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Reliable Evidence (reliable + evidence)
Selected AbstractsInterventions for treating traumatized necrotic immature permanent anterior teeth: inducing a calcific barrier & root strengtheningDENTAL TRAUMATOLOGY, Issue 4 2009Mohammad A. D. Al Ansary This systematic review attempts to establish where the effects of interventions using multi-visit apexification, single visit apical plug techniques and root strengthening procedures are consistent and where they may vary significantly. Objectives:, To evaluate the relative effectiveness of apexification and apical plug techniques as well as root strengthening procedures for treating traumatized necrotic immature permanent anterior teeth through a systematic review of randomized controlled trials. Reported immediate and/or long-term adverse events and effects of the materials and techniques are also evaluated. Search strategy & selection criteria:, Structured electronic and hand search was performed with no restriction on the language of publication. Only randomized controlled trials comparing different apical barrier formation techniques and root strengthening procedures in traumatized necrotic immature anterior teeth were assessed. Results:, Two hundred studies were identified but only two were suitable for inclusion. Included studies investigated multi-visit apexification techniques using calcium hydroxide and tricalcium phosphate. There were no eligible studies investigating root strengthening procedures or any other intervention for apical barrier formation in necrotic immature anterior teeth. No reliable information was available on long-term adverse effects of the reported interventions or cost implications. Conclusions:, Based on two included studies, there is weak evidence supporting the use of either calcium hydroxide or tricalcium phosphate for apical barrier formation in necrotic immature anterior teeth employing multi-visit apexification techniques. The evidence is insufficient to provide guidelines for practice. There was no reliable evidence on adverse events or long-term effects after the use of calcium hydroxide or tricalcium phosphate justifying caution in their use in apical barrier formation techniques. [source] Selective attention in anxiety: Distraction and enhancement in visual searchDEPRESSION AND ANXIETY, Issue 1 2003Mike Rinck Abstract According to cognitive models of anxiety, anxiety patients exhibit an attentional bias towards threat, manifested as greater distractibility by threat stimuli and enhanced detection of them. Both phenomena were studied in two experiments, using a modified visual search task, in which participants were asked to find single target words (GAD-related, speech-related, neutral, or positive) hidden in matrices made up of distractor words (also GAD-related, speech-related, neutral, or positive). Generalized anxiety disorder (GAD) patients, social phobia (SP) patients afraid of giving speeches, and healthy controls participated in the visual search task. GAD patients were slowed by GAD-related distractor words but did not show statistically reliable evidence of enhanced detection of GAD-related target words. SP patients showed neither distraction nor enhancement effects. These results extend previous findings of attentional biases observed with other experimental paradigms. Depression and Anxiety 18:18,28, 2003. © 2003 Wiley-Liss, Inc. [source] The rise and quick fall of the theory of ancient economic imperialismECONOMIC HISTORY REVIEW, Issue 4 2009SVIATOSLAV DMITRIEV The theory of ancient economic imperialism has declined for two reasons. The first is the absence of any reliable evidence that the politics of ancient states was dictated by economic considerations. Additionally, the usual focus on the Roman provincial system limits the understanding of ,economic imperialism' to that of a ,formal empire' and ignores other ancient societies. The second reason, which so far has been neglected, is the changing vision of modern imperialism. Once the modern colonial system fell, the understanding of imperialism returned to that of the precolonial period, which saw imperialism in political and military terms. [source] Japanese guidelines for prevention of perioperative infections in urological fieldINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2007Tetsuro Matsumoto Abstract: For urologists, it is very important to master surgical indications and surgical techniques. On the other hand, the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, the evidence and the number of guidelines are limited. Among them, the preparation of guidelines has progressed, especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections, which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. The Japanese Society of UTI Cooperative Study Group has thus framed these guidelines supported by The Japanese Urological Association. The guidelines consist of the following nine techniques: open surgeries, laparoscopic surgeries, transurethral resection of bladder tumor, ureterorenoscope and transurethral lithotripsy, transurethral resection of the prostate, prostate biopsy, cystourethroscope, pediatric surgeries in the urological field, and extracorporeal shock wave lithotripsy and febrile neutropenia. These are the first guidelines for the prevention of perioperative infections in the urological field in Japan. Although most of these guidelines were made using reliable evidence, there are parts without enough evidence. Therefore, if new reliable data is reported, it will be necessary for these guidelines to be revised in the future. [source] A review of hand-washing techniques in primary care and community settingsJOURNAL OF CLINICAL NURSING, Issue 6 2009Sheree MS Smith Aim., This review seeks to identify the most effective hand-washing and hand-cleansing practice that could be used in primary care. Background., Healthcare associated infection is a major problem in the UK causing 5000 deaths every year. Current guidelines indicate expert opinion is the level of evidence for hand washing as an activity to reduce infection. Design., Systematic review. Method., Publications on hand-washing, hand-cleansing studies, policy and practice-based documents were sought by searching several databases. Terms used included hand washing, hand cleansing, hand hygiene, hand decontamination, infection control and primary care. Results., Few articles described the hand-washing technique in detail and some publications simply referred to either the European and British Standards or the Centre for Disease Control statement on hand washing. Major discrepancies in hand position and water flow direction were found. Several methodological problems were also identified and few studies were undertaken in primary care. Conclusion., This review has found a lack of evidence for hand-washing techniques being undertaken in practice today. Findings from hand-washing technique studies were inconclusive and methodological issues exist resulting in sparse reliable evidence. There is an urgent need to undertake methodologically sound studies of hand-washing techniques for use in the ever expanding scope of primary care practice. Relevance to clinical practice., Evidence for hand-washing and hand-cleansing techniques will inform healthcare professional practice, and contribute to the overall management of infection control in primary care. [source] Direct versus Indirect Veneer Restorations for Intrinsic Dental StainsJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 2 2006Article first published online: 25 APR 200 abstract Objective:, The purpose of this study was to examine the effectiveness of indirect and direct veneer restorations, particularly with regard to longevity and patient satisfaction. Materials and Methods:, This study evaluated the literature on randomized clinical trials comparing direct and indirect veneers on anterior teeth. The search strategy involved Medline and other databases and was followed by contacting authors to determine whether any additional published or unpublished studies were available. Relevant studies were assessed for factors such as quality of randomization, outcome assessment, and completeness of recall evaluation. Data from the studies were extracted by three independent reviewers using special forms. Authors were contacted for clarification and missing data. Study details such as dates, demographics of the sample, and outcomes were recorded. Results:, The electronic searches identified 29 clinical trials and 1 systematic review. Six of those were screened as potentially relevant to the review, but following a more detailed screening, only one study (Meijering and colleagues, 1998) met all of the inclusion criteria. In the 2-year recall of that study, the overall survival rates were 94% for porcelain, 90% for indirect composite, and 74% for direct composite veneers. The survival rate was higher when the incisal edge was reduced. Patient satisfaction rates were 93% for porcelain, 82% for indirect composite, and 67% for direct composite. Conclusion:, Very little reliable evidence compares the effectiveness of indirect versus indirect veneers. For an individual patient, the choice between the two options should take into account patient preference and the clinician's experience. [source] Capture,recapture models with heterogeneity to study survival senescence in the wildOIKOS, Issue 3 2010Guillaume Péron Detecting senescence in wild populations and estimating its strength raise three challenges. First, in the presence of individual heterogeneity in survival probability, the proportion of high-survival individuals increases with age. This increase can mask a senescence-related decrease in survival probability when the probability is estimated at the population level. To accommodate individual heterogeneity we use a mixture model structure (discrete classes of individuals). Second, the study individuals can elude the observers in the field, and their detection rate can be heterogeneous. To account for detectability issues we use capture,mark,recapture (CMR) methodology, mixture models and data that provide information on individuals' detectability. Last, emigration to non-monitored sites can bias survival estimates, because it can occur at the end of the individuals' histories and mimic earlier death. To model emigration we use Markovian transitions to and from an unobservable state. These different model structures are merged together using hidden Markov chain CMR models, or multievent models. Simulation studies illustrate that reliable evidence for survival senescence can be obtained using highly heterogeneous data from non site-faithful individuals. We then design a tailored application for a dataset from a colony of black-headed gull Chroicocephalus ridibundus. Survival probabilities do not appear individually variable, but evidence for survival senescence becomes significant only when accounting for other sources of heterogeneity. This result suggests that not accounting for heterogeneity leads to flawed inference and/or that emigration heterogeneity mimics survival heterogeneity and biases senescence estimates. [source] The use of multiple cues in mate choiceBIOLOGICAL REVIEWS, Issue 4 2003ULRIKA CANDOLIN ABSTRACT An increasing number of studies find females to base their mate choice on several cues. Why this occurs is debated and many different hypotheses have been proposed. Here I review the hypotheses and the evidence in favour of them. At the same time I provide a new categorisation based on the adaptiveness of the preferences and the information content of the cues. A few comparative and empirical studies suggest that most multiple cues are Fisherian attractiveness cues or uninformative cues that occur alongside a viability indicator and facilitate detection, improve signal reception, or are remnants from past selection pressures. However, much evidence exists for multiple cues providing additional information and serving as multiple messages that either indicate general mate quality or enable females that differ in mate preferences to choose the most suitable male. Less evidence exists for multiple cues serving as back-up signals. The importance of receiver psychology, multiple sensory environments and signal interaction in the evolution of multiple cues and preferences has received surprisingly little attention but may be of crucial importance. Similarly, sexual conflict has been proposed to result in maladaptive preferences for manipulative cues, and in neutral preferences for threshold cues, but no reliable evidence exists so far. An important factor in the evolution of multiple preferences is the cost of using additional cues. Most theoretical work assumes that the cost of choice increases with the number of cues used, which restricts the conditions under which preferences for multiple cues are expected to evolve. I suggest that in contrast to this expectation, the use of multiple cues can reduce mate choice costs by decreasing the number of mates inspected more closely or the time and energy spent inspecting a set of mates. This may be one explanation for why multiple cues are more common than usually expected. Finally I discuss the consequences that the use of multiple cues may have for the process of sexual selection, the maintenance of genetic variation, and speciation. [source] Sequence of the Cenozoic Mammalian Faunas of the Linxia Basin in Gansu, ChinaACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 1 2004DENG Tao Abstract In the Linxia Basin on the northeast margin of the Tibetan Plateau, the Cenozoic strata are very thick and well exposed. Abundant mammalian fossils are discovered in the deposits from the Late Oligocene to the Early Pleistocene. The Dzungariotherium fauna comes from the sandstones of the Jiaozigou Formation, including many representative Late Oligocene taxa. The Platybelodon fauna comes from the sandstones of the Dongxiang Formation and the conglomerates of the Laogou Formation, and its fossils are typical Middle Miocene forms, such as Hemicyon, Amphicyon, Platybelodon, Choerolophodon, Anchitherium, and Hispanotherium. The Hipparion fauna comes from the red clay of the Liushu and Hewangjia Formations, and its fossils can be distinctly divided into four levels, including three Late Miocene levels and one Early Pliocene level. In the Linxia Basin, the Hipparion fauna has the richest mammalian fossils. The Equus fauna comes from the Wucheng Loess, and it is slightly older than that of the classical Early Pleistocene Nihewan Fauna. The mammalian faunas from the Linxia Basin provide the reliable evidence to divide the Cenozoic strata of this basin and correlate them with European mammalian sequence. [source] Effective Synthesized/preappraised Evidence Formats in Emergency Medicine and the Use of Supplemental Knowledge Translation TechniquesACADEMIC EMERGENCY MEDICINE, Issue 11 2007Brian H. Rowe MD Most clinicians, and especially emergency physicians, are increasingly faced with the need for valid and reliable evidence upon which to base practice decisions in a timely fashion. Despite the accumulation of synthesized evidence in emergency medicine over the past decade, knowledge gaps still exist between what is known and what is practiced. In many cases, this failure in knowledge uptake relates to barriers in uptake as well as the difficulty of translating evidence from research to the bedside. Preappraised evidence syntheses represent a potential partial solution to these problems by providing condensed summaries of the large volume of scientific literature in our field. The participants in this workshop examined the availability, utility, and impact of preappraised evidence and examined innovative ways to translate this knowledge into practice. In addition, the workshop participants also explored more globally all knowledge translation methods that are distinct from clinical pathways (e.g., audit and feedback, academic detailing, reminders, and local opinion leaders). These are initiatives that are instituted at the level of a particular hospital or with respect to a certain condition, and emergency physicians need to understand their definition and application. Overall, the recommendations arising from this workshop have the potential to alter future emergency care in important ways. [source] | |||||||||||||