...of these methodologies are provided: * Randomized Controlled Trials – An RCT is a study that measures interventions effect by randomly assigning a person or persons to intervene into a program environment where non-intervened groups can be observed as well. * Direct Controlled Trials – Environment factors can be directly controlled to test effectiveness of a weapon system or new technology expected to operate in the environments that are created and directly controlled. * Quasi-Experimental or Comparison Group Studies – those with compared to those without intervention. * Non-Experimental Direct Analysis – may be used to analyze why a program is so effective. More detailed descriptions of these basic assessment methodologies are provided by the author, who goes on to introduce one of the central challenges to developing strong evidence of a program’s effectiveness – VALID measurement of the outcome or impact of a program compared to VALID measurement of what outcomes would have been in the absence of the program. This probably leads to another supported white paper for modeling and simulation. This article goes on to support the RCT and the unique advantage it has to allow for the evaluation of the intervention itself, as opposed to other factors, that cause the observed outcomes. With large enough numbers in the intervention group, there can be no doubt that the observed differences are attributable to the intervention RCT. The random selection is...
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... handsearching of relevant key journals, and screening of reference lists of included studies were undertaken. There was no language restriction, and unpublished research was sought. The selection criteria were randomized controlled trials comparing splint therapy to either no treatment or another active treatment. Data extraction and validity assessment were carried out independently and in duplicate. Studies were grouped according to treatment type. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only twelve met the inclusion criteria. There is insufficient evidence either for or against the use of stabilization splint therapy over other active interventions for the treatment of temporomandibular myofascial pain. However, it appears that stabilization splint therapy may be beneficial for reducing pain severity at rest and on palpation and depression when compared to no treatment. The authors suggested the need for well conducted RCTs that pay attention to method of allocation, blind outcome assessment, sample size, and duration of follow-up. Various measures were adopted to assess the outcomes of treatment. Standardization of the methods used to measure outcomes of the treatment of myofascial pain should be established in future RCTs. Dr. Al-Ani is Clinical Lecturer in Restorative Dentistry,...
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...Week 6 Discussion 3: Discuss different types of observational and intervention studies, compare the common and different characteristics of different intervention studies, and discuss reliability and validity issues related to intervention studies: Observational (non-experimental) studies are where the investigators are monitoring the relationships between influences and outcomes (Thiese, 2014). The most common types of observational studies include: Correlational Correlational studies determines whether there is a relationship or association between two or more variables (Melynk, Morrison-Beedy, & Cole, 2015). There is no manipulation of any of the variables and the participants are not placed in groups( Polit & Beck, 2014). Data is...
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...strongest outcomes have been obtained with a single, long (3-5 hour) session with a therapist, followed by a briefer follow-up session a week or so later. 2. How common are anxiety disorders? The most recent British Psychiatric Morbidity Survey1 estimates that 16.4% of the population have a diagnosable anxiety and/or depressive disorder. The diagnostic system that was used in the survey (ICD-10) is different from the diagnostic system (DSM-IV) that has been used in most trials of psychological treatments. For this reason, it is difficult to be precise about the number of individuals in the UK who have anxiety disorders for which there is an evidence based psychological treatment. The key difference between the two diagnostic systems is that ICD-10 has a mixed anxiety and depression category whereas DSM-IV does not. However, it seems reasonable to assume that about half of the UK cases of “anxiety and/or depressive disorder” will have problems that were the focus of treatment in anxiety disorder treatment trials. In other...
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...A randomised controlled trial on the effect of clamping the indwelling urinary catheter in patients with hip fracture Critical Appraisal In this quantitative research article, the authors have dealt with one of the most common clinical problem i.e. clamping of urinary catheter after hip surgery. Hip surgery is very common among the people of old age group especially above 75 years. Further, older women are more susceptible to hip fracture and commonly undergo hip injury (Johansson & Christensson, 2010). Bladder catheterization is a common clinical practice in surgeries. It helpful in monitoring urine output in patients. However, it is also associated with one of the major clinical problems, i.e. operative urinary retention (POUR). It can be defined as the inability of a patient to pass urine in spite of full bladder (Baldini, Bagry, Aprikian, & Carli, 2009). It is has been reported that patient of hip surgery are at higher risk of urinary retention (Balderi & Carli, 2010; Johansson & Christensson, 2010; Singh et al., 2010). In the case of hip replacement the incidence of POUR has been reported to be between 12- 84%. Similarly, in case of hip fracture the prevalence of POUR is 18% to 56% (Borghi et al., 2004; Oishi et al., 1995). The most effective intervention reported till date for reducing the risk of urinary retention is clamping of urinary catheter. The main objective of this paper was to investigate the efficacy of clamping of urinary catheter through randomized...
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...Cochrane review found low-to-moderate quality evidence that acupuncture improves pain and stiffness, but the effect was similar to that of sham acupuncture. In addition, in this Cochrane review, the benefit only lasted up to 1 month after therapy. There was also a suggestion that electroacupuncture, in which current is conducted through electrodes attached to acupuncture needles, may be more effective than manual acupuncture. However, this review was also limited by a paucity of large, well-designed trials. Acupuncture is traditionally used as only one component of a holistic, individualized treatment plan. One recent RCT (N=162) evaluated acupuncture in a more naturalistic clinical setting (Vas). In this study, women with fibromyalgia were referred from their primary care doctors to Traditional Chinese Medicine (TCM) practitioners who applied customized acupuncture treatments in 20-minute weekly sessions for 9 weeks based on the patient’s TCM diagnosis. The control intervention was the sham application of empty guide tubes to the back without puncturing the skin. At 6-month follow up, there was a small improvement in overall well-being, moderate improvement in pain, and moderate improvement in physical function. These effects were attenuated at 1 year, but there were additional confounders such as increased antidepressant use at this time point. In this setting, EULAR recommends acupuncture with a “weak for” rating, but further high-quality research using acupuncture in its...
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...Improving Compliance to Treatment Plan in DM Patients Table of Contents Problem Identification 3 Literature Review 5 Critical Analysis and Evaluation of Literature 6 Formulation of Intervention Protocol for Clinical Problem 12 Proposed Intervention 12 Outcomes and Associated Evaluation Criteria 13 References 15 Appendix: Table 18 Improving Compliance to Treatment Plan in DM Patients INTRODUCTION The Centers for Disease Control and Prevention (CDC) (2011) identified diabetes mellitus (DM) as a major public health disorder in the United States that results in one’s shortage of insulin or...
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...The Effect of Telemonitoring in CHF Patients Evidence Based Practice Project Question (PICOT) Question: In elderly individuals over the age of 65, does the use of a mobile phone-based medication adherence application, compared to a mobile phone texting reminder, increase medication compliance by 25%, within 12 weeks of implementing the program? Evidence Appraisal Matrix Source (APA) | Type of Study design (RCT, phenomenology, etc.)/Purpose | Level of Evidence(According toMelnyk & Fineout-Overholt) | Sample, settingInclusion/ExclusionCriteria | Methods, instruments, data analysis | Findings/Implications | Inglis, S. C. (2011). Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Of Systematic Reviews, (6), doi:10.1002/14651858.CD007228.pub2 | Systematic Review | Level I | Twenty-five studies and five published abstracts were included. 16 evaluated structured telephone support, 11 evaluated telemonitoring, and two tested both interventions. Inclusion criteria:only peer reviewed, published RCTs comparing structured telephone support or telemonitoring to usual care of CHF patients were included. | Various search engines such as: MEDLINE, EMBASE, CINAHL, and AMED were searched from 2006 to November 2008.Relevant studies and systematic reviews and abstract conference proceedings were hand searched. No language limits were applied. | Telemonitoringreduced all-cause mortality (RR 0.66, 95% CI 0.54 to 0.81, P...
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...160–162) The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven of 32 studies addressed this as an outcome; two of the three that compared satisfaction between groups showed a significant difference. Evaluations used many different measures, only one of which was designed for the end of life. In conclusion, researchers have conceptualized satisfaction in palliative...
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...academic achievement of their children. However, this role had neither been analyzed nor systematically studied using an experimental design until the 1960’s. The evaluation of the Head Start Program in the United States (Coleman, Campbell, Hobson, McPartland, Mod, Weinfeld, & York, 1966) fostered a national focus on outcomes related to parental involvement by suggesting a substantial relationship between parental involvement in their child’s education and their child’s success in academic domains. Subsequent studies have been presented which support the findings from Coleman, et al. (Duff & Adams, 1981; Henderson, 1987; 1988). Even so, other studies have reported either mixed or no significant differences between experimental and control groups when measuring the effect of parental involvement on student achievement (Griffith, 1996; Heller, & Fantuzzo, 1993; Henry, 1974; Keith, Reimers, Ferman, Pottenbaum, & Aubrey ,1986; Ryan, 1964; Searles, Lewis & Morrow, 1982). Some of the discrepancy across studies relates to the nature of the data collection and research design. For example, some investigators have studied the relationship between parental involvement and child school success using direct observation (Arbuckle & MacKinnon, 1988), surveys, or questionnaires (Edwards & Warin, 1999). Other investigators have utilized a traditional experimental design to compare student performances across...
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...Applying Social Network Interventions in Men Who Have Sex With Men: A Systematic Review Communication 623 Final Paper Presented in partial fulfillment of the requirements for Health Psychology Seminar at Annenberg School for Communication, University of Pennsylvania by Qijia Chen May 2014 Instructor: Professor John B. Jemmott, Annenberg School for Communication Abstract The current paper provides a comprehensive review of the literature on social network intervention in HIV prevention among MSM. I performed a systematic literature research in multi-lingual databases and located a relatively exhaustive collection of articles on social network interventions in MSM. There is strong evidence that such interventions are efficacious in generating changes in behavioral and psychological constructs that might lead to risk reduction in HIV infection and transmission. This paper identified several urgent issues in the current state of research development, particularly, a lack of theoretical development, an insufficient numbers of methodologically rigorous studies, and an absence of clear conceptual distinctions and implementary recommendations. The review also proposes potential solutions and suggestions for future research. Introduction Men who have sex with men (MSM) comprise the largest proportion of new HIV infections in the USA (CDC, 2011). Efforts to curtail the incidence of HIV infection require that at-risk individuals adopt effective behavioral changes....
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...Lackland AFB, Tex A cognitive behavioral therapy (CBT) that emphasizes exposure-based treatment is the most effective intervention for adults with acute stress disorder (ASD) (strength of recommendation [SOR]: B, meta-analysis of limited-quality randomized controlled trials [RCTs]). Exposure-based therapy reduces symptoms in adults with ASD more than CBT that focuses on cognitive restructuring; both therapies are better than no treatment at all (SOR: B, a limited-quality RCT). Avoid drug treatment within 4 weeks of appearance of symptoms, unless distress is too severe to be managed with psychological treatment alone (SOR: C, consensus guideline). Evidence summary ASD refers to a constellation of psychological symptoms that can occur within 4 weeks after a traumatic event.1 (For more on ASD, see http://www.psychologynet.org/dsm/stress. html.) Patients with symptoms that persist beyond 4 weeks or develop after 4 weeks are diagnosed with post-traumatic stress disorder (PTSD). Approximately 12.5% of people who experience a traumatic event develop ASD, and 10% develop PTSD, although not all patients who develop PTSD have preceding ASD.2 Early identification and treatment of ASD can decrease the percentage of patients who go on to develop PTSD.2 Exposure-based therapy works better than cognitive restructuring A 2009 meta-analysis of small, limited-quality RCTs noted that CBT based on re-exposure to memories of the traumatic event, when started within 3 months of the event, is...
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...Article The Effects of Mind-Body Interventions on Sleep Quality: A Systematic Review Rachel Neuendorf,1 Helané Wahbeh,1,2 Irina Chamine,2 Jun Yu,2 Kimberly Hutchison,2 and Barry S. Oken2 1 Helfgott Research Institute, National College of Natural Medicine, 049 SW Porter Street, Portland, OR 97201, USA Oregon Health and Science University, 3181 SW Sam Jackson Park Road, CR-120, Portland, OR 97239, USA 2 Correspondence should be addressed to Rachel Neuendorf; neuendorf@gmail.com Received 28 February 2015; Accepted 25 May 2015 Academic Editor: Lise Hestbaek Copyright © 2015 Rachel Neuendorf et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Study Objectives. To evaluate the effect of mind-body interventions (MBI) on sleep. Methods. We reviewed randomized controlled MBI trials on adults (through 2013) with at least one sleep outcome measure. We searched eleven electronic databases and excluded studies on interventions not considering mind-body medicine. Studies were categorized by type of MBI, whether sleep was primary or secondary outcome measure and outcome type. Results. 1323 abstracts were screened, and 112 papers were included. Overall, 67 (60%) of studies reported a beneficial effect on at least one sleep outcome measure. Of the most common interventions, 13/23 studies using meditation...
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...population, such as prevalence of an illness, or they may support inferences of cause and effect. Longitudinal studies differ from both in making a series of observations more than once on members of the study population over a period of time. Cross-sectional studies in medicine Cross-sectional studies involve data collected at a defined time. They are often used to assess the prevalence of acute or chronic conditions, or to answer questions about the causes of disease or the results of medical intervention. They may also be described as censuses. Cross-sectional studies may involve special data collection, including questions about the past, but they often rely on data originally collected for other purposes. They are moderately expensive, and are not suitable for the study of rare diseases. Difficulty in recalling past events may also contribute bias. 2. Quasi-Experimental Study A quasi-experimental study is a type of evaluation which aims to determine whether a program or intervention has the intended effect on a...
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...POSTPARTUM DEPRESSION: LITERATURE REVIEW OF RISK FACTORS AND INTERVENTIONS Donna E. Stewart, MD, FRCPC E. Robertson, M.Phil, PhD Cindy-Lee Dennis, RN, PhD Sherry L. Grace, MA, PhD Tamara Wallington, MA, MD, FRCPC ©University Health Network Women’s Health Program 2003 Prepared for: Toronto Public Health October 2003 Women’s Health Program Financial assistance by Health Canada Toronto Public Health Advisory Committee: Jan Fordham, Manager, Planning & Policy – Family Health Juanita Hogg-Devine, Family Health Manager Tobie Mathew, Health Promotion Consultant – Early Child Development Project Karen Wade, Clinical Nurse Specialist, Planning & Policy – Family Health Mary Lou Walker, Family Health Manager Karen Whitworth, Mental Health Manager Copyright: Copyright of this document is owned by University Health Network Women’s Health Program. The document has been reproduced for purposes of disseminating information to health and social service providers, as well as for teaching purposes. Citation: The following citation should be used when referring to the entire document. Specific chapter citations are noted at the beginning of each chapter. Stewart, D.E., Robertson, E., Dennis, C-L., Grace, S.L., & Wallington, T. (2003). Postpartum depression: Literature review of risk factors and interventions. POSTPARTUM DEPRESSION: LITERATURE REVIEW OF RISK FACTORS AND INTERVENTIONS Table of Contents EXECUTIVE SUMMARY 2 OVERALL METHODOLOGICAL FRAMEWORK 5 CHAPTER 1: RISK FACTORS FOR...
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