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High Quality Studies (high + quality_studies)
Selected AbstractsRibosomal RNA-targeted nucleic acid probes for studies in microbial ecologyFEMS MICROBIOLOGY REVIEWS, Issue 5 2000Rudolf Amann Abstract With readily applicable hybridization assays, mainly based on rRNA-targeted nucleic acid probes, and direct, cultivation-independent sequence retrieval, microbiologists can for the first time determine the true composition of microbial communities. Phylogenetic identification and exact spatiotemporal quantification of microorganisms will in the future become prerequisites for high quality studies in microbial ecology just as good taxonomy and solid quantification have always been for macroecology. This review is intended to give a short history of the development of rRNA-targeted nucleic acid probes and probe technologies, as well as of their application in microbial ecology. The current state of the art is described, and we will try to look into the future. Over the last decade, rRNA-targeted probes have become a handy tool for microbial ecologists. In order to speed up the transformation of microbial ecology from a mostly descriptive to a hypothesis-driven, experimental science more intense use must be made of the taxonomic precision and quantitativeness of rRNA-targeted probes. [source] Systematic review of interventions in the management of overweight and obese children which include a dietary componentINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2007Clare E Collins PhD BSc Dip Nutr Diet Dip Clin Epi APD Background, The prevalence of overweight and obesity in children and adolescents is increasing at an alarming rate around the world and prevention has become a key public health objective. Treatment and management of those already overweight and obese must be aligned with the best available evidence on effectiveness, if the risk of obesity-related morbidity and mortality is yet be reduced. Diet plays a pivotal role in successful treatment of obesity but to date, there is limited evidence on which to base practice. Objectives, To identify and present the best available evidence on the optimal dietetic treatment and management of children and adolescent who are overweight or obese. Search strategy, Published English language literature was searched using the electronic databases CINAHL, MEDLINE, PRE-MEDLINE, DARE, COCHRANE, EMBASE, AUSTROM, Current Concepts and Dissertation Abstracts. The databases were limited to English Language from 1975 until 2003. Government reports from the UK, USA and Australian were also searched and a hand search performed for the Journal of the Dietitians Association of Australia, International Journal of Obesity and the Journal of Human Nutrition and Dietetics and the bibliographies of retrieved articles. Selection criteria, (i) Interventions that evaluated the effectiveness of nutrition or dietary interventions to treat or manage overweight and obesity; (ii) Children aged less than 18 years; and (iii) Participants were defined as overweight or obese by relative weight or a measure of body weight status, studies that reported body weight per se were excluded. Data collection and analysis, An experienced professional librarian searched the databases, and two trained research assistants independently identified studies for retrieval and assessed each article for inclusion. The included studies were critically appraised for methodological quality by two people independently. Data were extracted from the appropriate articles and when a discrepancy arose, a third party would arbitrate. Main results, There were 116 articles that met the inclusion criteria. While 49 articles described randomised controlled trials, they arose from 37 separate studies. There were 67 non-randomised trials. Meta-analyses were performed on eight studies that included both a dietary intervention component and an adequate control group and on four studies that had follow-up data. There was a high degree of heterogeneity between studies and this made comparisons between studies problematic. Interventions that include diet therapy generally result in significant weight loss, at least in the short term. Many studies were poorly designed and had no or only minimal follow up. The details of the dietary intervention were often inadequately described and dietary outcomes rarely reported, making repetition of the studies difficult. Reviewers' conclusions, There is an urgent need for high quality studies investigating the optimal dietary approach to management of paediatric overweight and obesity. These studies require adequate follow up to ascertain if weight loss can be sustained in the long term. Details of the dietary prescription, adherence to the dietary intervention and diet-specific outcomes need to be reported in order to inform best practice. [source] Screening programmes for the early detection and prevention of oral cancerAUSTRALIAN DENTAL JOURNAL, Issue 2 2009O Kujan Background:, Screening programmes for major cancers, such as breast and cervical cancer have effectively decreased the mortality rate and helped to reduce the incidence of these cancers. Although oral cancer is a global health problem with increasing incidence and mortality rates, no national population-based screening programmes for oral cancer have been implemented. To date there is debate on whether to employ screening methods for oral cancer in the daily routine work of health providers. Objectives:, To assess the effectiveness of current screening methods in decreasing oral cancer mortality. Search strategy:, Electronic databases (MEDLINE, CANCERLIT, EMBASE (1966 to July 2005) and CENTRAL (The Cochrane Library 2005, Issue 3), bibliographies, handsearching of specific journals and contact authors were used to identify published and unpublished data. Selection criteria:, Randomized controlled trials of screening for oral cancer or precursor oral lesions using visual examination, toluidine blue, fluorescence imaging or brush biopsy. Data collection and analysis:, The search found 112 citations and these have been reviewed. One randomized controlled trial of screening strategies for oral cancer was identified as meeting the review's inclusion criteria. Validity assessment, data extraction and statistics evaluation were undertaken by two independent review authors. Main results:, One 10-year randomized controlled trial has been included (n = 13 clusters: 191 873 participants). There was no difference in the age-standardized oral cancer mortality rates for the screened group (16.4/100 000 person-years) and the control group (20.7/100 000 person-years). Interestingly, a significant 34% reduction in mortality was recorded in high-risk subjects between the intervention cohort (29.9/100 000 person-years) and the control arm (45.4/100 000). However, this study has some methodological weaknesses. Additionally, the study did not provide any information related to costs, quality of life or even harms of screening from false-positive or false-negative findings. Authors' conclusions:, Given the limitation of evidence (only one included randomized controlled trial) and the potential methodological weakness of the included study, it is valid to say that there is insufficient evidence to support or refute the use of a visual examination as a method of screening for oral cancer using a visual examination in the general population. Furthermore, no robust evidence exists to suggest that other methods of screening, toluidine blue, fluorescence imaging or brush biopsy, are either beneficial or harmful. Future high quality studies to assess the efficacy, effectiveness and costs of screening are required for the best use of public health resources. In addition, studies to elucidate the natural history of oral cancer, prevention methods and the effectiveness of opportunistic screening in high risk groups are needed. Future studies on improved treatment modalities for oral cancer and precancer are also required. Plain language summary:, Screening programmes for the early detection and prevention of oral cancer. More evidence needed to find out whether screening programmes could detect oral cancer earlier and reduce the number of deaths from this disease. Cancer of the mouth and back of the throat (oral cancer) has a low survival rate, largely because the disease is often not diagnosed until it is advanced. Screening the general population for oral cancer might make it possible to detect cases of the disease earlier. The most common method is visual inspection by a clinician, but other techniques include the use of a special blue "dye" and an imaging technique. The review found that there is not enough evidence to decide whether screening by visual inspection reduces the death rate for oral cancer, and no evidence for other screening methods. [source] The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studiesAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2010Lori Letts Background/aim:,Evidence that the physical environment is a fall risk factor in older adults is inconsistent. The study evaluated and summarised evidence of the physical environment as a fall risk factor. Methods:,Eight databases (1985,2006) were searched. Investigators evaluated quality of two categories (cross-sectional and cohort) of studies, extracted and analysed data. Results:,Cross-sectional: falls occur in a variety of environments; gait aids were present in approximately 30% of falls. Cohort:,Home hazards increased fall risk (odds ratio (OR) = 1.15; 95% confidence interval (CI): 0.97,1.36) although not significantly. When only the high quality studies were included, the OR = 1.38 (95% CI: 1.03,1.87), which was statistically significant. Use of mobility aids significantly increased fall risk in community (OR = 2.07; 95% CI: 1.59,2.71) and institutional (OR = 1.77; 95% CI: 1.66,1.89) settings. Conclusions:,Home hazards appear to be a significant risk factor in older community-dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls. [source] | ||||||||||