Concept: Direct examination
Previous meta-analyses comparing the efficacy of psychotherapeutic interventions for depression were clouded by a limited number of within-study treatment comparisons. This study used network meta-analysis, a novel methodological approach that integrates direct and indirect evidence from randomised controlled studies, to re-examine the comparative efficacy of seven psychotherapeutic interventions for adult depression.
Time-lapse imaging has proven highly valuable for studying development, yielding data of much finer resolution than traditional “still-shot” studies and allowing direct examination of tissue and cell dynamics. A major challenge for time-lapse imaging of animals is keeping specimens immobile yet healthy for extended periods of time. Although this is often feasible for embryos, the difficulty of immobilizing typically motile juvenile and adult stages remains a persistent obstacle to time-lapse imaging of post-embryonic development.
Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols.
A series of highly-cited experiments published in 2008 demonstrated a biasing effect of neuroimages on lay perceptions of scientific research. More recent work, however, has questioned this bias, particularly within legal contexts in which neuroscientific evidence is proffered by one of the parties. The present research moves away from the legal framework and describes five experiments that re-examine this effect. Experiments 1 through 4 present conceptual and direct replications of some of the original 2008 experiments, and find no evidence of a neuroimage bias. A fifth experiment is reported that confirms that, when laypeople are allowed multiple points of reference (e.g., when directly comparing neuroimagery to other graphical depictions of neurological data), a neuroimage bias can be observed. Together these results suggest that, under the right conditions, a neuroimage might be able to bias judgments of scientific information, but the scope of this effect may be limited to certain contexts.
Healthcare has become increasingly complex and care delivery models have changed dramatically (eg, team-based care, duty-hour restrictions). However, approaches to critical communications among providers have not evolved to meet these new challenges. Evidence from safety culture surveys, academic studies and malpractice claims suggests that healthcare handover quality is problematic, leading to preventable errors and adverse outcomes. To address this concern, from 2013 to 2016 Massachusetts General Hospital completed phase I of a multifaceted programme to implement standardised, structured handovers across all departments, units and direct care providers.
Inequalities in unintentional injuries between indigenous and non-indigenous children: a systematic review
- Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
- Published over 3 years ago
Indigenous children suffer a disproportionally high burden of unintentional injuries. A more detailed understanding of the underlying causes, risk factors and gaps in research is required to inform prevention efforts and direct future research. The aim of this review was to systematically assess the evidence regarding differences in rates of unintentional injuries between indigenous and non-indigenous children and to identify leading causes and underlying risk factors contributing to these differences.
Oxytocin has been shown to promote a host of social behaviors in humans but the exact mechanisms by which it exerts its effects are unspecified. One prominent theory suggests that oxytocin increases approach and decreases avoidance to social stimuli. Another dominant theory posits that oxytocin increases the salience of social stimuli. Herein, we report a direct test of these hypotheses. In a double-blind, placebo-controlled study we examined approach-avoidance motor responses to social and non-social emotional stimuli. One hundred and twenty participants self-administered either 24 IU oxytocin or placebo and moved a lever toward or away from pictures of faces depicting emotional expressions or from natural scenes appearing before them on a computer screen. Lever movements toward stimuli decreased and movements away increased stimuli size producing the illusion that stimuli moved away from or approached participants. Reaction time data were recorded. The task produced the effects that were anticipated on the basis of the approach-avoidance literature in relation to emotional stimuli, yet the anticipated speeded approach and slowed avoidance responses to emotional faces by the oxytocin group were not observed. Interestingly, the oxytocin treatment group was faster to approach and avoid faces depicting disgust relative to the placebo group, suggesting a salience of disgust for the former group. Results also showed that within the oxytocin group women’s reaction times to all emotional faces were faster than those of men, suggesting sex specific effects of oxytocin. The present findings provide the first direct evidence that intranasal oxytocin administration does not enhance approach/avoidance to social stimuli and does not exert a stronger effect on social vs. non-social stimuli in the context of processing of emotional expressions and scenes. Instead, our data suggest that oxytocin administration increases the salience of certain social stimuli and point to a possible role for oxytocin in behavioral prophylaxis.
The purpose of this article is to discuss the controversial topic of stuttering in preschool children and how to evaluate the options for treatment, emphasizing the role of external research evidence.
DNA evidence sample processing typically involves DNA extraction, quantification, and STR amplification; however, DNA loss can occur at both the DNA extraction and quantification steps, which is not ideal for forensic evidence containing low levels of DNA. Direct PCR amplification of forensic unknown samples has been suggested as a means to circumvent extraction and quantification, thereby retaining the DNA typically lost during those procedures. Direct PCR amplification is a method in which a sample is added directly to an amplification reaction without being subjected to prior DNA extraction, purification, or quantification. It allows for maximum quantities of DNA to be targeted, minimizes opportunities for error and contamination, and reduces the time and monetary resources required to process samples, although data analysis may take longer as the increased DNA detection sensitivity of direct PCR may lead to more instances of complex mixtures. ISO 17025 accredited laboratories have successfully implemented direct PCR for limited purposes (e.g., high-throughput databanking analysis), and recent studies indicate that direct PCR can be an effective method for processing low-yield evidence samples. Despite its benefits, direct PCR has yet to be widely implemented across laboratories for the processing of evidentiary items. While forensic DNA laboratories are always interested in new methods that will maximize the quantity and quality of genetic information obtained from evidentiary items, there is often a lag between the advent of useful methodologies and their integration into laboratories. Delayed implementation of direct PCR of evidentiary items can be attributed to a variety of factors, including regulatory guidelines that prevent laboratories from omitting the quantification step when processing forensic unknown samples, as is the case in the United States, and, more broadly, a reluctance to validate a technique that is not widely used for evidence samples. The advantages of direct PCR of forensic evidentiary samples justify a re-examination of the factors that have delayed widespread implementation of this method and of the evidence supporting its use. In this review, the current and potential future uses of direct PCR in forensic DNA laboratories are summarized.
The efficacy of graded motor imagery (GMI) for the management of complex regional pain syndrome (CRPS) is supported by evidence, but its treatment effect remains generally modest. Transcranial direct current stimulation (tDCS) has been advocated as an adjunct intervention to enhance the effect of motor imagery approaches in pain populations.