Potential value of systematic reviews of qualitative evidence in informing user-centred health and social care: findings from a descriptive overview

Objective Systematic reviews of quantitative evidence are well-established in health and social care. Systematic reviews of qualitative evidence are increasingly available, but volume, topics covered, methods used and reporting quality are largely unknown. We provide a descriptive overview of systematic reviews of qualitative evidence assessing health and social care interventions included on the Database of Abstracts of Reviews of Effects (DARE). Study design and setting We searched DARE for reviews published between 1st January 2009 and 31st December 2014. We extracted data on review content and methods, summarised narratively and explored patterns over time. Results We identified 145 systematic reviews conducted worldwide (64 in the UK). Interventions varied, but largely covered treatment or service delivery in community and hospital settings. There were no discernible patterns over time. Critical appraisal of primary studies was conducted routinely. Most reviews were poorly reported. Conclusion Potential exists to use systematic reviews of qualitative evidence when driving forward user-centred health and social care. We identify where more research is needed and propose ways to improve review methodology and reporting

Preliminary results for RR Lyrae stars and Classical Cepheids from the Vista Magellanic Cloud (VMC) Survey

The Vista Magellanic Cloud (VMC, PI M.R. Cioni) survey is collecting $K_S$-band time series photometry of the system formed by the two Magellanic Clouds (MC) and the "bridge" that connects them. These data are used to build $K_S$-band light curves of the MC RR Lyrae stars and Classical Cepheids and determine absolute distances and the 3D geometry of the whole system using the $K$-band period luminosity ($PLK_S$), the period - luminosity - color ($PLC$) and the Wesenhiet relations applicable to these types of variables. As an example of the survey potential we present results from the VMC observations of two fields centered respectively on the South Ecliptic Pole and the 30 Doradus star forming region of the Large Magellanic Cloud. The VMC $K_S$-band light curves of the RR Lyrae stars in these two regions have very good photometric quality with typical errors for the individual data points in the range of $\sim$ 0.02 to 0.05 mag. The Cepheids have excellent light curves (typical errors of $\sim$ 0.01 mag). The average $K_S$ magnitudes derived for both types of variables were used to derive $PLK_S$ relations that are in general good agreement within the errors with the literature data, and show a smaller scatter than previous studies.Comment: 7 pages, 6 figure. Accepted for publication in Astrophysics and Space Science. Following a presentation at the conference "The Fundamental Cosmic Distance Scale: State of the Art and the Gaia Perspective", Naples, May 201

High contrast D1_{1} line electromagnetically induced transparency in nanometric-thin rubidium vapor cell

Electromagnetically induced transparency (EIT) on atomic D$_{1}$ line of rubidium is studied using a nanometric-thin cell with atomic vapor column length in the range of L= 400 - 800 nm. It is shown that the reduction of the cell thickness by 4 orders as compared with an ordinary cm-size cell still allows to form an EIT resonance for $L= \lambda$ ($\lambda =794$ nm) with the contrast of up to 40%. Remarkable distinctions of EIT formation in nanometric-thin and ordinary cells are demonstrated. Despite the Dicke effect of strong spectral narrowing and increase of the absorption for $L=$ $\lambda /2$, EIT resonance is observed both in the absorption and the fluorescence spectra for relatively low intensity of the coupling laser. Well resolved splitting of the EIT resonance in moderate magnetic field for $L=$ $\lambda$ can be used for magnetometry with nanometric spatial resolution. The presented theoretical model well describes the observed results.Comment: Submitted to Applied Physics B: Lasers and Optics, 9 pages, 10 figure

Electroexcitation of the Δ+(1232)\Delta^{+}(1232) at low momentum transfer

We report on new p$(e,e^\prime p)\pi^\circ$ measurements at the $\Delta^{+}(1232)$ resonance at the low momentum transfer region. The mesonic cloud dynamics is predicted to be dominant and rapidly changing in this kinematic region offering a test bed for chiral effective field theory calculations. The new data explore the low $Q^2$ dependence of the resonant quadrupole amplitudes while extending the measurements of the Coulomb quadrupole amplitude to the lowest momentum transfer ever reached. The results disagree with predictions of constituent quark models and are in reasonable agreement with dynamical calculations that include pion cloud effects, chiral effective field theory and lattice calculations. The reported measurements suggest that improvement is required to the theoretical calculations and provide valuable input that will allow their refinements

Early above- and below-ground responses of subboreal conifer seedlings to various levels of deciduous canopy removal

We examined the growth of understory conifers, following partial or complete deciduous canopy removal, in a field study established in two regions in Canada. In central British Columbia, we studied the responses of three species (Pseudotsuga menziesii var. glauca (Beissn.) Franco, Picea glauca (Moench) Voss x Picea engelmannii Parry ex Engelm., and Abies lasiocarpa (Hook.) Nutt.), and in northwestern Quebec, we studied one species (Abies balsamea (L.) Mill.). Stem and root diameter and height growth were measured 5 years before and 3 years after harvesting. Both root and stem diameter growth increased sharply following release but seedlings showed greater root growth, suggesting that in the short term, improvement in soil resource capture and transport, and presumably stability, may be more important than an increase in stem diameter and height growth. Response was strongly size dependent, which appears to reflect greater demand for soil resources as well as higher light levels and greater tree vigour before release for taller individuals. Growth ratios could not explain the faster response generally attributed to true fir species or the unusual swift response of spruces. Good prerelease vigour of spruces, presumably favoured by deciduous canopies, could explain their rapid response to release

Biomarkers of Multiple Sclerosis

The search for an ideal multiple sclerosis biomarker with good diagnostic value, prognostic reference and an impact on clinical outcome has yet to be realized and is still ongoing. The aim of this review is to establish an overview of the frequent biomarkers for multiple sclerosis that exist to date. The review summarizes the results obtained from electronic databases, as well as thorough manual searches. In this review the sources and methods of biomarkers extraction are described; in addition to the description of each biomarker, determination of the prognostic, diagnostic, disease monitoring and treatment response values besides clinical impact they might possess. We divided the biomarkers into three categories according to the achievement method: laboratory markers, genetic-immunogenetic markers and imaging markers. We have found two biomarkers at the time being considered the gold standard for MS diagnostics. Unfortunately, there does not exist a single solitary marker being able to present reliable diagnostic value, prognostic value, high sensitivity and specificity as well as clinical impact. We need more studies to find the best biomarker for MS.publishersversionPeer reviewe

A novel formulation of inhaled sodium cromoglicate (PA101) in idiopathic pulmonary fibrosis and chronic cough: a randomised, double-blind, proof-of-concept, phase 2 trial

Background Cough can be a debilitating symptom of idiopathic pulmonary fibrosis (IPF) and is difficult to treat. PA101 is a novel formulation of sodium cromoglicate delivered via a high-efficiency eFlow nebuliser that achieves significantly higher drug deposition in the lung compared with the existing formulations. We aimed to test the efficacy and safety of inhaled PA101 in patients with IPF and chronic cough and, to explore the antitussive mechanism of PA101, patients with chronic idiopathic cough (CIC) were also studied. Methods This pilot, proof-of-concept study consisted of a randomised, double-blind, placebo-controlled trial in patients with IPF and chronic cough and a parallel study of similar design in patients with CIC. Participants with IPF and chronic cough recruited from seven centres in the UK and the Netherlands were randomly assigned (1:1, using a computer-generated randomisation schedule) by site staff to receive PA101 (40 mg) or matching placebo three times a day via oral inhalation for 2 weeks, followed by a 2 week washout, and then crossed over to the other arm. Study participants, investigators, study staff, and the sponsor were masked to group assignment until all participants had completed the study. The primary efficacy endpoint was change from baseline in objective daytime cough frequency (from 24 h acoustic recording, Leicester Cough Monitor). The primary efficacy analysis included all participants who received at least one dose of study drug and had at least one post-baseline efficacy measurement. Safety analysis included all those who took at least one dose of study drug. In the second cohort, participants with CIC were randomly assigned in a study across four centres with similar design and endpoints. The study was registered with ClinicalTrials.gov (NCT02412020) and the EU Clinical Trials Register (EudraCT Number 2014-004025-40) and both cohorts are closed to new participants. Findings Between Feb 13, 2015, and Feb 2, 2016, 24 participants with IPF were randomly assigned to treatment groups. 28 participants with CIC were enrolled during the same period and 27 received study treatment. In patients with IPF, PA101 reduced daytime cough frequency by 31·1% at day 14 compared with placebo; daytime cough frequency decreased from a mean 55 (SD 55) coughs per h at baseline to 39 (29) coughs per h at day 14 following treatment with PA101, versus 51 (37) coughs per h at baseline to 52 (40) cough per h following placebo treatment (ratio of least-squares [LS] means 0·67, 95% CI 0·48–0·94, p=0·0241). By contrast, no treatment benefit for PA101 was observed in the CIC cohort; mean reduction of daytime cough frequency at day 14 for PA101 adjusted for placebo was 6·2% (ratio of LS means 1·27, 0·78–2·06, p=0·31). PA101 was well tolerated in both cohorts. The incidence of adverse events was similar between PA101 and placebo treatments, most adverse events were mild in severity, and no severe adverse events or serious adverse events were reported. Interpretation This study suggests that the mechanism of cough in IPF might be disease specific. Inhaled PA101 could be a treatment option for chronic cough in patients with IPF and warrants further investigation