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Investigating Outcome (investigating + outcome)
Selected AbstractsUncovering Local Perspectives on Humanitarian Assistance and Its OutcomesDISASTERS, Issue 2 2000Oliver Bakewell This paper draws on a study of Angolan refugees in Zambia to suggest ways that the perspectives and interests of the local population can be included in the assessment of relief interventions. Taking an actor-oriented approach, the paper suggests stepping back from the categorisation of the situation as an emergency and particular groups of people as the beneficiaries. Such categories are imposed from outside and may not reflect local people's outlook on the situation. In the case of Angolans in Zambia, the category of refugees had dissolved in the border villages to the extent that it was practically impossible to distinguish between refugees and hosts. This was in contrast to the official settlements where people were marked out as refugees and the label was maintained and reproduced over many years. Investigating outcomes in the border villagers in terms of refugees and the refugee problem would have been futile. The paper calls for evaluations of humanitarian assistance in complex emergencies to look beyond the ,beneficiaries' and to investigate the wider context of ,normality'. Neglecting the life and world of local people will make it impossible to understand the process by which external interventions are mediated at the local level to give particular outcomes, and valuable lessons which could help alleviate suffering will be lost. [source] Outcome of secondary root canal treatment: a systematic review of the literatureINTERNATIONAL ENDODONTIC JOURNAL, Issue 12 2008Y.-L. Ng Abstract Aims, (i) To investigate the effects of study characteristics on the reported success rates of secondary root canal treatment (2°RCT or root canal retreatment); and (ii) to investigate the effects of clinical factors on the success of 2°RCT. Methodology, Longitudinal human clinical studies investigating outcome of 2°RCT which were published upto the end of 2006 were identified electronically (MEDLINE and Cochrane database 1966,2006 Dec, week 4). Four journals (Dental Traumatology, International Endodontic Journal, Journal of Endodontics, Oral Surgery Oral Medicine Oral Pathology Endodontics Radiology), bibliographies of all relevant papers and review articles were hand-searched. Two reviewers (Y-LN, KG) independently assessed and selected the studies based on specified inclusion criteria and extracted the data onto a pre-designed proforma, independently. The criteria were: (i) Clinical studies on 2°RCT; (ii) Stratified analyses available for 2°RCT where 1°RCT data included; (iii) Sample size given and larger than 10; (iv) At least 6-month post-operative review; (v) Success based on clinical and/or radiographic criteria (strict = absence of apical radiolucency; loose = reduction in size of radiolucency); and (vi) Overall success rate given or could be calculated from the raw data. Three strands of evidence or analyses were used to triangulate a consensus view. The reported findings from individual studies, including those excluded for quantitative analysis, were utilized for the intuitive synthesis which constituted the first strand of evidence. Secondly, the pooled weighted success rates by each study characteristic and potential prognostic factor were estimated using the random effect model. Thirdly, the effects of study characteristics and prognostic factors (expressed as odds ratios) on success rates were estimated using fixed and random effects meta-analysis with DerSimonean and Laird's methods. Meta-regression models were used to explore potential sources of statistical heterogeneity. Study characteristics considered in the meta-regression analyses were: decade of publication, study-specific criteria for success (radiographic, combined radiographic & clinical), unit of outcome measure (tooth, root), duration after treatment when assessing success (,at least 4 years' or ,<4 years'), geographic location of the study (North American, Scandinavian, other countries), and qualification of the operator (undergraduate students, postgraduate students, general dental practitioners, specialist or mixed group). Results, Of the 40 papers identified, 17 studies published between 1961 and 2005 were included; none were published in 2006. The majority of studies were retrospective (n = 12) and only five prospective. The pooled weighted success rate of 2°RCT judged by complete healing was 76.7% (95% CI 73.6%, 89.6%) and by incomplete healing, 77.2% (95% CI 61.1%, 88.1%). The success rates by ,decade of publication' and ,geographic location of study' were not significantly different at the 5% level. Eighteen clinical factors had been investigated in various combinations in previous studies. The most frequently and thoroughly investigated were ,periapical status' (n = 13), ,size of lesion' (n = 7), and ,apical extent of RF' (n = 5) which were found to be significant prognostic factors. The effect of different aspects of primary treatment history and re-treatment procedures has been poorly tested. Conclusions, The pooled estimated success rate of secondary root canal treatment was 77%. The presence of pre-operative periapical lesion, apical extent of root filling and quality of coronal restoration proved significant prognostic factors with concurrence between all three strands of evidence whilst the effects of 1°RCT history and 2°RCT protocol have been poorly investigated. [source] Outcome of secondary root canal treatment , Systematic review of the literatureINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2007Y.-L. Ng Aims, To assess the success rates of secondary root canal treatment (2oRCT) and identify factors influencing outcome. Methodology, Longitudinal clinical studies investigating outcome of 2oRCT were identified by electronic (medline) and hand searches. Inclusion criteria were data on: number of samples, those successful and definition of success. Two reviewers independently assessed the studies and extracted the data onto a proforma. The pooled weighted success rates by each potential prognostic factor were estimated using the binomial random effect model (MLwiN version 2.02) whilst their pooled effects (expressed as odds ratio) on success rates were estimated using fixed and random effects meta-analysis with DerSimonean and Laird's methods (Stata version 9.2). Meta-regression models were used to explore potential sources of statistical heterogeneity. Study characteristics considered in the meta-regression analyses were: decade of publication, study-specific criteria for success (radiographic, combined radiographic & clinical), unit of outcome measure (tooth and root), duration after treatment when assessing success (at least 4 years or shorter), geographic location of the study (North American, Scandinavian and other countries), and qualification of the operator (undergraduate students, postgraduate students, general dental practitioners, specialist or mixed group). Results, Of the 41 studies identified, 18 studies published between 1921 and 2005 were included. The majority of studies were retrospective (n = 13) and only five prospective. The pooled weighted success rate of 2oRCT judged by complete healing was 77.6% (95% CI 73.2%, 81.4%) and by incomplete healing, 77.4% (95% CI 64.1%, 86.7%). The success rates were similar by ,year of publication' and ,country of study'. Eighteen clinical factors were investigated in various combinations in previous studies. The most frequently investigated were ,periapical status' (n = 13), ,size of lesion' (n = 7), ,culture results prior to RF' (n = 5), and ,apical extent of root filling (RF)' (n = 4). The effect of different aspects of previous treatment and re-treatment technique has been poorly tested. Conclusions, The pooled weighted estimated success rate of 2oRCT was 77%, which was significantly (P , 0.001) influenced by the presence and size of pre-operative periapical lesion. The effects of existing canal content, procedural error and re-treatment technique were poorly investigated. [source] Non-psychiatric hospitalization of people with mental illness: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 8 2009Cindy Diamond Zolnierek Abstract Title.,Non-psychiatric hospitalization of people with mental illness: systematicreview. Aim., This paper is a report of a literature review of the evidence regarding outcomes experienced by severely mentally ill individuals hospitalized in general medical-surgical settings for non-psychiatric conditions. Background., Severely mentally ill individuals experience chronic medical illnesses at a rate greater than the general population. When hospitalized in non-psychiatric settings, they tend to be experienced as ,difficult' by nurses and to have longer lengths of stay. Data sources., The CINAHL and PUBMED databases were searched from 1 to 9 March 2008 to identify studies published between 1998 and 2008 investigating outcomes among people with mental illness hospitalized for non-psychiatric illness in general hospitals. Methods., Included studies were those published in English in peer reviewed journals and investigating patient outcomes. The studies were reviewed for relevance and inclusion criteria; the methodological quality of studies was not evaluated. Results., Twelve studies met inclusion criteria. All studies examining length of stay, costs of care or resource utilization showed increased measures for patients with psychiatric comorbidity. Interventions described included psychiatric liaison psychiatry and nursing, which failed to demonstrate improvement in outcomes. Conclusion., Nurses play a pivotal role in improving the inpatient care of this vulnerable population, but they struggle in their attempts to do so. Research to determine the best approaches to promote nurses' knowledge, positive attitudes and self-confidence in caring for patients with psychiatric comorbidity is needed. Investigation of the patient perspective on the inpatient experience might also provide insight for designing effective care processes. [source] |