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Very Limited Evidence (very + limited_evidence)
Selected AbstractsEffect of treatment delay upon pulp and periodontal healing of traumatic dental injuries , a review articleDENTAL TRAUMATOLOGY, Issue 3 2002J.O. Andreasen Abstract,,,Based on an analysis of the literature concerning parameters influencing the prognosis of traumatic dental injuries, few studies were found to have examined possible relationships between treatment delay and pulpal and periodontal ligament healing complications. It has been commonly accepted that all injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. For practical and especially economic reasons, various approaches can be selected to fulfill such a demand, such as acute treatment (i.e. within a few hours), subacute (i.e. within the first 24 h), and delayed (i.e. after the first 24 h). In this survey the consequences of treatment delay on pulpal and periodontal healing have been analyzed for the various dental trauma groups. Applying such a treatment approach to the various types of injuries, the following treatment guidelines can be recommended, based on our present rather limited knowledge of the effect of treatment delay upon wound healing. Crown and crown/root fractures: Subacute or delayed approach. Root fractures: Acute or subacute approach. Alveolar fractures: Acute approach (evidence however questionable). Concussion and subluxation: Subacute approach. Extrusion and lateral luxation: Acute or subacute approach (evidence however questionable). Intrusion: Subacute approach (evidence however questionable). Avulsion: If the tooth is not replanted at the time of injury, acute approach; otherwise subacute. Primary tooth injury: Subacute approach, unless the primary tooth is displaced into the follicle of the permanent tooth or occlusal problems are present; in the latter instances, an acute approach should be chosen. These treatment guidelines are based on very limited evidence from the literature and should be revised as soon as more evidence about the effect of treatment delay becomes available. [source] Effect of intensive training on heart rate variability in prepubertal swimmersEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2005A. Vinet Abstract Background, In children, there is very limited evidence focusing on the beneficial effect of exercise training on heart rate variability (HRV) during childhood. Despite the fact that more and more children are engaged in intensive training programs, the question arises if such intensive training involves deleterious effects on the cardiac autonomic nervous system during childhood. Thus the aim of the present study was to compare HRV parameters in highly trained swimmer boys and untrained counterparts. Methods, Twenty prepubertal boys, aged 11,12 years old, took part in the study. The children were divided into 11 highly trained prepubertal swimmers (training sessions of 8,10 h weekly for at least 4 years) and 9 age-matched active boys. HRV analysis was performed on diurnal recordings in the frequency (short-term recordings 6 min the most ,vagal') and time (long-term recordings 4 h centred on the 6 min most ,vagal') domains. Results, No significant differences were obtained between groups for all frequency variables whatever the mode of expression (absolute in ms2, relative in Ln or %). All time-domain components were not significantly different in swimmers and untrained boys. Conclusions, The results of the present study demonstrate that participating intensively in swimming training does not induce in children changes in HRV indices. Neither time nor domain HRV variables were significantly different between untrained and highly trained prepubertal boys. Thus, intensive training in healthy children does not involve deleterious effects on HRV. [source] Can paying for results help to achieve the Millennium Development Goals?JOURNAL OF EVIDENCE BASED MEDICINE, Issue 2 2009Overview of the effectiveness of results-based financing Abstract Objective Results-based financing and pay-for-performance refer to the transfer of money or material goods conditional on taking a measurable action or achieving a predetermined performance target. Results-based financing is widely advocated for achieving health goals, including the Millennium Development Goals. Methods We undertook an overview of systematic reviews of the effectiveness of RBF. We searched the Cochrane Library, EMBASE, and MEDLINE (up to August 2007). We also searched for related articles in PubMed, checked the reference lists of retrieved articles, and contacted key informants. We included reviews with a methods section that addressed the effects of any results-based financing in the health sector targeted at patients, providers, organizations, or governments. We summarized the characteristics and findings of each review using a structured format. Results We found 12 systematic reviews that met our inclusion criteria. Based on the findings of these reviews, financial incentives targeting recipients of health care and individual healthcare professionals are effective in the short run for simple and distinct, well-defined behavioral goals. There is less evidence that financial incentives can sustain long-term changes. Conditional cash transfers to poor and disadvantaged groups in Latin America are effective at increasing the uptake of some preventive services. There is otherwise very limited evidence of the effects of results-based financing in low- or middle-income countries. Results-based financing can have undesirable effects, including motivating unintended behaviors, distortions (ignoring important tasks that are not rewarded with incentives), gaming (improving or cheating on reporting rather than improving performance), widening the resource gap between rich and poor, and dependency on financial incentives. Conclusion There is limited evidence of the effectiveness of results-based financing and almost no evidence of the cost-effectiveness of results-based financing. Based on the available evidence and likely mechanisms through which financial incentives work, they are more likely to influence discrete individual behaviors in the short run and less likely to create sustained changes. [source] OPTIMAL AND ADAPTIVE SEMI-PARAMETRIC NARROWBAND AND BROADBAND AND MAXIMUM LIKELIHOOD ESTIMATION OF THE LONG-MEMORY PARAMETER FOR REAL EXCHANGE RATES,THE MANCHESTER SCHOOL, Issue 2 2005SAEED HERAVI The nature of the time series properties of real exchange rates remains a contentious issue primarily because of the implications for purchasing power parity. In particular are real exchange rates best characterized as stationary and non-persistent; nonstationary but non-persistent; or nonstationary and persistent? Most assessments of this issue use the I(0)/I(1) paradigm, which only allows the first and last of these options. In contrast, in the I(d) paradigm, d fractional, all three are possible, with the crucial parameter d determining the long-run properties of the process. This study includes estimation of d by three methods of semi-parametric estimation in the frequency domain, using both local and global (Fourier) frequency estimation, and maximum likelihood estimation of ARFIMA models in the time domain. We give a transparent assessment of the key selection parameters in each method, particularly estimation of the truncation parameters for the semi-parametric methods. Two other important developments are also included. We implement Tanaka's locally best invariant parametric tests based on maximum likelihood estimation of the long-memory parameter and include a recent extension of the Dickey,Fuller approach, referred to as fractional Dickey,Fuller (FD-F), to fractionally integrated series, which allows a much wider range of generating processes under the alternative hypothesis. With this more general approach, we find very little evidence of stationarity for 10 real exchange rates for developed countries and some very limited evidence of nonstationarity but non-persistence, and none of the FD-F tests leads to rejection of the null of a unit root. [source] Personal Goal Facilitation through Work: Implications for Employee Satisfaction and Well-BeingAPPLIED PSYCHOLOGY, Issue 2 2006Laura ter Doest Que le travail facilite la réalisation des objectifs personnels dépend de la perception de l'impact du travail sur l'atteinte de ces objectifs personnels. En accord avec la littérature sur l'autorégulation et le modèle cybernétique du stress organisationnel proposé par Edwards (1992), la facilitation de l'accès à ses objectifs personnels par le travail fut supposée en relation positive avec les attitudes relatives à l'emploi et le bien-être de l'employé. En outre, on a prédit un rapport plus étroit entre la facilitation de l'accès à ses objectifs personnels par le travail et les performances du salarié quand les buts personnels étaient fortement valorisés. Ces hypothèses ont été mises à l'épreuve à travers un questionnaire rempli par 1036 employés du secteur de la santé. D'après l'analyse de régression, la facilitation de l'accès à ses objectifs personnels par le travail expliquait une part importante de la variance du bien-être et des attitudes relatives à l'emploi, même après avoir contrôlé les caractéristiques des postes en référence au modèle de Karasek concernant les relations agents stressants,tension au travail (1979; Karasek & Theorell, 1990). L'importance des objectifs n'avait qu'une influence des plus limitées. On en conclut que la facilitation de l'accès à ses objectifs personnels par le travail offre une voie prometteuse pour explorer les attitudes liées à l'emploi et le bien-être, en complément des modèles plus traditionnels des caractéristiques de l'emploi. Personal goal facilitation through work refers to perceptions of the extent to which one's job facilitates the attainment of one's personal goals. In line with the self-regulation literature and Edwards' (1992) cybernetic model of organisational stress, personal goal facilitation through work was predicted to show positive associations with job attitudes and employee well-being. Moreover, stronger relationships between personal goal facilitation through work and employee outcomes were predicted for highly valued personal goals. These predictions were investigated in a questionnaire study of 1,036 health care employees. In regression analyses, personal goal facilitation through work accounted for substantial variance in job attitudes and well-being, even after controlling for job characteristics from Karasek's (1979; Karasek & Theorell, 1990) model of occupational stressor,strain relations. There was only very limited evidence of moderating effects of goal importance. It is concluded that personal goal facilitation through work offers a promising source of insight into job attitudes and well-being, complementing more traditional job characteristics models. [source] | ||||||||||