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Critical Appraisal (critical + appraisal)
Terms modified by Critical Appraisal Selected AbstractsThe Emerging Strategic Partnership between India and the EU: A Critical AppraisalEUROPEAN LAW JOURNAL, Issue 6 2007Saponti Baroowa In recent times however, amongst others, the changing external environment, the EU's emerging profile as a global actor and India's growing importance both regionally and globally warranted the need for greater political dialogue and cooperation between the two sides. What followed therefore was the formalisation at the highest level of the EU's political dialogue with India and its institutionalisation into a meaningful summit-level partnership leading to a strategic partnership. Areas of divergence and challenges remain but the opportunities that have surfaced are significant and deserving of attention. This article critically analyses the growing strategic partnership between India and the EU in the light of both these realities. [source] ADHESION TO LASER-PREPARED TOOTH STRUCTUREJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2006MS Author, Thomas J. Hilton DMD The use of Er:YAG (erbium : yttrium aluminum garnet and Er,Cr:YAG (erbium, chromium : yttrium scandium gallium garnet) lasers for tooth preparation has received much attention in recent years. Several advantages have been attributed to these devices, including a reduced need for local anesthesia for tooth preparation, less vibration to the patient, and more conservative cavity preparation. Another purported advantage has been the contention that adhesion to tooth structure is enhanced compared with other means of cavity preparation, even to the point of eliminating the need for conditioning and/or etching prior to adhesive system application. As the use of bonded, esthetic restorations has increased, it is important to know if this purported bonding advantage is valid. This Critical Appraisal examines evidence in the peer-reviewed scientific literature that contradicts this contention, and discusses concerns regarding the use of lasers in cavity preparation. [source] Glass Transition and Food Technology: A Critical AppraisalJOURNAL OF FOOD SCIENCE, Issue 7 2002M. Le Meste ABSTRACT: Most low water content or frozen food products are partly or fully amorphous. This review will discuss the extent to which it is possible to understand and predict their behavior during processing and storage, on the basis of glass transition temperature values (Tg) and phenomena related to glass transition. Two main conclusions are provisionally proposed. Firstly, glass transition cannot be considered as an absolute threshold for molecular mobility. Transport of water and other small molecules takes place even in the glassy state at a significant rate, resulting in effective exchange of water in multi-domains foods or sensitivity to oxidation of encapsulated materials. Texture properties (crispness) also appear to be greatly affected by sub-Tg relaxations and aging below Tg. Secondly, glass transition is only one among the various factors controlling the kinetics of evolution of products during storage and processing. For processes such as collapse, caking, crystallization, and operations like drying, extrusion, flaking, Tg data and WLF kinetics have good predictive value as regards the effects of temperature and water content. On the contrary, chemical/biochemical reactions are frequently observed at temperature below Tg, albeit at a reduced rate, and WLF kinetics may be obscured by other factors. [source] A Critical Appraisal of COX-2 Selective Inhibition and Analgesia: How Good So Far?PAIN PRACTICE, Issue 3 2003Pedro F. Bejarano MD Abstract: The development of COX-2 selective inhibitors has opened a new era of clinical investigation in NSAIDs. Discussion of the established concepts of inflammation and therapeutical uses of these drugs has changed the rationale for its clinical use and therapeutic labeling of these drugs. A comprehensive discussion across basic science and clinical areas involved in each of these concepts is presented. This led to a remarkable re-evaluation of our insights on their traditionally proposed mechanisms of analgesia, their side-effects, and the clinical indication of NSAIDs as "over the counter" pain killers. This may shift physicians toward a more rational use of this drug class. [source] A Critical Appraisal of Vitiligo Etiologic Theories.PIGMENT CELL & MELANOMA RESEARCH, Issue 4 2003Is Melanocyte Loss a Melanocytorrhagy? Common generalized vitiligo is an acquired depigmenting disorder characterized by a chronic and progressive loss of melanocytes from the epidermis and follicular reservoir. However, the mechanism of melanocyte disappearance has never been clearly understood, and the intervention of cellular and humoral autoimmune phenomena as primary events remains unproven. In this review, is discussed the data supporting the major theories of vitiligo, namely melanocyte destruction (autoimmune, neural and impaired redox status) and melanocyte inhibition or defective adhesion. Based on recent morphologic findings in vivo supporting a chronic detachment and transepidermal loss of melanocytes in common generalized vitiligo, a new theory is suggested proposing melanocytorrhagy as the primary defect underlying melanocyte loss, integrating most of the possible triggering/precipitating/enhancing effects of other known factors. [source] Theories of Practice in Anthropology: A Critical AppraisalANNALS OF ANTHROPOLOGICAL PRACTICE, Issue 1 2000Professor Marietta L. Baba First page of article [source] John, Jesus, and History Volume One: Critical Appraisals of Critical Views , Edited by Paul N. Anderson, Felix Just, and Tom ThatcherRELIGIOUS STUDIES REVIEW, Issue 3 2008Jane S. Webster No abstract is available for this article. [source] Critical appraisal of the mouse model of myocardial infarctionEXPERIMENTAL PHYSIOLOGY, Issue 4 2004Naomi M. Degabriele In order to critically evaluate the utility of a mouse model of myocardial infarction (MI) for therapeutic studies, we investigated survival, haemodynamic measurements and histopathology in mice with an occluding suture placed at one of three distinct sites along the left anterior descending coronary artery. The suture was placed at the atrioventricular juncture (High), or at two sites more distally towards the base (Middle and Low). In the High group, only 33% of animals survived 7 days after MI (P < 0.05 compared to all other groups). Only the Middle group had significantly reduced haemodynamics compared to sham-operated animals (maximum left ventricular pressure: 55.9 ± 3.5 versus 80.8 ± 5.1 mmHg, maximum change in pressure over time : 2003 ± 172 versus 4402 ± 491, P < 0.01). Histological examination showed morphological changes in all MI groups. The Middle group had larger lesions than the Low group (P < 0.05). Lesions in the anterior and lateral walls correlated, albeit weakly, with cardiac function. Power calculations indicated that, despite a certain amount of intragroup variation, the Middle Suture model may be useful for therapeutic studies to assess the effects of treatment on cardiac function and overall lesion size. [source] Experimental design comparison of studies evaluating doxorubicin nanoparticles in breast cancer therapyHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2008Farman A. Moayed Background The unique properties of nanoparticles (NP) qualify these colloidal systems for a wide range of medical applications, including diagnosis and treatment. Particularly in cancer therapy, NP have significantly enhanced the potential of conventional imaging, radiotherapy, and chemotherapy and, consequently, offered new avenues for early interventions. So far, breast cancer has been one of the most studied cancer types with NP research, which can benefit the occupational breast cancer for the increasing number of women in the labor force in industry. Objectives The objective of this study is to compare the experimental designs of preclinical studies that assessed the effect of doxorubicin NP (DOX-NP) on the estrogen-dependent MCF-7 breast cancer cell line using a recently established quantitative Experimental Appraisal Instrument (ExpAI). Methods A systematic review of research articles published between August 2004 and August 2005 on NP and breast cancer treatment with doxorubicin was performed using various online databases and indexes available through the University of Cincinnati. Restrictive inclusion and exclusion criteria were defined leading to selection of four relevant articles that used comparable experimental designs. Critical appraisal of those studies was performed by five independent assessors using the ExpAI version 2.0 and the results were summarized in a table of evidence. Results The study design in the selected articles was either between groups or mixed, with sample sizes varying from n = 3,6, and the evaluation of the effect of DOX-NP either in vitro or in vivo. The cytotoxic drug doxorubicin was the input variable in all studies, whereas different end points such as pharmacokinetic parameters, cytotoxicity surrogates (e.g., growth inhibition, mitochondrial activity), and quantitative analysis of messenger RNA were used as output variables. Conclusions Although the articles assessed in this article were preclinical experimental studies, the results showed that doxorubicin NP drugs can be used effectively to enhance the delivery process in MCF-7 breast cancer cells by increasing the circulation time and targeting the tumor tissues. Considering the rising number of women in the labor force and the risk of occupational breast cancer, it can be concluded that DOX-NP may potentially be used as an effective anticancer drug on humans, but further research and studies are required to understand how DOX-NP drugs might react in the human body before using it on breast cancer patients. © 2008 Wiley Periodicals, Inc. [source] Effects of music listening on adult patients' pre-procedural state anxiety in hospitalINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2008Elizabeth Gillen MSc Executive summary Background Anticipation of an invasive procedure in hospital is likely to provoke feelings of anxiety and stress in patients. An unfamiliar environment, loss of control, perceived or actual physical risk, dependence on strangers and separation from friends and family are all factors that can contribute to the development of such feelings. Recently, there has been considerable interest in the anxiolytic potential of music listening in a variety of clinical settings, yet thus far, little is known about the impact of music listening on the pre-procedural patient population. A systematic review of all literature to date was indicated to improve understanding of outcomes and impact of music listening on pre-procedural anxiety, thus helping nurses decide whether or not to incorporate music listening into practice and to highlight a need, or otherwise, for a related primary research agenda. Objective The objective of this review was to determine the best available evidence on the effectiveness of music listening in reducing adult hospital patients' pre-procedural state anxiety. Inclusion criteria Types of studies This review included randomised controlled trials and quasi-experimental research designs that examined the efficacy of music listening in reducing state anxiety among pre-procedural hospital patients published between January 1985 and February 2006. The search was limited to publications after 1985 to coincide with the increasing interest and use of complementary therapies within health care during the 1980s and 1990s. Types of participants Participants of interest to the review were adult day patients, ambulatory patients and inpatients who were about to undergo any type of clinical procedure. Types of intervention The review focused on studies that investigated pre-procedural music listening employed and prescribed as a potentially therapeutic activity. It excluded any other form of music therapy. Types of outcome measures The primary outcome measures examined were alterations in state anxiety and a variety of physiological variables such as blood pressure and respiration and heart rates. Search strategy A search for published and unpublished literature between January 1985 and February 2006 was conducted using all major electronic databases. A three-step search strategy was devised which consisted of using high-precision MeSH terminology and keywords to ensure that all material relevant to the review was captured. Critical appraisal The methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using the standard Joanna Briggs Institute (JBI) critical appraisal tools. Data extraction and synthesis Data were extracted from the studies that were identified as meeting the criteria for methodological quality using a data-extraction tool developed for the review. Studies were grouped by outcome measure and summarised using tabular and narrative formats. Results The review demonstrated that state anxiety is defined and measured using both psychological and physiological parameters. Music listening had a consistently positive and statistically significant effect on reducing psychological parameters of pre-procedural state anxiety. However, the results from the measurement of various pre-procedural physiological parameters failed to reveal any consistent positive changes in patients who had listened to music. This calls into question the adequacy of the theories in this area which link anxiety and the automated and central nervous systems and the effect that music listening may have on these processes and physiological responses. Conclusions/implications for practice 1,In order to reduce anxiety, it is likely that patients will benefit psychologically from having the opportunity to listen to music in the immediate pre-procedural period. 2,Patients do not appear to experience any alteration in physiological status as a result of listening to music. 3,Further research is indicated in order to replicate existing studies, to strengthen the evidence to support such interventions and to establish intervention parameters. 4,Further research is needed analysing the physiological mechanisms by which music listening is believed to reduce state anxiety and the contribution of the automated and other nervous systems to this reduction. [source] TIPS AND TRICKS: Critical appraisal of systematic reviewsINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2010Dónal P O'Mathúna PhD First page of article [source] Critical appraisal of rigour in interpretive phenomenological nursing researchJOURNAL OF ADVANCED NURSING, Issue 2 2006Lorna De Witt BScN RN Aim., This paper reports a critical review of published nursing research for expressions of rigour in interpretive phenomenology, and a new framework of rigour specific to this methodology is proposed. Background., The rigour of interpretive phenomenology is an important nursing research methods issue that has direct implications for the legitimacy of nursing science. The use of a generic set of qualitative criteria of rigour for interpretive phenomenological studies is problematic because it is philosophically inconsistent with the methodology and creates obstacles to full expression of rigour in such studies. Methods., A critical review was conducted of the published theoretical interpretive phenomenological nursing literature from 1994 to 2004 and the expressions of rigour in this literature identified. We used three sources to inform the derivation of a proposed framework of expressions of rigour for interpretive phenomenology: the phenomenological scholar van Manen, the theoretical interpretive phenomenological nursing literature, and Madison's criteria of rigour for hermeneutic phenomenology. Findings., The nursing literature reveals a broad range of criteria for judging the rigour of interpretive phenomenological research. The proposed framework for evaluating rigour in this kind of research contains the following five expressions: balanced integration, openness, concreteness, resonance, and actualization. Balanced integration refers to the intertwining of philosophical concepts in the study methods and findings and a balance between the voices of study participants and the philosophical explanation. Openness is related to a systematic, explicit process of accounting for the multiple decisions made throughout the study process. Concreteness relates to usefulness for practice of study findings. Resonance encompasses the experiential or felt effect of reading study findings upon the reader. Finally, actualization refers to the future realization of the resonance of study findings. Conclusion., Adoption of this or similar frameworks of expressions of rigour could help to preserve the integrity and legitimacy of interpretive phenomenological nursing research. [source] Effects of specific nutrients on periodontal disease onset, progression and treatmentJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2003Rodrigo F. Neiva Abstract Objectives: The aim of this paper is to review the available literature pertaining to the effects of specific nutritional elements (e.g. vitamin B-complex, vitamin C and dietary calcium) on general wound healing, periodontal disease status and response to periodontal therapy. Methods: Critical appraisal of various studies that have evaluated the effects of calcium, ascorbic acid and vitamin B-complex in wound healing and periodontal treatment. Results: Periodontal disease onset, progression and response to therapeutic interventions have been shown to be influenced by several systemic, local and environmental modifying factors. Nutritional supplementation has been suggested as a possible influencing factor on periodontal status and wound healing. Several studies have reported various degrees of association between nutritional elements/supplements and periodontal status, and others have reported possible positive influences of nutritional supplementation on periodontal therapeutic outcomes. Future research needs to more fully explore the presence and strength of association between nutrition and periodontal health. Conclusions: Data collected from the literature suggests that nutrient supplementation causes minimal or no side effects. However, the efficacy of prophylactic nutrient supplementation for the prevention of the onset and progression of periodontal disease, or for the enhancement of periodontal wound healing, remains to be determined. Zusammenfassung Es konnte gezeigt werden, dass der Beginn, der Verlauf und das Ansprechen auf therapeutische Intervention parodontaler Erkrankungen durch verschiedene modifizierende systemische, lokale und Umweltfaktoren beeinflusst werden. Ergänzungen zur Ernährung wurden als mögliche Einflussfaktoren für den parodontalen Status und die Wundheilung diskutiert. Diese Arbeit gibt eine Übersicht über die verfügbare Literatur zum Einfluss spezieller Elemente der Ernährung (z.B. Vitamin-B-Komplex, Vitamin C und Kalzium) auf die generelle Wundheilung, parodontale Erkrankungen sowie das Ansprechen auf parodontale Therapie. Verschiedene Studien haben über Zusammenhänge zwischen Elementen der Nahrung bzw. Ernährungsergänzungen und dem parodontalen Status berichtet. Andere berichten über mögliche positive Einflüsse von Ernährungsergänzungen auf das Ergebnis parodontaler Therapie. Besonderer Wert wird auf die kritische Bewertung der vorhandenen Studien gelegt und es werden Empfehlungen für zukünftigen Forschungsbedarf gegeben, um die Existenz und Ausprägung von Zusammenhängen zwischen Ernährung und parodontaler Gesundheit vollständig zu erfassen. Daten, die aus der Literatur gesammelt wurden, legen den Schluss nahe, dass eine Ergänzung der Ernährung minimale oder keine Nebenwirkungen hat. Allerdings die Wirksamkeit einer prophylaktischen Ernährungsergänzung für die Prävention der Entstehung und Progression von Parodontitis oder die Verbesserung der parodontalen Wundheilung muss noch bestimmt werden. Résumé L'apparition, la progression et la réponse de la maladie parodontale aux interventions thérapeutiques sont influencées par différents facteurs systémiques locaux et environnementaux. L'apport supplémentaire de substances nutritives a été suggéré comme facteur influençant l'état parodontal et la guérison. Cette étude revoit la littérature concernant les effets des éléments nutritionnels spécifiques comme le complexe vitaminique-B, le vitamine-C et le calcium diététique sur la guérison en général, l'état de la maladie parodontale et la réponse au traitement parodontal. Différentes études ont rapporté différents degrés d'association entre les éléments/suppléments nutritifs et l'état parodontal, et d'autres ont rapporté des influences positives possibles des suppléments nutritionnels sur la guérison thérapeutique parodontale. L'importance est axée sur l'appréciation critique d'études disponibles et sur une recommandation en recherches futures pour explorer davantage la présence et la force de l'association entre la nutrition et la santé parodontale. Des données collectées de la littérature suggèrent que l'apport de suppléments nutritifs n'est suivi que de peu ou pas d'effets secondaires. Cependant, l'efficacité d'un supplément nutritif prophylactique pour la prévention primaire et de la progression de la maladie parodontale, ou pour l'augmentation de la guérison parodontale reste à déterminer. [source] Critical appraisal of the management of severe malnutrition: 1.JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2006Epidemiology, treatment guidelines Abstract: Hospital case-fatality rates for severe malnutrition in the developing world remain high, particularly in Africa where they have not changed much over recent decades. In an effort to improve case management, WHO has developed treatment guidelines. The aim of this review is to critically appraise the evidence for the guidelines and review important recent advances in the management of severe malnutrition. We conclude that not only is the evidence base deficient, but also the external generalisability of even good-quality studies is seriously compromised by the great variability in clinical practice between regions and types of health facilities in the developing world, which is much greater than between developed countries. The diagnosis of severe wasting is complicated by the dramatic change in reference standards (from CDC/WHO 1978 to CDC 2000 in EpiNut) and also by difficulties in accurate measurement of length. Although following treatment guidelines has resulted in improved outcomes, there is evidence against the statement that case-fatality rates (particularly in African hospitals) can be reduced below 5% and that higher rates are proof of poor practice, because there is wide variation in severity of illness factors. The practice of prolonged hospital treatment of severe malnutrition until wasting and/or oedema has resolved is being replaced by shorter hospital stays combined with outpatient or community follow-up because of advances in dietary management outside of hospital. [source] Special Issue: KDIGO Clinical Practice Guideline for the Care of Kidney Transplant RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2009Article first published online: 14 OCT 200 Abstract The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on the monitoring, management, and treatment of kidney transplant recipients is intended to assist the practitioner caring for adults and children after kidney transplantation. The guideline development process followed an evidence-based approach, and management recommendations are based on systematic reviews of relevant treatment trials. Critical appraisal of the quality of the evidence and the strength of recommendations followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach. The guideline makes recommendations for immunosuppression, graft monitoring, as well as prevention and treatment of infection, cardiovascular disease, malignancy, and other complications that are common in kidney transplant recipients, including hematological and bone disorders. Limitations of the evidence, especially on the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research. [source] Critical appraisal of a randomized trial: surgery is superior to octreotide LAR in newly diagnosed patients with acromegalyCLINICAL ENDOCRINOLOGY, Issue 1 2010Rafael S. Scheffel No abstract is available for this article. [source] The relevance of the glycaemic index to our understanding of dietary carbohydratesDIABETIC MEDICINE, Issue 5 2000G. Frost Summary Aims To review the evidence for the importance of glycaemic index of dietary carbohydrate in disease prevention and control Methods A critical appraisal of the literature published in English between and cited on Medline between January 1966 and October 1999. Results Using basic, intervention and epidemiological studies from experienced teams, evidence that the glycaemic index of diet may influence outcome in terms of cardiovascular risk, risk of metabolic syndrome diseases and pregnancy was found Conclusions Consideration of glycaemic indices in making dietary recommendations may be expected to produce additional health benefit. [source] Green Approaches to Field Nitrate Analysis: An Electroanalytical PerspectiveELECTROANALYSIS, Issue 7 2009Radha Desai Abstract The different approaches that have been taken in the development of analytical methods for the determination of nitrate within the field are reviewed. The emphasis has been placed on providing a critical appraisal of the chemistry that underpins current commercial systems and the need to remove the dependence on heavy metal and concentrated acid components. The search for more environmentally acceptable and user friendly systems has long been pursued and the present communication seeks to explore the recent development in portable testing technologies and how they might evolve in the future. In particular, the role of electrochemical techniques in the latter are investigated and their potential application compared and contrasted with the more traditional wet chemical detection strategies. [source] Preventive Care in the Emergency Department: Should Emergency Departments Conduct Routine HIV Screening?ACADEMIC EMERGENCY MEDICINE, Issue 3 2003A Systematic Review Abstract Objective: To perform a systematic review of the emergency medicine literature to assess the appropriateness of offering routine HIV screening to patients in the emergency department (ED). Methods: The systematic review was conducted with the aid of a structured template, a companion explanatory guide, and a grading and methodological scoring system based on published criteria for critical appraisal. Two reviewers conducted independent searches using OvidR, PubMed, MD Consult, and Grateful Med. Relevant abstracts were reviewed; those most pertinent to the stated objective were selected for complete evaluation using the structured template. Results: Fifty-two relevant abstracts were reviewed; of these, nine were selected for detailed evaluation. Seven ED-based prospective cross-sectional seroprevalence studies found HIV rates of 2,17%. Highest rates of infection were seen among patients with behavioral risks such as male homosexual activity and intravenous drug use. Two studies demonstrated feasibility of both standard and rapid HIV testing in the ED, with more than half of the patients approached consenting to testing by either method, consistent with voluntary testing acceptance rates described in other settings. Several cost,benefit analyses lend indirect support for HIV screening in the ED. Conclusions: Multiple ED-based studies meeting the Centers for Disease Control and Prevention Guideline threshold to recommend routine screening, in conjunction with limited feasibility trials and extrapolation from cost,benefit studies, provide evidence to recommend that EDs offer HIV screening to high-risk patients (i.e., those with identifiable risk factors) or high-risk populations (i.e., those where HIV seroprevelance is at least 1%). [source] CETP inhibition in cardiovascular risk management: a critical appraisalEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2 2007R. P. F. Dullaart Abstract In view of the cardioprotective effect of high-density lipoproteins (HDL) and the limited effects of statin and fibrate therapy on HDL cholesterol, it is clinically relevant to test whether pharmacological treatment aimed at raising HDL lowers cardiovascular risk. Cholesteryl ester transfer protein (CETP) is a new therapeutic target, because the cholesteryl ester transfer process lowers HDL cholesterol and contributes to an atherogenic lipoprotein profile, particularly when plasma triglycerides are high. Clinical evidence suggests that coronary artery calcification as well as intima media thickness is positively related to plasma cholesteryl ester transfer, and that high plasma CETP concentration is associated with increased cardiovascular risk in hypertriglyceridaemia. However, CETP could also have anti-atherogenic potential, since it provides a potentially beneficial route for delivery of HDL-derived cholesteryl esters to the liver. In addition, CETP could also favourably stimulate peripheral cell cholesterol removal and enhance hepatic cholesterol uptake. Recent evidence suggests that a high CETP level may confer lower cardiovascular risk in the context of low triglycerides. At maximal doses, the CETP inhibitors JTT-705 and torcetrapib elicit a marked rise in HDL cholesterol of up to 34% and 91,106%, respectively. The effectiveness of these drugs on (intermediate) clinical outcome measures is currently being tested in large-scale phase III clinical trials, with torcetrapib being only evaluated in combination therapy with atorvastatin. When and how to use CETP inhibitors, e.g. in combination with a statin or a fibrate, is a major challenge. We propose that low HDL cholesterol in the context of high triglycerides, such as found in type 2 diabetes mellitus, could become an important indication area for this new class of drugs. [source] Functional connexin "hemichannels": A critical appraisalGLIA, Issue 7 2006David C. Spray Abstract "Hemichannels" are defined as the halves of gap junction channels (also termed connexons) that are contributed by one cell; "hemichannels" are considered to be functional if they are open in nonjunctional membranes in the absence of pairing with partners from adjacent cells. Several recent reviews have summarized the blossoming literature regarding functional "hemichannels", in some cases encyclopedically. However, most of these previous reviews have been written with the assumption that all data reporting "hemichannel" involvement really have studied phenomena in which connexons actually form the permeability or conductance pathway. In this review, we have taken a slightly different approach. We review the concept of "hemichannels", summarize properties that might be expected of half gap junctions and evaluate the extent to which the properties of presumptive "hemichannels" match expectations. Then we consider functions attributed to hemichannels, provide an overview of other channel types that might fulfill similar roles and provide sets of criteria that might be applied to verify involvement of connexin hemichannels in cell and tissue function. One firm conclusion is reached. The study of hemichannels is technically challenging and fraught with opportunities for misinterpretation, so that future studies must apply rigorous standards for detection of hemichannel expression and function. At the same time there are reasons to expect surprises, including the possibility that some time honored techniques for studying gap junctions may prove unsuitable for detecting hemichannels. We advise hemichannel researchers to proceed with caution and an open mind. © 2006 Wiley-Liss, Inc. [source] A critical appraisal of prognostic and predictive factors for common lung cancersHISTOPATHOLOGY, Issue 7 2006F B J M Thunnissen The outlook for patients with lung cancer remains poor despite advances in the understanding of the pathology and biology of this disease. To optimize treatment protocols prognostic data are essential. The current era with molecular research on mRNA expression analysis and proteomics will lead to a plethora of new molecular markers, which are likely to be correlated, at least in part, with each other and with disease activity, progression and survival. However, although the number of prognostic factors analysed in published systematic reviews on lung cancer is large, the scope of these factors in individual studies is often narrow. In daily practice prognostic factors other than general TNM staging are not implemented. To assess the efficacy of new prognostic factors for the management of individual patients with non-small cell lung cancer, studies with clinically relevant modelling are required. In this review arguments are provided to use a model combining radiological and histopathological growth rate, histopathological diagnosis and molecular characteristics as markers for metastatic capacity, tumour volume doubling time and expected response to targeted therapy. This may reveal time-related predictive information useful for treatment guidance of the individual patient. [source] A critical appraisal of the prognostic and predictive factors for uveal malignant melanomaHISTOPATHOLOGY, Issue 1 2004M A Mudhar Parsons First page of article [source] Health effects of nanomaterials: A critical appraisal approach and research to practiceHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2008Reynold Sequeira Background Researchers across the globe are studying health effects of various nanomaterials and nanostructures. Most of these studies are qualitative in nature and lack parallel research to compare and validate the reliability of the findings. Objective This research targets a critical appraisal of such clinical studies by first developing a suitable tool and then evaluating the quality of reporting of these trials. Methods The published articles were collected from a search of electronic databases and bibliographies of identified articles. A critical appraisal (ExpAI) suitable for assessment of such experimental studies was developed and the articles were appraised using this instrument. The main findings of the study were evaluated for their use in the development of new techniques for practice using a linguistic scale. Results Twenty-eight articles were found to satisfy the inclusion criteria adopted in this research. The methodological qualities of the published studies ranged from marginal to average. Conclusions Though the studies evaluated in this research have proven that nanoparticles do have adverse health effects, nanoparticles should not be discounted without exploring the possibility of using them to benefit companies and the general population. Reengineering should be considered while creating these new systems to overcome the health effects found by various studies. © 2008 Wiley Periodicals, Inc. [source] Research to practice: Effectiveness of controlled workplace interventions to reduce musculoskeletal disorders in the manufacturing environment,critical appraisal and meta-analysisHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 2 2008Setenay Tuncel Previous studies on the effectiveness of interventions in reducing musculoskeletal disorders (MSD) in manufacturing facilities had contradictory results, indicating a need for a quality assessment of these studies followed by a quantitative assessment of the overall effectiveness of the interventions. These assessments may also provide suggestions for practical implementations. The first objective of this study is to assess the effectiveness of controlled workplace interventions to reduce the occurrence of MSD in the manufacturing environment by utilizing meta-analysis integrated with the study quality score. The second objective is to translate the research findings into practical guidelines. Two hypotheses were tested pertinent to the first objective: (1) Controlled workplace interventions are effective in reducing the occurrence of MSD in different body regions among manufacturing workers and (2) the study quality scores do not depend on the evaluator. The study quality was assessed for all articles, however, meta effect size (meta-OR) was calculated only for the articles that reported prevalence of low back disorders (LBDs), using the Mantel,Haenszel method. The effect of study quality was included into meta-OR. The chi-square test of independence was employed to test the second hypothesis. Seven articles were identified. Study quality was poor (0.39 out of 2) to moderate (0.97). Insignificant reduction in LBDs prevalence (meta-OR = 0.925; 95% CI: 0.566,1.512) was found. Integration of the study quality did not have a substantial effect on the meta-OR (meta-OR = 0.933; 95% CI: 0.571,1.525). Each evaluator's study quality scores were not independent from the agreed quality scores (p < 0.01). The results suggested that practitioners should consider scientific evidence during design and implementation of an intervention, especially in terms of study duration, confounders, outcome measures, and data analysis. The articles reviewed exhibited the following: (1) the statistical insignificance of the meta-OR; (2) the relatively low methodological quality of studies; and (3) the small number of studies included in the meta-OR. The extent of the generalizability of meta-OR for LBD to other body regions was also in question. Future research should consider the following: (1) the physical and nonphysical work environment should be assessed to determine the workplace-specific needs, and the intervention should be structured around these needs; (2) group comparability, participation rate, subject loss, and randomization of subjects should be taken into account; (3) exposure and outcome measurement methods should be reported, as well as blinding of the observers and subjects, when applicable, to ensure reliability and validity; and (4) data analysis should be conducted adjusting for covariates and confounders, different lengths of follow-up, and level of exposure. © 2008 Wiley Periodicals, Inc. [source] Why gender and ,difference' matters: a critical appraisal of industrial relations researchINDUSTRIAL RELATIONS JOURNAL, Issue 4 2006Jane Holgate ABSTRACT Through a critical rereading of key UK workplace case studies this article explores why gender analysis matters to studies of people at work. We argue that the field of industrial relations could benefit from a greater engagement with feminist-influenced methodologies. In particular, we analyse three methodological approaches that can assist in understanding the lives of workers; a framework that recognises intersectionality; an account that accommodates both material and cultural explanations; and a research process that is reflexive and recognises positionality. These are identified as intrinsic to a gender-sensitive analysis, and through a comparison of key texts it is possible to highlight why their absence leads to much research in this field remaining ,gender blind'. [source] Measles virus and Crohn's disease: A critical appraisal of the current literatureINFLAMMATORY BOWEL DISEASES, Issue 1 2001Dr. Douglas J. Robertson Abstract The etiology of inflammatory bowel disease (IBD) is unknown. Recent reports in the literature have suggested that measles virus, both wild-type and vaccine-attenuated, might be a risk factor for Crohn's disease. We used the well-accepted Bradford-Hill criteria to evaluate the possible causal association between measles and IBD. Although the association may be biologically plausible, the literature lacks consistency, specificity, strength, and dose response. The current literature does not support an association between measles virus and IBD. [source] Corporate assets as a trust: for whom are corporate officers trustees in insolvency? the role of incentives in maintaining the trust,INTERNATIONAL INSOLVENCY REVIEW, Issue 2 2003Ronald B. Davis Uncertainty is a constant theme when corporations are in financial distress. Yet any successful restructuring of an insolvent corporation requires numerous stakeholders, including creditors, employees and suppliers, repose some degree of trust in those corporate officers who are trying to continue to operate the firm while restructuring it into a viable entity. This article looks at the issue of the positive and negative incentives that can be generated for corporate officers and directors from both their continuing control of corporate assets and their potential personal liability arising from corporate activity both before and after the corporation became insolvent. The potential role these incentives can play in providing a basis for the trust needed to meet the other governance challenges that arise in a restructuring is reviewed in the context of recent developments in Canada concerning the duties of corporate directors to creditors during insolvency. Also reviewed is the role of directors' insurance and indemnification in altering the incentives' effects on directors' behavior. Finally a critical appraisal is given of the present legal regime's provision for compromise of claims against corporate officers during restructuring, as well as the proposal to amend the law to allow complete exoneration of corporate directors from certain liabilities on insolvency. The article urges caution in altering the effects of incentives that may create the necessary basis for trust in the distressed corporation's officers amongst those stakeholders whose co-operation is crucial to restructuring. Copyright © 2003 John Wiley & Sons, Ltd. [source] Oral health-related quality of life in children: Part I. How well do children know themselves?INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 2 2008A systematic review Abstract:, Objective:, Paediatric oral disorders are likely to have a negative effect on the quality of life. Until recently, children's oral health-related quality of life (OHRQoL) was measured using parents as informants. Instruments have now been developed, which have demonstrated that with appropriate questionnaire techniques, valid and reliable information can be obtained from children. The aim of this study was to make a systematic review of the existing literature about child perceptions of OHRQoL and their validation. Methods:, A computerized search was conducted using Medline, ISI, Lilacs and Scielo for children's perception of OHRQoL. The inclusion criteria were: the articles should contain well-validated instruments and provide child perceptions of OHRQoL. Results:, From 89 records found, 13 fulfilled the criteria. All studies included in the critical appraisal of the project suggested good construct validity of overall child perceptions of OHRQoL. However, children's understanding of oral health and well-being are also affected by variables (age, age-related experiences, gender, race, education, culture, experiences related to oral conditions, opportunities for treatment, childhood period of changes, back-translating questionnaire, children self-perceived treatment need). Conclusions:, The structure of children's self-concept and health cognition is age-dependent as a result of their continuous cognitive, emotional, social and language development. By using appropriate questionnaire techniques, valid and reliable information can be obtained from children concerning their OHRQoL. [source] Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart diseaseINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2005Tamara Page RN BN HyperbaricNursCert GradDipNSc(HighDep) MNSc Executive summary Background, Coronary heart disease is the major cause of illness and death in Western countries and this is likely to increase as the average age of the population rises. Consumers with established coronary heart disease are at the highest risk of experiencing further coronary events. Lifestyle measures can contribute significantly to a reduction in cardiovascular mortality in established coronary heart disease. Improved management of cardiac risk factors by providing education and referrals as required has been suggested as one way of maintaining quality care in patients with established coronary heart disease. There is a need to ascertain whether or not nurse-led clinics would be an effective adjunct for patients with coronary heart disease to supplement general practitioner advice and care. Objectives, The objective of this review was to present the best available evidence related to nurse-led cardiac clinics. Inclusion criteria, This review considered any randomised controlled trials that evaluated cardiac nurse-led clinics. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Participants were adults (18 years and older) with new or existing coronary heart disease. The interventions of interest to the review included education, assessment, consultation, referral and administrative structures. Outcomes measured included adverse event rates, readmissions, admissions, clinical and cost effectiveness, consumer satisfaction and compliance with therapy. Results, Based on the search terms used, 80 papers were initially identified and reviewed for inclusion; full reports of 24 of these papers were retrieved. There were no papers included that addressed cost effectiveness or adverse events; and none addressed the outcome of referrals. A critical appraisal of the 24 remaining papers identified a total of six randomised controlled trials that met the inclusion criteria. Two studies addressed nurse-led clinics for patients diagnosed with angina, one looked at medication administration and the other looked at educational plans. A further four studies compared secondary preventative care with a nurse-led clinic and general practitioner clinic. One specifically compared usual care versus shared care introduced by nurses for patients awaiting coronary artery bypass grafting. Of the remaining three studies, two have been combined in the results section, as they are an interim report and a final report of the same study. Because of inconsistencies in reporting styles and outcome measurements, meta-analysis could not be performed on all outcomes. However, a narrative summary of each study and comparisons of specific outcomes assessed from within each study has been developed. Although not all outcomes obtained statistical significance, nurse-led clinics were at least as effective as general practitioner clinics for most outcomes. Recommendations, The following recommendations are made: ,The use of nurse-led clinics is recommended for patients with coronary heart disease (Level II). ,Utilise nurse-led clinics to increase clinic attendance and follow-up rates (Level II). ,Nurse-led clinics are recommended for patients who require lifestyle changes to decrease their risk of adverse outcomes associated with coronary heart disease (Level II). [source] | |||||||||||||||||||||||||||||||||||||||||||