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At least 739 records · Page 41Linked to original sources
PubMed2003

Non-pharmacological interventions in cognitively impaired and demented patients--a comparison with cholinesterase inhibitors.

The present paper reviews studies examining the effects of non-pharmacological stimulation, i.e. bright light, physical activity and tactile stimulation (touch), on cognition, affective behaviour, and the sleep-wake rhythm of impaired and demented elderly, both in a qualitative (narrative) and quantitative (meta-analytic) manner. An extensive search through eight bibliographic data bases (PubMed, Web of Science, ERIC, PsychINFO, Psyndex, Cinahl, Biological Abstracts and Rehabdata) was performed up to August 2002. The primary criterion for inclusion in this review was that studies provided sufficient data to calculate effect-sizes. In the qualitative analysis, all three types of stimulation appeared to improve cognitive functioning. Disturbances in behaviour react positively to bright light and tactile stimulation. Bright light was also beneficial to sleep. Tactile stimulation had, moreover, a beneficial influence on the patient-caretaker relationship. A comparison was made with several representative papers published since 1991 on the effects of acetylcholinesterase inhibitors on cognition and behaviour with representative papers on non-pharmacological stimulation interventions. Data indicated that improvements in cognition and affective behaviour by non-pharmacological interventions (d' = 0.32) and by cholinesterase inhibitors (d' = 0.31) were of similar effect-size. Possible mechanisms underlying the non-pharmacological stimulation effects are discussed and suggestions offered for future research.

Affect↗
PubMed1990

Setting human-health-based groundwater protection standards when toxicological data are inadequate.

Toxicological data are not adequate to assess fully the health effects of many of the pesticides that currently contaminate or have the potential to contaminate groundwater. The National Academy of Sciences estimated in 1984 that data to conduct a complete health hazard assessment exist for only 10% of the pesticides currently on the market. Many pesticides have not been tested for their ability to cause cancer, genetic mutation, or birth defects. There are significant gaps in the toxicological data base for the majority of pesticides for which the Environmental Protection Agency proposed health advisories in 1987. To help assure that groundwater standards are adequately protective of human health when toxicological data are not adequate, additional uncertainty factors can be incorporated into such standards. Alternatively, standards can be set at the level of detection. This should be the approach when no data exist to assess major potential health effects. For example, the detection limit could be the standard if no adequate oncogenicity studies have been conducted. In addition, generic standards may be employed when data are inadequate to set chemical-specific standards. New York State has recently taken this innovative generic standard approach.

Databases, Factual↗
PubMed1997

On evidence, embellishment and efficacy.

Evidence-based medicine (EBM) - to use a vogue word - is the contemporary mantra of many academic physicians. Unfortunately, the evidence they consider, although superficially convincing, is often slanted, occasionally deliberately, but more often as a result of carelessness and defects in study design. These biases and confounding factors are often hidden and arcane and seriously impair objective assessment. Such defects can only be detected when all investigators agree to go along with Bradford Hill's dictum, namely 'It is the essence of science to disclose both the data upon which a conclusion is based and the methods by which the conclusion is obtained'; a cardinal rule more often honoured in the breach than the observance.

Bias↗
PubMed2002

Foundations of "new" social science: institutional legitimacy from philosophy, complexity science, postmodernism, and agent-based modeling.

Since the death of positivism in the 1970s, philosophers have turned their attention to scientific realism, evolutionary epistemology, and the Semantic Conception of Theories. Building on these trends, Campbellian Realism allows social scientists to accept real-world phenomena as criterion variables against which theories may be tested without denying the reality of individual interpretation and social construction. The Semantic Conception reduces the importance of axioms, but reaffirms the role of models and experiments. Philosophers now see models as "autonomous agents" that exert independent influence on the development of a science, in addition to theory and data. The inappropriate molding effects of math models on social behavior modeling are noted. Complexity science offers a "new" normal science epistemology focusing on order creation by self-organizing heterogeneous agents and agent-based models. The more responsible core of postmodernism builds on the idea that agents operate in a constantly changing web of interconnections among other agents. The connectionist agent-based models of complexity science draw on the same conception of social ontology as do postmodernists. These recent developments combine to provide foundations for a "new" social science centered on formal modeling not requiring the mathematical assumptions of agent homogeneity and equilibrium conditions. They give this "new" social science legitimacy in scientific circles that current social science approaches lack.

Journal Article↗
PubMed2003

How farmers in Switzerland perceive fertilizers from recycled anthropogenic nutrients (urine).

We studied acceptance of a urine-based fertilizer product using a mail survey of 467 Swiss farmers. We distinguished among four production types: organic or IP farming, and with or without vegetable production. Considering that the idea of urine-based fertilizers is new, acceptance among the answering farmers was surprisingly high, with 57% explicitly stating that they thought it was a good or very good idea, and 42% willing to purchase such a product. The farmers of different production types did not differ strongly in their attitude towards urine-based fertilizers. Especially IP and vegetable farmers, who purchased additional fertilizers anyway, seem willing to accept urine-based fertilizers, hereby preferring a grainy, odorless ammonium nitrate fertilizer. Absolutely essential is a hazard-free product: 30% of all farmers had concerns regarding micropollutants. Based on fertilizer data, we demonstrate an existing demand for the nutrients N, P, and K in Switzerland, which could be partially substituted by a recycled urine product. Finally, we discuss methodological requirements of social science surveys. To obtain representative data on an entire population in a mail survey, multiple contacts with respondents are necessary. We argue that information and participation of stakeholders at an early stage is essential for successful technology transfer.

Adult↗
PubMed2004

Using XML technology for the ontology-based semantic integration of life science databases.

Several hundred internet accessible life science databases with constantly growing contents and varying areas of specialization are publicly available via the internet. Database integration, consequently, is a fundamental prerequisite to be able to answer complex biological questions. Due to the presence of syntactic, schematic, and semantic heterogeneities, large scale database integration at present takes considerable efforts. As there is a growing apprehension of extensible markup language (XML) as a means for data exchange in the life sciences, this article focuses on the impact of XML technology on database integration in this area. In detail, a general architecture for ontology-driven data integration based on XML technology is introduced, which overcomes some of the traditional problems in this area. As a proof of concept, a prototypical implementation of this architecture based on a native XML database and an expert system shell is described for the realization of a real world integration scenario.

Algorithms↗
PubMed1993

Science fiction becomes reality with M technologies.

Sophisticated data management--the ability to share information across geographical and technical boundaries via heterogeneous networks with seamless interoperability--was the stuff of science fiction just a few years ago. It is now a reality with M. Thomas Salander, vice chair of the M Technology Association and chairman of the MUMPS Development Committee, sets the scene and shows the way.

Computer Communication Networks↗
PubMed2001

Hormone replacement therapy and prevention of nonvertebral fractures: a meta-analysis of randomized trials.

CONTEXT: Hormone replacement therapy (HRT) is widely considered to reduce fractures, but this belief is based on observational data; evidence from randomized trials is lacking. OBJECTIVE: To conduct a systematic review of all randomized trials of HRT that have reported or collected nonvertebral fracture data but that may not have focused on fracture prevention. DATA SOURCES: The MEDLINE, EMBASE, Science Citation Index, and Cochrane Controlled Trials Register databases were searched from 1997 through 2000 and a search was conducted of all recent systematic reviews to identify older studies. Authors were contacted to establish whether fracture data had been collected but not reported. Researchers in the field and pharmaceutical companies also were contacted to try to identify unpublished studies. STUDY SELECTION: Trials were included in which participants had been randomized to at least 12 months of therapy and data on nonvertebral fractures at any other site and due to any cause were available. Of 70 initially identified studies, 22 were included in the analysis. DATA EXTRACTION: Both investigators extracted data independently and appraised trial quality according to the Jadad scale, which assesses the methods of randomization, concealment allocation, and reporting of withdrawals and dropouts. Disagreements were resolved by discussion. DATA SYNTHESIS: There was an overall 27% reduction in nonvertebral fractures in a pooled analysis (reduction favoring HRT in relative risk [RR], 0.73; 95% confidence interval [CI], 0.56-0.94; P =.02). This effect was greater among women randomized to HRT who had a mean age younger than 60 years (RR, 0.67; 95% CI, 0.46-0.98; P =.03). Among women with a mean age of 60 years or older, there was a reduced effect (RR, 0.88; 95% CI, 0.71-1.08; P =.22). For hip and wrist fractures alone, the effectiveness of HRT appeared more marked (RR, 0.60; 95% CI, 0.40-0.91; P =.02), particularly for women younger than 60 years (RR, 0.45; 95% CI, 0.26-0.79; P =.005). CONCLUSIONS: Our meta-analysis of randomized controlled trials of HRT noted a statistically significant reduction in nonvertebral fractures. However, this effect may be attenuated in older women.

Aged↗
PubMed1997

Is there a role for antioxidant vitamins in the prevention of cardiovascular diseases? An update on epidemiological and clinical trials data.

OBJECTIVES: To review prospective epidemiological studies and randomized clinical trials regarding the role of antioxidant vitamins (vitamins E and C and beta-carotene) in the prevention of cardiovascular diseases. DATA SOURCES: Computerized (MEDLINE and Science Citation Index) and manual searches on the role of antioxidant vitamins in cardiovascular disease management. STUDY SELECTION: Only prospective epidemiological studies and double-blind, controlled, randomized clinical trials, including at least 100 participants and providing sufficient data to allow quantitative estimation of the effects of vitamin intake were included. Retrospective epidemiological evaluations and other retrospective studies were excluded. Geographic correlation studies of population-based intake of antioxidants and cardiovascular disease rates were also excluded due to the potential large impact of confounders in cross-sectional analyses. DATA SYNTHESIS: Relative risk was evaluated for all prospective epidemiological studies. Relative risk reductions were evaluated for clinical trials. The Mantel-Haenszel method was used to estimate the relative risk reduction in clinical trials when not calculated in the original publication. A formal meta-analysis was not performed because very significant differences among study populations, type (supplemental versus dietary) and dosage of antioxidant vitamins, duration of follow-up and overall study design exist for both epidemiological investigations and clinical trials, and the pooling of study results could be misleading. CONCLUSIONS: Prospective epidemiological investigations suggest a reduction in cardiovascular risk associated with increased intake of antioxidant vitamins, particularly vitamin E. Randomized clinical trials remain inconclusive with regard to the role of vitamin E in cardiovascular protection. The large, randomized clinical trials of beta-carotene in primary prevention show no effect and potential for harm associated with the use of beta-carotene. There are inconclusive and insufficient epidemiological and clinical trial data with regard to the role of vitamin C in cardiovascular protection. Overall, it is recommended that wide-spread use of antioxidant vitamins in cardiovascular protection should not be instituted and should await the results of further ongoing clinical trials.

Adult↗
PubMed2006

HSCL LibQUAL+ 2004: from numbers and graphs to practical application.

The University of Florida Health Science Center Libraries created a task force representing various departments to review data from its 2004 LibQUAL+ survey. This review compared results from the 2002 and 2004 LibQUAL+ surveys, and the data from the Association of Academic Health Science Libraries 2004 cohort. The task force analyzed the key components of the LibQUAL+ survey: Affect of Service, Information Control, Library as Place, and user comments. At the conclusion of this review, the task force made recommendations and suggestions along departmental lines to meet the patrons' needs and expectations. In addition to following the task force recommendations, the Libraries independently implemented several new services and hired additional personnel after the completion of the 2004 survey. Combined, these changes should improve overall library service and increase customer satisfaction. Looking towards the 2006 LibQUAL+ survey, the task force will be convened in advance and will guide the entire process.

Consumer Behavior↗