Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools.

BACKGROUND: There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. METHODS: We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach. RESULTS: We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a 'gold standard' significantly hinders the evaluation of tools' validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations. CONCLUSIONS: There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence

Utilización de la yoga en la mejora del peso corporal y flujo pico espiratorio de personas con sobrepeso y obesidad

The present investigation is of the quasi-experimental type of temporal series design interrupted with a group with repeated measures of pretest and posttest. The objective of the same was the evaluation of a Yoga training program on the effects on the Peak Expiratory Flow (PEF) and on overweight-obesity of female patients who attended the Mutual Aid Groups of the Secretary of Health in Manzanillo, Mexico. The intervention group consisted of 15 women with an average age of 46 years (16) without chronic non-communicable diseases, the program was designed for 6 with two weekly sessions of 40 minutes each (80 min per week). The instruments used to verify the progress in the PEF and the BMI are: clinical history, portable flowmeters and a minimum protocol of weight and height Quetelet´s formula to determine the BMI, as well as an interview at the end of the intervention to know aspects about participation in the intervention. Among the main findings, there was a significant progress in Peak Expiratory Flow (PEF) after the intervention, the participants were able to make a deeper inhalation and a greater exhalation.  The results show positive effects on the PEF after a 6-week program with specific yoga work to improve breathing, but not for BMI and changes in body weight.  La presente investigación es de tipo cuasiexperimental de diseño serie temporal interrumpida con un grupo con medidas repetidas de pretest y postest. El objetivodel mismo, fue la evaluación de un programa de entrenamiento de Yoga sobre los efectosen elFlujo Pico Espiratorio (PEF) yen sobrepeso-obesidad de pacientes femeninos que asistieron a los Grupos de Ayuda Mutua de la Secretaria de Salud en Manzanillo, México. El grupo de intervención estuvo integrado por 15 mujeres con un promedio de edad de 46 años (±16) sin enfermedades crónicas no transmisibles, el programa se diseñó para 6 semanas con dos sesiones semanales de 40 minutos cada una (80 min por semana). Los instrumentos utilizados para verificar el progreso en el PEF e IMC fueron,historia clínica, flujometros portátiles y un protocolo mínimo de toma de peso y talla y la fórmula de Quetelet para determinar el IMC, así como, una entrevista al final de la intervención para conocer aspectos sobre la participación en la intervención. Entre los principales hallazgos se evidencia un progreso significativo en Flujo Pico Espiratorio (PEF) posterior a la intervención, las participantes fueron capaces de hacer una inspiración más profunda y una espiración mayor. Los resultados muestran efectos positivos en el PEF posterior a un programa de 6 semanas con trabajo de yoga específico para la mejora de respiración, pero no para disminución de IMC y cambios en el peso corporal

The AFLOW Fleet for Materials Discovery

The traditional paradigm for materials discovery has been recently expanded to incorporate substantial data driven research. With the intent to accelerate the development and the deployment of new technologies, the AFLOW Fleet for computational materials design automates high-throughput first principles calculations, and provides tools for data verification and dissemination for a broad community of users. AFLOW incorporates different computational modules to robustly determine thermodynamic stability, electronic band structures, vibrational dispersions, thermo-mechanical properties and more. The AFLOW data repository is publicly accessible online at aflow.org, with more than 1.7 million materials entries and a panoply of queryable computed properties. Tools to programmatically search and process the data, as well as to perform online machine learning predictions, are also available.Comment: 14 pages, 8 figure

Hierarchical information clustering by means of topologically embedded graphs

We introduce a graph-theoretic approach to extract clusters and hierarchies in complex data-sets in an unsupervised and deterministic manner, without the use of any prior information. This is achieved by building topologically embedded networks containing the subset of most significant links and analyzing the network structure. For a planar embedding, this method provides both the intra-cluster hierarchy, which describes the way clusters are composed, and the inter-cluster hierarchy which describes how clusters gather together. We discuss performance, robustness and reliability of this method by first investigating several artificial data-sets, finding that it can outperform significantly other established approaches. Then we show that our method can successfully differentiate meaningful clusters and hierarchies in a variety of real data-sets. In particular, we find that the application to gene expression patterns of lymphoma samples uncovers biologically significant groups of genes which play key-roles in diagnosis, prognosis and treatment of some of the most relevant human lymphoid malignancies.Comment: 33 Pages, 18 Figures, 5 Table

Impact Factor: outdated artefact or stepping-stone to journal certification?

A review of Garfield's journal impact factor and its specific implementation as the Thomson Reuters Impact Factor reveals several weaknesses in this commonly-used indicator of journal standing. Key limitations include the mismatch between citing and cited documents, the deceptive display of three decimals that belies the real precision, and the absence of confidence intervals. These are minor issues that are easily amended and should be corrected, but more substantive improvements are needed. There are indications that the scientific community seeks and needs better certification of journal procedures to improve the quality of published science. Comprehensive certification of editorial and review procedures could help ensure adequate procedures to detect duplicate and fraudulent submissions.Comment: 25 pages, 12 figures, 6 table

Search for pair-produced long-lived neutral particles decaying to jets in the ATLAS hadronic calorimeter in ppcollisions at √s=8TeV

The ATLAS detector at the Large Hadron Collider at CERN is used to search for the decay of a scalar boson to a pair of long-lived particles, neutral under the Standard Model gauge group, in 20.3fb−1of data collected in proton–proton collisions at √s=8TeV. This search is sensitive to long-lived particles that decay to Standard Model particles producing jets at the outer edge of the ATLAS electromagnetic calorimeter or inside the hadronic calorimeter. No significant excess of events is observed. Limits are reported on the product of the scalar boson production cross section times branching ratio into long-lived neutral particles as a function of the proper lifetime of the particles. Limits are reported for boson masses from 100 GeVto 900 GeV, and a long-lived neutral particle mass from 10 GeVto 150 GeV