Research Statement Research Articles

Why allied health professionals use evidence-based clinical guidelines in stroke rehabilitation: A systematic review and meta-synthesis of qualitative studies

Objective: To capture qualitative research about the perspectives and reasoning of allied health professionals about variability in the use of clinical guidelines in stroke rehabilitation. Data sources: Ovid Medline, Psychinfo, Cochrane, Ovid Emcare, Scopus and Web of Science. Method: The review protocol followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Qualitative or mixed methods research that provided qualitative data about use of clinical guidelines delivered by allied health professionals in stroke rehabilitation was included. Clinical guidelines included any evidence-based documents that guided allied health stroke rehabilitation practice. All studies were screened in duplicate at title and abstract and then at full text. Included studies were appraised using the McMaster Critical Appraisal Tool. Results: Data from 850 allied health professionals in 22 qualitative research studies from seven different countries were analysed and synthesised. Four themes were developed including: context necessitates strategy, all clients are different, systemic changes are needed and need a good reason to change something. The findings aligned with the four arms of evidence-base practice. Allied health professionals use clinical guidelines when they align with their reasoning and match the ‘sweet spot’ for client goals and circumstance. Clinical guideline use is attributed to sufficient resourcing, time and motivation and a strong research culture within health systems. Conclusions: Variabilities in clinical guideline use by allied health professionals are due to their clinical reasoning, contextual factors, client characteristics and enabling health systems.

(Re)Establishment of fatherhood among fathers of children with mental disorders: A qualitative metasynthesis.

This metasynthesis synthesized and interpreted qualitative research results on the experience of fathers who care for children with mental disorders. It followed the guidelines from the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. A search was conducted in five databases. The Critical Appraisal Skills Programme qualitative research checklist was used to evaluate the quality of the studies, and the Confidence in the Evidence from Reviews of Qualitative Research (Grade-CERQual) approach was used to assess review findings. Thematic analysis of 12 articles included yielded the theme (re)establishment of fatherhood and four subthemes: redefinition of expectations, redefinition of the fatherhood role, benefits achieved with increased father involvement, and strengths and challenges in fatherhood, all of which demonstrated how repercussions from diagnosis and redefinition of expectations of masculinity and fatherhood affected the way fathers exercise fatherhood. Fathers were participative and attentive to their child's needs, even in a challenging context demanding integration of care with work obligations. This metasynthesis highlights challenges faced by fathers in acquiring new skills and competencies while caring for their children. The findings identify a need for interventions to facilitate fathers' involvement in caring for their children.

Research Priorities for Patients with Heart Failure and Central Sleep Apnea. An Official American Thoracic Society Research Statement.

Background: Central sleep apnea (CSA) is common among patients with heart failure and has been strongly linked to adverse outcomes. However, progress toward improving outcomes for such patients has been limited. The purpose of this official statement from the American Thoracic Society is to identify key areas to prioritize for future research regarding CSA in heart failure.Methods: An international multidisciplinary group with expertise in sleep medicine, pulmonary medicine, heart failure, clinical research, and health outcomes was convened. The group met at the American Thoracic Society 2019 International Conference to determine research priority areas. A statement summarizing the findings of the group was subsequently authored using input from all members.Results: The workgroup identified 11 specific research priorities in several key areas: 1) control of breathing and pathophysiology leading to CSA, 2) variability across individuals and over time, 3) techniques to examine CSA pathogenesis and outcomes, 4) impact of device and pharmacological treatment, and 5) implementing CSA treatment for all individualsConclusions: Advancing care for patients with CSA in the context of heart failure will require progress in the arenas of translational (basic through clinical), epidemiological, and patient-centered outcome research. Given the increasing prevalence of heart failure and its associated substantial burden to individuals, society, and the healthcare system, targeted research to improve knowledge of CSA pathogenesis and treatment is a priority.

Challenges and opportunities to developing a frailty index using electronic health record data

Older adults represent the majority of patients diagnosed with cancer yet remain under-represented in clinical trials [ [1] Ludmir E.B. Mainwaring W. Lin T.A. et al. Factors associated with age disparities among Cancer clinical trial participants. JAMA Oncol. 2019; 5: 1769-1773 Crossref PubMed Scopus (60) Google Scholar ]. The reasons for this are multifaceted and include clinician bias against recommending trial participation to older adults, trial unavailability, patient ineligibility, and other social and cultural barriers [ [2] Hurria A. Levit L.A. Dale W. et al. Improving the evidence base for treating older adults with Cancer: American society of clinical oncology statement. J Clin Oncol. 2015; 33: 3826-3833 Crossref PubMed Scopus (227) Google Scholar ]. Underrepresentation leads to a lack of evidence to guide management recommendations for older adults, forcing clinicians to extrapolate from data generated in potentially younger, healthier patients. The American Society of Clinical Oncology (ASCO) has repeatedly identified research using real-world data as a mechanism to fill this evidence gap. A 2015 ASCO research statement recommended that developers of research and clinical databases ensure that their systems collect geriatric assessment (GA) data and have the functionality to support real-world data studies designed to improve the evidence base supporting the treatment of older adults [ [2] Hurria A. Levit L.A. Dale W. et al. Improving the evidence base for treating older adults with Cancer: American society of clinical oncology statement. J Clin Oncol. 2015; 33: 3826-3833 Crossref PubMed Scopus (227) Google Scholar ]. Similarly, action items from a 2017 ASCO-U.S. Food and Drug Administration (FDA) co-sponsored workshop included standardizing and enhancing the quality of data recorded in electronic health records (EHRs) to facilitate better geriatric oncology research [ [3] Levit L.A. Singh H. Klepin H.D. et al. Expanding the evidence base in geriatric oncology: action items from an FDA-ASCO workshop. J Natl Cancer Inst. 2018; 110: 1163-1170 Crossref PubMed Scopus (35) Google Scholar ].

The Image of China and the United States of America in Selected African Media

ABSTRACT The aim of this article is to present the media images of the United States and China in Africa, based on qualitative and quantitative analyses of opinion journalism in Kenya and Zimbabwe. The rationale of the research is dictated by the rivalry for Africa between China and the USA and the need to measure the success of each side at the media level. All the opinion articles in the top five newspapers in each of these two African countries, with references to China or the USA, during the calendar year 2017 have been counted and classified from the point of view of the presence of positive, neutral or negative assessments about China and the USA. The results show that compared to the USA, China has a significantly better image in both African countries. The USA less clearly loses the competition with China in terms of values, sociopolitical and cultural patterns, but more clearly in the assessments of its actual activities in Africa. The quantitative results indicate that in the positive assessments of China, there is no significant contrast between the Zimbabwean (mainly state-controlled) and the Kenyan press. In contrast, the share of the articles with negative assessments of the USA in Zimbabwe (76 per cent) and Kenya (47 per cent) differ substantially. These results correlate quite well with the statements of previous researchers regarding the successes of Chinese soft power and the high expectation for the China model, as well as the recent decline of the image of the USA internationally.

Integration processes and identity: a view of the European youth

The presented article, based on the empirical study materials, examines the concept of European identity and the attitude to the European integration of the young people in a number of the EU countries. The relevance of the study is determined by the lack of a clear definition of the concept of “European identity” in the scientific discourse, as well as the need to assess to what extent the opinion of Europeans, in particular of the younger generation, coincides with the statements of researchers in this field. The objective of this study is to determine how representatives of European youth understand European identity, to highlight its main elements and assess the impact of European integration processes on the formation of European and national identities. Students from European countries were selected as the target group of the study, since their worldview was formed in the context of a united Europe. The research was carried out within the framework of the Erasmus + Jean Monnet Project “Transformation of identities in Europe and Russia in modern conditions” (Project No. 611458-EPP-1-2019-1-RU-EPPJMO-PROJECT). In conducting the research, the in-depth interview was chosen as the main method.he results of the study showed that respondents, whilst identifying themselves as Europeans, still find their national identity more important. Among the elements of European identity, the respondents name, first of all, “European values” (mobility, freedom, democracy), as well as cultural (religion) and behavioral characteristics (love of travel). The study results are preliminary and allow us to identify the most significant trends in the formation of the modern European identity, that will serve as the basis for further research.

Practical Guidance in the Conduct of a Scoping Review: Insights from Experience in the College of Public Health, University of the Philippines Manila

Objective. We aimed to provide practical guidance on the scoping review process, building on the methodologies and general steps outlined by Arksey and O’Malley, Levac et al. and The Joanna Briggs Institute. Methods. We reviewed the methodologies of three scoping studies conducted by the authors in the College of Public Health, University of the Philippines Manila between 2016 and 2017. For each project, we outlined the steps, tools utilized, good practices performed, challenges encountered, and recommendations for improving the scoping review process in relation to existing guidelines. We compared the similarities and differences across the three reviews and guidelines to come up with a list of good practices and recommendations. Results. We propose an expanded 10-step and iterative framework based on our analysis of three scoping studies: Define your research question; 2. Specify your research statement according to population, concept, and context; Prepare the necessary tools, forms, and software packages; 4. Assemble your expert panel and/or consultants; Develop your search strategy; 6. Implement the search strategy and retrieve identified studies; 7. Screen and assess studies for inclusion in the scoping review; 8. Chart the data; 9. Synthesize your results; and 10. Prepare your final report. Conclusion. Scoping reviews as a method of evidence synthesis are increasingly gaining popularity among researchers due to the scope of what can be reviewed in a relatively short amount of time. With only three scoping studies informing our proposed methodology, other issues and challenges in the conduct of a scoping review may have been missed in the expanded framework presented in this paper. We suggest future studies to apply existing scoping review methodologies, to further enhance this rapidly evolving framework in research, policy, and practice.

Latar Belakang Pendidikan Orang Tua dan Pola Asuh Keluarga Berpengaruh Terhadap Perkembangan Moral Spiritual Anak

PARENTS’ EDUCATIONAL BACKGROUND AND FAMILY PARENTING AFFECTED ON THE DEVELOPMENT OF CHILDREN SPIRITUAL MORAL. The level of education possessed by parents is one of the factors that influenced parenting provided by parents to children which in turn will affect the development of child’s spiritual moral, but that we need to know is the extent to which the role of these factors could influenced their spiritual moral development. Based on the research statement, the aimed of this research was to know the significant of parents’ educational background and family parenting on the development of children spiritual moral in Islamic Junior High School of Al-khairiyah Pabuaran – Cilegon. This research used a survey method with a quantitative approach. From the result of the research known that parents’ educational background effected on the development of children spiritual moral shown that tcount > ttable (5.030 > 2.0280), and family parenting affected on the development of children spiritual moral it’s shown that tcount > ttable (14.743 > 2.0280), and between X1 and X2 variable appeared that rcount was 0,51 all of which were greater than r table 0,329, so it concluded that there was a significance influence of parents’ educational background and family parenting on the development of children spiritual moral.

Autonomous Intelligent Vehicles (AIV): Research statements, open issues, challenges and road for future

The vehicle business has accomplished extraordinary outcomes in creating dependable, sheltered and reasonable vehicles throughout the only remaining century. Autonomous Vehicles (AV) are turning into a reality due to generous late improvements in Internet of Things (IoTs), Programmable Logic Controller (PLC) and correspondence innovations in computing filed. Notice that self-sufficient vehicles here are for vehicles just including transports, light vehicles, and so forth Model models have now voyaged a huge number of miles in test driving for self-ruling vehicles (under self-sufficient vehicles). This isn't a final attempt to self-governing vehicles; we have to plan Autonomous Intelligent Vehicles (AIV) that can make a compelling (for example, without hurting people) choice over the street organization. Later on, self-governing vehicles will be a reality, in any event, for commercialization, as by and by. In AIV, we face various specialized and non-specialized issues, for example, programming multifaceted nature, constant information examination and testing and confirmation. Handling these issues requires viable and prompt arrangements that meet the prerequisites, guidelines and strategies of clients, industry and government. The analysis of this work will help numerous research analysts who work in Autonomous Vehicles or Intelligent Transport Systems today and so on in near future to get better solution.

Informing Healthcare Decisions with Observational Research Assessing Causal Effect. An Official American Thoracic Society Research Statement.

Rationale: Decisions in medicine are made on the basis of knowledge and reasoning, often in shared conversations with patients and families in consideration of clinical practice guideline recommendations, individual preferences, and individual goals. Observational studies can provide valuable knowledge to inform guidelines, decisions, and policy.Objectives: The American Thoracic Society (ATS) created a multidisciplinary ad hoc committee to develop a research statement to clarify the role of observational studies—alongside randomized controlled trials (RCTs)—in informing clinical decisions in pulmonary, critical care, and sleep medicine.Methods: The committee examined the strengths of observational studies assessing causal effects, how they complement RCTs, factors that impact observational study quality, perceptions of observational research, and, finally, the practicalities of incorporating observational research into ATS clinical practice guidelines.Measurements and Main Results: There are strengths and weakness of observational studies as well as RCTs. Observational studies can provide evidence in representative and diverse patient populations. Quality observational studies should be sought in the development of ATS clinical practice guidelines, and medical decision-making in general, when 1) no RCTs are identified or RCTs are appraised as being of low- or very low-quality (replacement); 2) RCTs are of moderate quality because of indirectness, imprecision, or inconsistency, and observational studies mitigate the reason that RCT evidence was downgraded (complementary); or 3) RCTs do not provide evidence for outcomes that a guideline committee considers essential for decision-making (e.g., rare or long-term outcomes; “sequential”).Conclusions: Observational studies should be considered in developing clinical practice guidelines and in making clinical decisions.

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Patella dislocations and patellofemoral instability: a current concepts review

ABSTRACT Lateral patellar dislocation affects young, active patients with an incidence rate of 5.8 per 100 000. The management of first episode dislocations is non-surgical in the majority of cases, unless associated pathology dictates surgical intervention. Approximately 40% of cases that are treated non-surgically will develop recurrent patellofemoral instability. Evidence supports surgical intervention in these cases; however, the best approach is debatable. Most research and consensus statements agree that medial patellofemoral ligament reconstruction (MPFLR) should be performed in most cases. Additional procedures can be used 'a la carte' according to certain conditions or pathology. A tibial tubercle osteotomy (TTO) is usually indicated in patients with maltracking and/or patella alta, but the direction and degree of correction must be carefully considered. Trochleoplasty is technically demanding and should be reserved for a select few patients with severe trochlear dysplasia. It should be performed by an experienced knee surgeon due to the high risk of inadvertent complications. Level of evidence: Level 5 Keywords: patellofemoral instability, patellar dislocation

Set of graphic symbols for visual modeling in social-humanitarian knowledge

The paper raises and discusses the research problem of knowledge visualization. It is stated that the scientific knowledge knows a lot of visual languages that allow us to describe and transmit knowledge, stimulate the cognitive process and provide it with a sufficiently high level of formalizing. However, as mentioned in the paper, the availability of visual languages in social and humanitarian knowledge is currently insufficient, which is due to the fact that there are no general and rich in content visual languages describing social and humanitarian processes. The paper considers the theoretical basis of the author’s proposed solution to the previously posed problem of deficit of available visual languages. The author notes that visual epistemology should be one of theoretical statements of research into the uses of visual languages. Another significant theoretical basis suggested for solving the problem are the ideas of functional asymmetry of the human brain, considered in the context of so-called computer metaphor. The third theoretical basis of the solution embraces the concepts of visual language, visual modeling, and visual model. The author proposes the set of graphic symbols, the basic elements of which are two signs – the sign of the object and the sign of the relationship between objects. Furthermore, the author proposes additional signs for indicate various types of links and relations between objects. The paper states that in addition to cognitive functions, visual modeling performs a significant communicative function, as it makes the results of the cognitive process more visible and more convenient for perception. The author emphasizes the variability of visual modeling processes and stresses that these processes largely depend on the aesthetic consciousness of the cognizing subject. Such dependence indicates that epistemology and aesthetics are somehow intertwined in visual modeling. The final part of the paper summarizes the results of the research. The author notes that the set of visual signs as components of the visual language proposed by the author can be successfully used in solving such problems as: systematic description and visual modelling of complex processes and systems, both in social and humanitarian fields and beyond them; modelling, description and analysis of text, discourse, reasoning.

Integrating human rights into sexual and reproductive health research: moving beyond the rhetoric, what will it take to get us there?

ABSTRACT The integration of human rights principles in sexual and reproductive health (SRH) research is often recognised to be of value. Good examples abound but lack of clarity persists as to what defines rights-inclusive SRH research. To help move the field forward, this article seeks to explore how key stakeholders responsible for funding and supporting rights in SRH research understand the strengths and weaknesses of what is being done and where, and begins to catalogue potential tools and actions for the future. Interviews with a range of key stakeholders including international civil servants, donors and researchers committed to and supportive of integrating rights into SRH research were conducted and analysed. Interviews confirmed important differences in what is understood to be SRH rights-oriented research and what it can accomplish. General barriers include lack of understanding about the importance of rights; lack of clarity as to the best approach to integration; fear of adding more work with little added benefit; as well as the lack of methodological guidance or published research methodologies that integrate rights. Suggestions include the development of a comprehensive checklist for each phase of research from developing a research statement through ultimately to publication; development of training modules and workshops; inclusion of rights in curricula; changes in journal requirements; and agreement among key funding sources to mandate the integration of rights principles in research proposals they receive. As a next step, cataloguing issues and concerns at local levels can help move the integration of human rights in SRH research from rhetoric to reality.

Recommendations to Streamline and Standardize Clinical Trial Site Feasibility Assessments: An ASCO Research Statement.

Feasibility assessments (FAs) are important to establish site capabilities to conduct clinical trials and their suitability for specific trials. However, current FA methods used by biotechnology and pharmaceutical (biotech-pharma) trial sponsors and contract research organizations (CROs) are costly, inefficient, unnecessarily burdensome, and resource intensive. These methods delay trial start-up, act as a barrier to site participation, and ultimately reduce timely patient access to clinical trials and novel treatments. An ASCO Task Force was convened to assess the specific burdens and challenges with FAs and to develop recommendations to improve their efficiencies and effectiveness. Stakeholders (including trial sites, biotech-pharma sponsors, and CROs) provided insights into challenges and offered solutions through two surveys and an in-person meeting. The Task Force used the feedback to formulate consensus recommendations to improve FAs for oncology clinical trials. Three key recommendations were identified for application across all biotech-pharma sponsored trials: (1) implement a streamlined and uniform FA process across trials and sponsors; (2) minimize and standardize questions; and (3) leverage technology to centralize FAs, facilitate communications, and reduce redundancies. There is an urgency to improve the current FA process, which is costly, inconsistent, inefficient, labor intensive, and of uncertain effectiveness. All stakeholders stand to benefit from implementing these recommendations, which aim to minimize burdens and ensure that more trial sites and patients have timely access to oncology clinical trials. To have meaningful impact, adoption and consistent execution of these recommendations across all trials, sponsors, CROs, and sites are essential.

Подмосковные Фили в 1920-е годы.

The author examines socio-economic and cultural provisions of the Fili, located in the Western suburb of Moscow of during the nep. Topic for the study area in scientific and local history the literature was practically not studied. The source base was documents extracted from archives Moscow and newly introduced in scientific - research agreements, protocol, statements, resolutions and instructions to deputies. Sources allow you to determine features of peasant occupations agriculture, small scale artisanal fisheries, trade. Special attention is paid to on the establishment of industrial production, its industry focus. Documents reflecting the activities at Fili concession of enterprise the firm Junkers, let us find out the forms and methods governance and relationships foreign companies with Soviet power. The article also explains the state of improvement, life and leisure local population. The conclusion of the article emphasizes the temporary the nature of the nep and its collapse by the late 1920s.

The evaluation of populist tendences in the debate of the Christian Churches in Germany. Theological and moral perspective

In the ecumenical dialogue of the Christian Churches (both Catholic and Evangelical), the issue of the development of populist tendencies is the subject of research, debate and joint statements by their most prominent representatives. This joint voice shows, on the one hand, the genesis and directions of the spread of populist ideas, pointing out all dangers for the development of civil society, and on the other hand, it highlights the weaknesses of the democratic system in the face of all abuses consisting in the concentration of capital and disturbing social justice, reducing the participation of citizens in decision-making processes and, in the case of the European Union, the development of federalist visions to the detriment of the community of homelands dominated by more developed economic and financial countries.

Методи і прийоми виховання мовної особистості учнів у світлі педагогічних ідей І. Огієнка

The article draws attention to the problem of educating the language personality of the student, methodological bases and the role of methodological tools are analyzed in the education of the students’ personality by means of the Ukrainian language. The main statements of modern research on the education of language personality have been clarifi ed, which is closely connected with the practical advice of I. Ohiienko, who once developed guidelines and recommendations that help improve the school educational system. The system of methods and techniques of language education of students’ personalities is analyzed; their structure is substantiated, those that contrib-ute harmonious development of the students’ personality are singled out.

Simulation in Undergraduate Education.

Simulation is an integral component of undergraduate nursing education because it allows for a safe, timely, and prescriptive approach to meet learning objectives at the levels of individual simulations, courses, and academic programs. This review of the literature provides an overview of steps taken to move simulation forward in undergraduate nursing education, and it highlights educational theories, research, best practices, and policy statements underpinning modern nursing simulation. This chapter outlines simulation and curriculum integration approaches and provides examples of participant, course, and program outcomes.

Напрямки драматургії у цирковому мистецтві 1990-х-2000-х рр. Проблеми видової релевантності

Стаття присвячена дослідженню генезису «Nouveau Cirque» або «нового цирку» як художнього явища. При цьому основна увага приділяється періоду з початку 1990-х рр. до наших днів, важливою характеристикою якого стала актуалізація питань релевантності циркового мистецтва з урахуванням його взаємозв’язків із театром, що помітно зміцніли в цей час. На основі аналізу сучасного контенту, а також тверджень вітчизняних і зарубіжних дослідників, ставиться проблема теоретичної відповідності театралізованих циркових шоу-програм класичним видовим канонам. Ключовим аспектом статті стало проведення чіткої демаркаційної лінії між театрально-цирковими виставами і театральним мистецтвом, феномен «Nouveau Cirque» був визначений автором як повноцінний етап у розвитку цирку.