scholarly journals Translational and Implementation Research to Bridge Evidence and Implementation

2019 ◽  
Vol 75 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Klaus Kraemer ◽  
Kesso Gabrielle van Zutphen
Keyword(s):  
Implementation Research ◽  
Evidence Base ◽  
Nutritional Deficiencies ◽  
Current Evidence ◽  
Biological Research ◽  
Past Century ◽  
Double Burden ◽  
Current Evidence Base ◽  
The Right

Background: The role of science in guiding interventions and programs and contributing to progress in achieving global targets is undeniable. In public health nutrition, biological research in the past century focused largely on single nutrients and provided the basis for addressing nutritional deficiencies. This focus has now expanded to consider evidence including, but not limited, to knowledge about food, diet, behavior, context, and culture. The complex double burden of malnutrition will need to be addressed through a wider lens that appreciates the multiple and interrelated facets that underpin it. Summary: Despite the acknowledged importance of translational research in improving nutritional outcomes, significant gaps remain in the process leading from science to practice. This article sheds light on 2 examples that demonstrate this, namely, anemia and stunting. Further, much work is still required to translate the current evidence base into effective actions that result in impact at scale, pointing toward the need for more implementation research in nutrition. Key Messages: While discoveries may take time to surface and implementers are impatient to address the challenge at hand, it is essential to identify and deploy the best available evidence while continuously advancing the evidence base, and to seek the right balance between action and inaction.

The Effect of Gender on Women-led Small Enterprises: The Case of India

2013 ◽  
Vol 2 (1) ◽  
pp. 61-75
Author(s):  
Debasree Das Gupta
Keyword(s):  
Gender Gap ◽  
Institutional Environment ◽  
State Level ◽  
Evidence Base ◽  
Current Evidence ◽  
Economic Activities ◽  
Related Factors ◽  
Current Evidence Base ◽  
Entrepreneurial Activities

The importance of women-led enterprises for any country’s economic growth and competitiveness is well established. According to a 2009 study, in India female-run enterprises in recent years have performed significantly better than other enterprises in terms of productivity and export percentages. However, gender gap in entrepreneurial initiatives in India is among the highest in the world. Although accepted as crucial, the role of public policy towards addressing these barriers is under-researched in the entrepreneurship literature. Further, the current evidence base on state-level predictors of female enterprises is scant. The aim of this study is to highlight these gaps. In doing so, the focus is on interpreting the role of gender correlates—fertility, female educational attainment and female economic activities—in facilitating or hindering women-led enterprises. Indeed, previous studies have identified gender-related factors to have the greatest impact on women’s choice in not taking up entrepreneurial activities. An empirical regression analysis and a qualitative review of the institutional environment are conducted. The findings presented in this study indicate the need for a realignment of policy focus towards addressing gender barriers and developing managerial skills, in addition to technical skills, of women entrepreneurs.

scholarly journals Interventions for challenging behaviour in intellectual disability

2014 ◽  
Vol 20 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Afia Ali ◽  
Jessica Blickwedel ◽  
Angela Hassiotis
Keyword(s):  
Intellectual Disability ◽  
Evidence Base ◽  
Current Evidence ◽  
List Type ◽  
Challenging Behaviour ◽  
Pharmacological Treatments ◽  
Current Evidence Base ◽  
The Individual

SummaryChallenging behaviour is common in intellectual disability but it is difficult to diagnose and manage. It can adversely affect the quality of life of the individual and cause the breakdown of community placements, resulting in hospital admission. This article discusses the aetiology of challenging behaviour (including the complex relationship with mental illness), diagnostic problems, the current evidence base in relation to psychosocial and pharmacological treatments, and service delivery.LEARNING OBJECTIVES•Understand the aetiological basis of challenging behaviour.•Understand the role of functional analysis.•Appreciate the evidence base in relation to the psychological and pharmacological treatment of challenging behaviour.

The Treatment of Adults with Acute Lymphoblastic Leukemia

Hematology ◽  
2008 ◽  
Vol 2008 (1) ◽  
pp. 381-389 ◽  
Author(s):  
Adele Fielding
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Evidence Base ◽  
Current Evidence ◽  
Disease Biology ◽  
Current Evidence Base ◽  
Low Incidence ◽  
Treat All

Abstract Despite the relatively low incidence of acute lymphoblastic leukemia (ALL) in adults, large national and international collaborations have recently improved our understanding of how to treat ALL in adults. This article documents and examines the current evidence base for a “state of the art” therapy in both Philadelphia chromosome–negative and –positive adult ALL. The article comments upon areas of therapeutic debate, such as the role of bone marrow transplantation. In particular, the controversial subject of whether the superior outcome seen in younger patients is predicated on disease biology or therapeutic strategy is examined closely. Promising approaches under development are also discussed.

scholarly journals IAPT and the internet: the current and future role of therapist-guided internet interventions within routine care settings

2020 ◽  
Vol 13 ◽  
Author(s):  
Graham R. Thew
Keyword(s):  
Evidence Base ◽  
Routine Care ◽  
Current Evidence ◽  
List Type ◽  
Face To Face ◽  
Internet Interventions ◽  
Psychological Therapies ◽  
Current Evidence Base ◽  
Online Format ◽  
The Right

Abstract Compared with the traditional face-to-face format, therapist-guided internet interventions offer a different approach to supporting clients in learning skills to manage and overcome mental health difficulties. Such interventions are already in use within IAPT (Improving Access to Psychological Therapies) and other routine care settings, but given their potential to deliver treatment more efficiently and therefore increase availability and access to evidence-based interventions, their use is likely to increase significantly over the coming years. This article outlines what is meant by therapist-guided internet interventions and why an online format is thought to be advantageous for clients, therapists, services, and communities more broadly. It reviews the current evidence in the context of common therapist beliefs about internet-based treatment. It aims to identify gaps where further research is required, particularly in relation to the broader implementation of these treatments in IAPT and other routine clinical services. Specifically, it emphasises the importance of choosing the right programmes, providing adequate therapist training in their use, and considering practical and organisational issues, all of which are likely to determine the success of implementation efforts. Key learning aims (1) To understand what therapist-guided internet interventions are and their potential advantages. (2) To understand the current evidence base for these interventions. (3) To learn where further research is needed with regard to both the interventions themselves, and to their broader implementation in IAPT.

scholarly journals Is Deqi an Indicator of Clinical Efficacy of Acupuncture? A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Shuo Zhang ◽  
Wei Mu ◽  
Lu Xiao ◽  
Wen-Ke Zheng ◽  
Chun-Xiang Liu ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Clinical Studies ◽  
Human Subjects ◽  
Physiological Mechanism ◽  
Evidence Base ◽  
Preliminary Evidence ◽  
Current Evidence ◽  
Clinical Effects ◽  
Current Evidence Base

Objective. Despite the systematic literature review of the current evidence, we aim to answer the question “ is Deqi an indicator of clinical effects in acupuncture treatment?”Methods. We systematically searched CNKI, VIP, Wanfang Data, PubMed, Embase, and the CENTRAL for three types of study: (1) empirical research probing into the role of Deqi in acupuncture; (2) mechanism studies examining the effect of Deqi on physiological parameters in animal models and human subjects; (3) clinical studies that compared the outcome of acupuncture with Deqi with that of acupuncture without Deqi. Two reviewers independently extracted data, undertook qualitative or quantitative analysis, and summarized findings.Results. The ancient Chinese acupuncturists valued the role of Deqi as a diagnostic tool, a prognosis predictor, and a necessary part of the therapeutic procedure. Findings from modern experimental research provided preliminary evidence for the physiological mechanism that produced Deqi. Few clinical studies generated conflicting evidence of the comparative effectiveness of acupuncture with Deqi versus acupuncture without Deqi for a variety of conditions.Conclusion. The current evidence base is not solid enough to draw any conclusion regarding the predicative value of natural Deqi for clinical efficacy or the therapeutic value of manipulation-facilitated Deqi.

The development of safer walking technology: a review

2015 ◽  
Vol 9 (2) ◽  
pp. 100-115 ◽  
Author(s):  
Esmé Wood ◽  
Gillian Ward ◽  
John Woolham
Keyword(s):  
Decision Making ◽  
Social Care ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
People With Dementia ◽  
Published Evidence ◽  
Health And Social Care ◽  
Current Evidence Base ◽  
The Right

Purpose – The purpose of this paper is to gain a greater understanding of the development of safer walking technology for people with dementia through contemporary literature. Design/methodology/approach – A two stage systematic approach to searching the literature was adopted. Initially this involved searching the literature to gain a broad overview of the development of safer walking technology and the context in which it has been developed. Then, this literature was examined in detail to look at published evidence surrounding the use of safer walking technology by people with dementia. These articles were quality appraised and a meta ethnographic approach taken to synthesis of the findings. Findings – There is a small but growing body of literature within this field. Whilst there is only limited evidence to support the use of safer walking technologies for people with dementia, the evidence to date indicates great potential for its use. If provided with the right support and guidance, safer walking technology has the potential to increase freedoms and independence for people with dementia; gaining them improved access to outdoor spaces and environments to support their health and wellbeing. However, if the safer walking technology continues to be associated with only risk management it will not achieve this potential. Research limitations/implications – The published literature within this field is small and has limited generalisability as much of it was generated in recent years has been by the same small research teams, often reusing data sets. There is also very little research that examines the experience of actually using safer walking technology and even less which explores the views of people with dementia. It is evident that a greater breadth and depth of knowledge is needed within this field to develop a clearer understanding of how this technology is used and perceived by all stakeholders concerned. In particular the literature would benefit from greater consideration of the views and experiences of people with dementia themselves. Practical implications – For many people with dementia, health and social care professionals can play an important role in ensuring appropriate assessment and support in the decision-making process when using safer walking technology. However, greater support is needed in decision making for all people with dementia, especially those people not currently engaged with specialist services. Therefore greater awareness of the benefits and limitations of this technology is needed by all health and social care professionals as well as the general public. Originality/value – At the time of conducting this review the author is unaware of any other systematic search of literature or overview of research on the use of safer walking technology and its use by people with dementia. Despite this safer walking technology is growing in popularity, commonly recommended by health and social care practitioners and often marketed and purchased directly by people with dementia and their families. This review offers an insight into the development of the technology and the current evidence base for its use.

scholarly journals TCT Connect 2020 Trial Update: FORECAST, COMBINE OCT-FFR and DEFINE-PCI

2021 ◽  
Vol 16 ◽  
Author(s):  
Kevin Cheng ◽  
Ranil de Silva
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Evidence Base ◽  
Current Evidence ◽  
Future Research ◽  
Plaque Morphology ◽  
Current Evidence Base ◽  
Clinical Questions ◽  
Artery Disease

Recent studies reported at TCT Connect 2020 have investigated a number of open clinical questions regarding the role of coronary physiology and the assessment of plaque morphology for diagnosis (FORECAST), risk stratification (COMBINE OCT-FFR) and treatment evaluation (DEFINE-PCI) of patients with coronary artery disease. In this article, the authors provide a critical appraisal of these studies and evaluate how they add to the current evidence base for management of patients with epicardial coronary artery disease. Furthermore, they discuss their potential impact on clinical practice, limitations of these studies and unanswered clinical questions that are areas for future research.

Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

2020 ◽  
Vol 18 (2) ◽  
pp. 135-150
Author(s):  
Harsha S. Nagarajarao ◽  
Chandra P. Ojha ◽  
Archana Kedar ◽  
Debabrata Mukherjee
Keyword(s):  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Narrow Channel ◽  
Paradoxical Embolism ◽  
Current Evidence ◽  
Foramen Ovale ◽  
The Right ◽  
The Relationship ◽  
Current Guidelines

: Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between the right and left atria in approximately 25-27% of adults. : In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

scholarly journals Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

2020 ◽  
pp. 1-15
Author(s):  
Daniel Joseph Lamport ◽  
Claire Michelle Williams
Keyword(s):  
Systematic Reviews ◽  
Evidence Base ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Current Evidence Base ◽  
Cognitive Benefits ◽  
Meta Analyses ◽  
The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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