The challenge of acute-stroke management: does telemedicine offer a solution?

<p><b>Background:</b> Several studies have described successful experiences with the use of telemedicine in acute stroke. The objective of this study was to assess the feasibility, acceptability, and treatment delivery reliability, of telemedicine systems for the clinical and radiological assessment, and management of acute-stroke patients.</p> <p><b>Summary of Review:</b> A systematic review of the literature was carried out. Studies were included if they met the following criteria: (1) study population included participants with a diagnosis of suspected acute stroke, (2) intervention included the use of telemedicine systems to aid assessment, diagnosis, or treatment in acute stroke, and (3) outcomes measured related to feasibility in clinical practice, acceptability to patients, carers, and staff, reliability of telemedicine systems, and effectiveness in delivering treatment, especially tissue plasminogen activator (tPA). Overall, 17 relevant non-randomised studies reported that telemedicine systems were feasible and acceptable. Interrater reliability was excellent for global clinical assessments and decisions on radiological exclusion criteria although agreement for individual assessment items was more variable. Telemedicine systems were associated with increased use of tPA.</p> <p><b>Conclusion:</b> Although there is limited reliable evidence, observational studies have indicated that telemedicine systems can be feasible, acceptable, and reliable in acute-stroke management. In addition, telemedicine consultations were associated with improved delivery of tPA.</p&gt

Определение ускорений и сил инерции при вращении валков вибрационного классификатора

У статті представлено результати досліджень із визначення прискорень і сил інерції при обертанні валків вібраційного класифікатора. Встановлено величини прискорень і значення переносної сили інерції при відносному русі валка навколо осі.The article presents findings on acceleration and inertia force determination at rotation of vibrating classifier rolls. Values of acceleration and force of moving space are specified at relative roll movement about axis

Meeting the review family : exploring review types and associated information retrieval requirements

Background and objectives The last decade has witnessed increased recognition of the value of literature reviews for advancing understanding and decision making. This has been accompanied by an expansion in the range of methodological approaches and types of review. However, there remains uncertainty over definitions and search requirements beyond those for the ‘traditional’ systematic review. This study aims to characterise health related reviews by type and to provide recommendations on appropriate methods of information retrieval based on the available guidance. Methods A list of review types was generated from published typologies and categorised into ‘families’ based on their common features. Guidance on information retrieval for each review type was identified by searching pubmed, medline and Google Scholar, supplemented by scrutinising websites of review producing organisations. Results Forty‐eight review types were identified and categorised into seven families. Published guidance reveals increasing specification of methods for information retrieval; however, much of it remains generic with many review types lacking explicit requirements for the identification of evidence. Conclusions Defining review types and utilising appropriate search methods remain challenging. By familiarising themselves with a range of review methodologies and associated search methods, information specialists will be better equipped to select suitable approaches for future projects

Interventions targeting social isolation in older people: a systematic review

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. METHODS: Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. RESULTS: Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting. CONCLUSIONS: More, well-conducted studies of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. However, it appeared that common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format. Interventions in which older people are active participants also appeared more likely to be effective. Future interventions incorporating all of these characteristics may therefore be more successful in targeting social isolation in older people.National Institute for Health Researc

Evidence-based public health practice

Public health decisions that are based on critical appraisal of the best available evidence will lead to the development of interventions that have the maximum potential to impact on the health and well-being of the community. The principles of evidence-based practice are now well established for clinical medicine. Evidence-based public health is less well developed. How evidence-based decision making can be incorporated into work practice is illustrated. Public health practitioners have the responsibility to contribute to the body of evidence that will support decision making; advocate for evidence-based public health decision making; and advocate for resources to support evidence-based public health practice

Inflammatory bowel diseases and psychological issues: A new approach for a systematic analysis of the academic debate

Inflammatory bowel disease (IBD) has received increasing attention in recent years within the literature, due to its incidence and prevalence. The pathogenesis of IBD is still unclear, but the research community is increasingly suggesting that psychological issues may play a role in its aetiology and in exacerbation of symptoms. However, the literature regarding the psychological factors associated with IBD remains controversial and fragmented. The aim of the present study is twofold: (1) to identify, through a bibliometric analysis, the current state of the ongoing scientific debate regarding the relationship between IBD and psychological/psychiatric factors; (2) to analyse, through a qualitative software-based thematic analysis, the main themes characterizing the literature on this topic from 1988 to 2012. This study highlighted increasing number of academic publications in recent years regarding the multiplicity of factors related to the disease process in IBD, thus confirming the growing interest in this issue. IBD is becoming increasingly recognized by the medical literature as being exacerbated by a multi-componential process that needs to be studied through a biopsychosocial theoretical perspective which ables to orient multidisciplinary healthcare organizations and clinical interventions aimed at addressing IBD patient needs at different levels. This study also sheds light on two possible theoretical perspectives through which the academic community has considered IBD: A biomedical point of view that addresses the need for an etiological explanation of IBD and a behavioural point of view that aims at describing the observable symptoms and measurable health outcomes of clinical interventions such as patient adherence and engagement in the care and treatment process