Association between framing of the research question using the PICOT format and reporting quality of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Experts recommend formulating a structured research question to guide the research design. However, the basis for this recommendation has not been formally evaluated. The aim of this study was to examine if a structured research question using the PICOT (<b>P</b>opulation, <b>I</b>ntervention, <b>C</b>omparator, <b>O</b>utcome, <b>T</b>ime-frame) format is associated with a better reporting quality of randomized controlled trials (RCTs).</p> <p>Methods</p> <p>We evaluated 89 RCTs reports published in three endocrinology journals in 2005 and 2006, the quality of reporting of which was assessed in a previous study. We examined whether the reports stated each of the five elements of a structured research question: population, intervention, comparator, outcome and time-frame. A PICOT score was created with a possible score between 0 and 5. Outcomes were: 1) a 14-point overall reporting quality score (OQS) based on the Consolidated Standards for Reporting Trials; and 2) a 3-point key score (KS), based on allocation concealment, blinding and use of intention-to-treat analysis. We conducted multivariable regression analyses using generalized estimating equations to determine if a higher PICOT score or the use of a structured research question were independently associated with a better reporting quality. Journal of publication, funding source and sample size were identified as factors associated with OQS in our previous report on this dataset, and therefore included in the model.</p> <p>Results</p> <p>A higher PICOT score was independently associated with OQS (incidence rate ratio (IRR) = 1.021, 95% CI: 1.012 to 1.029) and KS (IRR = 1.142, 95% CI: 1.079 to 1.210). A structured research question was present in 33.7% of the reports and it was associated with a better OQS (IRR = 1.095, 95% CI 1.059-1.132) and KS (IRR = 1.530, 95% CI 1.311-1.786).</p> <p>Conclusions</p> <p>Better framing of the research question using the PICOT format is independently associated with better overall reporting quality - although the effect is small - and better reporting of key methodologies.</p

Interactions among Ecological Factors That Explain the Psychosocial Quality of Life of Children with Complex Needs

Purpose. To explore the associations and interactions among ecological factors and explain the psychosocial quality of life of children with complex needs. Methods. In this cross-sectional survey consenting parents were identified by the Children's Treatment Network. Families were eligible if the child from 0 to 19 years, resided in Simcoe/York, and there were multiple family needs. Regression analysis was used to explore associations and interactions. n = 429. Results. Younger children, without conduct disorder, without hostile and punitive parenting and with low adverse family impact demonstrated the highest levels of psychosocial quality of life. Statistically significant interactions between processes of care and parent variables highlight the complexity of real life situations. Conclusions. It is not possible to fully understand the child's psychosocial quality of life in complex needs families by considering only simple associations between ecological factors. A multitude of factors and interactions between these factors are simultaneously present and the care of these families requires a holistic approach

Developmental trajectories of expert perception processing of Chinese characters in primary school children

Previous studies have demonstrated that inversion effect and left-side bias are stable expertise markers in Chinese character processing among adults. However, it is less clear how these markers develop early on (i.e., among primary school students). Therefore, this study aimed to investigate the development of the two markers by comparing primary school-aged students of three age groups (Grade 1, Grade 3, and Grade 5) and adults in tests of inversion effect (Experiment 1) and left-sided bias effect (Experiment 2). The results replicated that both effects during Chinese character processing were present among adults. However, more importantly, the effects were different among primary school-aged students in different grades: the inversion effect was found as early as in Grade 1, but the left-side bias effect did not emerge in Grade 1 and as approximated that of adults until Grade 3. The study suggested a potential dissociation in developing different aspects of expertise during Chinese character processing in early childhood

System Integration and Its Influence on the Quality of Life of Children with Complex Needs

Purpose. To explore the interactions between child and parents psychosocial factors and team integration variables that may explain improvements in physical dimensions of the PEDS QL quality of life of children with complex needs after 2 years. Methods. In this 2-year study, parents were identified by the Children's Treatment Network. Families were eligible if the child was aged 0–19 years, had physical limitations, resided in either Simcoe County or the Region of York, Ontario, and there were multiple other family needs. Regression analysis used to explore associations and interactions; n = 110. Results. A child's physical quality of life was affected by interacting factors including child's behavior, parenting, and integrated care. Statistically significant interactions between team integration, processes of care, and child/parent variables highlight the complexity of the rehabilitation approach in real-life situations. Conclusions. Rehabilitation providers working with children with complex needs and their families should also address child and parent problematic behaviors. When this was the case in high integrated teams, the child's physical quality of life improved after two years

Healing Rate and Post-obturation Pain of Single-versus Multiple-visit Endodontic Treatment for Infected Root Canals: A Systematic Review

Abstract Introduction: The choice of single-versus multiple-visit root canal treatment for infected teeth is in dispute. The purpose of this systematic review was to compare the healing rate and post-obturation pain of single-versus multiple-visit root canal treatment for teeth with infected root canals. Methods: An exhaustive literature search combined with specified inclusion criteria was performed to identify randomized or quasi-randomized controlled trials (RCTs or quasi-RCTs), comparing root canal treatment in single and multiple appointments (2 or more visits) in patients with infected root canals. Results: Ten RCTs were identified and included in this review. Of these, 6 compared the healing rate and 5 compared the prevalence of post-obturation pain in single-and multiple-visit root canal treatment on teeth with infected root canals. No significant difference was observed in the healing rate between single-versus multiple-visit root canal treatment, as well as the incidence of medium-term post-obturation pain. As to the short-term follow up, the prevalence of postobturation pain was significantly lower in single-visit than in multiple-visit group. Conclusions: On the basis of current studies, the healing rate of single-and multiple-visit root canal treatment is similar for infected teeth. Patients experience less frequency of short-term post-obturation pain after single-visit than those having multiple-visit root canal treatment. (J Endod 2010;-:1-8

Interactions among Ecological Factors That Explain the Psychosocial Quality of Life of Children with Complex Needs

properly cited. Purpose. To explore the associations and interactions among ecological factors and explain the psychosocial quality of life of children with complex needs. Methods. In this cross-sectional survey consenting parents were identified by the Children&apos;s Treatment Network. Families were eligible if the child from 0 to 19 years, resided in Simcoe/York, and there were multiple family needs. Regression analysis was used to explore associations and interactions. n = 429. Results. Younger children, without conduct disorder, without hostile and punitive parenting and with low adverse family impact demonstrated the highest levels of psychosocial quality of life. Statistically significant interactions between processes of care and parent variables highlight the complexity of real life situations. Conclusions. It is not possible to fully understand the child&apos;s psychosocial quality of life in complex needs families by considering only simple associations between ecological factors. A multitude of factors and interactions between these factors are simultaneously present and the care of these families requires a holistic approach

Effect of HAP decomposition on the corrosion behavior of Ti-HAP biocomposites

Ti-HAP biocomposites are gained attention for combining the attractive properties of Ti and hydroxyapatite (HAP). However, the decomposition of HAP at elevated processing temperatures is a major concern since it can lead to structural flaws and may deteriorate the corrosion resistance of Ti. The present study aims to investigate the corrosion behavior of Ti-HAP composite processed by powder metallurgy by performing potentiodynamic polarization and electrochemical impedance spectroscopy in 0.9wt% NaCl solution at body temperature. Results show that the presence of Ti lowers the HAP decomposition temperatures resulting in the formation of HAP-depleted zones acting as electrochemically active sites, decreasing the corrosion resistance.This study was supported by the Foundation for Science andTechnology (FCT), Portugal with the reference projects UID/EEA/04436/2013, EXCL/EMS-TEC/0460/2012, and M-ERA-NET/0001/2015, as well, by FEDER funds through the COMPETE 2020–Programa Operacional Competitividade eInternacionalização (POCI) with the reference project POCI-01-0145-FEDER-006941. The authors would also like toacknowledge Prof. Ana Senos (University of Aveiro) andProf. José Carlos Teixeira (University of Minho) for theprovision of the characterization facilities

Mobile phone text messages for improving adherence to antiretroviral therapy (ART): a protocol for an individual patient data meta-analysis of randomised trials

IntroductionMobile phone text messaging is emerging as an important tool in the care of people living with HIV; however, reports diverge on its efficacy in improving adherence to antiretroviral therapy (ART), and little is known about which patient groups may benefit most from phone-based adherence interventions. We will conduct an individual patient data meta-analysis to investigate the overall and subgroup effects of text messaging in three recently published text-messaging randomised controlled trials.Methods and analysisData from two Kenyan and one Cameroonian trial will be verified, reformatted and merged. We will determine pooled effect sizes for text messaging versus standard care for improving adherence to ART using individual patient random-effects meta-analysis. We will test for the interaction effects of age, gender, level of education and duration on ART. Sensitivity analyses will be conducted with regard to thresholds for adherence, methods of handling missing data and fixed-effects meta-analysis. Only anonymised data will be collected from the individual studies.Ethics and disseminationEthical approval was obtained for the individual studies. The results of this paper will be disseminated as peer-reviewed publications, at conferences and as part of a doctoral thesis. This individual patient data meta-analysis may provide important insights into the effects of text messaging on ART adherence in different subpopulations, with important implications for programme implementation involving such interventions and future research

Mobile phone text messages for improving adherence to antiretroviral therapy (ART): an individual patient data meta-analysis of randomised trials

ObjectivesOur objectives were to analyse the effects of text messaging versus usual care in improving adherence to antiretroviral therapy (ART) in people living with HIV using individual patient data meta-analysis. Adjusted, sensitivity and subgroup analyses were conducted.Setting3 randomised controlled trials conducted between 2010 and 2012 in rural and urban centres in Cameroon and Kenya (two studies) were used.ParticipantsA total of 1166 participants were included in this analysis (Cameroon=200; Kenya=428 and 538).Primary and secondary outcomesThe primary outcome was adherence to ART >95%. The secondary outcomes were mortality, losses to follow-up, transfers and withdrawals.ResultsText messaging improved adherence to ART (OR 1.38; 95% CIs 1.08 to 1.78; p=0.012), even after adjustment for baseline covariates (OR 1.46; 95% CI 1.13 to 1.88; p=0.004). Primary education (compared with no formal education) was associated with a greater intervention effect on adherence (OR 1.65; 95% CI 1.10 to2.48; p=0.016) and also showed a significant subgroup effect (p=0.039). In sensitivity analysis, our findings were robust to a modified threshold of adherence, multiple imputation for missing dataand aggregate level data pooling, but not to fixed-effects meta-analyses using generalised estimation equations. There was a significant subgroup effect for long weekly (p=0.037), short weekly text messages (p=0.014) and interactive messaging (p=0.010). Text messaging did not significantly affect any of the secondary outcomes.ConclusionsText messaging has a significant effect on adherence to ART, and this effect is influenced by level of education, gender, timing (weekly vs daily) and interactivity. We recommend the use of interactive weekly text messaging to improve adherence to ART, which is most effective in those with at least a primary level of education