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Robust Studies (robust + studies)
Selected AbstractsDepressive symptoms among mothers of children with epilepsy: A review of prevalence, associated factors, and impact on childrenEPILEPSIA, Issue 11 2009Mark A. Ferro Summary The impact of epilepsy is not limited to the child experiencing seizures, but affects all members of the family. As primary caregivers, mothers are particularly at risk for experiencing increased depressive symptoms and risk for clinical depression. The objective of this systematic review was to critically assess available evidence regarding the prevalence, associated factors, and impact of maternal depressive symptoms on child outcomes in epilepsy. Using a modified version of the Quality Index, studies were rigorously evaluated in terms of reporting, external validity, and internal validity. Limitations in the study designs and analytic techniques of previous research are discussed, and study methods to overcome these barriers are presented in order to advance this research area. Up to 50% of mothers of children with epilepsy are at risk for clinical depression. Correlates of maternal depressive symptoms include a number of modifiable risk factors such as role ambiguity, worry, and satisfaction with relationships. In addition, studies suggest that depressive symptoms in mothers have a negative impact on child outcomes in epilepsy including behavior problems and health-related quality of life. The overall mean score on the Quality Index was 9.7, indicating a midrange quality score, suggesting a need for more methodologically robust studies. [source] Risk markers associated with challenging behaviours in people with intellectual disabilities: a meta-analytic studyJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2003K. McClintock A meta-analysis of prevalence and cohort studies conducted over the last 30 years was carried out to identify risk markers for challenging behaviour shown by individuals with intellectual disabilities (IDs). A total of 86 potential studies was identified from the review, with 22 (25.6%) containing sufficient data to enable a statistical analysis to be conducted. Results indicated that males were significantly more likely to show aggression than females, and that individuals with a severe/profound degree of ID were significantly more likely to show self-injury and stereotypy than individuals with a mild/moderate degree of ID. Individuals with a diagnosis of autism were significantly more likely to show self-injury, aggression and disruption to the environment whilst individuals with deficits in receptive and expressive communication were significantly more likely to show self-injury. In most cases, tests for heterogeneity were statistically significant, as expected. The meta-analysis highlighted the paucity of methodologically robust studies of risk markers for challenging behaviours and the lack of data on incidence, prevalence and chronicity of challenging behaviour in this population. [source] Is it time to revisit residual renal function in haemodialysis? (Review Article)NEPHROLOGY, Issue 3 2007TSUN G NG SUMMARY: Residual renal function (RRF) is not currently emphasized for patients undergoing haemodialysis (HD). The role of RRF is well recognized in the peritoneal dialysis population as studies have clearly demonstrated a survival benefit with preservation of RRF. There is however, data to suggest that RRF is important in HD patients as well. Contemporary HD therapies using high flux biocompatible synthetic dialysers, bicarbonate buffered ultrapure dialysis fluids with ultrafiltration control appear to allow better preservation of RRF. The long held belief that peritoneal dialysis is better at preserving RRF than HD may no longer be true. More robust studies are required to determine the relative importance of RRF in HD and strategies to best preserve this vital asset. [source] Assessing levels of contaminants in breast milk: methodological issues and a framework for future researchPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2008Mary J. Renfrew Summary To assess the scale of the possible exposure by the breast-fed infant to potentially harmful substances in breast milk, methodologically robust studies are essential. Many studies in this field, however, do not report details of crucial issues such as recruitment and milk sampling. The aims of the study reported here were to develop robust methods for the study of contaminants in breast milk, and to develop a framework for future research and population monitoring. Three cohorts of women and babies were recruited by midwives from five sites in northern England. Cohort 1 (cross-sectional, n = 322) were asked to provide two milk samples, one at one week following birth and one at a subsequent time point. Cohort 2 (longitudinal, n = 54) were asked to provide five samples at specified time points over the first 12,16 weeks after birth. Cohort 3 (convenience, n = 18), mothers of babies in the Special Care Unit, were asked to donate surplus breast milk. A novel method of analysing fat concentration in small volumes was developed and tested. A randomly selected set of samples from different donors and stages of lactation was screened for organochlorine pesticide residues, polychlorinated biphenyls, dioxins/furans, phthalates and heavy metals. A total of 453 samples were donated. Cohort 3 was the least successful route of recruitment. Cohorts 1 and 2 combined were most representative of the population. Sample collection, transport and storage procedures, and the collection of data on life style and diet, were robust and acceptable to women. Midwifery involvement in recruitment was an essential component. This study offers a framework both for the conduct of future research studies, and for the establishment of regional and national monitoring mechanisms for contaminants in breast milk. Similar work on contaminants in formula as fed to babies is needed to inform risk assessment methods. [source] Diabetes and complementary therapies: mapping the evidencePRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 7 2007K Pilkington MSc, MRPharmS Senior Research Fellow Abstract Complementary therapies are widely used by people with diabetes for the condition itself, for diabetes-related complications or for non-diabetes related problems. The aim of this review is to summarise the current research evidence on complementary therapies in the management of diabetes and resulting complications. The review draws primarily on systematic reviews conducted as part of the CAMEOL project (www.rccm.org.uk/cameol), included in the Cochrane Library or on the National Library for Health Complementary and Alternative Medicine Specialist Library (www.library.nhs.uk/cam). Searches were also carried out for studies published subsequently or on other therapies to provide an indication of overall research activity. Systematic reviews were found or conducted on a range of herbs, dietary supplements, massage, acupuncture, homoeopathy, hypnotherapy, meditation, reflexology and yoga. Individual studies were located on several other therapies. Studies addressed metabolic control, general well-being and complications. Herbs and dietary supplements continue to be the main focus of research activity. Acupuncture trials are also numerous but almost exclusively conducted in China using traditional approaches. For most other therapies, research evidence is limited by extent or quality. Overall, limited data from well-designed randomised controlled trials are available and results are difficult to translate into clinical practice. Based on promising findings, several herbs, dietary supplements, exercise or body-based therapies and acupuncture require further investigation. For most therapies, well-designed robust studies replicating small preliminary studies are required to support those involved in diabetes care in providing evidence-based advice on the safe and effective use of complementary therapies. Copyright © 2007 John Wiley & Sons. [source] Psychological treatments for functional non-epileptic attacks: a systematic reviewACTA NEUROPSYCHIATRICA, Issue 4 2009Danielle Gaynor Objective: There is a lack of clarity about the most useful intervention for functional non-epileptic attacks (FNEA). Outcomes for this condition remain often poor, with considerable personal, social and economic impact. In order to guide clinical practice and future research in this area, we have performed a systematic review of the published literature on the psychological treatment of FNEA. Methods: A comprehensive literature search was carried out using key words: non-epileptic seizures; psychogenic seizures; psychogenic non-epileptic seizures; pseudoseizures; funny turns; non-epileptic attack; hysterical seizures; and pseudoepileptic. Studies specifically looking at psychological treatment of FNEA were identified. Studies of patients also having comorbid organic seizure disorders were excluded. Results: 17 studies that met the inclusion criteria were identified. A broad variety of psychological interventions for FNEA has been investigated. Only one randomised controlled trial has been completed to date. Existing evidence appears to suggest that various psychological treatments, including presenting the diagnosis, psychoeducation, behavioural therapies and mixed modality treatments, may be effective. Conclusion: While a range of psychological treatments may be beneficial for this patient group, we do not have clear evidence to suggest which treatment is most efficacious. Specific elements of presenting the diagnosis and psychoeducation may be required in addition to traditional cognitive behavioural therapeutic approaches. Large, methodologically robust studies are urgently required to establish the most effective form of treatment. [source] | ||||||||||