103 research outputs found
Music therapy for depression.
Background Depression is a highly prevalent mood disorder that is characterised by persistent low mood, diminished interest, and loss of pleasure. Music therapy may be helpful in modulating moods and emotions. An update of the 2008 Cochrane review was needed to improve knowledge on effects of music therapy for depression. Objectives 1. To assess effects of music therapy for depression in people of any age compared with treatment as usual (TAU) and psychological, pharmacological, and/or other therapies. 2. To compare effects of different forms of music therapy for people of any age with a diagnosis of depression. Search methods We searched the following databases: the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR; from inception to 6 May 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; to 17 June 2016); Thomson Reuters/Web of Science (to 21 June 2016); Ebsco/PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed (to 5 July 2016); the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, the National Guideline Clearing House, and OpenGrey (to 6 September 2016); and the Digital Access to Research Theses (DART)-Europe E-theses Portal, Open Access Theses and Dissertations, and ProQuest Dissertations and Theses Database (to 7 September 2016). We checked reference lists of retrieved articles and relevant systematic reviews and contacted trialists and subject experts for additional information when needed. We updated this search in August 2017 and placed potentially relevant studies in the "Awaiting classification" section; we will incorporate these into the next version of this review as appropriate
Narrow-band Imaging for Detection of Neoplasia at Colonoscopy: a Meta-analysis of Data From Individual Patients in Randomized Controlled Trials
Background & Aims
Adenoma detection rate (ADR) is an important quality assurance measure for colonoscopy. Some studies suggest that narrow band imaging (NBI) may be more effective at detection of adenomas than white-light endoscopy (WLE) when bowel preparation is optimal. We conducted a meta-analysis of data from individual patients in randomized controlled trials that compared the efficacy of NBI to WLE in detection of adenomas.
Methods
We searched MEDLINE, EMBASE, and Cochrane library databases, through April 2017, for randomized controlled trials that assessed detection of colon polyps by high-definition WLE vs NBI and from which data on individual patients was available. The primary outcome measure was ADR adjusted for bowel preparation quality. Multilevel regression models were used with patients nested within trials, and trial included as a random effect.
Results
We collected data from 11 trials, comprising 4491 patients and 6636 polyps detected. Adenomas were detected in 952/2251 (42.3%) participants examined by WLE vs 1011/2239 (45.2%) participants examined by NBI (unadjusted odds ratio [OR] for detection of adenoma by WLE vs NBI, 1.14; 95% CI, 1.01–1.29; P=.04). NBI outperformed WLE only when bowel preparation was best: adequate preparation OR, 1.07 (95% CI, 0.92–1.24; P=.38) vs best preparation OR, 1.30 (95% CI, 1.04–1.62; P=.02). Second-generation bright NBI had a better ADR than WLE (second-generation NBI OR, 1.28; 95% CI, 1.05–1.56; P=.02), whereas first-generation NBI did not. NBI detected more non-adenomatous polyps than WLE (OR, 1.24; 95% CI, 1.06–1.44; P=.008) and flat polyps than WLE (OR, 1.24; 95% CI, 1.02–1.51; P=.03).
Conclusions
In a meta-analysis of data from individual patients in randomized controlled trials, we found NBI to have a higher ADR than WLE, and that this effect is greater when bowel preparation is optimal
Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP
Background:
Surgery for obesity and metabolic diseases has been evolved in the light of new scientific evidence, long-term outcomes and accumulated experience. EAES has sponsored an update of previous guidelines on bariatric surgery.
Methods:
A multidisciplinary group of bariatric surgeons, obesity physicians, nutritional experts, psychologists, anesthetists and a patient representative comprised the guideline development panel. Development and reporting conformed to GRADE guidelines and AGREE II standards.
Results:
Systematic review of databases, record selection, data extraction and synthesis, evidence appraisal and evidence-to-decision frameworks were developed for 42 key questions in the domains Indication; Preoperative work-up; Perioperative management; Non-bypass, bypass and one-anastomosis procedures; Revisional surgery; Postoperative care; and Investigational procedures. A total of 36 recommendations and position statements were formed through a modified Delphi procedure.
Conclusion:
This document summarizes the latest evidence on bariatric surgery through state-of-the art guideline development, aiming to facilitate evidence-based clinical decisions
EAES and SAGES 2018 consensus conference on acute diverticulitis management:evidence-based recommendations for clinical practice
Background Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. Methods Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with < 70% agreement. Results A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members’ online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. Conclusion This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice
Early prediction of outcome of activities of daily living after stroke: a systematic review
Background and Purpose-Knowledge about robust and unbiased factors that predict outcome of activities of daily living (ADL) is paramount in stroke management. This review investigates the methodological quality of prognostic studies in the early poststroke phase for final ADL to identify variables that are predictive or not predictive for outcome of ADL after stroke. Methods-PubMed, Ebsco/Cinahl and Embase were systematically searched for prognostic studies in which stroke patients were included = 3 months poststroke. Risk of bias scores were used to distinguish high-and low-quality studies and a qualitative synthesis was performed. Results-Forty-eight of 8425 identified citations were included. The median risk of bias score was 17 out of 27 (range, 6-22) points. Most studies failed to report medical treatment applied, management of missing data, rationale for candidate determinants and outcome cut-offs, results of univariable analysis, and validation and performance of the model, making the predictive value of most determinants indistinct. Six high-quality studies showed strong evidence for baseline neurological status, upper limb paresis, and age as predictors for outcome of ADL. Gender and risk factors such as atrial fibrillation were unrelated to this outcome. Conclusions-Because of insufficient methodological quality of most prognostic studies, the predictive value of many clinical determinants for outcome of ADL remains unclear. Future cohort studies should focus on early prediction using simple models with good clinical performance to enhance application in stroke management and research. (Stroke. 2011;42:1482-1488.
Chemical sterilization in in vitro propagation of Arundina bambusifolia Lindl. and Epidendrum ibaguense Kunth
Quality specifications in postgraduate medical e-learning: an integrative literature review leading to a postgraduate medical e-learning model
Descriptors for unprofessional behaviours of medical students: a systematic review and categorisation
User preferences for adaptive user interfaces in health information systems
An adaptive user interface requires identification of user requirements. Interface designers and engineers must understand end-user interaction with the system to improve user interface design. A combination of interviews and observations is applied for user requirement analysis in health information systems (HIS). Then, user preferences are categorized in this paper as either data entry, language and vocabulary, information presentation, or help, warning and feedback. The user preferences in these categories were evaluated using the focus group method. Focus group sessions with different types of HIS users comprising medical staff (with and without computer skills) and system administrators identified each user group’s preference for the initial adaptation of the HIS user interface. User needs and requirements must be identified to adapt the interface to users during data entry into the system. System designers must understand user interactions with the system to identify their needs and preferences. Without this, interface design cannot be adapted to users and users will not be comfortable using the system and eventually abandon its use
Техники визуализации в переговорном процессе
Negotiations beneficial to negotiators’ interests are the most effective model of conflict resolution. This
approach to negotiations necessarily requires cooperative interaction between participants. However,
the problem of organizing cooperation remains open. This article describes visualization techniques
applicable in negotiation process and shows possibilities for effective realization of negotiation
techniques. The experimental research has shown that visualization helps to productively resolve
contradictions by allowing their registering and structuring and facilitates transition of participants’
attitudes from confrontation to cooperationПереговоры по интересам – наиболее эффективная модель разрешения конфликтов. Этот
подход к переговорам с необходимостью требует кооперативного взаимодействия участников.
Однако вопрос о средствах организации кооперации остается открытым. В статье описаны
техники визуализации, применимые в переговорном процессе, и показаны их возможности для
эффективной реализации технологии ведения переговоров. Экспериментальное исследование
показало, что визуализация способствует продуктивному разрешению противоречия за счет
его оформления и обеспечивает смену установки участников с конфронтации на коопераци
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