Methods for the thematic synthesis of qualitative research in systematic reviews

<p>Abstract</p> <p>Background</p> <p>There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies.</p> <p>Methods</p> <p>We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved.</p> <p>Results</p> <p>We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses.</p> <p>Conclusion</p> <p>We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.</p

Evolution of particle-scale dynamics in an aging clay suspension

Multispeckle x-ray photon correlation spectroscopy was employed to characterize the slow dynamics of a colloidal suspension formed by highly-charged, nanometer-sized disks. At scattering wave vectors $q$ corresponding to interparticle length scales, the dynamic structure factor follows a form $f(q,t) \sim \exp[-(t/\tau)^{\beta}$], where $\beta \approx$ 1.5. The characteristic relaxation time $\tau$ increases with the sample age $t_a$ approximately as $\tau \sim t_a^{1.8}$ and decreases with $q$ approximately as $\tau \sim q^{-1}$. Such a compressed exponential decay with relaxation time that varies inversely with $q$ is consistent with recent models that describe the dynamics in disordered elastic media in terms of strain from random, local structural rearrangements. The amplitude of the measured decay in $f(q,t)$ varies with $q$ in a manner that implies caged particle motion at short times. The decrease in the range of this motion and an increase in suspension conductivity with increasing $t_a$ indicate a growth in the interparticle repulsion as the mechanism for internal stress development implied by the models.Comment: 4 pages, includes 4 postscript figures; accepted for publication in Phys Rev Let

A phase II study of capecitabine and oxalplatin combination chemotherapy in patients with inoperable adenocarcinoma of the gall bladder or biliary tract

Background: Advanced biliary tract carcinomas are associated with a poor prognosis, and palliative chemotherapy has only modest benefit. This multi-centre phase II study was conducted to determine the efficacy of capecitabine in combination with oxaliplatin in patients with inoperable gall bladder or biliary tract cancer. Methods: This was a Phase II, non-randomised, two-stage Simon design, multi-centre study. Ethics approval was sought and obtained by the North West MREC, and then locally by the West Glasgow Hospitals Research Ethics Com mittee. Eligible patients with inoperable locally advanced or metastatic adenocarcinoma of the gall bladder or biliary tract and with adequate performance status, haematologic, renal, and hepatic function were treated with capecit abine (1000 mg/m2 po, twice daily, days 1–14) and oxaliplatin (130 mg/m2 i.v., day 1) every 3 weeks for up to six cycles. The primary objective of the study was to determine the objective tumour response rates (complete and partial). The secondary objectives included assessment of toxicity, progression-free survival, and overall survival. Results: Forty-three patients were recruited between July 2003 and December 2005. The regimen was well tolerated with no grade 3/4 neutropenia or thrombocytopenia. Grade 3/4 sensory neuropathy was observed in six patients. Two-thirds of patients received their chemotherapy without any dose delays. Overall response rate was 23.8 % (95 % CI 12.05–39.5 %). Stable disease was observed in a further 13 patients (31 %) and progressive disease observed in 12 (28.6 %) of patients. The median progression-free survival was 4.6 months (95 % CI 2.8–6.4 months; Fig. 1) and the median overall survival 7.9 months (95 % CI 5.3–10.4 months; Fig. 2). Conclusion: Capecitabine combined with oxaliplatin has a lower disease control and shorter overall survival than the combination of cisplatin with gemcitabine which has subsequently become the standard of care in this disease. How ever, capecitabine in combination with oxaliplatin does have modest activity in this disease, and can be considered as an alternative treatment option for patients in whom cisplatin and/or gemcitabine are contra-indicated

Short-Term Removal of Exercise Impairs Glycemic Control in Older Adults: A Randomized Trial

Postprandial glycemia (PPG) predicts cardiovascular disease, and short-term physical inactivity increases PPG in young, active adults. Whether this occurs in older, active adults who may be more prone to bouts of inactivity is unknown. This study determined if postprandial interstitial glucose (PPIG) was impaired in active older adults following the removal of exercise for 3 days (NOEX) compared to active young adults. In this randomized, crossover study, 11 older (69.1 ± 1.9 years) and 9 young (32.8 ± 1.8 years) habitually active (≥90 min/week of exercise) adults completed 3-days of NOEX and 3-days of normal habitual exercise (EX), separated by ≥1 week. Diet was standardized across phases. Glycemic control (3-day average) was assessed via continuous glucose monitoring during both phases. Significant main effects of age and phase were detected (p \u3c 0.05), but no interaction was found for steps/day (p \u3e 0.05) (old EX: 6283 ± 607, old NOEX: 2380 ± 382 and young EX: 8798 ± 623, young NOEX: 4075 ± 516 steps/day). Significant main effects of age (p = 0.002) and time (p \u3c 0.001) existed for 1-h PPIG, but no effect of phase or interactions was found (p \u3e 0.05). Significant main effects (p \u3c 0.05) of age (old: 114 ± 1 mg/dl, young: 106 ± 1 mg/dl), phase (NOEX: 112 ± 1 mg/dl, EX: 108 ± 1 mg/dl), and time (0 min: 100 ± 2, 30 min: 118 ± 2, 60 min: 116 ± 2, 90 min: 111 ± 2, 120 min: 108 ± 2 mg/dl) in 2-h PPIG were detected, but no interaction was found (p \u3e 0.05). However, only significant main effects of phase (NOEX: 14 ± 1 and EX:12 ± 1, p \u3e 0.05) were found for 24-h blood glucose standard deviation. Older adults appear to have impaired glycemic control compared to young adults and exercise removal impairs glycemic control in both populations. Yet, the impairment in glycemic control with exercise removal is not different between old and young adults

Understanding children’s constructions of meanings about other children: implications for inclusiveeducation

This paper explores the factors that influence the way children construct meanings about other children, and especially those who seem to experience marginalisation, within school contexts. The research involved an ethnographic study in a primary school in Cyprus over a period of 5 months. Qualitative methods were used, particularly participant observations and interviews with children. Interpretation of the data suggests that children's perceptions about other children, and especially those who come to experience marginalisation, are influenced by the following factors: other children and the interactions between them; adults’ way of behaving in the school; the existing structures within the school; and the cultures of the school and the wider educational context. Even though the most powerful factor was viewed to be the adults’ influence, it was rather the interweaving between different factors that seemed to lead to the creation of particular meanings for other children. In the end, it is argued that children's voices should be seen as an essential element within the process of developing inclusive practices.<br/

Food activities and identity maintenance in old age: a systematic review and meta-synthesis

This article has been made available through the Brunel Open Access Publishing Fund.Objectives: Services provided to older people should be developed based on active ageing policies. Nutrition is one aspect of active ageing, but little is known about how food activities contribute to psychological well-being in later life. This is a systematic review of qualitative and quantitative research that answers the question ‘What is known about the relationship between food activities and the maintenance of identities in old age?’

Mechanical robustness of HL-LHC collimator designs

Two new absorbing materials were developed as collimator inserts to fulfil the requirements of HL-LHC higher brightness beams: molybdenum-carbide graphite (MoGr) and copper-diamond (CuCD). These materials were tested under intense beam impacts at CERN HiRadMat facility in 2015, when full jaw prototypes were irradiated. Additional tests in HiRadMat were performed in 2017 on another series of material samples, including also improved grades of MoGr and CuCD, and different coating solutions. This paper summarizes the main results of the two experiments, with a main focus on the behaviour of the novel composite blocks, the metallic housing, as well as the cooling circuit. The experimental campaign confirmed the final choice for the materials and the design solutions for HL-LHC collimators, and constituted a unique chance of benchmarking numerical models. In particular, the tests validated the selection of MoGr for primary and secondary collimators, and CuCD as a valid solution for robust tertiary collimators

Wetland succession in a permafrost collapse: interactions between fire and thermokarst

To determine the influence of fire and thermokarst in a boreal landscape, we investigated peat cores within and adjacent to a permafrost collapse feature on the Tanana River Floodplain of Interior Alaska. Radioisotope dating, diatom assemblages, plant macrofossils, charcoal fragments, and carbon and nitrogen content of the peat profile indicate ~600 years of vegetation succession with a transition from a terrestrial forest to a sedge-dominated wetland over 100 years ago, and to a &lt;i&gt;Sphagnum&lt;/i&gt;-dominated peatland in approximately 1970. The shift from sedge to &lt;i&gt;Sphagnum&lt;/i&gt;, and a decrease in the detrended tree-ring width index of black spruce trees adjacent to the collapse coincided with an increase in the growing season temperature record from Fairbanks. This concurrent wetland succession and reduced growth of black spruce trees indicates a step-wise ecosystem-level response to a change in regional climate. In 2001, fire was observed coincident with permafrost collapse and resulted in lateral expansion of the peatland. These observations and the peat profile suggest that future warming and/or increased fire disturbance could promote permafrost degradation, peatland expansion, and increase carbon storage across this landscape; however, the development of drought conditions could reduce the success of both black spruce and &lt;i&gt;Sphagnum&lt;/i&gt;, and potentially decrease the long-term ecosystem carbon storage

Self-dual Ginzburg-Landau vortices in a disk

We study the properties of the Ginzburg-Laundau model in the self-dual point for a two-dimensional finite system . By a numerical calculation we analyze the solutions of the Euler-Lagrange equations for a cylindrically symmetric ansatz. We also study the self-dual equations for this case. We find that the minimal energy configurations are not given by the Bogomol'nyi equations but by solutions to the Euler Lagrange ones. With a simple approximation scheme we reproduce the result of the numerical calculation.Comment: 8 pages, 4 figures, RevTex macro