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Studies Used (studies + used)
Selected AbstractsQuantified superiority of cognitive behaviour therapy to antidepressant drugs: a challenge to an earlier meta-analysisACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2008G. B. Parker Objective:, The study aimed to review the conclusion of a previously published meta-analysis which quantified distinct superiority of cognitive therapy to antidepressant drug-therapy (P < 0.0001). Method:, We sought to include all studies used in the original meta-analysis. Adopting both that study's inclusion criteria and additional criteria resulted in a reduced set of studies. We analysed both ,completer' and ,intention to treat' data, using effect size and odds ratio quantification. Results:, There was an overall trend for cognitive therapy to be superior to antidepressant drug-therapy, but this was significant for only one of the four meta-analyses (an intention to treat analysis). We demonstrated considerable heterogeneity between studies, and a significantly higher drop-out rate in the antidepressant groups. Conclusion:, The previous interpretation , cognitive therapy being distinctly superior to antidepressant medication , cannot be sustained from the currently analysed data set. [source] Targeted group antenatal prevention of postnatal depression: a reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2003M.-P. Austin Objective:, To review the efficacy of antenatal group interventions aimed at reducing postnatal depression (PND) in ,at risk' women. Method:, Medline, Psyclit, HEALTHSTAR, EMBASE, Cochrane library, UK National Research Register and CINHAL searches were performed from 1960 to December 2001 focussing on randomized controlled trials (RCTs). Results:, As statistical synthesis of the studies was not feasible, a qualitative review is provided. All five studies reviewed suffer from substantial limitations including small numbers; unrealistic effect sizes; large attrition rates; lack of a systematic approach in identifying those ,at risk' and thus clinically heterogenous samples. Three of the studies used unvalidated interventions that were educational or supportive in approach. While one such study reported a benefit of intervention, the largest study using a structured intervention, reported no effect. A very small study using interpersonal therapy, was promising but needs replication with an adequate sample size. Conclusion:, There is currently little evidence from RCTs to support the implementation of antenatal group interventions to reduce PND in ,at risk' women. Further studies addressing the significant methodological limitations are recommended before concluding that antenatal targeted interventions have no place in maternity care. [source] Animal models of diabetes mellitusDIABETIC MEDICINE, Issue 4 2005D. A. Rees Abstract Animal models have been used extensively in diabetes research. Early studies used pancreatectomised dogs to confirm the central role of the pancreas in glucose homeostasis, culminating in the discovery and purification of insulin. Today, animal experimentation is contentious and subject to legal and ethical restrictions that vary throughout the world. Most experiments are carried out on rodents, although some studies are still performed on larger animals. Several toxins, including streptozotocin and alloxan, induce hyperglycaemia in rats and mice. Selective inbreeding has produced several strains of animal that are considered reasonable models of Type 1 diabetes, Type 2 diabetes and related phenotypes such as obesity and insulin resistance. Apart from their use in studying the pathogenesis of the disease and its complications, all new treatments for diabetes, including islet cell transplantation and preventative strategies, are initially investigated in animals. In recent years, molecular biological techniques have produced a large number of new animal models for the study of diabetes, including knock-in, generalized knock-out and tissue-specific knockout mice. [source] Resilience thinking: Interview with Brian WalkerECOLOGICAL MANAGEMENT & RESTORATION, Issue 2 2007Tein McDonald Summary This interview with Brian Walker, chair of the research-based Resilience Alliance, outlines the main concepts and propositions behind ,resilience thinking' and touches on the importance of this paradigm for individuals and organizations involved in managing complex social-ecological systems. It refers to the origins, work and publications of the Resilience Alliance, listing and elaborating the key case studies used to illustrate the Alliance's main proposition that complex social-ecological systems do not behave in a predictable linear fashion. Rather, research indicates it is normal for complex systems to go through cycles of increasing and decreasing resilience and to have potential to shift, (in a self-organising way) to potentially undesirable states or entirely new systems if certain component variables are severely impacted by management. Such shifts can be novel and ,surprising', and are often not beneficial or desirable for societies. This is particularly the case where small-scale solutions push the problem upwards in a system, causing loss of resilience at a global scale. Predicting thresholds is therefore important to managers and is a key research focus for members of the Resilience Alliance who are currently building an accessible database to support decision-making in global natural resource management. [source] The Effects of Adjunctive Topiramate on Cognitive Function in Patients with EpilepsyEPILEPSIA, Issue 3 2003Suzee Lee Summary: ,Purpose: We investigated possible cognitive effects of topiramate (TPM) in polypharmacy on patients with intractable epilepsy. Methods: Study 1 evaluated 22 consecutively admitted patients whose antiepileptic drugs (AEDs) on admission to the Montreal Neurological Hospital included TPM. Performance on neuropsychological tests administered on and subsequently off TPM was analyzed. Four patients also were tested before taking TPM, allowing comparisons off, then on, and then off the drug again. Measures included intellectual function, verbal and nonverbal memory, language, word and design fluency, somatosensory sensitivity, and motor skills. In Study 2, 16 patients at the Minnesota Epilepsy Group were tested first off, then on TPM with nine cognitive tasks that measured concentration, verbal fluency, language, and psychomotor speed. Results: In Study 1, significant (p , 0.01) improvements were observed off TPM on 13 measures including verbal and nonverbal fluency and certain verbal and perceptual tasks. Notably, verbal learning and memory were unaffected; a limited effect was observed on nonverbal memory. Patients tested 3 times scored better in both tests off TPM compared with on this drug. In Study 2, declines on TPM were observed on all measures, significantly (p , 0.05) for tests of fluency, sustained concentration, and visual motor processing speed. Conclusions: TPM was associated with declines in fluency, attention/concentration, processing speed, language skills, and perception; working memory but not retention was affected. As the two studies used an opposite order of testing on versus off TPM, our results clearly show a performance decrement while patients are taking TPM, without respect to which condition is tested first. [source] Enhancing catch-and-release science with biotelemetryFISH AND FISHERIES, Issue 1 2008Michael R. Donaldson Abstract Catch-and-release (C&R) angling is widely practised by anglers and is a common fisheries management strategy or is a by-product of harvest regulations. Accordingly, there is a growing body of research that examines not only the mortality associated with C&R, but also the sublethal physiological and behavioural consequences. Biotelemetry offers a powerful means of remotely monitoring the behaviour, physiology and mortality of fish caught and released in their natural environment, but we contend that its usefulness is still underappreciated by scholars and managers. In this study, we review the applications of biotelemetry in C&R science, identify novel research directions, opportunities and challenges. There are now about 250 C&R studies but only one quarter of these utilize biotelemetry. In fact, almost all of the C&R studies that have used biotelemetry have been conducted within the last decade. We found that the majority of C&R telemetry studies used either radio or acoustic telemetry, while comparatively few studies have used satellite technologies. Most C&R biotelemetry studies have been used to assess mortality rates, behavioural impairments or to evaluate the effects of displacement on fish. A small fraction of studies (<8%) have used physiological sensors despite the fact that these tools are highly applicable to understanding the multiple sublethal consequences of C&R and are useful for providing mechanistic insights into endpoints such as death. We conclude that C&R science has the potential to benefit greatly from biotelemetry technology, particularly with respect to providing more robust short-term and delayed mortality estimates and adopting a more integrative and comparative approach to understanding the lethal and sublethal impacts of C&R. However, there are still a number of challenges including (i) the need for appropriate controls and methodological approaches, (ii) the need for accounting for tagging and handling stress and mortality, and (iii) the need for certainty in assessing mortality. However, the benefits associated with C&R biotelemetry outweigh its disadvantages and limitations and thereby offer C&R researchers a suite of new tools to enhance fisheries management and conservation. [source] Enabling regional management in a changing climate through Bayesian meta-analysis of a large-scale disturbanceGLOBAL ECOLOGY, Issue 3 2010M Aaron MacNeil ABSTRACT Aim, Quantifying and predicting change in large ecosystems is an important research objective for applied ecologists as human disturbance effects become increasingly evident at regional and global scales. However, studies used to make inferences about large-scale change are frequently of uneven quality and few in number, having been undertaken to study local, rather than global, change. Our aim is to improve the quality of inferences that can be made in meta-analyses of large-scale disturbance by integrating studies of varying quality in a unified modelling framework that is informative for both local and regional management. Innovation, Here we improve conventionally structured meta-analysis methods by including imputation of unknown study variances and the use of Bayesian factor potentials. The approach is a coherent framework for integrating data of varying quality across multiple studies while facilitating belief statements about the uncertainty in parameter estimates and the probable outcome of future events. The approach is applied to a regional meta-analysis of the effects of loss of coral cover on species richness and the abundance of coral-dependent fishes in the western Indian Ocean (WIO) before and after a mass bleaching event in 1998. Main conclusions, Our Bayesian approach to meta-analysis provided greater precision of parameter estimates than conventional weighted linear regression meta-analytical techniques, allowing us to integrate all available data from 66 available study locations in the WIO across multiple scales. The approach thereby: (1) estimated uncertainty in site-level estimates of change, (2) provided a regional estimate for future change at any given site in the WIO, and (3) provided a probabilistic belief framework for future management of reef resources at both local and regional scales. [source] Review of quality of life: menorrhagia in women with or without inherited bleeding disordersHAEMOPHILIA, Issue 1 2008M. SHANKAR Summary., The objectives of this study were to identify the impact of menorrhagia on the health-related quality of life (HRQOL) of women in general and those with inherited bleeding disorders and to identify the commonly used tools in assessing quality of life. A review of studies evaluating quality of life in women suffering from menorrhagia was conducted. Data sources used included electronic databases Medline and Embase. Reference lists and bibliographies of the relevant papers and books were hand-searched for additional studies. Eighteen of the 53 studies identified measured quality of life prior to treatment of menorrhagia. Ten of the studies used a validated measure of quality of life. Five studies involving a total of 1171 women with menorrhagia in general and using SF-36 were considered for further review. The mean SF-36 scores in women with menorrhagia were worse in all the eight scales when compared with normative scores from a general population of women. Three studies, involving 187 women, assessed the quality of life in women with menorrhagia and inherited bleeding disorders. None of these studies used a validated HRQOL score making it difficult for comparison. However, all reported poorer scores in study women compared to the controls. In conclusion, HRQOL is adversely affected in women with menorrhagia in general and in those with inherited bleeding disorders. HRQOL evaluation is useful in the management of women with menorrhagia for assessment of treatment efficacy. [source] Migraine Headache Recurrence: Relationship to Clinical, Pharmacological, and Pharmacokinetic Properties of TriptansHEADACHE, Issue 4 2003Gilles Géraud MD Background and Objectives.,Triptan use is associated with headache recurrence, and this has been cited as an important reason for patient dissatisfaction with the treatment. The mechanism by which recurrence occurs is not clear, and the incidence of recurrence varies with the triptan used. In order to explore the pharmacological and physiological interaction of triptans and migraine headache recurrence further, some specific clinical, pharmacological, and pharmacokinetic factors that might influence migraine recurrence were evaluated in a review of the major efficacy data for the drugs in the triptan class. These factors were 5-HT1B and 5-HT1D receptor activities, the pharmacokinetic elimination half-life of each triptan, and the clinical efficacy of each compound, determined by the proportion of patients with headache relief and the therapeutic gain over placebo. Methods.,Clinical data were derived from 31 triptan, placebo-controlled, major efficacy studies used in a previous meta-analysis. The mean recurrence rate, mean headache response, and therapeutic gain were calculated using the results from the individual clinical studies. Mean headache response and therapeutic gain were calculated at the time point used to define recurrence in each study. Data for binding affinity and potency were taken from a direct-comparison in vitro pharmacology study, and the elimination half-life quoted in the data sheet for each triptan was used. Rank correlation with recurrence rate was performed for each of the test parameters. Results.,Mean headache recurrence rates ranged from 17% for frovatriptan 2.5 mg to 40% for rizatriptan. Elimination half-life and recurrence were inversely correlated (r = ,1.0, P = .0016). There was also a significant inverse correlation between 5-HT1B receptor potency and recurrence (r = ,0.68, P = .034), but 5-HT1D receptor potency was not correlated with recurrence (r = ,0.20, P = .54). In addition, the binding affinities for the 5-HT1B and 5-HT1D receptors were not correlated to headache recurrence. Importantly, it also was demonstrated that initial clinical efficacy was not correlated to headache recurrence. The correlation coefficient for headache response was 0.18 (P = .53) and for therapeutic gain, ,0.11 (P = .71). Conclusion.,The incidence of migraine headache recurrence varies between drugs in the triptan class. Migraine recurrence does not appear to be related to initial clinical efficacy, but is influenced by the pharmacological and pharmacokinetic properties of the individual triptans. The triptans with longer half-lives and greater 5-HT1B receptor potency had the lowest rates of headache recurrence. [source] Which neuroreceptors mediate the subjective effects of MDMA in humans?HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2001A summary of mechanistic studies Abstract In preclinical studies, 3,4-methylenedioxymethamphetamine (MDMA, ,Ecstasy') has been shown to release serotonin (5-HT), dopamine and norepinephrine. However, the role of these neurotransmitters and their corresponding receptor sites in mediating the subjective effects of MDMA has not yet been studied in humans. Therefore, we investigated the effects of three different neuroreceptor pretreatments on the subjective, cardiovascular and adverse effects of MDMA (1.5 mg/kg orally) in 44 healthy human volunteers. Pretreatments were: the selective serotonin reuptake inhibitor citalopram (40 mg intravenously) in 16 subjects, the 5-HT2 antagonist ketanserin (50 mg orally) in 14 subjects, and the D2 antagonist haloperidol (1.4 mg intravenously) in 14 subjects. Each of these studies used a double-blind placebo-controlled within-subject design and all subjects were examined under placebo, pretreatment, MDMA and pretreatment plus MDMA conditions. Citalopram markedly reduced most of the subjective effects of MDMA, including positive mood, increased extraversion and self-confidence. Cardiovascular and adverse effects of MDMA were also attenuated by citalopram. Haloperidol selectively reduced MDMA-induced positive mood but had no effect on other subjective effects of MDMA or the cardiovascular or adverse responses to MDMA. Ketanserin selectively reduced MDMA-induced perceptual changes and emotional excitation. These results indicate that the overall psychological effects of MDMA largely depend on carrier-mediated 5-HT release, while the more stimulant-like euphoric mood effects of MDMA appear to relate, at least in part, to dopamine D2 receptor stimulation. The mild hallucinogen-like perceptual effects of MDMA appear to be due to serotonergic 5-HT2 receptor stimulation. Copyright © 2001 John Wiley & Sons, Ltd. [source] Further examination of the convergent and discriminant validity of the student,teacher relationship scaleINFANT AND CHILD DEVELOPMENT, Issue 6 2009Sarah Doumen Abstract Two studies extended psychometric research on the Student,Teacher Relationship Scale (STRS) with kindergarten and preschool children (N1 = 60,71; N2 = 35) and their teachers. These studies used a multi-method approach to replicate and extend previous findings concerning the convergent validity of the STRS Closeness, Conflict, and Dependency scale and to further examine the discriminant validity of the STRS. Study 1 investigated convergence between the STRS scales and child- and peer-reports of the same constructs based on a multi-trait multi-method approach. Study 2 examined the pattern of associations between the STRS and indicators of teacher,child relationship quality rated by external observers. Support was found for the convergent validity and to a lesser extent the discriminant validity of the STRS Closeness and Conflict scale. For the STRS Dependency scale, additional research remains necessary. Copyright © 2009 John Wiley & Sons, Ltd. [source] The contribution of cohort studies to prescribing researchJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2002J. A. Simpson PhD This paper highlights the main issues in the design, analysis and interpretation of cohort studies used in prescribing research. [source] Debugging Decomposition Data,Comparative Taphonomic Studies and the Influence of Insects and Carcass Size on Decomposition RateJOURNAL OF FORENSIC SCIENCES, Issue 1 2010Tal Simmons Ph.D. Abstract:, Comparison of data from a variety of environments and ambient temperatures has previously been difficult as few studies used standardized measures of time/temperature and decomposition. In this paper, data from previous studies and recent experiments are compared using simple conversions. These conversions allow comparison across multiple environments and experiments for the first time. Plotting decomposition score against logADD allows the exponential progression of decomposition to be expressed as a simple linear equation. Data comparison from many environments and temperatures shows no difference in decomposition progression when measured using Accumulated Degree Days. The major effector of change in rate was insect presence, regardless of depositional environment, species, or season. Body size is significant when carcasses are accessed by insects; when insects are excluded, while bodies are indoors, submerged, or buried, then decomposition progresses at the same rate regardless of body size. [source] Mind-Body Interventions During PregnancyJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 2 2008Amy E. Beddoe ABSTRACT Objective:, To examine published evidence on the effectiveness of mind-body interventions during pregnancy on perceived stress, mood, and perinatal outcomes. Data sources:, Computerized searches of PubMed, Cinahl, PsycINFO, and the Cochrane Library. Study Selection:, Twelve out of 64 published intervention studies between 1980 and February 2007 of healthy, adult pregnant women met criteria for review. Data extraction and synthesis:, Studies were categorized by type of mind-body modality used. Progressive muscle relaxation was the most common intervention. Other studies used a multimodal psychoeducation approach or a yoga and meditation intervention. The research contained methodological problems, primarily absence of a randomized control group or failure to adequately control confounding variables. Nonetheless, there was modest evidence for the efficacy of mind-body modalities during pregnancy. Treatment group outcomes included higher birthweight, shorter length of labor, fewer instrument-assisted births, and reduced perceived stress and anxiety. Conclusions:, There is evidence that pregnant women have health benefits from mind-body therapies used in conjunction with conventional prenatal care. Further research is necessary to build on these studies in order to predict characteristics of subgroups that might benefit from mind-body practices and examine cost effectiveness of these interventions on perinatal outcomes. [source] Pharmacologic Dissociation Between Impulsivity and Alcohol Drinking in High Alcohol Preferring MiceALCOHOLISM, Issue 8 2010Brandon G. Oberlin Background:, Impulsivity is genetically correlated with, and precedes, addictive behaviors and alcoholism. If impulsivity or attention is causally related to addiction, certain pharmacological manipulations of impulsivity and/or attention may affect alcohol drinking, and vice versa. The current studies were designed to explore the relationship among impulsivity, drinking, and vigilance in selectively bred High Alcohol Preferring (HAP) mice, a line that has previously demonstrated both high impulsivity and high alcohol consumption. Amphetamine, naltrexone, and memantine were tested in a delay discounting (DD) task for their effects on impulsivity and vigilance. The same drugs and doses were also assessed for effects on alcohol drinking in a 2-bottle choice test. Methods:, HAP mice were subjected to a modified version of adjusting amount DD using 0.5-second and 10-second delays to detect decreases and increases, respectively, in impulsive responding. In 2 experiments, mice were given amphetamine (0.4, 0.8, or 1.2 mg/kg), naltrexone (3 and 10 mg/kg), and memantine (1 and 5 mg/kg) before DD testing. Another pair of studies used scheduled access, 2-bottle choice drinking to assess effects of amphetamine (0.4, 1.2, or 3.0 mg/kg), naltrexone (3 and 10 mg/kg), and memantine (1 and 5 mg/kg) on alcohol consumption. Results:, Amphetamine dose-dependently reduced impulsivity and vigilance decrement in DD, but similar doses left alcohol drinking unaffected. Naltrexone and memantine decreased alcohol intake at doses that did not affect water drinking but had no effects on impulsivity or vigilance decrement in the DD task. Conclusions:, Contrary to our hypothesis, none of the drugs tested here, while effective on either alcohol drinking or impulsivity, decreased both behaviors. These findings suggest that the genetic association between drinking and impulsivity observed in this population is mediated by mechanisms other than those targeted by the drugs tested in these studies. [source] Generation and interrogation of a pure nuclear spin state by parahydrogen-enhanced NMR spectroscopy: a defined initial state for quantum computationMAGNETIC RESONANCE IN CHEMISTRY, Issue 3 2005D. Blazina Abstract We describe a number of studies used to establish that parahydrogen can be used to prepare a two-spin system in a pure state, which is suitable for implementing NMR quantum computation. States are generated by pulsed and continuous-wave (CW) UV laser initiation of a chemical reaction between Ru(CO)3(L2) [where L2 = dppe = 1,2-bis(diphenylphosphino)ethane or L2 = dpae = 1,2-bis(diphenylarsino)ethane] with pure parahydrogen (generated at 18 K). This process forms Ru(CO)2(dppe)(H)2 and Ru(CO)2(dpae)(H)2 on a sub-microsecond time-scale. With the pulsed laser, the spin state of the hydride nuclei in Ru(CO)2(dppe)(H)2 has a purity of 89.8 ± 2.6% (from 12 measurements). To achieve comparable results by cooling would require a temperature of 6.6 mK, which is unmanageable in the liquid state, or an impractical magnetic field of 0.44 MT at room temperature. In the case of CW initiation, reduced state purities are observed due to natural signal relaxation even when a spin-lock is used to prevent dephasing. When Ru(CO)3(dpae) and pulsed laser excitation are utilized, the corresponding dihydride product spin state purity was determined as 106 ± 4% of the theoretical maximum. In other words, the state prepared using Ru(CO)3(dpae) as the precursor is indistinguishable from a pure state. Copyright © 2004 John Wiley & Sons, Ltd. [source] Botulinum neurotoxins for post-stroke spasticity in adults: A systematic review,,MOVEMENT DISORDERS, Issue 6 2009Antonio Emanuele Elia MD Abstract The aim of this systematic review was to determine whether botulinum neurotoxin (BoNT) reduce spasticity or improve function in adult patients after stroke. Eleven double-blind randomized placebo-controlled trials met inclusion criteria. They encompassed 782 patients, 767 (98%) of whom received BoNT/A, and 15 (2%) BoNT/B. Most studies used the Ashworth scale as primary outcome measure. Differences between treated and control groups were assessed as categorical or continuous comparisons. The overall effect on upper limb spasticity was in favor of BoNT/A. A significantly higher number of patients had a reduction of upper limb spasticity at 4-week and 8-week evaluations in the treatment group compared with placebo. Mean changes in joint spasticity revealed improvement 3 to 6 weeks and 9 to 12 weeks after treatment. There were insufficient data to establish BoNT/A efficacy on lower limb spasticity or the effect of BoNT/B on the upper and lower limbs. Because of inconsistency and heterogeneity of the available data, it was not possible to perform a meta-analysis on disability and patients' reported outcomes. There was an overlapping safety profile between the treatment and the placebo groups. BoNT/A reduces upper limb spasticity in patients post-stroke, but the improvement in functional ability remains to be established. This gap needs to be filled by new studies to assess the effect of BoNT in the context of multidisciplinary patient management. © 2009 Movement Disorder Society [source] Epidemiology underpinning research in the aetiology of orofacial clefts,ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 3 2007Peter Mossey Structured Abstract Author,,, Mossey P Introduction,,, Epidemiological information gathered through birth defects surveillance is an important adjunct to carrying out clinical and aetiological research. Information on the incidence in the population, causative risk factors and providing baseline data prior to intervention are all important elements. Under the auspices of the World Health Organisation, it was agreed that a global registry and database on craniofacial anomalies should be created and this, the International Database on Craniofacial Anomalies (ICDFA) was designed to gather information on craniofacial abnormalities from existing birth defects registries and databases around the world to become a resource underpinning research. There are currently 62 registries covering 2 million births per year contributing to a database along with information on the size and type of studies used to collect the information, any variation in ascertainment and on the inclusion of syndromes and associated abnormalities. Generation of hypotheses,,, From the epidemiological data collected it is possible to carry out meta-analysis and to search for trends and consistencies in the data that enable hypothesis to be generated. Issues such as geographical distribution, ethnicity, gender, associated abnormalities and clefts in stillbirths can all be examined in a meta-analytical approach. Collection of information on risk factors such as maternal illnesses, medications, lifestyle factors, nutrition and perhaps occupational exposures enables investigation into environmental contribution to causality and genetic predisposition. A range of techniques are currently being used to identify new candidate genes and ultimately it will be necessary to test genetic and environmental hypothesis in the context of human population studies. Conclusions,,, It is only by consistency of association between different populations with different gene pools and maternal exposures, lifestyles, nutrition etc that conclusive evidence regarding causality will be found. It is therefore essential, and a major objective of the WHO that international multicentre collaborative studies are setup to gather the appropriate evidence and improve knowledge and the cause of birth defects in general and orofacial clefts in particular, with the ultimate humanitarian and scientific objective of the WHO being primary prevention. Clinical utility and implications,,, This IDCFA project fulfils three basic objectives namely to enable global surveillance of CFA; to create online access to those who wish to contribute to the IDCFA, and to develop an online directory of resources on craniofacial anomalies for the support of research and improving quality of care. The next sttif for IPDTOC are to expand the number of participating registries and to actively collect data on other craniofacial birth defects. [source] Psychological Intervention Following Implantation of an Implantable Defibrillator: A Review and Future RecommendationsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2007SUSANNE S. PEDERSEN Ph.D. Background:The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current evidence on the efficacy of psychological intervention in ICD patients and recommendations for future research. Methods:We searched the PubMed and PsycInfo databases in the period between January 1980 and April 2007, using a set of a priori determined keywords. Based on the search and a hand search of the reference lists of the included articles, we identified nine studies that fulfilled the inclusion criteria. Results:The majority of studies used a randomized controlled trial design, but studies varied considerably in sample size, response, attrition rate, and type of intervention. However, most interventions were multifactorial, using cognitive behavioral therapy as one of the mainstays of treatment. Overall, psychological interventions seem to have little impact on shocks and heart rate variability. Some studies found a decrease in depressive symptoms and gains in quality of life, but the most notable effects are seen in improved exercise capacity and reductions in anxiety. Effect sizes for changes in anxiety in the intervention group ranged from small to large compared to small in the usual care group, using Cohen's effect size index. Conclusions:Preliminary evidence from small-scale intervention trials suggests that psychological intervention is worthwhile in ICD patients. Nevertheless, large-scale, well-designed trials are warranted to substantiate these findings. A multifactorial approach using a cognitive behavioral component paired with exercise training is likely to be the most successful. [source] Attachment models of the self and others: Relations with self-esteem, humanity-esteem, and parental treatmentPERSONAL RELATIONSHIPS, Issue 3 2004Michelle A. Luke The present research tested the extent to which perceptions of early childhood experiences with parents predicted general views of the self (i.e., self-esteem) and others (i.e., humanity-esteem), and whether attachment self- and other-models mediated these links. Two studies used a new measure of humanity-esteem (Luke & Maio, 2004) to achieve these ends. As expected, indices that tapped a positive model of the self in relationships were associated with high self-esteem and indices that tapped a positive model of others in relationships were associated with high humanity-esteem. Also, early attachment experiences with fathers and mothers predicted self-esteem and humanity-esteem, respectively, and these direct relations were mediated by the attachment models. The studies, therefore, provide direct evidence that attachment measures predict general favorability toward the self and others, while revealing novel differences in the roles of childhood experiences with fathers and mothers. No variables, it is held, have more far-reaching effects on personality development than a child's experiences within the family: for, starting during his first months in his relation with his mother figure, and extending through the years of childhood and adolescence in his relation to both parents, he builds up working models of how attachment figures are likely to behave towards him in any of a variety of situations; and on those models are based all his expectations, and therefore all his plans, for the rest of his life. Bowlby (1973; p. 369) [source] Key Elements for Church-Based Health Promotion Programs: Outcome-Based Literature ReviewPUBLIC HEALTH NURSING, Issue 6 2002Jane Peterson Abstract Although not a new concept, church-based health promotion programs have yet to be widely researched. Few of the initial studies used randomized and controlled designs. Dissemination of study results has been sporadic, with findings often reported in church periodicals. A renewed interest in church-based health promotion programs (CBHPP) is emerging. The purpose of this article is to propose seven key elements found in a literature review to be beneficial in establishing church-based community health promotion programs that demonstrated desired health promotion outcomes. Based on the outcomes of successful CBHPP, the following key elements have been identified: partnerships, positive health values, availability of services, access to church facilities, community-focused interventions, health behavior change, and supportive social relationships. An example of one program that embodies these elements is presented. The Heart and Soul Program, designed to increase physical activity in midlife women to reduce their risk of cardiovascular disease with advancing age, is discussed within the context of the elements for successful church-based programs. CBHPP have effectively promoted health behaviors within certain communities. To promote health and wellness in light of our diverse society and health needs, health promotion professionals and churches can be dynamic partners. [source] A systematic review of evaluation in formal continuing medical educationTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 1 2007Jing Tian MD Abstract Introduction: Physicians spend a considerable amount of time in Continuing Medical Education (CME) to maintain their medical licenses. CME evaluation studies vary greatly in evaluation methods, levels of evaluation, and length of follow-up. Standards for CME evaluation are needed to enable comparison among different studies and to detect factors influencing CME evaluation. Methods: A review of the CME evaluation literature was conducted on primary research studies published from January 2000 to January 2006. Studies assessing only satisfaction with CME were excluded, as were studies where fewer than 50% of the participants were practicing physicians. Thirty-two studies were included in the analyses. Determinations were made about evaluation methods, outcome measures, and follow-up assessment. Results: Only 2 of 32 reviewed studies addressed all evaluation levels: physician changes in knowledge and attitudes (level 2), practices (level 3), and improved patient health status (level 4). None of the studies using self-developed instruments (n = 10) provided reliability and validity information. Only 6 studies used validated scales. Twenty studies had a follow-up period of 6 months or less, and 11 had a follow-up period between 1 and 2 years. Discussion: A gold standard for evaluating the effectiveness of CME would include assessment of all 4 levels of evaluation. A valid, reliable, and adaptable CME evaluation questionnaire addressing variables in the second level is needed to allow comparison of effectiveness across CME interventions. A minimum 1-year postintervention follow-up period may also be indicated to investigate the sustainability of intervention outcomes. [source] Resolving the differences in plant burial responsesAUSTRAL ECOLOGY, Issue 1 2010MATTHEW E. GILBERT Abstract Burial is one of the major factors influencing plant ecology in deserts and coastal areas. Consequently, many studies have measured the responses of dune plants to sand burial. However, there remains little agreement about the mechanisms and characteristics constituting the burial response of plants. In particular, stimulation of growth has been reported as the most common plant burial response; however, stimulation has not been reported consistently among studies. Here, a literature survey showed that the depth of burial relative to the height of the plant determined whether the growth of a species was stimulated by burial. Growth stimulation was limited to shallow burial depths, while burial depths greater than the height of the plant consistently resulted in reduced growth. As studies used widely differing burial depths or units of growth measurement, the variation in reported stimulation of plant growth can be partly attributed to differences in experimental procedure. The stimulation of growth in many species was accompanied by an increase in photosynthesis over a limited period and by a shift in biomass allocation from root to shoot. Most plants demonstrated stimulated growth (up to 200%) in response to shallow burial indicating that some burial response mechanisms are general to many species. However, a few specialist dune species displayed a much greater ability to respond to burial (up to 700% stimulation of plant mass). Although allocation shifts and increased photosynthesis have been shown to be associated with dune plant burial response, there remains a need for field measurements that focus on the diversity of mechanisms underlying plant response to burial. [source] The utility of mixed-effects covariate analysis in rapid selection of doses in pediatric subjects: A case study with fexofenadine hydrochlorideBIOPHARMACEUTICS AND DRUG DISPOSITION, Issue 9 2004Rajesh Krishna Abstract Fexofenadine hydrochloride is a non-sedating antihistamine that is used in the treatment of symptoms associated with seasonal allergic rhinitis and chronic idiopathic urticaria. A pooled analysis of pharmacokinetic data from children 6 months to 12 years of age and adults was conducted to identify the dose(s) in children that produce exposures comparable to those in adults for the treatment of seasonal allergic rhinitis. The pharmacokinetic parameter database included peak and overall exposure data from 269 treatment exposures from 136 adult subjects, and 90 treatment exposures from 77 pediatric allergic rhinitis patients. The data were pooled and analysed using NONMEM software, version 5.0. A covariate model based on body weight and age and a power function model based on body weight were identified as appropriate models to describe the variability in fexofenadine oral clearance and peak concentration, respectively. Individual oral clearance estimates were on average 44%, 36% and 61% lower in children 6 to 12 years (n = 14), 2 to 5 years (n = 21), and 6 months to 2 years (n = 42), respectively, compared with adults. Trial simulations (n = 100) were carried out based on the final pharmacostatistical models and parameter estimates to identify the appropriate dose(s) in children relative to the marketed dose of 60 mg fexofenadine hydrochloride in adults. The trials were designed as crossover studies in 18 subjects comprising various potential dosing regimens with and without weight stratification. Pharmacokinetic parameter variability was assumed to have a log-normal distribution. Individual weights and ages were simulated using mean (SD) estimates derived from the studies used in this analysis and proportional measurement/model mis-specification errors derived from the analysis were incorporated into the simulation. The results indicated that a 30 mg dose of fexofenadine hydrochloride administered to children 1 to 12 years of age and weighing >10.5 kg and a 15 mg dose administered to children 6 months and older and weighing ,10.5 kg produces exposures similar to those seen with the 60 mg dose in adults. Copyright © 2004 John Wiley & Sons, Ltd. [source] Bendectin and birth defects II: Ecological analysesBIRTH DEFECTS RESEARCH, Issue 2 2003Jeffrey S. Kutcher BACKGROUND Bendectin was the primary pharmaceutical treatment of nausea and vomiting of pregnancy (NVP) in the United States until the early 1980s. Its manufacture was then discontinued after public allegations that it was causing birth defects. Subsequently, meta-analyses of the many epidemiological cohort and case/control studies used to examine that hypothesis have demonstrated the absence of a detectable teratogenic effect. This study presents an ecological analysis of the same hypothesis that examines specific malformations. METHODS Annual birth defect prevalence data for the 1970s to the 1990s have been obtained for specific birth defects from the Center for Disease Control's nationwide Birth Defect Monitoring Program. These data for the US have been compared graphically to the annual US Bendectin sales for the treatment of NVP. Data have also been obtained for annual US rates for hospitalization for NVP. The three data sets have been temporally compared in graphic analysis. RESULTS The temporal trends in prevalence rates for specific birth defects examined from 1970 through 1992 did not show changes that reflected the cessation of Bendectin use over the 1980,84 period. Further, the NVP hospitalization rate doubled when Bendectin use ceased. CONCLUSIONS The population results of the ecological analyses complement the person-specific results of the epidemiological analyses in finding no evidence of a teratogenic effect from the use of Bendectin. Birth Defects Research (Part A) 67:88,97, 2003. © 2003 Wiley-Liss, Inc. [source] Intravitreal and plasmatic levels of erythropoietin after sub-conjunctival administration in rabbitsACTA OPHTHALMOLOGICA, Issue 2009AP RESENDE Purpose Recently Erythropoietin (EPO) had been shown to have neuroprotective and neuroregenerative effects on retinal ganglion cells, apart from its erythropoietic properties, being a promissory alternative on ischemic retinal diseases. With the present study we pretend to evaluate the efficacy of subconjuntival injection for ocular EPO delivery. Methods New Zealand albino rabbits (n=6) were used. Complete ophthalmic examinations were carried out before and after the injections for 15 days. The proceedings (intravitreal punch and subconjuntival injections) were carried out under general anaesthesia. Through the subconjuntival route 100 UI of EPO diluted in 50 ,l saline solution 0,9% was administered. The opposite eyes of each animal served as controls. The vitreous and plasmatic concentration of EPO were measured using the ELISA method. Results Administration of EPO through the subconjuntival route allowed a vitreous absortion that reached the highest 24 hours after administration with 0,6 mUI/ml of EPO quantified in 100 ,l of vitreous sample. The sistemic absorption reached the highest concentration 3 hours after subconjunctival administration and 48 hours after the administration the plasmatic concentration of EPO regained physiologic values. EPO was not detected on control eyes. Conclusion All the previous studies used the systemic or intravitreal route of administration to acquire therapeutic concentrations of EPO on the retina, both difficult to use in clinical practice. In this study, the subconjuntival route proved to be a promising alternative for ocular EPO delivery. However further studies are necessary to assess the blood and intravitreal kinetics of EPO after subconjuntival administration. [source] | |||||||||||||||||||||||||||||||