1
|
Prowse SR, Treweek S, Kiezebrink K, Hanna C. Evidencing the impacts of health research: Insights from trials reported in the 2018 Australian Engagement and Impact Assessment. Health Promot J Austr 2024; 35:423-432. [PMID: 37493241 DOI: 10.1002/hpja.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/03/2023] [Accepted: 06/23/2023] [Indexed: 07/27/2023] Open
Abstract
ISSUE ADDRESSED While definitions of impact may vary, they often refer to the wider benefits of research evidenced beyond academia. We evaluated case studies featuring randomised trials from the 2018 Engagement and Impact Assessment to better understand how the impacts of health research are evidenced and assessed within Australia. METHODS We collated and evaluated 'high' scoring case studies submitted by higher education institutions with a focus on randomised trials across all areas of health research. A qualitative coding system was used for manual content analysis to assess the key characteristics of trials reported, subsequent impacts and the methods used to evidence impacts. RESULTS A total of 14 case studies were identified citing 35 clinical trials. The majority of interventions were behavioural with a focus on mental, behavioural or neurodevelopmental disorders. Most trials were phase III, focused on the treatment of the indication and were funded by industry. Contribution to clinical guidelines was the highest cited research impact. While there was evidence of researchers seeking to maximise trial impact, case studies lacked details on the role of trial participants and other beneficiaries in generating impact. CONCLUSIONS The impacts of health research can be improved through a better understanding of the priorities and agendas of funders, providing evidence of tangible impact rather than information that is contextual or predictive, and through the early development of impact strategies involving both researchers and beneficiaries. SO WHAT?: Large-scale impact exercises intended for a broad range of disciplines may not be reflective of the depth and scope of health sciences research including trials.
Collapse
Affiliation(s)
- Sarah R Prowse
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Shaun Treweek
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Kirsty Kiezebrink
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Catherine Hanna
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
2
|
Tanda E, Ruiu G, Casula M, Lamia I, Serra A, Boscolo Meneguolo A, Zappadu S, Sanfilippo R, Camparini S, Petruzzo P. Minor amputation after revascularization in chronic limb-threatening ischemia: What is the optimal timing? Vascular 2023:17085381231214819. [PMID: 37946368 DOI: 10.1177/17085381231214819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Patients with chronic limb-threatening ischemia (CLTI) have a high risk of lower limb amputation and loss of walking independence. Minor amputations play a key role in ensuring walking independence and they represent a challenge in terms of timing and level for vascular surgeons. A major cause of re-amputation is a defect in wound healing and a possible predictor of re-amputation for non-healing wounds could be the incorrect timing of minor amputation after revascularization. The lack of evidence in the literature leads to a wide variability of choices in clinical practice. The purpose of this study was to try to find the optimal timing analysing the risk of re-amputation in CLTI patients who have undergone successful revascularization and minor amputation focussing on timing of minor amputation. METHODS We conducted a single centre retrospective analysis on a cohort of 151 patients consecutively admitted to our hospital for CLTI (Rutherford 5) between January 2014 and April 2022. All the enrolled patients underwent successful revascularization of lower limbs and a minor amputation for dry acral necrosis. The characteristics of the patients and the revascularization procedures were collected and analysed. Patients were divided into two groups based on the timing of minor amputation performed before (group 1) or after the day (group 2) that best predicts the risk of re-amputation according to a Receiver Operating Characteristic (ROC) curve analysis. The primary outcome of this study was the risk of re-amputation during the first 60 days of follow-up after a primary minor amputation, with revascularization still effective. The impact of the timing of minor amputation after revascularization, the type of revascularization and the presence of risk factors known to prolong the wound healing process were evaluated in a uni- and multi-variable logistic regression model. RESULTS Systemic hypertension, and type of revascularization (i.e. open vs endovascular) were independent predictors of the risk of re-amputation at 60 days (HR 4.26, 95% CI 1.30-14.04, p = .017 and HR 2.35, 95% CI 1.16-4.78, p = .018, respectively). Moreover, time ≤14 days between revascularization and first amputation was associate with a clear, albeit not statistically significant, trend toward increased risk of re-amputation (HR 2.09, 95% CI 0.97-4.51, p = .06). CONCLUSIONS In a cohort of patients who underwent a successful revascularization for CLTI and a minor amputation for dry gangrene in the first 14 days after revascularization, a higher -although not significant-risk of re-amputation was reported. In this cohort of patients, a delayed demolitive procedure should be considered to allow better tissue perfusion and to reduce the risk of re-amputation.
Collapse
Affiliation(s)
- Elisabetta Tanda
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
- Unit of Vascular Surgery, Cliniche San Pietro Hospital, AOU Sassari, Sassari, Italy
| | - Giovanni Ruiu
- Unit of Vascular Surgery, Cardiovascular Department, San Michele Hospital, ARNAS "G. Brotzu", Cagliari, Italy
| | - Matteo Casula
- Cardiology and Cardiovascular Intensive Care Unit, Cardiovascular Department, San Michele Hospital, ARNAS "G. Brotzu", Cagliari, Italy
| | - Irene Lamia
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
| | - Arianna Serra
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
| | - Anna Boscolo Meneguolo
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
| | - Sara Zappadu
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
- Unit of Vascular Surgery, Cliniche San Pietro Hospital, AOU Sassari, Sassari, Italy
| | - Roberto Sanfilippo
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
| | - Stefano Camparini
- Unit of Vascular Surgery, Cardiovascular Department, San Michele Hospital, ARNAS "G. Brotzu", Cagliari, Italy
| | - Palmina Petruzzo
- Unit of Vascular Surgery, Department of Surgical Sciences, University of Cagliari, Policlinico "D. Casula", Cagliari, Italy
| |
Collapse
|
3
|
Genowska A, Zarębska-Michaluk D, Tyszko P, Strukcinskiene B, Moniuszko-Malinowska A, Rzymski P, Flisiak R. Trends of infections and mortality due to hepatitis B virus (2005-2022) and the potential impact of the COVID-19 pandemic: a population-based study in Poland. Clin Exp Hepatol 2023; 9:286-296. [PMID: 37790687 PMCID: PMC10544055 DOI: 10.5114/ceh.2023.131225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023] Open
Abstract
Aim of the study To analyze the hepatitis B virus (HBV) infection and mortality in Poland according to sociodemographic characteristics, trends over time, and the impact of the COVID-19 pandemic on hepatitis B epidemiology. Material and methods We examined HBV infection cases and deaths reported by national registries and used Joinpoint analysis to estimate time trends in the years 2005-2021. To assess the impact of the COVID-19 pandemic on HBV infection, we used monthly information and compared 2020-2022 with 2019. Results The Joinpoint analysis showed that in Poland between 2005 and 2021, there were pronounced decreasing trends of acute HBV infection, and during the pandemic period, acute HBV infection dramatically decreased (annual percent change, APC2019-2021 for men -57.65%, and women -42.10%, both ptrend < 0.05). There was a fluctuation in trends for chronic HBV infection, shifting from positive to negative in both genders in 2016, and over the pandemic, there were decreasing trends (APC2019-2021 for men -26.94% and women -28.96%, both ptrend < 0.05). From March to July 2022, the value of the diagnosis rate of HBV infection was lower compared to the respective months in 2019, but from September to December 2022, the rate changes were positive. Mortality due to HBV infection decreased in both genders, mainly within the 2005-2019 period. Conclusions During the COVID-19 pandemic, a sharp decrease in HBV diagnosis rates in Poland, especially in acute cases, was observed. However, trends of hepatitis B infection require further monitoring. It is necessary to introduce a national screening program that also encompasses the population of migrants and improve the linkage to care.
Collapse
Affiliation(s)
- Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, Bialystok, Poland
| | | | - Piotr Tyszko
- Medical University of Warsaw, Warsaw, Poland
- Institute of Rural Health, Lublin, Poland
| | | | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
| |
Collapse
|
4
|
Jiang X, Liu MW, Zhang X, Dong JY, Miao L, Sun ZH, Dong SS, Zhang L, Yang L, Li M. Observational Study of the Natural Growth History of Peripheral Small-Cell Lung Cancer on CT Imaging. Diagnostics (Basel) 2023; 13:2560. [PMID: 37568923 PMCID: PMC10417025 DOI: 10.3390/diagnostics13152560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND This study aimed to investigate the natural growth history of peripheral small-cell lung cancer (SCLC) using CT imaging. METHODS A retrospective study was conducted on 27 patients with peripheral SCLC who underwent at least two CT scans. Two methods were used: Method 1 involved direct measurement of nodule dimensions using a calliper, while Method 2 involved tumour lesion segmentation and voxel volume calculation using the "py-radiomics" package in Python. Agreement between the two methods was assessed using the intraclass correlation coefficient (ICC). Volume doubling time (VDT) and growth rate (GR) were used as evaluation indices for SCLC growth, and growth distribution based on GR and volume measurements were depicted. We collected potential factors related to imaging VDT and performed a differential analysis. Patients were classified into slow-growing and fast-growing groups based on a VDT cut-off point of 60 days, and univariate analysis was used to identify factors influencing VDT. RESULTS Median VDT calculated by the two methods were 61 days and 71 days, respectively, with strong agreement. All patients had continuously growing tumours, and none had tumours that decreased in size or remained unchanged. Eight patients showed possible growth patterns, with six possibly exhibiting exponential growth and two possibly showing Gompertzian growth. Tumours deeper in the lung grew faster than those adjacent to the pleura. CONCLUSIONS Peripheral SCLC tumours grow rapidly and continuously without periods of nongrowth or regression. Tumours located deeper in the lung tend to grow faster, but further research is needed to confirm this finding.
Collapse
Affiliation(s)
- Xu Jiang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (X.J.); (M.-W.L.); (X.Z.); (L.M.); (L.Z.)
| | - Meng-Wen Liu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (X.J.); (M.-W.L.); (X.Z.); (L.M.); (L.Z.)
| | - Xue Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (X.J.); (M.-W.L.); (X.Z.); (L.M.); (L.Z.)
| | - Ji-Yan Dong
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (J.-Y.D.); (Z.-H.S.)
| | - Lei Miao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (X.J.); (M.-W.L.); (X.Z.); (L.M.); (L.Z.)
| | - Zi-Han Sun
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (J.-Y.D.); (Z.-H.S.)
| | - Shu-Shan Dong
- Clinical Science, Philips Healthcare, Beijing 100600, China;
| | - Li Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (X.J.); (M.-W.L.); (X.Z.); (L.M.); (L.Z.)
| | - Lin Yang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (J.-Y.D.); (Z.-H.S.)
| | - Meng Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (X.J.); (M.-W.L.); (X.Z.); (L.M.); (L.Z.)
| |
Collapse
|
5
|
Im C, Song S, Kim K. The associations of psychological burnout and time factors on medication errors in rotating shift nurses in Korea: A cross sectional descriptive study. Nurs Open 2023. [PMID: 37115503 DOI: 10.1002/nop2.1794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
AIM To describe the associations of psychological burnout and time factors on hospital nurses' medication errors. DESIGN A cross-sectional survey design was used. METHODS A structured questionnaire pertaining to psychological burnout, time factors and medication error was administered to 200 bedside nurses working at two tertiary university hospitals in Korea. The associations between the psychological burnout, time factor and medication error were analysed with the zero-inflated negative binomial regression for over-dispersed and over-abundant zeros count data. RESULTS Higher psychological burnout, shorter meal time during duty and longer weekly overtime were associated with an increased likelihood of medication error of nurses working in tertiary university hospitals. For medication safety, nurse managers should provide appropriate administrative support to nurses to cope with psychological burnout of nurses. Work time management should also be considered as human factors to satisfy the needs of nurses, such as securing meal times and maintaining a low level of weekly overtime.
Collapse
Affiliation(s)
- Cheongin Im
- Department of Nursing, College of Medicine, Inha University, Incheon City, South Korea
| | - Suyoung Song
- Department of Nursing, College of Medicine, Inha University, Incheon City, South Korea
| | - Kyoungja Kim
- Department of Nursing, College of Medicine, Inha University, Incheon City, South Korea
| |
Collapse
|
6
|
Xu G, Ding R, Cheng H, Xing Q. Gradual Acquisition of Professional Knowledge, Audit Quality and Audit Fees. Front Psychol 2022; 13:759875. [PMID: 35369164 PMCID: PMC8969421 DOI: 10.3389/fpsyg.2022.759875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/21/2022] [Indexed: 11/19/2022] Open
Abstract
The acquisition of professional knowledge is a core issue in the formation of auditor industry expertise; however, previous literature has neglected the time required for auditors to acquire professional knowledge. We examine the audit quality and fees of audit firms in different stages of an auditor acquiring professional knowledge and find that, in the initial stage of the process of knowledge acquisition, audit quality and audit fees decrease. However, in the long run, knowledge learning has a more obvious effect on the improvement of audit quality and audit fees. Specifically, knowledge learning has a positive effect on the development of audit firms.
Collapse
Affiliation(s)
- Gaoshuang Xu
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | - Rui Ding
- Business School, University of Shanghai for Science and Technology, Shanghai, China
| | - Hanxiu Cheng
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | - Qiuhang Xing
- Guanghua School of Management, Peking University, Beijing, China
| |
Collapse
|
7
|
Hsieh YL, Tay J, Hsu SH, Chen WT, Fang YD, Liew CQ, Chou EH, Wolfshohl J, d'Etienne J, Wang CH, Tsuang FY. Early versus Late Surgical Decompression for Traumatic Spinal Cord Injury on Neurological Recovery: A Systematic Review and Meta-Analysis. J Neurotrauma 2021; 38:2927-2936. [PMID: 34314253 DOI: 10.1089/neu.2021.0102] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate whether early surgical decompression was associated with favorable neurological recovery in patients with traumatic spinal cord injury (tSCI). We searched PubMed and Embase from the database inception through December 2020 and selected studies comparing the impact of early versus late surgical decompression on neurological recovery as assessed by American Spinal Injury Association Impairment Scale (AIS) for adult patients sustaining tSCI. We pooled the effect estimates in random-effects models and quantified the heterogeneity by the I2 statistics. Subgroup analysis and meta-regression analysis was conducted to identify significant outcome moderator. We included 26 studies involving 3574 patients in the meta-analysis. The pooled results demonstrated significant association between early surgical decompression and an improvement of at least one AIS grade (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.41-2.41; I2, 48.06%). The benefits of early surgical decompression were consistently observed across different subgroups, including patients with cervical or thoracolumbar injury and patients with complete or incomplete injury. The meta-regression analysis indicated that cut-off timing defining early versus late decompression was a significant effect moderator, with early decompression performed before post-tSCI 8 or 12 h associated with greatest benefits (OR, 3.37; 95% CI, 1.74-6.50; I2, 53.52%). No obvious publication bias was detected by the funnel plot. In conclusion, early surgical decompression was associated with favorable neurological recovery for tSCI patients. However, there was a lack of high-quality evidence and the results need further examination.
Collapse
Affiliation(s)
- Yu-Lin Hsieh
- Department of Internal Medicine, Danbury Hospital, Danbury, Connecticut, USA
| | - Joyce Tay
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Hsien Hsu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Ting Chen
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yao-De Fang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiat-Qiao Liew
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Eric H Chou
- Department of Emergency Medicine, Baylor Scott and White All Saints Medical Center, Fort Worth, Texas, USA
| | - Jon Wolfshohl
- Department of Emergency Medicine, Baylor Scott and White All Saints Medical Center, Fort Worth, Texas, USA
| | - James d'Etienne
- Department of Emergency Medicine, John Peter Smith Hospital, Fort Worth, Texas, USA
| | - Chih-Hung Wang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
| | - Fon-Yih Tsuang
- Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan
| |
Collapse
|
8
|
Carlsen CH, Kathrin Baumgart J, Kocbach J, Haugnes P, Paulussen EMB, Sandbakk Ø. Framework for In-Field Analyses of Performance and Sub-Technique Selection in Standing Para Cross-Country Skiers. Sensors (Basel) 2021; 21:4876. [PMID: 34300615 DOI: 10.3390/s21144876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/11/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022]
Abstract
Our aims were to evaluate the feasibility of a framework based on micro-sensor technology for in-field analyses of performance and sub-technique selection in Para cross-country (XC) skiing by using it to compare these parameters between elite standing Para (two men; one woman) and able-bodied (AB) (three men; four women) XC skiers during a classical skiing race. The data from a global navigation satellite system and inertial measurement unit were integrated to compare time loss and selected sub-techniques as a function of speed. Compared to male/female AB skiers, male/female Para skiers displayed 19/14% slower average speed with the largest time loss (65 ± 36/35 ± 6 s/lap) found in uphill terrain. Female Para/AB skiers utilized DP, DK, and DIA, 61/43%, 15/10%, and 25/47% of the distance at low speeds, respectively, while the corresponding numbers for male Para/AB skiers were 58/18%, 1/13%, and 40/69%. At higher speeds, female Para/AB skiers utilized DP and OTHER, 26/52% and 74/48% of the distance, respectively, while corresponding numbers for male Para/AB skiers were 29/66% and 71/34%. This indicates different speed thresholds of the classical sub-techniques for Para than AB skiers. The framework provides a point of departure for large-scale international investigations of performance and related factors in Para XC skiing.
Collapse
|
9
|
Hou XS, Liu HL, Fu YB, Wang SS, Chen P, Li B. [Instructive significance of "treatment in accordance with time factor" for the idea of clinical diagnosis and treatment with acupuncture and moxibustion]. Zhongguo Zhen Jiu 2021; 41:331-4. [PMID: 33798320 DOI: 10.13703/j.0255-2930.20200316-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Treatment in accordance with time factor" is one of the key principles of acupuncture and moxibustion treatment. In clinical practice of acupuncture and moxibustion, the connotation of "timing/time factor" should be fully understood and the temporal rule on physiology and pathology affected by the changes of four seasons and day and night be grasped. Based on the change law of qi, blood, yin and yang and the rise and fall rules of pathogens and antipathogenic qi, the intervention is exerted timely. The dynamic law of acupoints should be associated with the changes in pathogenesis and illness location, thus, the acupoint selection, needle manipulation and needle withdrawal can be operated precisely. The idea of time factor should be considered in the whole process of clinical diagnosis and treatment with acupuncture and moxibustion so as to provide some guidance for clinical analysis and practice.
Collapse
Affiliation(s)
- Xue-Si Hou
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
| | - Hui-Lin Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
| | - Yuan-Bo Fu
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
| | - Shao-Song Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
| | - Peng Chen
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of TCM, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
| |
Collapse
|
10
|
Abstract
OBJECTIVE To investigate the optimum rehabilitation start timing for improved functional outcomes after stroke in Japan. DESIGN A retrospective database study. SUBJECTS A total of 140,655 patients with stroke from 1,161 acute hospitals in Japan. Only data for those patients who were discharged alive was included in the analysis. METHODS Activities of daily living were assessed. Comparisons were made using the rehabilitation start day after hospital admission. Reference day 2 was compared with days 1, 3, 4, 5, and 6 or later. Modified Rankin Scale at time of discharge was used as the primary outcome. In addition, cases of ischaemic stroke and haemorrhagic stroke were analysed as separate subgroups. RESULTS Univariate and multivariate logistic regression analyses showed that starting rehabilitation on day 2 resulted in a better outcome than starting on day 3 or later. There was no significant difference in outcome between starting rehabilitation on days 1 and 2 in all cases and subgroup of patient with infarction stroke. For a subgroup of patients with haemorrhagic stroke, starting rehabilitation on day 2 resulted in a better outcome than starting on day 1. CONCLUSION Starting post-stroke rehabilitation on the day of admission or second day of hospitalization may be the optimum timing for functional outcomes. However, for haemorrhagic stroke, starting rehabilitation on the second day of hospitalization may be more effective than on the day of admission.
Collapse
Affiliation(s)
- Satoshi Otokita
- Graduate School of Medicine, Kyoto University, Department of Healthcare Economics and Quality Management, Kyoto, Japan
| | | | | | | | | | | |
Collapse
|
11
|
Pieper D, Antoine SL, Morfeld JC, Mathes T, Eikermann M. Methodological approaches in conducting overviews: current state in HTA agencies. Res Synth Methods 2013; 5:187-99. [PMID: 26052845 DOI: 10.1002/jrsm.1107] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 11/07/2013] [Accepted: 11/11/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Overviews search for reviews rather than for primary studies. They might have the potential to support decision making within a shorter time frame by reducing production time. We aimed to summarize available instructions for authors intending to conduct overviews as well as the currently applied methodology of overviews in international Health Technology Assessment (HTA) agencies. METHODS We identified 127 HTA agencies and scanned their websites for methodological handbooks as well as published overviews as HTA reports. Additionally, we contacted HTA agencies by e-mail to retrieve possible unidentified handbooks or other related sources. RESULTS In total, eight HTA agencies providing methodological support were found. Thirteen HTA agencies were found to have produced overviews since 2007, but only six of them published more than four overviews. Overviews were mostly employed in HTA products related to rapid assessment. Additional searches for primary studies published after the last review are often mentioned in order to update results. CONCLUSIONS Although the interest in overviews is rising, little methodological guidance for the conduct of overviews is provided by HTA agencies. Overviews are of special interest in the context of rapid assessments to support policy-making within a short time frame. Therefore, empirical work on overviews needs to be extended. National strategies and experience should be disclosed and discussed.
Collapse
Affiliation(s)
- Dawid Pieper
- Institute for Research in Operative Medicine, Director: Univ.- Prof. Dr. Prof. h.c. Edmund A. M. Neugebauer, Chair of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, D-51109, Cologne, Germany
| | - Sunya-Lee Antoine
- Institute for Research in Operative Medicine, Director: Univ.- Prof. Dr. Prof. h.c. Edmund A. M. Neugebauer, Chair of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, D-51109, Cologne, Germany
| | - Jana-Carina Morfeld
- Institute for Research in Operative Medicine, Director: Univ.- Prof. Dr. Prof. h.c. Edmund A. M. Neugebauer, Chair of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, D-51109, Cologne, Germany
| | - Tim Mathes
- Institute for Research in Operative Medicine, Director: Univ.- Prof. Dr. Prof. h.c. Edmund A. M. Neugebauer, Chair of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, D-51109, Cologne, Germany
| | - Michaela Eikermann
- Institute for Research in Operative Medicine, Director: Univ.- Prof. Dr. Prof. h.c. Edmund A. M. Neugebauer, Chair of Surgical Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, D-51109, Cologne, Germany
| |
Collapse
|
12
|
Affiliation(s)
- R L De Wilde
- Department of Obstetrics, Gynecology and Gynecological Oncology, Pius Clinic, 26121 Oldenburg
| |
Collapse
|