Interventions for behaviour change and self-management in stroke secondary prevention: protocol for an overview of reviews

Abstract Background Stroke secondary prevention guidelines recommend medication prescription and adherence, active education and behavioural counselling regarding lifestyle risk factors. To impact on recurrent vascular events, positive behaviour/s must be adopted and sustained as a lifestyle choice, requiring theoretically informed behaviour change and self-management interventions. A growing number of systematic reviews have addressed complex interventions in stroke secondary prevention. Differing terminology, inclusion criteria and overlap of studies between reviews makes the mechanism/s that affect positive change difficult to identify or replicate clinically. Adopting a two-phase approach, this overview will firstly comprehensively summarise systematic reviews in this area and secondly identify and synthesise primary studies in these reviews which provide person-centred, theoretically informed interventions for stroke secondary prevention. Methods An overview of reviews will be conducted using a systematic search strategy across the Cochrane Database of Systematic Reviews, PubMed and Epistomonikas. Inclusion criteria: systematic reviews where the population comprises individuals post-stroke or TIA and where data relating to person-centred risk reduction are synthesised for evidence of efficacy when compared to standard care or no intervention. Primary outcomes of interest include mortality, recurrent stroke and other cardiovascular events. In phase 1, two reviewers will independently (1) assess the eligibility of identified reviews for inclusion; (2) rate the quality of included reviews using the ROBIS tool; (3) identify unique primary studies and overlap between reviews; (4) summarise the published evidence supporting person-centred behavioural change and self-management interventions in stroke secondary prevention and (5) identify evidence gaps in this field. In phase 2, two independent reviewers will (1) examine person-centred, primary studies in each review using the Template for Intervention Description and Replication (TIDieR checklist), itemising, where present, theoretical frameworks underpinning interventions; (2) group studies employing theoretically informed interventions by the intervention delivered and by the outcomes reported (3) apply GRADE quality of evidence for each intervention by outcome/s identified from theoretically informed primary studies. Disagreement between reviewers at each process stage will be discussed and a third reviewer consulted. Discussion This overview will comprehensively bring together the best available evidence supporting person-centred, stroke secondary prevention strategies in an accessible format, identifying current knowledge gaps

The Influence Of The Environment In Forming Michael Oher's Personality In The Blind Side Movie (2009): A Reader Response Theory

This research discusses about how the environment taking its role in changing Michael Oher's personality in The Blind Side movie that was responded by the reviewers on Rottentomatoes website. Applying the theory of reader response, this research aims to know what is the most used type of reader response implemented in reviewing Michael Oher's forming personality. This research is using descriptive qualitative method and there are primary and secondary data sources. The primary data are taken from the reviewers of The Blind Side movie in Rottentomatoes website, and the secondary data are some references and material that relates to the study needs such as articles in websites. In this research, the data taken from November 2009 until January 2020 that reaches 210 reviewers in total with 6,1 rating given by the reviewers. The result then shows that textual reader response is dominating the applied category of reader response

What Do Reviewers Want? Reflections on Editing the Journal for the Past Year

The peer review process can be challenging. In this essay, the journal’s editor and editorial assistant present a summary of reviewers’ comments to authors from the past year. In presenting themes across 79 reviews, this essay arms authors with knowledge about reviewers’ expectations for manuscripts submitted to the journal. A secondary aim of this essay is to encourage reviewers to continue providing supportive and helpful feedback. As the journal heads into its third year of publishing, we are well on our way to creating the first home for high-quality risk and crisis communication research from around the globe

The Construction of Muslim Terrorism in the Kingdom Movie 2007 Directed by Peter Berg: A Reception Theory

This study belongs to the literary study. This study analyzes the construction of Muslim terrorism based on reader response reflected in The Kingdom Movie (2007). There are two objectives of the study, the first is to describe the dominant issues by the reviewers in applying reader response theory to Peter Berg’s The Kingdom movie, and the second is to explain the reason why the dominant issue are perceived differently by reviewers. This study is a qualitative study and using two data sources; they are primary and secondary data. The primary data source is the reviews of The Kingdom movie (2007) by Peter Berg from IMDb (Internet Movie Database). The secondary data of this study are taken from other sources such as literary book, previous studies, articles, journals, and also website related to reader response theory. This study aimed to reveal how the cultural reader response reflected to The Kingdom movie. The dominant issue which is respond by the reviewers is the terrorism dealing with the culture reader response

Preference Of Book To Movie Version Of Khaled Hosseini’s The Kite Runner (2007): Reader Response Theory

This research is concerning to reader’s preference of book to movie version The Kite Runner (2007) by Khaled Hosseini using Reader-Response theory. The objective of the study is to know what the reader’s reason for preferring the book. This research belongs to Qualitative research that used primary data and secondary data source. The data was gained from IMDb (Internet Movie Database) as many as 235 reviewers’ response is the primary data source. Meanwhile, other references such as books, previous studies, journals, and another which associated to this analysis are the secondary data source. There are three results that found in this research. First, the researcher decided 10 main issues from reviewers’ response. Second, the researcher took the reviewer’s background based on their continental. The last is, the reasons for preferring a book to the movie were categorized into 5 issues

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

BACKGROUND: Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. METHODS: RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. RESULTS: The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results may not be generalizable to children with persistent vomiting. CONCLUSION: There were no clinically important differences between ORT and IVT in terms of efficacy and safety. For every 25 children (95% CI: 20, 50) treated with ORT, one would fail and require IVT. The results support existing practice guidelines recommending ORT as the first course of treatment in appropriate children with dehydration secondary to gastroenteritis

Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees

<p>Abstract</p> <p>Background</p> <p>In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking.</p> <p>Results</p> <p>This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness.</p> <p>Conclusions</p> <p>Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion.</p> <p>Reviewers</p> <p>This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin.</p> <p>Open peer review</p> <p>Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.</p

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs.

Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH-specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously