40 research outputs found
Applying the Risk of Bias Tool in a Systematic Review of Combination Long-Acting Beta-Agonists and Inhaled Corticosteroids for Persistent Asthma
Background: The Risk of Bias (RoB) tool is used to assess internal validity of randomized controlled trials (RCTs). Our objectives were to: 1) evaluate inter-rater agreement of the RoB tool; 2) determine the time to access supplemental study information; 3) compare the RoB tool with the Jadad scale and Schulz allocation concealment (AC); and 4) examine the relationship between RoB and effect estimates. Methods: We conducted a systematic review of long-acting beta agonists (LABA) combined with inhaled corticosteroids (ICS) for adults with persistent asthma. Two reviewers independently assessed 107 trials using RoB, Jadad, and AC. One reviewer searched for study protocols. We assessed inter-rater agreement using weighted Kappa (k) and the correlation between tools using Kendall’s Tau (t). Mean differences in effect sizes for RCTs with different RoB were calculated using inverse variance method and random effects model. Results: Trials had good Jadad scores (median 4, IQR 3-4); however, 85 % had unclear AC and 87 % high RoB. The factor that most influenced RoB was the potential inappropriate influence of study sponsors (95 % industry funded). Agreement on RoB domains was fair (k = 0.40) to almost perfect (k = 0.86), and moderate for overall RoB (k = 0.41). Median time to complete RoB assessments was 21 minutes (IQR 14-27) and 12 minutes (IQR 9-16) to search for protocols. Protocols were identified for 5/42 studies (12%); in 3 cases the assessment of selective outcome reporting changed. There was low correlation between overall RoB vs. Jadad (t =0.04
The Vehicle, Spring 2010
Table of Contents
ForgettingRashelle McNairpage 34
MuseMary Lieskepage 35
My CompulsionAshton Tembypage 38
MemoryKate Vandermeerpage 41
Killmercialize MeGreg Petersonpage 42
PenJake Smithpage 46
GrassKate Vandermeerpage 48
Character CreationMary Lieskepage 52
Ring Around TheKim Hunter-Perkinspage 54
The Great Cursive ScareJake Smithpage 55
OpiateDoug Urbanskipage 61
What Happens to Little Girls...Jennifer O\u27Neilpage 63
Poetry
Sunny DaysRyan Poolpage 2
AtlantisDoug Urbanskipage 4
Garbage CityKate Vandermeerpage 6
Fat Girl ThongsKim Hunter-Perkinspage 7
MercilessRosalia Pecorapage 19
ChemistryMary Lieskepage 20
He-Who-Stopped-TalkingJustin Sudkamppage 22
In Which Iris Contemplates a Barren EarthSean Slatterypage 24
At the Bottom of the WorldNick Canadaypage 27
Dogma: Mush!Scott Maypage 28
ThiefMary Lieskepage 29
Prose
Coming HomeDoug Urbanskipage 8
DodoDan Davispage 31
The Poet in the PedestrianScott Maypage 37
Toxic RainJacob Swansonpage 40
What\u27s Your Greatest Fear?Justine Fittonpage 43
Soul VoiceHolly Thomaspage 49
Conversations with a SniperKim Hunter-Perkinspage 56
LettersDaniel Paquinpage 65
Art
San Marcos, MexicoKate Vandermeercover
Contemplation of the World\u27s EndNicholas Giffordpage 18
Little Lady SitsSarah Hadwigerpage 26
MoodAlycia Rockeypage 30
Four Ducks in a RowMegan Mathypage 36
The Daily EasternBen Tillerypage 39
BirdsAlycia Rockeypage 45
March of the BugsMegan Mathypage 47
Mexico Work ExperienceKate Vandermeerpage 53
Feather and JewelsAlycia Rockeypage 60
The ForgottenMegan Mathypage 64
Special Features
Fall 2009-Spring 2010 Vehicle Award Winnerspage 1
James K. Johnson Creative Writing Awardpage 74
Kim Hunter-PerkinsWinning Entries (Poetry)page 75
Clint WalkerWinning Entry (Fiction)page 86
Faculty Spotlight: Professor Jason Brownpage 99
About the Contributorspage 106
About the Editorspage 110https://thekeep.eiu.edu/vehicle/1093/thumbnail.jp
From the Trenches: A Cross-Sectional Study Applying the GRADE Tool in Systematic Reviews of Healthcare Interventions
Background: GRADE was developed to address shortcomings of tools to rate the quality of a body of evidence. While much has been published about GRADE, there are few empirical and systematic evaluations. Objective: To assess GRADE for systematic reviews (SRs) in terms of inter-rater agreement and identify areas of uncertainty. Design: Cross-sectional, descriptive study. Methods: We applied GRADE to three SRs (n = 48, 66, and 75 studies, respectively) with 29 comparisons and 12 outcomes overall. Two reviewers graded evidence independently for outcomes deemed clinically important a priori. Inter-rater reliability was assessed using kappas for four main domains (risk of bias, consistency, directness, and precision) and overall quality of evidence. Results: For the first review, reliability was: k = 0.41 for risk of bias; 0.84 consistency; 0.18 precision; and 0.44 overall quality. Kappa could not be calculated for directness as one rater assessed all items as direct; assessors agreed in 41 % of cases. For the second review reliability was: 0.37 consistency and 0.19 precision. Kappa could not be assessed for other items; assessors agreed in 33 % of cases for risk of bias; 100 % directness; and 58 % overall quality. For the third review, reliability was: 0.06 risk of bias; 0.79 consistency; 0.21 precision; and 0.18 overall quality. Assessors agreed in 100 % of cases for directness. Precision created the most uncertainty due to difficulties in identifying ‘‘optimal’ ’ information size and ‘‘clinica
Characteristics of Patients with Oseltamivir-Resistant Pandemic (H1N1) 2009, United States
During April 2009–June 2010, thirty-seven (0.5%) of 6,740 pandemic (H1N1) 2009 viruses submitted to a US surveillance system were oseltamivir resistant. Most patients with oseltamivir-resistant infections were severely immunocompromised (76%) and had received oseltamivir before specimen collection (89%). No evidence was found for community circulation of resistant viruses; only 4 (unlinked) patients had no oseltamivir exposure
Patient-centered interventions to improve medication management and adherence: A qualitative review of research findings
Patient-centered approaches to improving medication adherence hold promise, but evidence of their effectiveness is unclear. This review reports the current state of scientific research around interventions to improve medication management through four patient-centered domains: shared decision-making, methods to enhance effective prescribing, systems for eliciting and acting on patient feedback about medication use and treatment goals, and medication-taking behavior
Behavioural and Developmental Interventions for Autism Spectrum Disorder: A Clinical Systematic Review
Background: Much controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD). We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD. Methods and Findings: Comprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlle
Structural brain correlates of childhood inhibited temperament: an ENIGMA-Anxiety Mega-analysis
NWORubicon 019.201SG.022Pathways through Adolescenc
Mycorrhizal feedbacks influence global forest structure and diversity
One mechanism proposed to explain high species diversity in tropical systems is strong negative conspecific density dependence (CDD), which reduces recruitment of juveniles in proximity to conspecific adult plants. Although evidence shows that plant-specific soil pathogens can drive negative CDD, trees also form key mutualisms with mycorrhizal fungi, which may counteract these effects. Across 43 large-scale forest plots worldwide, we tested whether ectomycorrhizal tree species exhibit weaker negative CDD than arbuscular mycorrhizal tree species. We further tested for conmycorrhizal density dependence (CMDD) to test for benefit from shared mutualists. We found that the strength of CDD varies systematically with mycorrhizal type, with ectomycorrhizal tree species exhibiting higher sapling densities with increasing adult densities than arbuscular mycorrhizal tree species. Moreover, we found evidence of positive CMDD for tree species of both mycorrhizal types. Collectively, these findings indicate that mycorrhizal interactions likely play a foundational role in global forest diversity patterns and structure
Phylogenetic classification of the world's tropical forests
Knowledge about the biogeographic affinities of the world’s tropical forests helps to better understand regional differences in forest structure, diversity, composition, and dynamics. Such understanding will enable anticipation of region-specific responses to global environmental change. Modern phylogenies, in combination with broad coverage of species inventory data, now allow for global biogeographic analyses that take species evolutionary distance into account. Here we present a classification of the world’s tropical forests based on their phylogenetic similarity. We identify five principal floristic regions and their floristic relationships: (i) Indo-Pacific, (ii) Subtropical, (iii) African, (iv) American, and (v) Dry forests. Our results do not support the traditional neo- versus paleotropical forest division but instead separate the combined American and African forests from their Indo-Pacific counterparts. We also find indications for the existence of a global dry forest region, with representatives in America, Africa, Madagascar, and India. Additionally, a northern-hemisphere Subtropical forest region was identified with representatives in Asia and America, providing support for a link between Asian and American northern-hemisphere forests.</p