Systematic reviews of complementary therapies - an annotated bibliography. Part 1: Acupuncture

Background Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with acupuncture. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of acupuncture; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. Results From a total of 48 potentially relevant reviews preselected in a screeening process 39 met the inclusion criteria. 22 were on various pain syndromes or rheumatic diseases. Other topics addressed by more than one review were addiction, nausea, asthma and tinnitus. Almost unanimously the reviews state that acupuncture trials include too few patients. Often included trials are heterogeneous regarding patients, interventions and outcome measures, are considered to have insufficient quality and contradictory results. Convincing evidence is available only for postoperative nausea, for which acupuncture appears to be of benefit, and smoking cessation, where acupuncture is no more effective than sham acupuncture. Conclusions A large number of systematic reviews on acupuncture exists. What is most obvious from these reviews is the need for (the funding of) well-designed, larger clinical trials

The incidence of associated fractures of the upper limb in fractures of the radial head

Radial head fractures are common injuries. In American publications, one-third of the patients with these fractures have been shown to have associated injuries. The aim of this retrospective study is to describe the epidemiology of radial head fractures and associated fractures of the ipsilateral upper extremity in a European population. This study describes the epidemiology of radial head and associated fractures of the upper extremity in a Dutch population by a retrospective radiographic review of all patients with a radial head fracture between 1 January 2006 and 1 July 2007. A total of 147 radial head fractures were diagnosed in 145 patients. The incidence in the general population was 2.5 per 10.000 per year. The average age was 45.9 (SD 17.3) years and male–female ratio was 2:3. The mean age of males was significantly lower (37.1, SD 14.2 years) than of women (53.9, SD 16.4 years). Associated fracture of the upper extremity was found in 10.2%. Coronoid fractures were most common (4.1%). Associated upper limb fractures in patients with a radial head fracture are common in the European population. It is of clinical importance to suspect associated lesions and to perform a thorough physical examination and additional radiological examination on demand

Scaling solutions and geodesics in moduli space

In this paper we consider cosmological scaling solutions in general relativity coupled to scalar fields with a non-trivial moduli space metric. We discover that the scaling property of the cosmology is synonymous with the scalar fields tracing out a particular class of geodesics in moduli space - those which are constructed as integral curves of the gradient of the log of the potential. Given a generic scalar potential we explicitly construct a moduli metric that allows scaling solutions, and we show the converse - how one can construct a potential that allows scaling once the moduli metric is known.Comment: 10 pages, 3 figure

Association between characteristics of nursing teams and patients' aggressive behavior in closed psychiatric wards

PURPOSE: Estimate the effect of nursing, shift, and patient characteristics on patients' aggression. DESIGN AND METHODS: Follow‐up study on a closed psychiatric ward was performed to estimate the effect of nursing team characteristics and patient characteristics on the incidence of aggression. FINDINGS: The incidence of aggression (n = 802 in sample) was lower in teams with >75% male nurses. Teams scoring high on extraversion experienced more verbal aggression and teams scoring high on neuroticism experienced more physical aggression. Younger patients and/or involuntarily admitted patients were more frequently aggressive. PRACTICE IMPLICATIONS: These findings could stimulate support for nurses to prevent aggression

Cross-classified multilevel models improved standard error estimates of covariates in clinical outcomes – a simulation study

Objective: To compare estimates of effect and variability resulting from standard linear regression analysis and hierarchical multilevel analysis with cross-classified multilevel analysis under various scenarios. Study design and setting: We performed a simulation study based on a data structure from an observational study in clinical mental health care. We used a Markov chain Monte Carlo approach to simulate 18 scenarios, varying sample sizes, cluster sizes, effect sizes and between group variances. For each scenario, we performed standard linear regression, multilevel regression with random intercept on patient level, multilevel regression with random intercept on nursing team level and cross-classified multilevel analysis. Results: Applying cross-classified multilevel analyses had negligible influence on the effect estimates. However, ignoring cross-classification led to underestimation of the standard errors of the covariates at the two cross-classified levels and to invalidly narrow confidence intervals. This may lead to incorrect statistical inference. Varying sample size, cluster size, effect size and variance had no meaningful influence on these findings. Conclusion: In case of cross-classified data structures, the use of a cross-classified multilevel model helps estimating valid precision of effects, and thereby, support correct inferences

Dynamics of Generalized Assisted Inflation

We study the dynamics of multiple scalar fields and a barotropic fluid in an FLRW-universe. The scalar potential is a sum of exponentials. All critical points are constructed and these include scaling and de Sitter solutions. A stability analysis of the critical points is performed for generalized assisted inflation, which is an extension of assisted inflation where the fields mutually interact. Effects in generalized assisted inflation which differ from assisted inflation are emphasized. One such a difference is that an (inflationary) attractor can exist if some of the exponential terms in the potential are negative.Comment: 27 page

Brane solutions and integrability: a status report

We review the status of the integrability and solvability of the geodesics equations of motion on symmetric coset spaces that appear as sigma models of supergravity theories when reduced over respectively the timelike and spacelike direction. Such geodesic curves describe respectively timelike and spacelike brane solutions. We emphasize the applications to black holes.Comment: 4 pages, Proceedings of ERE 2010, Granada, 6-10 september 201

Brane solutions and integrability: a status report

We review the status of the integrability and solvability of the geodesics equations of motion on symmetric coset spaces that appear as sigma models of supergravity theories when reduced over respectively the timelike and spacelike direction. Such geodesic curves describe respectively timelike and spacelike brane solutions. We emphasize the applications to black holes.Comment: 4 pages, Proceedings of ERE 2010, Granada, 6-10 september 201