine to improve lung function in patients with cystic fibrosis is supported by published evidence. Medline and the Cochrane Library were searched and the reference lists of all retrieved papers and of relevant chapters of

  16. Parenting Training for Intellectually Disabled Parents: A Cochrane Systematic Review

    Science.gov (United States)

    Coren, Esther; Thomae, Manuela; Hutchfield, Jemeela

    2011-01-01

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

  17. Effects of Systematic Screening and Detection of Child Abuse in Emergency Departments

    NARCIS (Netherlands)

    Louwers, Eveline C. F. M.; Korfage, Ida J.; Affourtit, Marjo J.; Scheewe, Dop J. H.; van de Merwe, Marjolijn H.; Vooijs-Moulaert, Anne-Françoise S. R.; van den Elzen, Annette P. M.; Jongejan, Mieke H. T. M.; Ruige, Madelon; Manaï, Badies H. A. N.; Looman, Caspar W. N.; Bosschaart, Adriaan N.; Teeuw, Arianne H.; Moll, Henriëtte A.; de Koning, Harry J.

    2012-01-01

    OBJECTIVE: Although systematic screening for child abuse of children presenting at emergency departments might increase the detection rate, studies to support this are scarce. This study investigates whether introducing screening, and training of emergency department nurses, increases the detection

  18. Amitraz, an underrecognized poison: A systematic review

    Directory of Open Access Journals (Sweden)

    Sahajal Dhooria

    2016-01-01

    Results: The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%. Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear. Interpretation & conclusions: Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management.

  19. Systematic reviews: guidance relevant for studies of older people.

    Science.gov (United States)

    Shenkin, Susan D; Harrison, Jennifer K; Wilkinson, Tim; Dodds, Richard M; Ioannidis, John P A

    2017-09-01

    Systematic reviews and meta-analyses are increasingly common. This article aims to provide guidance for people conducting systematic reviews relevant to the healthcare of older people. An awareness of these issues will also help people reading systematic reviews to determine whether the results will influence their clinical practice. It is essential that systematic reviews are performed by a team which includes the required technical and clinical expertise. Those performing reviews for the first time should ensure they have appropriate training and support. They must be planned and performed in a transparent and methodologically robust way: guidelines are available. The protocol should be written-and if possible published-before starting the review. Geriatricians will be interested in a table of baseline characteristics, which will help to determine if the studied samples or populations are similar to their patients. Reviews of studies of older people should consider how they will manage issues such as different age cut-offs; non-specific presentations; multiple predictors and outcomes; potential biases and confounders. Systematic reviews and meta-analyses may provide evidence to improve older people's care, or determine where new evidence is required. Newer methodologies, such as meta-analyses of individual level data, network meta-analyses and umbrella reviews, and realist synthesis, may improve the reliability and clinical utility of systematic reviews. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

  20. Mechanisms of action of lumbar supports: a sytematic review

    NARCIS (Netherlands)

    van Poppel-Bruinvels, M.N.M.; de Looze, M.P.; Koes, B.W.; Smid, T.; Bouter, L.M.

    2000-01-01

    Study Design. A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. Objective. To summarize the evidence bearing on the putative mechanisms of action of lumbar supports. Summary of Background Data. A restriction of trunk

  1. [Medical indications for acupuncture: Systematic review].

    Science.gov (United States)

    Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme

    2016-09-16

    Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Molecular systematics of the Canidae.

    Science.gov (United States)

    Wayne, R K; Geffen, E; Girman, D J; Koepfli, K P; Lau, L M; Marshall, C R

    1997-12-01

    Despite numerous systematic studies, the relationships among many species within the dog family, Canidae, remain unresolved. Two problems of broad evolutionary significance are the origins of the taxonomically rich canidae fauna of South America and the development in three species of the trenchant heel, a unique meat-cutting blade on the lower first molar. The first problem is of interest because the fossil record provides little evidence for the origins of divergent South American species such as the maned wolf and the bush dog. The second issue is problematic because the trenchant heel, although complex in form, may have evolved independently to assist in the processing of meat. We attempted to resolve these two issues and five other specific taxonomic controversies by phylogenetic analysis of 2,001 base pairs of mitochondrial DNA (mtDNA) sequence data from 23 canidae species. The mtDNA tree topology, coupled with data from the fossil record, and estimates of rates of DNA sequence divergence suggest at least three and possibly four North American invasions of South America. This result implies that an important chapter in the evolution of modern canids remains to be discovered in the fossil record and that the South American canidae endemism is as much the result of extinction outside of South America as it is due to speciation within South America. The origin of the trenchant heel is not well resolved by our data, although the maximum parsimony tree is weakly consistent with a single origin followed by multiple losses of the character in several extant species. A combined analysis of the mtDNA data and published morphological data provides unexpected support for a monophyletic South American canidae clade. However, the homogeneity partition tests indicate significant heterogeneity between the two data sets.

  3. Dhat syndrome: a systematic review.

    Science.gov (United States)

    Udina, Marc; Foulon, Hubert; Valdés, Manuel; Bhattacharyya, Sagnik; Martín-Santos, Rocío

    2013-01-01

    Dhat syndrome is a widely recognized clinical condition often seen on the Indian subcontinent that is characterized by a preoccupation with semen loss in urine and other symptoms such as fatigue or depressed mood. Although it has been considered to be a culture-bound syndrome, it may also be regarded as a distinct manifestation of depression or another medical illness. The purpose of this paper was to carry out a systematic review on Dhat syndrome. A review of the literature published up until February 2012 was conducted using the key words [Dhat syndrome] or [semen-loss anxiety] or [semen-loss syndrome]. We included only original studies. The majority of studies reported patients from the Indian subcontinent. There was a high degree of heterogeneity among the studies. Dhat was a common condition in young people from certain cultures and origins. Depressive and anxiety symptoms were common, including fatigue, sleepiness, and sexual dysfunction. Good clinical engagement, social support, and sexual education were useful in some cases. Given the high rate of comorbid depressive symptoms, antidepressant has been used. In an increasingly globalized world, clinicians must be able to properly diagnose and treat patients from other cultures, who may report symptoms that are influenced by their beliefs, culture, or place of origin. Dhat may be a common manifestation of a depressive or anxiety disorder in certain cultures. Further research is needed to improve our understanding of this condition, to clarify its nosologic status, and to offer appropriate treatment to affected individuals. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  4. "Systematizing" ethics consultation services.

    Science.gov (United States)

    Bruce, Courtenay R; Eves, Margot M; Allen, Nathan G; Smith, Martin L; Peña, Adam M; Cheney, John R; Majumder, Mary A

    2015-03-01

    While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: (1) train-the-trainer, (2) local capacity-building, (3) circuit-riding, and (4) consolidated accountability. We note each model's benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations.

  5. Group Decision Process Support

    DEFF Research Database (Denmark)

    Gøtze, John; Hijikata, Masao

    1997-01-01

    Introducing the notion of Group Decision Process Support Systems (GDPSS) to traditional decision-support theorists.......Introducing the notion of Group Decision Process Support Systems (GDPSS) to traditional decision-support theorists....

  6. Systematic Reviews in Sports Medicine.

    Science.gov (United States)

    DiSilvestro, Kevin J; Tjoumakaris, Fotios P; Maltenfort, Mitchell G; Spindler, Kurt P; Freedman, Kevin B

    2016-02-01

    The number of systematic reviews published in the orthopaedic literature has increased, and these reviews can help guide clinical decision making. However, the quality of these reviews can affect the reader's ability to use the data to arrive at accurate conclusions and make clinical decisions. To evaluate the methodological and reporting quality of systematic reviews and meta-analyses in the sports medicine literature to determine whether such reviews should be used to guide treatment decisions. The hypothesis was that many systematic reviews in the orthopaedic sports medicine literature may not follow the appropriate reporting guidelines or methodological criteria recommended for systematic reviews. Systematic review. All clinical sports medicine systematic reviews and meta-analyses from 2009 to 2013 published in The American Journal of Sports Medicine (AJSM), The Journal of Bone and Joint Surgery (JBJS), Arthroscopy, Sports Health, and Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) were reviewed and evaluated for level of evidence according to the guidelines from the Oxford Centre for Evidence-Based Medicine, for reporting quality according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and for methodological quality according to the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Analysis was performed by year and journal of publication, and the levels of evidence included in the systematic reviews were also analyzed. A total of 200 systematic reviews and meta-analyses were identified over the study period. Of these, 53% included evidence levels 4 and 5 in their analyses, with just 32% including evidence levels 1 and 2 only. There were significant differences in the proportion of articles with high levels of evidence (P Systematic reviews and meta-analyses in orthopaedics sports medicine literature relied on evidence levels 4 and 5 in 53% of studies over the 5-year study period. Overall, PRISMA and

  7. Self-sacrifice in 'desperado' contests between relatives

    Directory of Open Access Journals (Sweden)

    Monnin Thibaud

    2010-10-01

    Full Text Available Abstract Intra-specific competition occurs in all animal species and can lead to escalated conflict. Overt fighting entails the risk of injury or death, and is usually avoided through the use of conventions or pre-fight assessments. However, overt fighting can be expected when value of the contest outweighs the value of the future, as contestants have little or nothing to lose. In these situations, respect for conventions and asymmetries between contestants can break down, and overt fighting becomes more likely (the desperado effect. Such conditions can arise in contests between queens over colony ownership in social insects, because the value of inheriting a colony of potentially thousands of helpers is huge and queens may have very limited alternative reproductive options. However, in social species the balance of possible outcomes may be influenced by inclusive fitness, as contestants are often relatives. Here we present a simple model based on social insects, which demonstrates that not fighting can be selectively advantageous when there is a risk posed by fighting to inclusive fitness, even when not fighting is likely to result in death. If contestants are related, a loser can still gain indirect fitness through the winner, whereas fighting introduces a risk that both queens will die and thereby obtain zero inclusive fitness. When relatedness is high and fighting poses a risk of all contestants dying, it can be advantageous to cede the contest and be killed, rather than risk everything by fighting.

  8. Women in Computer Sciences in Romania: Success and Sacrifice

    Science.gov (United States)

    Ward, Kelly; Dragne, Cornelia; Lucas, Angelina J.

    2014-01-01

    The purpose of this article is to more fully understand the professional lives of women academics in computer sciences in six Romanian universities. The work is exploratory and relies on a qualitative framework to more fully understand what it means to be a woman academic in high-tech disciplines in a second world economy. We conducted in-depth,…

  9. Sacrifice in close relationships : Motives, emotions, and relationship outcomes

    NARCIS (Netherlands)

    Righetti, Francesca; Impett, Emily

    2017-01-01

    Romantic partners often face situations in which their preferences, interests and goals are not well aligned—what is good for one partner is not good for the other. In these situations, people need to make a decision between pursuing their own self-interest and sacrificing for their partner or the

  10. A case study of anorexia nervosa driven by religious sacrifice.

    Science.gov (United States)

    Davis, Amelia A; Nguyen, Mathew

    2014-01-01

    Anorexia nervosa (AN) is considered a relatively "modern" disorder; however, a number of scholarly works have cited examples of voluntary self-starvation dating back to several centuries. In particular, there are many examples of female starvation for religious reasons during the medieval period, with many being elevated to sainthood. We present a case of an elderly woman with AN who began restricting her diet when she was 13-years old while studying to be a nun at a Catholic convent. She reports that, during the development of her disease, she had no mirrors and, rather than restricting her diet to be thin or attractive, she restricted her diet to be closer to God in hopes of becoming a Saint. This unique case presents an opportunity to deepen our understanding of AN and the cultural context that affects its development.

  11. A Case Study of Anorexia Nervosa Driven by Religious Sacrifice

    Directory of Open Access Journals (Sweden)

    Amelia A. Davis

    2014-01-01

    Full Text Available Anorexia nervosa (AN is considered a relatively “modern” disorder; however, a number of scholarly works have cited examples of voluntary self-starvation dating back to several centuries. In particular, there are many examples of female starvation for religious reasons during the medieval period, with many being elevated to sainthood. We present a case of an elderly woman with AN who began restricting her diet when she was 13-years old while studying to be a nun at a Catholic convent. She reports that, during the development of her disease, she had no mirrors and, rather than restricting her diet to be thin or attractive, she restricted her diet to be closer to God in hopes of becoming a Saint. This unique case presents an opportunity to deepen our understanding of AN and the cultural context that affects its development.

  12. DEER BELIEF AND DEER SACRIFICE AROUND STEPPE CULTURE

    Directory of Open Access Journals (Sweden)

    Aslı KAHRAMAN ÇINAR

    2016-04-01

    Full Text Available Turkish people have spreaded on a large area historically. They have left a mark on all the places they reach. The history of Turks begun in Central Asian Steppes. In reaction to the steppe culture, the human communities of Turks are hunter-nomad communities. The hunter-nomad comminuties make a living from stockfarming and apiculture. The deer is one of the essential animals for t he hunter-nomad communities in the daily life. In the steppe, the deer is seen in all area of social life. Further, the deer motives are commonly used in political, military, financial, the most religious areas. The hunter-nomad comminuties benefit by the meat, milk, leather, horns, nails, etc of the deer. In this study, we dwell on the deer with regard to its intended purposes and usage areas according to steppe culture. The references of this study are references are inscriptions, mythologic stories and archeological datas.

  13. White Involvement in the Civil Rights Movement: Motivation and Sacrifices

    Science.gov (United States)

    Clark, J. Spencer

    2009-01-01

    In 1964, the Freedom Summer Project brought nearly one thousand volunteers to the South, most of which were northern white students, to facilitate Black voter registration. Allowing northern Whites to take part in the Movement created a tension within the Student Nonviolent Coordinating Committee (SNCC) as "two principal concerns were whether they…

  14. A Case Study of Anorexia Nervosa Driven by Religious Sacrifice

    OpenAIRE

    Amelia A. Davis; Mathew Nguyen

    2014-01-01

    Anorexia nervosa (AN) is considered a relatively “modern” disorder; however, a number of scholarly works have cited examples of voluntary self-starvation dating back to several centuries. In particular, there are many examples of female starvation for religious reasons during the medieval period, with many being elevated to sainthood. We present a case of an elderly woman with AN who began restricting her diet when she was 13-years old while studying to be a nun at a Catholic convent. She rep...

  15. Early Home Supported Discharge of Stroke Patients:

    DEFF Research Database (Denmark)

    Larsen, Torben; Olsen, T. Skyhøj; Sørensen, Jan

    2006-01-01

    OBJECTIVES: A comprehensive and systematic assessment (HTA) of early home-supported discharge by a multidisciplinary team that plans, coordinates, and delivers care at home (EHSD) was undertaken and the results were compared with that of conventional rehabilitation at stroke units. METHODS......: A systematic literature search for randomized trials (RCTs) on "early supported discharge" was closed in April 2005. RCTs on EHSD without information on (i) death or institution at follow-up, (ii) change in Barthél Index, (iii) length of hospital stay, (iv) intensity of home rehabilitation, or (v) baseline...... are discussed. CONCLUSIONS: EHSD is evidenced as a dominant health intervention. However, financial barriers between municipalities and health authorities have to be overcome. For qualitative reasons, a learning path of implementation is recommended where one stroke unit in a region initiates EHSD...

  16. Systematic Review Workshop (August 2013)

    Science.gov (United States)

    The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.

  17. Morality in the mundane. Specific Needs for Ethics Support in Elderly Care

    NARCIS (Netherlands)

    Dauwerse, L.M.; van der Dam, S.; Abma, T.A.

    2012-01-01

    Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly

  18. Systematics in delayed neutron yields

    Energy Technology Data Exchange (ETDEWEB)

    Ohsawa, Takaaki [Kinki Univ., Higashi-Osaka, Osaka (Japan). Atomic Energy Research Inst.

    1998-03-01

    An attempt was made to reproduce the systematic trend observed in the delayed neutron yields for actinides on the basis of the five-Gaussian representation of the fission yield together with available data sets for delayed neutron emission probability. It was found that systematic decrease in DNY for heavier actinides is mainly due to decrease of fission yields of precursors in the lighter side of the light fragment region. (author)

  19. Systematics of evaporation

    International Nuclear Information System (INIS)

    Klots, C.E.

    1991-01-01

    Beginning with rather basic principles, general relations are obtained for evaporative rate constants. These are established both as a function of energy and of temperature. In parallel with this, expressions are developed for the kinetic energy distribution of the separating species. Explicit evaluation of the rate constants in the case of 'chemical' evaporation from an entity containing n monomeric units yields as a typical result k(T)(s -1 )=3.10 13 n 2/3 exp[6/n 1/3 ]exp(-ΔE a (n)/k B T). Experimental evidence in support of this relation is cited. Applications to thermionic emission are also noted. (orig.)

  20. Systematic assessment of environmental risk factors for bipolar disorder

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Köhler, Cristiano A.; Evangelou, Evangelos

    2017-01-01

    factors supported by high epidemiological credibility. Methods: We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD......Objectives: The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk...... met the inclusion criteria (seven meta-analyses and nine qualitative systematic reviews). Fifty-one unique environmental risk factors for BD were evaluated. Six meta-analyses investigated associations with a risk factor for BD. Only irritable bowel syndrome (IBS) emerged as a risk factor for BD...

  1. A support shield for a powered support

    Energy Technology Data Exchange (ETDEWEB)

    Korczynski, P; Rojicek, P

    1982-08-31

    The subject of this invention is a support shield for a powered support. This shield resists creep of the coal from the longwall face, including an inclined longwall. It involves an arrangement wherein the distributor hinge is separated into upper and lower sections. The lower section holds a second hinge and the end of the rod of the pressure cylinder, one end of which is connected to the roof support. An advantage of the support is that compared to existing supports, it is self-advancing and holds stopes with coal which slopes in its formation or has inrushes. To a certain degree it prevents the stope space from ejecting fine pieces of rock from the longwall roof using an inter-timber support between the powered support and the stope. The support shield is moved by a simple system of levers which makes it possible, using a pressurized cylinder, to transmit a significant force to the coal stope. In this case, when the coal inrushes exceed the designed capabilities of the shield, a wooden extension piece is placed between the support and the face, through which the support pressure is applied.

  2. Application of systematic review methodology to the field of nutrition.

    Science.gov (United States)

    Lichtenstein, Alice H; Yetley, Elizabeth A; Lau, Joseph

    2008-12-01

    Systematic reviews represent a rigorous and transparent approach to synthesizing scientific evidence that minimizes bias. They evolved within the medical community to support development of clinical and public health practice guidelines, set research agendas, and formulate scientific consensus statements. The use of systematic reviews for nutrition-related topics is more recent. Systematic reviews provide independently conducted comprehensive and objective assessments of available information addressing precise questions. This approach to summarizing available data is a useful tool for identifying the state of science including knowledge gaps and associated research needs, supporting development of science-based recommendations and guidelines, and serving as the foundation for updates as new data emerge. Our objective is to describe the steps for performing systematic reviews and highlight areas unique to the discipline of nutrition that are important to consider in data assessment. The steps involved in generating systematic reviews include identifying staffing and planning for outside expert input, forming a research team, developing an analytic framework, developing and refining research questions, defining eligibility criteria, identifying search terms, screening abstracts according to eligibility criteria, retrieving articles for evaluation, constructing evidence and summary tables, assessing methodological quality and applicability, and synthesizing results including performing meta-analysis, if appropriate. Unique and at times challenging, nutrition-related considerations include baseline nutrient exposure, nutrient status, bioequivalence of bioactive compounds, bioavailability, multiple and interrelated biological functions, undefined nature of some interventions, and uncertainties in intake assessment. Systematic reviews are a valuable and independent component of decision-making processes by groups responsible for developing science-based recommendations

  3. Galaxy Clusters: Substructure and Mass Systematics

    Science.gov (United States)

    Zhang, Yu-Ying

    2010-07-01

    We calibrate the X-ray measured hydrostatic equilibrium (H.E.) mass and assess the origin of the H.E. mass systematics using 2-D spectrally measured X-ray properties. We obtained that the average X-ray mass derived from H.E. using XMM-Newton data is lower compared to the weak lensing mass from Subaru data for relaxed clusters in a sample of 12 clusters at z~0.2. This is comparable to the expectation of numerical simulations because of the non-thermal pressure support due to turbulence and bulk motions. The gas mass to weak lensing mass ratio shows no dependence on the cluster morphology, which indicates that the gas mass may be a good mass proxy regardless of the cluster dynamical state. To understand the origin of the systematics of the H.E. mass, we investigated 4 nearby clusters, for which the substructure is quantified by the radial fluctuations in the spectrally measured 2-D maps by a cumulative/differential scatter profile relative to the mean profile within/at a given radius. The amplitude of and the discontinuity in the scatter complements 2-D substructure diagnostics, e.g. indicating the most disturbed radial range. There is a tantalizing link between the substructure identified using the scatter of the entropy and pressure fluctuations and the deviation of the H.E. mass relative to the expected mass based on the representative scaling relation, e.g., M-Mgas, particularly at r500-the radius within which the over-density, Δ, is 500 with respect to the critical density. This indicates that at larger radii, the systematic error of the H.E. mass may well be caused by substructure.

  4. 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

  5. Quality of systematic reviews in pediatric oncology--a systematic review.

    Science.gov (United States)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W; van Dalen, Elvira C; Kremer, Leontien C M

    2009-12-01

    To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. We identified eligible systematic reviews through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological quality of systematic reviews was low for all ten items, but the quality of Cochrane systematic reviews was significantly higher than systematic reviews published in regular journals. On a 1-7 scale, the median overall quality score for all systematic reviews was 2 (range 1-7), with a score of 1 (range 1-7) for systematic reviews in regular journals compared to 6 (range 3-7) in Cochrane systematic reviews (pmethodological flaws leading to a high risk of bias. While Cochrane systematic reviews were of higher methodological quality than systematic reviews in regular journals, some of them also had methodological problems. Therefore, the methodology of each individual systematic review should be scrutinized before accepting its results.

  6. Certification of support services

    International Nuclear Information System (INIS)

    Hroch, A.; Osusky, V.

    2006-01-01

    In this paper the process of certification of support services in the Slovenske elektrarne, a. s. is described. The nuclear power plants are also included into support services. Provisions and economic aspects of support services are discussed

  7. A systematic approach to safety case maintenance

    International Nuclear Information System (INIS)

    Kelly, T.P.; McDermid, J.A.

    2001-01-01

    A crucial aspect of safety case management is the ongoing maintenance of the safety argument through life. Throughout the operational life of any system, changing regulatory requirements, additional safety evidence and a changing design can challenge the corresponding safety case. In order to maintain an accurate account of the safety of the system, all such challenges must be assessed for their impact on the original safety argument. This is increasingly being recognised by many safety standards. However, many safety engineers are experiencing difficulties with safety case maintenance at present, the prime reason being that they do not have a systematic and methodical approach by which to examine the impact of change on safety argument. The size and complexity of safety arguments and evidence being presented within safety cases is increasing. Nowhere is this more apparent than for Electrical, Electronic and Programmable Electronic systems attempting to comply with the requirements and recommendations of software and hardware safety standards such as and UK Defence Standards 00-54 [MoD. 00-54 Requirements of Safety Related Electronic Hardware in Defence Equipment. Ministry of Defence, Interim Defence Standard, 1999], 00-55 []. However, this increase in safety case complexity exacerbates problems of comprehension and maintainability later on in the system lifecycle. This paper defines and describes a tool-supported process, based upon the principles of goal structuring, that attempts to address these difficulties through facilitating the systematic impact assessment of safety case challenges

  8. Educational attainment and obesity: A systematic review

    Science.gov (United States)

    Cohen, Alison K.; Rai, Manisha; Rehkopf, David H.; Abrams, Barbara

    2013-01-01

    Background Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. Methods The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese, and Spanish were included. Results This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables, and/or attempted to assess causality through the use of quasi-experimental designs. Conclusions Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention. PMID:23889851

  9. Educational attainment and obesity: a systematic review.

    Science.gov (United States)

    Cohen, A K; Rai, M; Rehkopf, D H; Abrams, B

    2013-12-01

    Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

  10. Psychological Stress and Mitochondria: A Systematic Review.

    Science.gov (United States)

    Picard, Martin; McEwen, Bruce S

    Mitochondria are multifunctional life-sustaining organelles that represent a potential intersection point between psychosocial experiences and biological stress responses. This article provides a systematic review of the effects of psychological stress on mitochondrial structure and function. A systematic review of the literature investigating the effects of psychological stress on mitochondrial function was conducted. The review focused on experimentally controlled studies allowing us to draw causal inference about the effect of induced psychological stress on mitochondria. A total of 23 studies met the inclusion criteria. All studies involved male laboratory animals, and most demonstrated that acute and chronic stressors influenced specific facets of mitochondrial function, particularly within the brain. Nineteen studies showed significant adverse effects of psychological stress on mitochondria and four found increases in function or size after stress. In humans, only six observational studies were available, none with experimental designs, and most only measured biological markers that do not directly reflect mitochondrial function, such as mitochondrial DNA copy number. Overall, evidence supports the notion that acute and chronic stressors influence various aspects of mitochondrial biology, and that chronic stress exposure can lead to molecular and functional recalibrations among mitochondria. Limitations of current animal and human studies are discussed. Maladaptive mitochondrial changes that characterize this subcellular state of stress are termed mitochondrial allostatic load. Prospective studies with sensitive measures of specific mitochondrial outcomes will be needed to establish the link between psychosocial stressors, emotional states, the resulting neuroendocrine and immune processes, and mitochondrial energetics relevant to mind-body research in humans.

  11. VARIABLE STIFFNESS HAND PROSTHESIS: A SYSTEMATIC REVIEW

    Directory of Open Access Journals (Sweden)

    S. Cecilia Tapia-Siles

    2017-06-01

    Full Text Available Prosthetics is an important field in engineering due to the large number of amputees worldwide and the associated problems such as limited functionality of the state of the art. An important functionality of the human hand is its capability of adjusting the stiffness of the joints depending on the currently performed task. For the development of new technology it is important to understand the limitations of existing resources. As part of our efforts to develop a variable stiffness grasper for developing countries a systematic review was performed covering technology of body powered and myoelectric hand prosthesis. Focus of the review is readiness of prosthetic hands regarding their capability of controlling the stiffness of the end effector. Publications sourced through three different digital libraries were systematically reviewed on the basis of the PRISMA standard. We present a search strategy as well as the PRISMA assessment of the resulting records which covered 321 publications. The records were assessed and the results are presented for the ability of devices to control their joint stiffness. The review indicates that body powered prosthesis are preferred to myoelectric hands due to the reduced cost, the simplicity of use and because of their inherent ability to provide feedback to the user. Stiffness control was identified but has not been fully covered in the current state of the art. In addition we summarise the identified requirements on prosthetic hands as well as related information which can support the development of new prosthetics.

  12. Rolamento posterior do fêmur na artroplastia total do joelho: comparação entre as próteses com preservação e com sacrifício do ligamento cruzado posterior Femoral roll back in total knee arthroplasty: comparison between prostheses that preserve and sacrifice the posterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Lúcio Honório de Carvalho Júnior

    2011-01-01

    Full Text Available OBJETIVO: Comparar a posteriorização do ponto de contato entre o componente femoral e o polietileno tibial à medida em que o joelho é fletido em dois tipos de artroplastia total do joelho, uma com sacrifício e outra com preservação do ligamento cruzado posterior (LCP. MÉTODOS: Foram analisados, sob fluoroscopia, 36 joelhos de 32 pacientes submetidos a artroplastia total do joelho. Analisando as imagens em perfil, foi medido o ponto de contato do fêmur com o polietileno tibial com o joelho em extensão completa e em 90 graus de flexão, mensurando-se o percentual de "rolamento" posterior do fêmur nas artroplastias em que o ligamento cruzado posterior (LCP foi sacrificado e naquelas nas quais esse foi preservado. RESULTADOS: O percentual médio de posteriorização do fêmur foi de 13,24% nos casos em que o LCP foi sacrificado e de 5,75% nos casos em que esse foi preservado. A diferença entre essas medidas foi estatisticamente significativa, com p = 0,026615. CONCLUSÃO: Na artroplastia total do joelho, sacrificar o LCP aumenta a translação posterior do ponto de contato entre o fêmur e a tíbia à medida em que o joelho é flexionado até 90 graus.OBJECTIVE: To compare the rollback of the contact point between the femoral component and the tibial polyethylene as the knee is flexed, in two types of total knee arthroplasty: one that sacrifices and the other that preserves the posterior cruciate ligament (PCL. METHODS: Under fluoroscopy, 36 knees from 32 patients who underwent total knee arthroplasty were evaluated. Using lateral images, the contact points between the femur and the tibial polyethylene with the knee in complete extension and at 90° of flexion were measured, thereby measuring the percentage rollback of the femur in arthroplasties in which the PCL was sacrificed and in those in which it was preserved. RESULTS: The mean percentage rollback of the femur was 13.24% in the cases in which the PCL was sacrificed and 5.75% in

  13. A web-based system to facilitate local, systematic quality improvement by multidisciplinary care teams: development and first experiences of CARDSS Online

    NARCIS (Netherlands)

    van Engen-Verheul, Mariëtte M.; van der Veer, Sabine N.; de Keizer, Nicolette F.; Tjon Sjoe Sjoe, Winston; van der Zwan, Eric P. A.; Peek, Niels

    2013-01-01

    Continuous monitoring and systematic improvement of quality have become increasingly common in healthcare. To support multidisciplinary care teams in improving their clinical performance using feedback on quality indicators, we developed the CARDSS Online system. This system supports (i) monitoring

  14. Atlas of nuclear isomers and their systematics

    International Nuclear Information System (INIS)

    Jain, Ashok Kumar; Maheshwari, Bhoomika

    2015-01-01

    Isomers can be viewed as a separate class of nuclei and offer interesting possibilities to study the behavior of nuclei under varied conditions of excitation energy, spin, life-time and particle configuration. We have completed a horizontal evaluation of nuclear isomers and the resulting data set contains a wealth of information which offers new insights in the nuclear structure of a wide range of configurations, nuclei approaching the drip lines etc. We now have reliable data on approximately 2460 isomers having a half-life ≥ 10 ns. A few of the systematics of the properties of nuclear isomers like excitation energy, half-life, spin, abundance etc. will be presented. The data set of semi-magic isomers strongly supports the existence of seniority isomers originating from the higher spin orbitals. (author)

  15. Religion and Suicide Risk: A Systematic Review.

    Science.gov (United States)

    Lawrence, Ryan E; Oquendo, Maria A; Stanley, Barbara

    2016-01-01

    Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

  16. A Systematic Method for Search Term Selection in Systematic Reviews

    Science.gov (United States)

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-01-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a…

  17. Achalasia: a systematic review.

    Science.gov (United States)

    Pandolfino, John E; Gawron, Andrew J

    2015-05-12

    Achalasia significantly affects patients' quality of life and can be difficult to diagnose and treat. To review the diagnosis and management of achalasia, with a focus on phenotypic classification pertinent to therapeutic outcomes. Literature review and MEDLINE search of articles from January 2004 to February 2015. A total of 93 articles were included in the final literature review addressing facets of achalasia epidemiology, pathophysiology, diagnosis, treatment, and outcomes. Nine randomized controlled trials focusing on endoscopic or surgical therapy for achalasia were included (734 total patients). A diagnosis of achalasia should be considered when patients present with dysphagia, chest pain, and refractory reflux symptoms after an endoscopy does not reveal a mechanical obstruction or an inflammatory cause of esophageal symptoms. Manometry should be performed if achalasia is suspected. Randomized controlled trials support treatments focused on disrupting the lower esophageal sphincter with pneumatic dilation (70%-90% effective) or laparoscopic myotomy (88%-95% effective). Patients with achalasia have a variable prognosis after endoscopic or surgical myotomy based on subtypes, with type II (absent peristalsis with abnormal pan-esophageal high-pressure patterns) having a very favorable outcome (96%) and type I (absent peristalsis without abnormal pressure) having an intermediate prognosis (81%) that is inversely associated with the degree of esophageal dilatation. In contrast, type III (absent peristalsis with distal esophageal spastic contractions) is a spastic variant with less favorable outcomes (66%) after treatment of the lower esophageal sphincter. Achalasia should be considered when dysphagia is present and not explained by an obstruction or inflammatory process. Responses to treatment vary based on which achalasia subtype is present.

  18. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

  19. Bicep2. III. INSTRUMENTAL SYSTEMATICS

    International Nuclear Information System (INIS)

    Ade, P. A. R.; Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R.; Barkats, D.; Benton, S. J.; Bischoff, C. A.; Buder, I.; Karkare, K. S.; Bullock, E.; Dowell, C. D.; Duband, L.; Fliescher, S.; Halpern, M.; Hasselfield, M.; Hilton, G. C.; Irwin, K. D.

    2015-01-01

    In a companion paper, we have reported a >5σ detection of degree scale B-mode polarization at 150 GHz by the Bicep2 experiment. Here we provide a detailed study of potential instrumental systematic contamination to that measurement. We focus extensively on spurious polarization that can potentially arise from beam imperfections. We present a heuristic classification of beam imperfections according to their symmetries and uniformities, and discuss how resulting contamination adds or cancels in maps that combine observations made at multiple orientations of the telescope about its boresight axis. We introduce a technique, which we call “deprojection,” for filtering the leading order beam-induced contamination from time-ordered data, and show that it reduces power in Bicep2's actual and null-test BB spectra consistent with predictions using high signal-to-noise beam shape measurements. We detail the simulation pipeline that we use to directly simulate instrumental systematics and the calibration data used as input to that pipeline. Finally, we present the constraints on BB contamination from individual sources of potential systematics. We find that systematics contribute BB power that is a factor of ∼10× below Bicep2's three-year statistical uncertainty, and negligible compared to the observed BB signal. The contribution to the best-fit tensor/scalar ratio is at a level equivalent to r = (3–6) × 10 −3

  20. Bicep2. III. INSTRUMENTAL SYSTEMATICS

    Energy Technology Data Exchange (ETDEWEB)

    Ade, P. A. R. [School of Physics and Astronomy, Cardiff University, Cardiff, CF24 3AA (United Kingdom); Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R. [Department of Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Barkats, D. [Joint ALMA Observatory, ESO, Santiago (Chile); Benton, S. J. [Department of Physics, University of Toronto, Toronto, ON (Canada); Bischoff, C. A.; Buder, I.; Karkare, K. S. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, MA 02138 (United States); Bullock, E. [Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455 (United States); Dowell, C. D. [Jet Propulsion Laboratory, Pasadena, CA 91109 (United States); Duband, L. [SBT, Commissariat à l’Energie Atomique, Grenoble (France); Fliescher, S. [Department of Physics, University of Minnesota, Minneapolis, MN 55455 (United States); Halpern, M.; Hasselfield, M. [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada); Hilton, G. C.; Irwin, K. D., E-mail: csheehy@uchicago.edu [National Institute of Standards and Technology, Boulder, CO 80305 (United States); Collaboration: Bicep2 Collaboration; and others

    2015-12-01

    In a companion paper, we have reported a >5σ detection of degree scale B-mode polarization at 150 GHz by the Bicep2 experiment. Here we provide a detailed study of potential instrumental systematic contamination to that measurement. We focus extensively on spurious polarization that can potentially arise from beam imperfections. We present a heuristic classification of beam imperfections according to their symmetries and uniformities, and discuss how resulting contamination adds or cancels in maps that combine observations made at multiple orientations of the telescope about its boresight axis. We introduce a technique, which we call “deprojection,” for filtering the leading order beam-induced contamination from time-ordered data, and show that it reduces power in Bicep2's actual and null-test BB spectra consistent with predictions using high signal-to-noise beam shape measurements. We detail the simulation pipeline that we use to directly simulate instrumental systematics and the calibration data used as input to that pipeline. Finally, we present the constraints on BB contamination from individual sources of potential systematics. We find that systematics contribute BB power that is a factor of ∼10× below Bicep2's three-year statistical uncertainty, and negligible compared to the observed BB signal. The contribution to the best-fit tensor/scalar ratio is at a level equivalent to r = (3–6) × 10{sup −3}.

  1. Methodology of a systematic review.

    Science.gov (United States)

    Linares-Espinós, E; Hernández, V; Domínguez-Escrig, J L; Fernández-Pello, S; Hevia, V; Mayor, J; Padilla-Fernández, B; Ribal, M J

    2018-05-03

    The objective of evidence-based medicine is to employ the best scientific information available to apply to clinical practice. Understanding and interpreting the scientific evidence involves understanding the available levels of evidence, where systematic reviews and meta-analyses of clinical trials are at the top of the levels-of-evidence pyramid. The review process should be well developed and planned to reduce biases and eliminate irrelevant and low-quality studies. The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and subsequently of the selected complete texts (PRISMA). Once the studies have been selected, we need to (v) extract the necessary data into a form designed in the protocol to summarise the included studies, (vi) assess the biases of each study, identifying the quality of the available evidence, and (vii) develop tables and text that synthesise the evidence. A systematic review involves a critical and reproducible summary of the results of the available publications on a particular topic or clinical question. To improve scientific writing, the methodology is shown in a structured manner to implement a systematic review. Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Quality of systematic reviews in pediatric oncology--a systematic review

    DEFF Research Database (Denmark)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W

    2009-01-01

    BACKGROUND: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. METHODS: We identified eligible systematic reviews...... through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality...... assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. RESULTS: We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological...

  3. Effects of Need Supportive Teaching on Early Adolescents' Motivation and Engagement: A Review of the Literature

    Science.gov (United States)

    Stroet, Kim; Opdenakker, Marie-Christine; Minnaert, Alexander

    2013-01-01

    In the present paper we systematically review the corpus of evidence on the effects of need supportive teaching on early adolescents' motivation and engagement for school. Based on Self-Determination Theory, we define need supportive teaching in terms of teachers' provision of autonomy support, structure, and involvement. The results of an…

  4. Healthcare professional behaviour change using technological supports: A realist literature review

    OpenAIRE

    Chris Keyworth; Jo Hart; Chris A. Armitage

    2015-01-01

    Background Changing healthcare professional behaviour is fundamental to effective patient management. Recent systematic reviews examining healthcare professional behaviour change interventions (such as audit and feedback) suggest that technological support is likely to be crucial in helping healthcare professionals to improve patient outcomes. However we know little about the effectiveness of technological support interventions, and whether the design of technological support interventions...

  5. Effects of need supportive teaching on early adolescents' motivation and engagement : A review of the literature

    NARCIS (Netherlands)

    Stroet, Kim; Opdenakker, Marie; Minnaert, Alexander

    In the present paper we systematically review the corpus of evidence on the effects of need supportive teaching on early adolescents' motivation and engagement for school. Based on Self-Determination Theory, we define need supportive teaching in terms of teachers' provision of autonomy support,

  6. Tuning the reactivity of Ru nanoparticles by defect engineering of the reduced graphene oxide support

    KAUST Repository

    Liu, Xin; Sui, Yanhui; Meng, Changgong; Han, Yu

    2014-01-01

    We systematically investigated the electronic structure of Ru nanoparticles supported on various local structures on reduced graphene oxide (rGO) by first-principles-based calculations. We showed that Ru nanoparticles prefer to nucleate

  7. Relating performance of thin-film composite forward osmosis membranes to support layer formation and structure

    KAUST Repository

    Tiraferri, Alberto; Yip, Ngai Yin; Phillip, William A.; Schiffman, Jessica D.; Elimelech, Menachem

    2011-01-01

    the technology to the point that it is commercially viable. Here, a systematic investigation of the influence of thin-film composite membrane support layer structure on forward osmosis performance is conducted. The membranes consist of a selective polyamide

  8. A Decision Support System for Assessing Trade-Offs between Ecosystem Management Goals: An Application in Portugal

    Directory of Open Access Journals (Sweden)

    Jordi Garcia-Gonzalo

    2014-12-01

    Full Text Available Cork oak (Quercus suber L. and holm oak (Quercus rotundifolia ecosystems are characteristic of Mediterranean forestry in Portugal. Even though cork is the most valuable product, these ecosystems provide multiple products and services. Assessing trade-offs between multiple goals is thus critical for the effectiveness of oak ecosystem management planning. This paper focuses on the development of a decision support system for oak ecosystems’ scenario analysis including multiple criteria. It includes an innovative decision support systems (DSS functionality to assess trade-offs between the criteria that may support negotiation and consensus building between decision-makers and forest stakeholders. Specifically, a module that encapsulates the Feasible Goals Method/Interactive Decision Maps (FGM/IDM technique is developed for interactive visualization of the Pareto frontier. The Pareto frontier illustrates the degree to which improving one particular criterion requires accepting sacrifices in the achievements of others. It thus provides information about trade-offs between competing decision-makers’ preferences. Results are discussed for a large-scale application encompassing over 1 million ha of cork and holm oak forest ecosystems in Southern Portugal. This study demonstrates the potential of the new DSS functionality to enhance multi-objective forest planning, namely by facilitating participation by stakeholders and providing transparency to the decision-making processes.

  9. Interventions for Age-Related Macular Degeneration: Are Practice Guidelines Based on Systematic Reviews?

    Science.gov (United States)

    Lindsley, Kristina; Li, Tianjing; Ssemanda, Elizabeth; Virgili, Gianni; Dickersin, Kay

    2016-04-01

    Are existing systematic reviews of interventions for age-related macular degeneration incorporated into clinical practice guidelines? High-quality systematic reviews should be used to underpin evidence-based clinical practice guidelines and clinical care. We examined the reliability of systematic reviews of interventions for age-related macular degeneration (AMD) and described the main findings of reliable reviews in relation to clinical practice guidelines. Eligible publications were systematic reviews of the effectiveness of treatment interventions for AMD. We searched a database of systematic reviews in eyes and vision without language or date restrictions; the database was up to date as of May 6, 2014. Two authors independently screened records for eligibility and abstracted and assessed the characteristics and methods of each review. We classified reviews as reliable when they reported eligibility criteria, comprehensive searches, methodologic quality of included studies, appropriate statistical methods for meta-analysis, and conclusions based on results. We mapped treatment recommendations from the American Academy of Ophthalmology (AAO) Preferred Practice Patterns (PPPs) for AMD to systematic reviews and citations of reliable systematic reviews to support each treatment recommendation. Of 1570 systematic reviews in our database, 47 met inclusion criteria; most targeted neovascular AMD and investigated anti-vascular endothelial growth factor (VEGF) interventions, dietary supplements, or photodynamic therapy. We classified 33 (70%) reviews as reliable. The quality of reporting varied, with criteria for reliable reporting met more often by Cochrane reviews and reviews whose authors disclosed conflicts of interest. Anti-VEGF agents and photodynamic therapy were the only interventions identified as effective by reliable reviews. Of 35 treatment recommendations extracted from the PPPs, 15 could have been supported with reliable systematic reviews; however, only 1

  10. MSUD Family Support Group

    Science.gov (United States)

    ... The Treatment Of MSUD The MSUD Family Support Group has provided funds to Buck Institute for its ... of the membership of the MSUD Family Support Group, research for improved treatments and potential cure was ...

  11. Civil Support Operations

    Science.gov (United States)

    2010-08-01

    marijuana eradication; linguist support; air and ground transportation; intelligence analysis; tunnel detection; engineering support; and...optical, infra-red and synthetic aperture radar imagery, as well as full motion video. Incident awareness and assessment requirements are based on the

  12. Reactor pressure vessel support

    International Nuclear Information System (INIS)

    Butti, J.P.

    1977-01-01

    A link and pin support system provides the primary vertical and lateral support for a nuclear reactor pressure vessel without restricting thermally induced radial and vertical expansion and contraction. (Auth.)

  13. Paladin Software Support Lab

    Data.gov (United States)

    Federal Laboratory Consortium — The Paladin Software Support Environment (SSE) occupies 2,241 square-feet. It contains the hardware and software tools required to support the Paladin Automatic Fire...

  14. Videogames for Emotion Regulation: A Systematic Review.

    Science.gov (United States)

    Villani, Daniela; Carissoli, Claudia; Triberti, Stefano; Marchetti, Antonella; Gilli, Gabriella; Riva, Giuseppe

    2018-04-01

    Emotion regulation (ER) supports multiple individual functions and promotes mental health and wellbeing. Among the tools that may be used to help people in managing their affective states, videogames are reaching attention and are showing positive effects. Yet, little is known about their effectiveness. This study aims to assess the amount and quality of studies investigating the effects and modalities of the use of videogames for ER. A systematic literature search according to PRISMA guidelines was performed. Subsequently, according to expert advice other few studies have been added. Twenty-three studies met the inclusion criteria and were included in the review; they can be categorized into three groups, namely (1) cross-sectional and qualitative studies, (2) experimental studies investigating the effects of videogame experience on ER and (3) ER intervention with serious games. Discussion of the reviewed studies highlights that frequent gaming with commercial games offers more opportunities for ER improvement (related to gameplay and enjoyment of fictional properties) than limited-time experiences, such as those supported by bespoke serious games. This research area is still in its infancy and findings need to be interpreted with caution; furthermore, future reviews are encouraged to include clinical populations. Videogames offer several opportunities for ER and a challenge for educational and psychological interventions.

  15. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  16. Technology to Support Sign Language for Students with Disabilities

    Science.gov (United States)

    Donne, Vicki

    2013-01-01

    This systematic review of the literature provides a synthesis of research on the use of technology to support sign language. Background research on the use of sign language with students who are deaf/hard of hearing and students with low incidence disabilities, such as autism, intellectual disability, or communication disorders is provided. The…