Are Persons With Intellectual and Developmental Disabilities Being Embraced in Healthy Aging Interventions?

Abstract We carried out a systematic review of healthy ageing interventions for adults with IDD. Twenty-three prospective studies including 2,398 men and women [average age: 44.3 years old] were found worldwide. Among them were only five RCTs. The designs usually were within or between subjects involving small sample sizes (ranging from 8 to 379 participants), mostly non-randomised or without follow up. We identified four thematic areas: Physical activity - nutrition and health (n = 10); Health education and health exams (n = 6); Social inclusion and community participation (n = 3); and Multi-components (n = 4). Overall, studies found effective outcomes, such as loss of body weight and improvement in nutritional habits, despite a few negative findings. We conclude that healthy ageing initiatives for people with IDD continue to be scarce, incipient, and sporadic. More research should embrace health promotion in people with IDD as a programme practice and public policy.

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Efficacy of Healthy Aging Interventions for Adults With Intellectual and Developmental Disabilities: A Systematic Review

The Gerontologist ◽

10.1093/geront/gnaa192 ◽

2020 ◽

Cited By ~ 1

Author(s):

Flavia H Santos ◽

Johanna Zurek ◽

Matthew P Janicki

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Promotion ◽

Developmental Disabilities ◽

Social Inclusion ◽

Healthy Aging ◽

Small Sample ◽

Intellectual And Developmental Disabilities ◽

Intrinsic Factors ◽

The Impact

Abstract Background and Objectives There is a lack of information on intervention strategies employed for health promotion and disease prevention for older adults with intellectual and developmental disabilities (IDD), who usually experience poorer health compared to their peers without IDD. We carried out the first systematic review to scrutinize the impact of intrinsic factors (e.g., cognitive, mental, and physical health, etc.), on health status of older adults with IDD. Research Design and Methods To assess the efficacy of such interventions, we examined 23 articles including prospective ‘healthy aging’ interventions designed for adults with IDD. Searches were carried out in the databases Web of Science; Scielo; PsycINFO in April 2020. Articles were organized in thematic areas: (1) Physical activity and health nutrition (n=10); (2) Health education and health screening (n=6); (3) Social inclusion and community participation (n=3); and (4) Multi-components (n=4). Except for five RCT studies, the designs were mainly non-randomized, involving small sample sizes (Nrange = 8 to 379 participants), and lacking follow up. Results The studies included 2,398 men and women with IDD (ranging in age from 18 to 86 years [mean age: 44.3 yrs.]). Overall, intervention outcomes were mostly positive, however some negative outcomes were reported. Discussion and Implications In brief, healthy aging interventions for people with IDD remain scarce, incipient, and sporadic. We recommend that more attention needs to be given to active health promotion with people with IDD as a program practice among organizations and as a focal public policy among governments.

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Cannabis and breastfeeding

Paediatrics & Child Health ◽

10.1093/pch/pxaa037 ◽

2020 ◽

Vol 25 (Supplement_1) ◽

pp. S26-S28 ◽

Cited By ~ 1

Author(s):

Lisa Graves

Keyword(s):

Health Care Providers ◽

Small Sample ◽

Adverse Outcomes ◽

Care Providers ◽

High Quality ◽

High Quality Evidence ◽

Small Sample Sizes ◽

The Impact ◽

Quality Evidence

Abstract Cannabis is one of the most commonly used substances in Canada with 15% of Canadians reporting use in 2019. There is emerging evidence that cannabis is linked to an impact on the developing brain in utero and adverse outcomes in infants, children, and adolescents. The impact of cannabis during breastfeeding has been limited by studies with small sample sizes, follow-up limited to 1 year and the challenge of separating prenatal exposure from that during breastfeeding. In the absence of high-quality evidence, health care providers need to continue to engage women in conversation about the potential concerns related to breastfeeding and cannabis use.

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EROSITA: AGN SCIENCE, BACKGROUND DETERMINATION, AND OPTICAL FOLLOW-UP SPECTROSCOPY

Acta Polytechnica ◽

10.14311/ap.2013.53.0793 ◽

2013 ◽

Vol 53 (A) ◽

pp. 793-798

Author(s):

Thomas Boller

Keyword(s):

Small Sample ◽

Scientific Success ◽

X Ray ◽

Photometric Redshift ◽

Sky Survey ◽

Extended Sources ◽

Small Sample Sizes ◽

Primary Instrument ◽

The Ideal

More than 20 years after the highly impacting ROSAT all-sky survey in the soft X-ray spectral range, we are close to the next major X-ray all/sky surveys with eROSITA. eROSITA will be the primary instrument on-board the Russian “Spectrum–Roentgen–Gamma” (SRG) satellite which will be launched from Baikonur in 2014 and placed in an L2 orbit. It will perform the first imaging all-sky survey in the medium energy X-ray range up to 10 keV with an unprecedented spectral and angular resolution. The eROSITA all sky X-ray survey will take place in a very different context than the ROSAT survey. There is now a wealth of complete, ongoing and planned surveys of the sky in broad range of wavelengths from the gamma, X-ray to the radio. A significant amount of science can be accomplished through the multi-frequency study of the eROSITA AGN and cluster sample, including optical confirmation and photometric redshift estimation of the eROSITA extended sources and AGNs. Optical spectroscopy has been, and will for the foreseeable future be, one of the main tools of astrophysics allowing studies of a large variety of astronomical objects over many fields of research. The fully capitalize on the eROSITA potential, a dedicated spectroscopic follow-up program is needed. 4MOST is the ideal instrument to secure the scientific success of the eROSITA X-ray survey and to overcome the small sample sizes together with selection biases that plagued past samples. The aim is to have the instrument commissioned in 2017, well matched to the data releases of eROSITA and Gaia. The design and implementation of the 4MOST facility simulator aimed to optimize the science output for eROSITA is described in necessary details.

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Continuous circular cycling as a predictor of treatment response in bipolar disorders: a comprehensive review of the current literature

CNS Spectrums ◽

10.1017/s1092852917000189 ◽

2017 ◽

Vol 23 (1) ◽

pp. 24-28 ◽

Cited By ~ 1

Author(s):

Antonio Tundo ◽

Paola Cavalieri

Keyword(s):

Bipolar Disorders ◽

Poor Response ◽

Term Treatment ◽

Small Sample ◽

Long Term Treatment ◽

Group Members ◽

Short And Long Term ◽

Small Sample Sizes

Evidence from the literature suggests that, on average, 27% of patients with a bipolar disorder (BD) experience a continuous cycling course (CCC) and that this subgroup differs significantly from patients with a noncontinuous cycling course (N-CCC) with respect to sociodemographic characteristics and clinical presentation. The aim of the present paper is to review the studies that evaluated short- and long-term treatment responses in BD patients with CCC. The retrieved studies indicate that CCC is a significant predictor of poor response to long-term treatment with lithium (the odds of a response in the CCC group were 57% less than in the N-CCC group; p<0.01), as well as to polytherapies including lithium and/or an antiepileptic augmented, when necessary, with an antipsychotic and/or antidepressant. The percentage of patients without new episodes during follow-up was significantly lower in the CCC group compared with the N-CCC group (15.4 vs. 37.6% , p<0.01). Compared with patients in the N-CCC group, members of the CCC group had a poorer response and lower remission rates after 12-week antidepressant treatments for a major depressive episode (82.3 vs. 50%, p =0.002; 69.6 vs. 40.9%, p=0.013). These findings, underlining that CCC is a predictor of poor response to short- and long-term treatment in BD, should be interpreted considering the limitations of the reviewed studies (the small sample sizes, the small number of trials and their observational nature, the lack of randomization or placebo controls, and the unblinded nature of the outcomes). Clinical trials and observational studies with larger samples are warranted to confirm the conclusions of our review.

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Procedures for the Analysis of Differential Item Functioning (DIF) for Small Sample Sizes

Evaluation & the Health Professions ◽

10.1177/0163278705278276 ◽

2005 ◽

Vol 28 (3) ◽

pp. 283-294 ◽

Cited By ~ 50

Author(s):

Jin-Shei Lai ◽

Jeanne Teresi ◽

Richard Gershon

Keyword(s):

Differential Item Functioning ◽

Small Sample ◽

Small Samples ◽

Sample Sizes ◽

Education And Health ◽

Item Functioning ◽

Related Quality ◽

Health Related ◽

Small Sample Sizes

An item with differential item functioning (DIF) displays different statistical properties, conditional on a matching variable. The presence of DIF in measures can invalidate the conclusions of medical outcome studies. Numerous approaches have been developed to examine DIF in many areas, including education and health-related quality of life. There is little consensus in the research community regarding selection of one best method, and most methods require large sample sizes. This article describes some approaches to examine DIF with small samples (e.g., less than 200).

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Digital health tools for the passive monitoring of depression: a systematic review of methods

npj Digital Medicine ◽

10.1038/s41746-021-00548-8 ◽

2022 ◽

Vol 5 (1) ◽

Author(s):

Valeria De Angel ◽

Serena Lewis ◽

Katie White ◽

Carolin Oetzmann ◽

Daniel Leightley ◽

...

Keyword(s):

Computer Science ◽

Digital Health ◽

Unipolar Depression ◽

Small Sample ◽

Digital Signals ◽

Quality Of Reporting ◽

Starting Point ◽

Small Sample Sizes

AbstractThe use of digital tools to measure physiological and behavioural variables of potential relevance to mental health is a growing field sitting at the intersection between computer science, engineering, and clinical science. We summarised the literature on remote measuring technologies, mapping methodological challenges and threats to reproducibility, and identified leading digital signals for depression. Medical and computer science databases were searched between January 2007 and November 2019. Published studies linking depression and objective behavioural data obtained from smartphone and wearable device sensors in adults with unipolar depression and healthy subjects were included. A descriptive approach was taken to synthesise study methodologies. We included 51 studies and found threats to reproducibility and transparency arising from failure to provide comprehensive descriptions of recruitment strategies, sample information, feature construction and the determination and handling of missing data. The literature is characterised by small sample sizes, short follow-up duration and great variability in the quality of reporting, limiting the interpretability of pooled results. Bivariate analyses show consistency in statistically significant associations between depression and digital features from sleep, physical activity, location, and phone use data. Machine learning models found the predictive value of aggregated features. Given the pitfalls in the combined literature, these results should be taken purely as a starting point for hypothesis generation. Since this research is ultimately aimed at informing clinical practice, we recommend improvements in reporting standards including consideration of generalisability and reproducibility, such as wider diversity of samples, thorough reporting methodology and the reporting of potential bias in studies with numerous features.

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An evaluation of the use of ronidazole for the treatment of Tritrichomonas foetus in cats

Veterinary Evidence ◽

10.18849/ve.v4i4.263 ◽

2019 ◽

Vol 4 (4) ◽

Author(s):

Genever Bethan Morgan

Keyword(s):

Dose Range ◽

Clinical Signs ◽

Case Series ◽

Small Sample ◽

Tritrichomonas Foetus ◽

Bottom Line ◽

Successful Resolution ◽

Small Sample Sizes ◽

Randomised Controlled

PICO question In cats infected with Tritrichomonas foetus, does treatment with oral ronidazole compared to an alternative antiprotozoal treatment or placebo result in successful resolution of clinical signs and eradication of disease? Clinical bottom line Ronidazole use appears to be efficacious in eradicating infection with Tritrichomonas foetus and resolving diarrhoea associated with infection. A dose range of 30–50 mg/kg 12–24 hourly has been suggested, with evidence suggesting that a dose of 30 mg/kg 24 hourly for 14 days may be effective. However, some cats may require higher doses and some may not respond to treatment, and relapse may occur during a protracted period following completion of the treatment course. Neurological side effects appear to be uncommon but may occur with doses of 30 mg/kg and above. A total of six studies are reviewed: Three randomised, controlled studies, one cohort study and two case series (one retrospective). Findings indicate efficacy of ronidazole treatment in eradicating infection and resolving diarrhoea, however many studies involved small sample sizes and limited follow-up. Therefore, evidence to support the use of ronidazole in Tritrichomonas foetus infected cats remains relatively limited.

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Per Oral Pyloromyotomy for Gastroparesis: A Systematic Review of the Current Literature and Future Recommendations

Gastrointestinal Disorders ◽

10.3390/gidisord2040038 ◽

2020 ◽

Vol 2 (4) ◽

pp. 415-422

Author(s):

Luis O. Chavez ◽

Gian Galura ◽

Alejandro Robles ◽

Marco A. Bustamante-Bernal ◽

Richard McCallum

Keyword(s):

Qualitative Data ◽

Therapeutic Option ◽

Small Sample ◽

Objective Data ◽

Inclusion Criteria ◽

Data Synthesis ◽

Endoscopic Myotomy ◽

Small Sample Sizes ◽

Per Oral

Background: Gastric per oral endoscopic myotomy (GPOEM) was developed as a therapeutic option for gastroparesis after the pylorus was identified as a key target for gastroparesis management. This study includes a systematic literature review of studies in which GPOEM was utilized as therapy for gastroparesis. Methods: A literature search was conducted in three databases (MEDLINE, Scopus and Embase) of articles that included the keywords “GPOEM”, “Gastric per oral endoscopy myotomy” or “per oral pyloromyotomy” and “Gastroparesis” in the abstract or title. The search covered articles published until 29 February 2020. Results: A total of 139 articles were identified. Only 15 articles met the final inclusion criteria and were retrieved for qualitative data synthesis. Conclusion: GPOEM for gastroparesis is shown to have a high success rate among the studies but data interpretations are limited because of small sample sizes and short follow-up. Subjective and objective data prior to and post-GPOEM will be mandatory to establish credibility. The procedure is technically feasible and safe based on the limited studies available.

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The Adaptation of a Measure of Confidence in Assessing, Formulating, and Managing Suicide Risk

Crisis ◽

10.1027/0227-5910/a000830 ◽

2021 ◽

Author(s):

David M. Sandford ◽

Olivia J. Kirtley ◽

Richard Thwaites ◽

Dave Dagnan ◽

Rory C. O'Connor

Keyword(s):

Suicide Risk ◽

Preliminary Investigation ◽

Training Group ◽

Small Sample ◽

Good Test ◽

Psychological Therapies ◽

Before And After ◽

Small Sample Sizes ◽

Uk National Health Service

Abstract. Background: To date little has been done to evaluate the effectiveness of suicide risk formulation training. Aims: We aimed to investigate the psychometric properties of a new scale measuring clinicians' confidence in assessing, formulating, and managing suicide risk. Method: A total of 128 mental health practitioners from an UK National Health Service Trust completed the scale. Of them, 85 from an Improving Access to Psychological Therapies service did so before and after training in Risk Assessment, Formulation, and Management (RAFM); 28 practitioners from the Older Adults service also completed the measure. For test–retest analysis, a further 15 completed the scale again 1 week after baseline without attending any training. Of the training group, 52 (61%) completed the measure at the 6-month follow-up. Results: Analysis indicated a single-factor structure, good test–retest reliability, and statistically significant increases in confidence between pre- and posttraining and between pretraining and 6 month follow-up. Cohen's effect size values suggest a moderate-to-large effect. Limitations: The relatively small sample sizes indicate that this study should be considered a preliminary investigation of a new measure, which warrants further replication. Conclusion: This measure could be useful in gauging practitioners' confidence in the RAFM approach and in evaluating and developing training.

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Reluxation Rates Following Different Techniques for Open Stabilisation of Feline Coxofemoral Dislocations

Veterinary Evidence ◽

10.18849/ve.v4i1.185 ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Elly Russell

Keyword(s):

Open Access ◽

Surgical Technique ◽

Open Reduction ◽

Small Sample ◽

Insufficient Evidence ◽

Short Term ◽

Bottom Line ◽

Exclusion Criteria ◽

Small Sample Sizes

PICO questionIn cats with craniodorsal coxofemoral luxation does surgical stabilisation using a toggle rod technique result in a lower rate of reluxation than using a transarticular pin?Clinical bottom lineThere is currently insufficient evidence to identify if transarticular pinning or a toggle rod technique result in lower rates of reluxation following surgical management of craniodorsal coxofemoral luxations in cats.Both transarticular pinning and toggling using the Arthrex Mini TightRope system with Arthrex FiberWire suture resulted in 0% reluxation rates at short-term radiographic follow up with 0/20 joints reluxated at 2–6 weeks post-transarticular pinning and 0/4 joints reluxated at 6 weeks post-toggling.Toggling using an IMEX toggle (IMEX Veterinary Inc.) and polydioxanone (PDS II, Ethicon) suture had a higher reluxation rate of 14% (2/14 joints) at 3.5 to 6 weeks postsurgery.Longer term follow up of joints stabilised using transarticular pinning found 16.6% reluxation (2/13 joints) when radiographed at least 6 months after surgery.Small sample sizes, and variations in the length of follow up, inclusion and exclusion criteria and surgical technique significantly challenges any conclusions that may be drawn.It does appear that reluxation rates for all three techniques investigated here compare favourably to generally quoted reluxation rates following open reduction (28% quoted by Rochereau et al., 2012) and that the use of all reported techniques can be justified for the management of craniodorsal coxofemoral luxations in cats. <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

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