A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder.

To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice.We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles.Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained.No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for 'high quality'. Nevertheless, not all included studies were adequately powered for determining an effect.Large effect sizes associated with 95 % confidence intervals suggest that 'Neuromotor Task Training', 'Task-oriented Motor Training' and 'Motor Imagery + Task Practice Training' are the most effective reported interventions for improving motor skills in children with developmental coordination disorder

A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder

Objective: To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice. Data sources: We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles. Review methods: Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained. Results: No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for 'high quality'. Nevertheless, not all included studies were adequately powered for determining an effect. Conclusion: Large effect sizes associated with 95 % confidence intervals suggest that 'Neuromotor Task Training', 'Task-oriented Motor Training' and 'Motor Imagery + Task Practice Training' are the most effective reported interventions for improving motor skills in children with developmental coordination disorder.</p

User-centered visual analysis using a hybrid reasoning architecture for intensive care units

One problem pertaining to Intensive Care Unit information systems is that, in some cases, a very dense display of data can result. To ensure the overview and readability of the increasing volumes of data, some special features are required (e.g., data prioritization, clustering, and selection mechanisms) with the application of analytical methods (e.g., temporal data abstraction, principal component analysis, and detection of events). This paper addresses the problem of improving the integration of the visual and analytical methods applied to medical monitoring systems. We present a knowledge- and machine learning-based approach to support the knowledge discovery process with appropriate analytical and visual methods. Its potential benefit to the development of user interfaces for intelligent monitors that can assist with the detection and explanation of new, potentially threatening medical events. The proposed hybrid reasoning architecture provides an interactive graphical user interface to adjust the parameters of the analytical methods based on the users' task at hand. The action sequences performed on the graphical user interface by the user are consolidated in a dynamic knowledge base with specific hybrid reasoning that integrates symbolic and connectionist approaches. These sequences of expert knowledge acquisition can be very efficient for making easier knowledge emergence during a similar experience and positively impact the monitoring of critical situations. The provided graphical user interface incorporating a user-centered visual analysis is exploited to facilitate the natural and effective representation of clinical information for patient care

Formative exploration of students’ perception about Community Medicine teaching at Mahatma Gandhi Institute of Medical Sciences, Sewagram, India

Objective: The objectives of the present formative research were to explore the medical undergraduates’ study problems and their perceptions about various teaching approaches in currently practiced teaching curriculum of Community Medicine. Material and Methods: The present formative research was undertaken at Dr. Sushila Nayar School of Public Health incorporating Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram. The respondents were 17 (26.5%) conveniently selected final year exam appearing medical undergraduates from 2004 regular batch of 64 students. A triangulation of qualitative research methods like free listing, pile sort exercise and a Focus Group Discussion (FGD) were used. A two dimensional scaling and hierarchical cluster analysis was completed with the pile sort data. The data was analyzed by using software Anthropac 4.98.1/X software. Results: The medical undergraduates could understand the topics like Integrated Management of Neonatal and Childhood (IMNCI), Primary Health Care (PHC), cold chain system for vaccines, immunization and health education, dietary survey and cluster survey method taught in the community based camp approaches. Students found it difficult to comprehend the core of subject from the scattered lecture series over a long teaching period, especially using lengthy over head projector/liquid crystal display presentations. The major problems encountered in studying the subject of Community Medicine were difficulty in understanding the concepts of biostatistics, confusions due to apparently similar text in National Health Programs and difficulty to recall disease statistics due to vast syllabus. Conclusions: Students perceived the community based camp approach of teaching as a best method to understand the subject, which is an integration of task oriented assignments, integration of social sciences within medical domain and active community involvement. Hence, the community based camp approach can be scaled up as a best Community Medicine teaching approach. The active learning methods could be used to improve the lectures and the clinics which should be more concentrated in final year of teachin

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: NL

Proceedings ICPW'07: 2nd International Conference on the Pragmatic Web, 22-23 Oct. 2007, Tilburg: N

Rationalism and Empiricism in Modern Medicine

The roots of rationalism and empiricism in the Hippocratic tradition are explored. The triumph of the rationalists in the founding of modern medicine is emphasized. The development of clinical epidemiology and the evidence-based medicine over the last 30 years is described. The tension illuminates fundamental clinical and policy questions that doctors, the health care system, and the legal system confront today