1,720,990 research outputs found
A multimodal intervention of manual therapy, exercise, and psychological management for painful diabetic neuropathy: intervention development and feasibility trial protocol
No full textBackground: therapeutic options for people experiencing neuropathic pain from diabetic peripheral neuropathy are limited, and impact can be severe. Physical and psychological interventions remain under-explored but may offer promise, especially in multimodal combination programs.Objectives and methods: to address this gap, an intervention was developed according to the Medical Research Council’s framework for complex interventions, including research expert and stakeholder input. This will be tested for acceptability and feasibility in a trial.Results: NeuOst (Neuropathy Optimisation through Self-management and Therapy) is a manual therapy-based intervention, incorporating exercise, psychologically informed training, and education. The protocol for a single-site, parallel, three-arm, partially participant-blinded, randomized controlled trial is presented. The experimental treatment is a 5-week course of NeuOst as adjunct to patients’ usual care. Comparators are a control intervention that lacks pre-specified components of interest as adjunct to usual care and usual care only in adults with painful diabetic peripheral neuropathy. The follow-up period is 16 weeks. Primary outcomes are feasibility measures such as recruitment, eligibility, and consent rates, retention, blinding, fidelity, acceptability, and safety. Secondary and exploratory outcomes involve clinical measures and qualitative feedback. A protocol was prospectively registered (NCT06423391).Conclusion: after initial intervention development, a feasibility trial will inform intervention refinement and future research steps
Effects of an e-learning programme on osteopaths’ back pain attitudes: a mixed methods feasibility study
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis ::a synthesis of systematic reviews and guidance
No full textAim
To investigate for congenital muscular torticollis (CMT) and positional plagiocephaly (PP) the effectiveness and safety of manual therapy, repositioning and helmet therapy (PP only) using a systematic review of systematic reviews and national guidelines.
Methods
We searched four major relevant databases: PubMed, Embase, Cochrane and MANTIS for research studies published between the period 1999–2019. Inclusion criteria were systematic reviews that analysed results from multiple studies and guidelines that used evidence and expert opinion to recommend treatment and care approaches. Three reviewers independently selected articles by title, abstract and full paper review, and extracted data. Selected studies were described by two authors and assessed for quality. Where possible meta-analysed data for change in outcomes (range of movement and head shape) were extracted and qualitative conclusions were assessed.
Results
We found 10 systematic reviews for PP and 4 for CMT. One national guideline was found for each PP and CMT. For PP, manual therapy was found to be more effective than repositioning including tummy time (moderate to high evidence) but not better than helmet therapy (low evidence). Helmet therapy was better than usual care or repositioning (low evidence); and repositioning better than usual care (moderate to high evidence).
The results for CMT showed that manual therapy in the form of practitioner-led stretching had moderate favourable evidence for increased range of movement. Advice, guidance and parental support was recommended in all the guidance to reassure parents of the favourable trajectory and nature of these conditions over time.
Conclusions
Distinguishing between superiority of treatments was difficult due to the lack of standardised measurement systems, the variety of outcomes and limited high quality studies. More well powered effectiveness and efficacy studies are needed. However overall, advice and guidance on repositioning (including tummy-time) and practitioner-led stretching were low risk, potentially helpful and inexpensive interventions for parents to consider
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Which trial design is best for the study of physical, psychological, and self-management interventions for people with persistent pain? developing best-practice trial methods across the pragmatic-explanatory continuum
No full textThis PhD project aimed to address major challenges of designing and conducting randomised controlled trials (RCTs) for physical, psychological, and self-management (PPS) interventions for people with pain. Such challenges include designing adequate ‘sham’ control interventions and ensuring participant and provider blinding to control for context-dependent effects. Studies are also commonly criticised for limited generalisability of results beyond the immediate study population and setting; high generalisability being a typical objective of so-called pragmatic trials. The primary objective of this PhD was to provide evidence-based guidance for trial design that is specific to PPS interventions and covers best-practice methods across the pragmatic-explanatory spectrum. A secondary objective was to explore the developed recommendations on the example of a feasibility trial protocol, studying a multimodal intervention for people with painful diabetic neuropathy.
The project involved two systematic reviews of trial methods. One describing self-declared ‘pragmatic’ and ‘comparative effectiveness’ pain trials, and another PPS trials employing ‘sham’ or ‘placebo controls’. The latter involved a meta-regression analysis, which demonstrated that the level of similarity between experimental and control interventions can bias trial outcomes. Informed by these reviews, two independent consensus processes were conducted. One process led to two guidance statements for pragmatic trials in pain research. This was based on expert-led discussions as part of the dedicated 2020 Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) meeting. The second consensus process involved a modified Delphi survey with trial designers and placebo effect researchers, interviews with patient partners, and live consensus discussions. This process resulted in a comprehensive guideline for control intervention design, conduct, and reporting in PPS trials. The so-called ‘CoPPS Statement’ was published in the BMJ and adopted by the EQUATOR network library. Finally, a multimodal osteopathy-based intervention was created, and a feasibility trial protocol written to test the usability of the guidance frameworks. The systematic reviews, consensus processes, and feasibility trial protocol development are described in detail in this thesis.
As a result of this PhD, trial designers now have access to two comprehensive evidence-based frameworks to guide their decision-making in the design, conduct, and analysis phases of PPS trials. End-users of trials can employ these frameworks to guide their interpretation of such studies. Overall, these novel frameworks address major methodological criticisms of earlier trials in a manner that is specific to PPS interventions and may allow for more rigorous and transparent future research.
Furthermore, this project highlighted that while nonpharmacological interventions are distinct from drugs, RCTs of PPS interventions can still be of high quality. The developed methodological guidance statements facilitate this by accounting for differences to drug research, providing rigorously developed and innovative resources for researchers designing and conducting RCTs of PPS interventions for people with pain and other conditions. The usability evaluation as part of the feasibility trial protocol development showed the CoPPS Statement to be comprehensive and clear for the design of control interventions in an efficacy-focused trial. The IMMPACT statements were less prescriptive but were found relevant for trials across pragmatic-explanatory spectrum. However, the distinctiveness of complex nonpharmacological intervention research will remain a challenge for the involved professions, for evidence synthesis, and for policy decision-making.
Project limitations include a lack of practical testing of the developed recommendation frameworks prior to their publication and insufficient involvement of people from regions other than Europe, the US, and Australasia. Future research needs to determine the applicability of the developed frameworks to other therapeutic areas and settings. Their long-term impact on trial quality and practical usefulness will also have to be evaluated to identify potential needs for refinement.Open Acces
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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