It's not the years in your life that matter, it's the life in your years

No abstract available

Post-myocardial infarction education is effective but not enough on its own

No abstract available

Predictors of pain relief following spinal cord stimulation in chronic back and leg pain and failed back surgery syndrome: a systematic review and meta-regression analysis

We sought to assess the extent to which pain relief in chronic back and leg pain (CBLP) following spinal cord stimulation (SCS) is influenced by patient‐related factors, including pain location, and technology factors. A number of electronic databases were searched with citation searching of included papers and recent systematic reviews. All study designs were included. The primary outcome was pain relief following SCS, we also sought pain score (pre‐ and post‐SCS). Multiple predictive factors were examined: location of pain, history of back surgery, initial level of pain, litigation/worker's compensation, age, gender, duration of pain, duration of follow‐up, publication year, continent of data collection, study design, quality score, method of SCS lead implant, and type of SCS lead. Between‐study association in predictive factors and pain relief were assessed by meta‐regression. Seventy‐four studies (N = 3,025 patients with CBLP) met the inclusion criteria; 63 reported data to allow inclusion in a quantitative analysis. Evidence of substantial statistical heterogeneity (P < 0.0001) in level of pain relief following SCS was noted. The mean level of pain relief across studies was 58% (95% CI: 53% to 64%, random effects) at an average follow‐up of 24 months. Multivariable meta‐regression analysis showed no predictive patient or technology factors. SCS was effective in reducing pain irrespective of the location of CBLP. This review supports SCS as an effective pain relieving treatment for CBLP with predominant leg pain with or without a prior history of back surgery. Randomized controlled trials need to confirm the effectiveness and cost‐effectiveness of SCS in the CLBP population with predominant low back pain

Career pathways of youth work graduates

A survey of the 49 youth work students who graduated from the Edith Cowan University in the years 1986 to 1988 was undertaken. Information was sought on the occupational destinations of graduates including the time taken to obtain a first appointment, impediments experienced\u27 in attempting to gain a position, and perceived barriers to future career prospects. The study found that most graduates were able to obtain employment in the youth affairs field. However, it is clear that life is not easy for many youth workers for reasons such as low salaries, adverse working conditions, lack of professional status, and uncertain funding arrangements. In spite of the impact of these factors a majority of graduates have chosen to remain in youth affairs

Surrogate endpoints in trials-a call for better reporting

Better reporting of RCTs with primary surrogate endpoints

Cardiac rehabilitation

No abstract available

Artifacts, Activities, Benefits and Blockers: Exploring Enterprise Architecture Practice in Depth

Enterprise architecture (EA) is a collection of artifacts describing an organization from an integrated business and IT perspective and intended to improve business and IT alignment. The purpose of this study is to identify benefits and blockers associated with specific EA-related activities and respective artifacts. Most existing studies discuss the benefits and problems of EA practice in general without relating them to specific activities constituting EA practice. This study is based on 18 interviews with architects and leverages the grounded theory approach. As a result of our analysis, we identify eight consistent activity areas constituting EA practice. Each activity area implies certain activities supported by some EA artifacts leading to specific benefits often impeded by some blockers. Our analysis indicates that EA practice includes many diverse activities usually, though not always, closely associated with specific types of EA artifacts. Moreover, benefits and blockers of EA practice are also very activity-specific

'Who Cares?' The experiences of caregivers of adults living with heart failure, chronic obstructive pulmonary disease and coronary artery disease: a mixed methods systematic review

Objective: To assess the experiences of unpaid caregivers providing care to people with heart failure (HF) or chronic obstructive pulmonary disease (COPD) or coronary artery disease (CAD). Design: Mixed methods systematic review including qualitative and quantitative studies. Data sources: Databases searched: Medline Ebsco, PsycInfo, CINAHL Plus with Full Text, Embase, Web of Science, Ethos: The British Library and ProQuest. Grey literature identified using: Global Dissertations and Theses and Applied Sciences Index and hand searches and citation checking of included references. Search time frame: 1 January 1990 to 30 August 2017. Eligibility criteria for selecting studies: Inclusion was limited to English language studies in unpaid adult caregivers (>18 years), providing care for patients with HF, COPD or CAD. Studies that considered caregivers for any other diagnoses and studies undertaken in low-income and middle-income countries were excluded. Quality assessment of included studies was conducted by two authors. Data analysis/synthesis: A results-based convergent synthesis was conducted. Results: Searches returned 8026 titles and abstracts. 54 studies—21 qualitative, 32 quantitative and 1 mixed method were included. This totalled 26 453 caregivers who were primarily female (63%), with median age of 62 years. Narrative synthesis yielded six concepts related to caregiver experience: (1) mental health, (2) caregiver role, (3) lifestyle change, (4) support for caregivers, (5) knowledge and (6) relationships. There was a discordance between paradigms regarding emerging concepts. Four concepts emerged from qualitative papers which were not present in quantitative papers: (1) expert by experience, (2) vigilance, (3) shared care and (4) time. Conclusion: Caregiving is life altering and complex with significant health implications. Health professionals should support caregivers who in turn can facilitate the recipient to manage their long-term condition. Further longitudinal research exploring the evolution of caregiver experiences over time of patients with chronic cardiopulmonary conditions is required

Can Enterprise Architecture Be Based on the Business Strategy?

Enterprise architecture (EA) is a set of documents describing various aspects of an organization from an integrated business and IT perspective. EA facilitates information systems planning and helps improve business and IT alignment. Traditionally, the concept of EA was closely coupled with the business strategy and mainstream EA methodologies recommend starting the EA effort from documenting the business strategy and then using it as the basis for defining the required structure of information systems. This conceptual paper discusses in detail four practical problems with the business strategy that question its value as the basis for EA initiatives. The presence of these problems challenges one of the most cherished beliefs or even axioms of the EA discipline: that EA should be based on the business strategy. This paper raises a number of questions regarding the information inputs necessary for the EA effort and calls for further research in respective directions