1,721,090 research outputs found
Considering older people's views is important in gaining and maintaining participation in falls prevention interventions
No full textUse of a night-time hand positioning splint reduced pain, improved grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis
No full textResearch objective: To evaluate the effectiveness of a night-time wrist/ hand splint in patients with rheumatoid arthritis. Design: Randomised controlled trial with concealed allocation, outcome assessor blinding, adequate followup, baseline equivalence and intent-to-treat analysis. PEDro score=6/8 internal validity; 2/2 statistical reporting. Setting: Outpatient clinics, Rheumatology Division, University of São Paulo, Brazil Participants: Fifty participants with rheumatoid arthritis (average duration 9.5 years), 82% female, average age 51, mean hand pain on entry to study approximately 6 on a 0-10 visual analog scale (VAS). Intervention: A positioning splint was made for participants in the experimental group with instructions to wear it while sleeping. The splint placed hand in 10° wrist dorsiflexion, 25-30° flexion of metacarpophalangeal joints, 30° proximal interphalangeal joint flexion and thumb abduction. Mean time of splint use per night was 8 hours (range 4.5-11 hours). Participants in the control group were not provided with a splint. Outcome measures: Participants assessed at baseline, 45 and 90 days. Primary outcome hand pain (VAS scale 0-10). Secondary outcomes included grip strength (using the Jamar dynamometer); pinch strength (using pinch gauge); function (measured with Health Assessment Questionnaire that has a score range of 0 to 3 with higher scores indicating poorer function); upper limb disability and symptoms (measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire); and patient satisfaction with treatment (Likert scale). Main findings: At 3 months the mean VAS hand pain for the control group was 5.79 (standard deviation (SD) 2.14) versus 3.4 (SD 2.08) in the splint group. This equates to a mean difference between groups in hand pain at 3 months of 2.39, with a 95% confidence interval (CI) of 1.15 to 3.63. Statistically significant differences were also found between groups for Health Assessment Questionnaire score (0.55, 95% CI 0.25 to 0.84), DASH Q2 score (34.72, 95% CI 24.54 to 44.90) and DASH Q3 score (21.07, 95% CI 11.42 to 30.72), and palmer pinch strength (-0.88, 95% CI -1.66 to -0.10). Authors' conclusions: The use of a night-time hand positioning splint reduces pain, improves grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis. © 2009 The Authors. Journal compilatio
Experimental investigation of the influence of floodwater due to ship grounding on motions and global loads
Get PDFHigh profile collision and grounding incidents show that safety standards for ships need improvement to ensure ship survivability and reduce the potential for loss of life. An experimental investigation into the influence of floodwater, and transient flooding on the motions and structural response of a ship hull following a grounding incident is presented. Results show that floodwater can have a significant effect on the magnitude of ship responses; testing of the transient flooding case provides the opportunity to quantify the magnitude of these changes as well as the time to flood by provision of intact and flooded data during a single test. The movement of the floodwater free surface shows some substantial second order sloshing effects when close to the ship peak response, but little movement in higher frequency waves. Comparisons to classification design rules indicate that there is scope for further assessment of safety margins, including investigation of global responses in conjunction with any local loading due to the presence of floodwater. Future work will look at improving the modelling of the floodwater free surface and carrying out further transient flooding testing in order to better quantify the effect of a ship grounding incident on the survivability of a vessel
Questions about prognosis: Examples of appraisals from different health professions
No full textThis chapter is an accompaniment to the previous chapter (Chapter 8), where the steps involved in answering a clinical question about prognosis were explained. In order to further help you learn how to deal with prognostic clinical questions when they arise and appraise the evidence, this chapter contains a number of worked examples of questions about prognosis from a range of health professions. The worked examples in this chapter follow the same format as the examples in Chapters 5 and 7 . In addition, as with the worked examples that were written for Chapters 5 and 7 , the authors of the worked examples in this chapter were asked not to choose a systematic review (for the reason that was explained in Chapter 5), but instead to find the next best available level of evidence to answer the prognostic question that was generated from the clinical scenario
Evidence about effects of interventions
No full textAfter reading this chapter, you should be able to:• Understand more about study designs appropriate for answering questions about effects ofinterventions• Generate a structured clinical question about an intervention for a clinical scenario• Appraise the validity of randomised controlled trials• Understand how to interpret the results from randomised controlled trials and calculateadditional results (such as confidence intervals) where possible• Describe how evidence about the effects of intervention can be used to informpractic
Understanding evidence from qualitative research: examples of assessment of quality (critical appraisal) from different health professions
No full textThis chapter is an accompaniment to the previous chapter (Chapter 10), where the steps involved in answering a clinical question about patients' experiences and concerns were explained. To further help you learn how to assess the quality (critically appraise) the evidence for this type of question, this chapter contains worked examples of questions about patients' experiences and concerns. The Critical Appraisal Skills Program(CASP) qualitative checklist1 for assessing the quality of qualitative research has been used as a guide in..
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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