scholarly journals Prescription of the First Prosthesis and Later use in Children with Congenital Unilateral Upper Limb Deficiency: A Systematic Review

2006 ◽  
Vol 30 (2) ◽  
pp. 165-173 ◽  
Author(s):  
M. Meurs ◽  
C. G. B. Maathuis ◽  
C. Lucas ◽  
M. Hadders-Algra ◽  
C. K. van der Sluis
Keyword(s):  
Upper Limb ◽  
Functional Outcomes ◽  
Scientific Evidence ◽  
Rejection Rate ◽  
Cochrane Database ◽  
Based Medicine ◽  
First Time ◽  
Limb Deficiency ◽  
Rejection Rates

Background: The prosthetic rejection rates in children with an upper limb transversal reduction deficiency are considerable. It is unclear whether the timing of the first prescription of the prosthesis contributes to the rejection rates. Objective: To reveal whether scientific evidence is available in literature to confirm the hypothesis that the first prosthesis of children with an upper limb deficiency should be prescribed before two years of age. We expect lower rejection rates and better functional outcomes in children fitted at young age. Methods: A computerized search was performed in several databases (Medline, Embase, Cinahl, Amed, Psycinfo, PiCarta and the Cochrane database). A combination of the following keywords and their synonyms was used: “prostheses, upper limb, upper extremity, arm and congenital”. Furthermore, references of conference reports, references of most relevant studies, citations of most relevant studies and related articles were checked for relevancy. Results: The search yielded 285 publications, of which four studies met the selection criteria. The methodological quality of the studies was low. All studies showed a trend of lower rejection rates in children who were provided with their first prosthesis at less than two years of age. The pooled odds ratio of two studies showed a higher rejection rate in children who were fitted over two years of age (pooled OR = 3.6, 95% CI 1.6 – 8.0). No scientific evidence was found concerning the relation between the age at which a prosthesis was prescribed for the first time and functional outcomes. Conclusion: In literature only little evidence was found for a relationship between the fitting of a first prosthesis in children with a congenital upper limb deficiency and rejection rates or functional outcomes. As such, clinical practice of the introduction of a prosthesis is guided by clinical experience rather than by evidence-based medicine.

How to Search and Critique Scientific Evidence for Decision-Making

2017 ◽  
pp. 100-123
Author(s):  
Mayuree Tangkiatkumjai ◽  
Win Winit-Watjana ◽  
Li-Chia Chen
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Literature Search ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Evidence Based ◽  
Search Terms ◽  
Based Medicine ◽  
Complementary And Alternative

A clinical decision on the use of complementary and alternative medicine (CAM) should be made based on evidence-based medicine (EBM) together with practitioner's knowledge and experiences. This chapter describes the process of EBM, including how to address a clinical question, do a systematic search for appropriate evidence with key search terms, appraise the evidence and make a clinical decision on CAM applications. An effective literature search should be performed by using a structured search strategy in searching biomedical and CAM databases, such as the National Center for Complementary and Alternative Medicine (CAM Citation Index). Few standard tools are recommended to evaluate the quality of CAM studies, i.e. the CONSORT extension for herbal interventions and STRICTA for RCTs of acupuncture. Additionally, some guidelines for designing RCTs in Chinese herbal medicine (CHM) can also be adopted to critique CAM literature. A clinical decision on choosing optimal CAM for patient care should be based on the current best evidence emerged from the EBM process.

Management of anterior cervical pseudarthrosis

2009 ◽  
Vol 11 (2) ◽  
pp. 228-237 ◽  
Author(s):  
Michael G. Kaiser ◽  
Praveen V. Mummaneni ◽  
Paul G. Matz ◽  
Paul A. Anderson ◽  
Michael W. Groff ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Consensus Conference ◽  
Class Iii ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Cervical Spine Surgery ◽  
Cochrane Database ◽  
Strength Based ◽  
Based Medicine

Object The objective of this systematic review was to use evidence-based medicine to identify the best methodology for diagnosis and treatment of anterior pseudarthrosis. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to pseudarthrosis and cervical spine surgery. Abstracts were reviewed, after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Evaluation for pseudarthrosis is warranted, as there may be an association between clinical outcome and pseudarthrosis. The strength of this association cannot be accurately determined because of the variable incidence of symptomatic and asymptomatic pseudarthroses (Class III). Revision of a symptomatic pseudarthrosis may be considered because arthrodesis is associated with improved clinical outcome (Class III). Both posterior and anterior approaches have proven successful for surgical correction of an anterior pseudarthrosis. Posterior approaches may be associated with higher fusion rates following repair of an anterior pseudarthrosis (Class III). Conclusions If suspected, pseudarthrosis should be investigated because there may be an association between arthrodesis and outcome. However, the strength of this association cannot be accurately determined. Anterior and posterior approaches have been successful.

scholarly journals Eyes-Free Tongue Gesture and Tongue Joystick Control of a Five DOF Upper-Limb Exoskeleton for Severely Disabled Individuals

2021 ◽  
Vol 15 ◽  
Author(s):  
Mostafa Mohammadi ◽  
Hendrik Knoche ◽  
Mikkel Thøgersen ◽  
Stefan Hein Bengtson ◽  
Muhammad Ahsan Gull ◽  
...  
Keyword(s):  
Visual Feedback ◽  
Upper Limb ◽  
Degrees Of Freedom ◽  
Continuous Control ◽  
Clinical Case Study ◽  
Upper Limb Exoskeleton ◽  
Control Interface ◽  
Cord Injury ◽  
First Time

Spinal cord injury can leave the affected individual severely disabled with a low level of independence and quality of life. Assistive upper-limb exoskeletons are one of the solutions that can enable an individual with tetraplegia (paralysis in both arms and legs) to perform simple activities of daily living by mobilizing the arm. Providing an efficient user interface that can provide full continuous control of such a device—safely and intuitively—with multiple degrees of freedom (DOFs) still remains a challenge. In this study, a control interface for an assistive upper-limb exoskeleton with five DOFs based on an intraoral tongue-computer interface (ITCI) for individuals with tetraplegia was proposed. Furthermore, we evaluated eyes-free use of the ITCI for the first time and compared two tongue-operated control methods, one based on tongue gestures and the other based on dynamic virtual buttons and a joystick-like control. Ten able-bodied participants tongue controlled the exoskeleton for a drinking task with and without visual feedback on a screen in three experimental sessions. As a baseline, the participants performed the drinking task with a standard gamepad. The results showed that it was possible to control the exoskeleton with the tongue even without visual feedback and to perform the drinking task at 65.1% of the speed of the gamepad. In a clinical case study, an individual with tetraplegia further succeeded to fully control the exoskeleton and perform the drinking task only 5.6% slower than the able-bodied group. This study demonstrated the first single-modal control interface that can enable individuals with complete tetraplegia to fully and continuously control a five-DOF upper limb exoskeleton and perform a drinking task after only 2 h of training. The interface was used both with and without visual feedback.

scholarly journals Evidence-Based Phytoiatry, a New Approach in Crop Protection

2019 ◽  
Vol 20 (1) ◽  
pp. 171
Author(s):  
Marcello Iriti ◽  
Elena Maria Varoni
Keyword(s):  
Plant Protection ◽  
Crop Protection ◽  
Plant Protection Products ◽  
Scientific Quality ◽  
Evidence Based ◽  
New Approach ◽  
Novel Concept ◽  
Based Medicine ◽  
First Time

In the past decades, the scientific quality of biomedical studies has been hierarchically depicted in the well-known pyramid of evidence-based medicine (EBM), with higher and higher levels of evidence moving from the base to the top. Such an approach is missing in the modern crop protection and, therefore, we introduce, for the first time, this novel concept of evidence-based phytoiatry in this field. This editorial is not a guideline on plant protection products (PPP) registration, but rather a scientific and technical support for researchers involved in the general area of plant pathology, providing them with evidence-based information useful to design critically new studies.

Epidemiology 2: Study Design

2010 ◽  
pp. 47-58
Author(s):  
Muktar H. Aliyu
Keyword(s):  
Study Design ◽  
Scientific Evidence ◽  
Epidemiologic Study ◽  
Scientific Research ◽  
Time Frame ◽  
Epidemiologic Studies ◽  
Evidence Based ◽  
Study Designs ◽  
Based Medicine

The usefulness of evidence arising from scientific research is influenced by several factors, and foremost among these factors is the design of the epidemiologic study from which the findings are drawn. In evidence-based medicine, the quality of scientific evidence is often graded on the base of the type of study design and includes appraisal of methods by which studies of exposure and outcomes are planned and implemented. Several factors must be considered when designing a scientific study, including the hypothesis being tested, study cost, time frame, subject characteristics, choice of variables or measurements, and ethical concerns. In this chapter, the different types of study designs commonly encountered in clinical research, common measures of morbidity and mortality in epidemiology, and errors (random and systematic) that may threaten conclusions derived from inferences arising from epidemiologic studies are discussed.

scholarly journals Pseudomonas aeruginosa infection in patients with cystic fibrosis: scientific evidence regarding clinical impact, diagnosis, and treatment

2013 ◽  
Vol 39 (4) ◽  
pp. 495-512 ◽  
Author(s):  
Luiz Vicente Ribeiro Ferreira da Silva Filho ◽  
Flavia de Aguiar Ferreira ◽  
Francisco Jose Caldeira Reis ◽  
Murilo Carlos Amorim de Britto ◽  
Carlos Emilio Levy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Scientific Evidence ◽  
Scientific Information ◽  
Clinical Impact ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Pseudomonas Aeruginosa Infection ◽  
Based Medicine

Evidence-based techniques have been increasingly used in the creation of clinical guidelines and the development of recommendations for medical practice. The use of levels of evidence allows the reader to identify the quality of scientific information that supports the recommendations made by experts. The objective of this review was to address current concepts related to the clinical impact, diagnosis, and treatment of Pseudomonas aeruginosa infections in patients with cystic fibrosis. For the preparation of this review, the authors defined a group of questions that would be answered in accordance with the principles of PICO–an acronym based on questions regarding the Patients of interest, Intervention being studied, Comparison of the intervention, and Outcome of interest. For each question, a structured review of the literature was performed using the Medline database in order to identify the studies with the methodological design most appropriate to answering the question. The questions were designed so that each of the authors could write a response. A first draft was prepared and discussed by the group. Recommendations were then made on the basis of the level of scientific evidence, in accordance with the classification system devised by the Oxford Centre for Evidence-Based Medicine, as well as the level of agreement among the members of the group.

scholarly journals Analysis of Sample Rejection and the Impact on Quality of Care in Patients in a Single Tertiary Healthcare Facility in Malaysia

2020 ◽  
Vol 5 (13) ◽  
pp. 175-181
Author(s):  
Fatmawati Kamal ◽  
Wan Asmuni Wan Mohd Saman ◽  
Madyhah Adbul Monir
Keyword(s):  
Quality Of Care ◽  
Publishing House ◽  
Rejection Rate ◽  
Healthcare Facility ◽  
Specialist Centre ◽  
Tertiary Healthcare ◽  
International Publishing ◽  
The Impact ◽  
Rejection Rates

The Malaysian Society for Quality in Health (MSQH), recommended a rejection rate of less than 1%. Many studies reported rejection rates of 0.1% to 3.49%. This study was conducted at the UiTM Medical Specialist Centre from January 2019 to October 2019. The blood bank and haematology workstation both rejected 84 (5.7%) and 560 (3.38%) samples, respectively. The main causes of sample rejection were clotted and lysed samples. Most of the rejected samples came from the wards, followed by the emergency department. This study showed the need for improvement in venipuncture techniques and types of equipment.Keywords: Rejection rates; Sample rejection; Quality of care; Tertiary centreeISSN: 2398-4287 © 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v5i13.2104

Cervical laminoforaminotomy for the treatment of cervical degenerative radiculopathy

2009 ◽  
Vol 11 (2) ◽  
pp. 198-202 ◽  
Author(s):  
Robert F. Heary ◽  
Timothy C. Ryken ◽  
Paul G. Matz ◽  
Paul A. Anderson ◽  
Michael W. Groff ◽  
...  
Keyword(s):  
Cervical Radiculopathy ◽  
Consensus Conference ◽  
Cervical Disc ◽  
Class Iii ◽  
Level Of Evidence ◽  
Outcomes Measures ◽  
Cochrane Database ◽  
Strength Based ◽  
Based Medicine

Object The objective of this systematic review was to use evidence-based medicine to examine the efficacy of posterior laminoforaminotomy in the treatment of cervical radiculopathy. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to posterior laminoforaminotomy and cervical radiculopathy. Abstracts were reviewed, and studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations which contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Posterior laminoforaminotomy improves clinical outcome in the treatment of cervical radiculopathy resulting from soft lateral cervical disc displacement or cervical spondylosis with resulting narrowing of the lateral recess. All studies were Class III. The most frequent design flaw involved the lack of utilization of validated outcomes measures. In addition, few historical studies included a detailed preoperative analysis of the patients. As such, the vast majority of studies that included both pre- and postoperative assessments with legitimate outcomes measures have been performed since 1990. Conclusions Posterior laminoforaminotomy is an effective treatment for cervical radiculopathy.

Communication Sciences and Disorders PhD Graduates' Perceptions of Their PhD Program

2020 ◽  
Vol 5 (2) ◽  
pp. 463-478
Author(s):  
Elizabeth Crais ◽  
Melody Harrison Savage
Keyword(s):  
Detailed Examination ◽  
Career Expectations ◽  
Doctoral Preparation ◽  
Creative Solutions ◽  
Phd Education ◽  
Doctor Of Philosophy ◽  
First Time ◽  
Students Success ◽  
Phd Program

Purpose The shortage of doctor of philosophy (PhD)–level applicants to fill academic and research positions in communication sciences and disorders (CSD) programs calls for a detailed examination of current CSD PhD educational practices and the generation of creative solutions. The intended purposes of the article are to encourage CSD faculty to examine their own PhD program practices and consider the perspectives of recent CSD PhD graduates in determining the need for possible modifications. Method The article describes the results of a survey of 240 CSD PhD graduates and their perceptions of the challenges and facilitators to completing a PhD degree; the quality of their preparation in research, teaching, and job readiness; and ways to improve PhD education. Results Two primary themes emerged from the data highlighting the need for “matchmaking.” The first time point of needed matchmaking is prior to entry among students, mentors, and expectations as well as between aspects of the program that can lead to students' success and graduation. The second important matchmaking need is between the actual PhD preparation and the realities of the graduates' career expectations, and those placed on graduates by their employers. Conclusions Within both themes, graduate's perspectives and suggestions to help guide future doctoral preparation are highlighted. The graduates' recommendations could be used by CSD PhD program faculty to enhance the quality of their program and the likelihood of student success and completion. Supplemental Material https://doi.org/10.23641/asha.11991480

Sign in / Sign up

Export Citation Format

Share Document