Background: Acne vulgaris is a multifaceted skin disorder, affecting more than 85% of young individuals worldwide. Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non‐pharmacological therapies can be viable alternatives for conventional therapies. However, sufficient evidence‐based support in the efficacy and safety of non‐pharmacological therapies is lacking. Objective: To assess the efficacy and safety of several non‐pharmacological therapies in the treatment of acne vulgaris. Methods: A systematic literature review, including a best‐evidence synthesis, was performed to identify literature. Three electronic databases were accessed and searched for studies published between January 2000 and May 2017. Results: Thirty‐three eligible studies were included in our systematic review. Three main types of non‐pharmacological therapies were identified laser‐ and light‐based therapies, chemical peels and fractional microneedling radiofrequency. The majority of the included studies demonstrated a significant reduction in acne lesions. However, only seven studies had a high methodologic quality. Based on these seven trials, a best‐evidence synthesis was conducted. Strong evidence was found for glycolic acid (10–40%). Moderate evidence was found for amino fruit acid (20–60%), intense pulsed light (400–700 and 870–1200 nm) and the diode laser (1450 nm). Initially, conflicting evidence was found for pulsed dye laser (585–595 nm). The most frequently reported side‐effects for non‐pharmacological therapies included erythema, tolerable pain, purpura, oedema and a few cases of hyperpigmentation, which were in most cases mild and transient. Conclusion: Circumstantial evidence was found for non‐pharmacological therapies in the treatment of acne vulgaris. However, the lack of high methodological quality among included studies prevented us to draw clear conclusions, regarding a stepwise approach. Nevertheless, our systematic review including a best‐evidence synthesis did create order and structure in resulting outcomes in which a first step towards future research is generated.
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Evidence-based research (EBR) is the systematic and transparent use of prior research to inform a new study so that it answers questions that matter in a valid, efficient, and accessible manner. This study surveyed experts about existing (e.g., citation analysis) and new methods for monitoring EBR and collected ideas about implementing these methods. We conducted a cross-sectional study via an online survey between November 2022 and March 2023. Participants were experts from the fields of evidence synthesis and research methodology in health research. Open-ended questions were coded by recurring themes; descriptive statistics were used for quantitative questions. Ideas proposed in this study for monitoring the implementation of EBR can be used to refine methods and define responsibility but should be further explored in terms of feasibility and acceptability. Different methods may be needed to determine if the use of EBR is improving over time.
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Objectives This exploratory study was conducted to find out how well the concept of evidence-based research (EBR) is known among European health researchers with substantial clinical research experience, and which barriers affect the use of an EBR approach. The concept of EBR implies that researchers use evidence synthesis to justify new studies and to inform their design. Design A cross-sectional exploratory survey study. Setting and participants The survey was conducted among European health researchers. Respondents included 205 health researchers (physicians, nurses, dentists, allied health researchers and members of other professions involved in health research) with a doctoral degree or at least 5 years of research experience. Primary and secondary outcome measures The primary outcome measures were the level of awareness of the concept of EBR and the presence of barriers affecting the use of an EBR approach. Secondary outcome measures include correlations between sociodemographic characteristics (eg, profession) and awareness of EBR. Results We discovered that 84.4% of the respondents initially indicated their awareness of the concept of EBR. Nevertheless, 22.5% of them concluded that, on reading the definition, they either do not know or do not fully comprehend the concept of EBR. The main barriers affecting the use of an EBR approach were related to organisational issues, such as not being attributed resources (30.5% of the respondents), time (24.8%) or access to implement it (14.9%). Conclusions Despite the limitations, this study clearly shows that ongoing initiatives are necessary to raise awareness about the importance of implementing the EBR approach in health research. This paper contributes to a discussion of the issues that obstruct the implementation of the EBR approach and potential solutions to overcome these issues, such as improving the knowledge and skills necessary to practice the EBR approach.
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Objectives: Direct access is a term that describes the ability of patients to seek healthcare from midlevel dental providers (MLDPs) without first seeing a dentist. Theobjective of this study was to synthesize the evidence for the effects and costs ofdirect access to MLDPs in a primary dental care environment and assess the attitudesof various stakeholders to this method of care delivery.Methods:The literature was examined for descriptive, observational, and experi-mental study designs to examine the evidence for direct access in dentistry. Elec-tronic searches were undertaken of the Database of Abstracts of Reviews ofEffectiveness, bibliographic subscription databases, open access databases, and thegray literature.Results:The search identified 371 records, although the extent of experimental evi-dence was limited. The majority of included studies were descriptive and recordedthe subjective views of different stakeholders, following the introduction of thepolicy.Conclusions:The limited extent of experimental evidence regarding direct access toMLDPs contrasts with their widespread use across Europe, the United States, andthe southern hemisphere. Suggestions are made for a research program to improvethe evidence base for direct access
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Background: Peer review is at the heart of the scientific process. With the advent of digitisation, journals started to offer electronic articles or publishing online only. A new philosophy regarding the peer review process found its way into academia: the open peer review. Open peer review as practiced by BioMed Central (BMC) is a type of peer review where the names of authors and reviewers are disclosed and reviewer comments are published alongside the article. A number of articles have been published to assess peer reviews using quantitative research. However, no studies exist that used qualitative methods to analyse the content of reviewers’ comments. Methods: A focused mapping review and synthesis (FMRS) was undertaken of manuscripts reporting qualitative research submitted to BMC open access journals from 1 January – 31 March 2018. Free-text reviewer comments were extracted from peer review reports using a 77-item classification system organised according to three key dimensions that represented common themes and sub-themes. A two stage analysis process was employed. First, frequency counts were undertaken that allowed revealing patterns across themes/sub-themes. Second, thematic analysis was conducted on selected themes of the narrative portion of reviewer reports. Results: A total of 107 manuscripts submitted to nine open-access journals were included in the FMRS. The frequency analysis revealed that among the 30 most frequently employed themes “writing criteria” (dimension II) is the top ranking theme, followed by comments in relation to the “methods” (dimension I). Besides that, some results suggest an underlying quantitative mindset of reviewers. Results are compared and contrasted in relation to established reporting guidelines for qualitative research to inform reviewers and authors of frequent feedback offered to enhance the quality of manuscripts. Conclusions: This FMRS has highlighted some important issues that hold lessons for authors, reviewers and editors. We suggest modifying the current reporting guidelines by including a further item called “Degree of data transformation” to prompt authors and reviewers to make a judgment about the appropriateness of the degree of data transformation in relation to the chosen analysis method. Besides, we suggest that completion of a reporting checklist on submission becomes a requirement.
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BACKGROUND AND PURPOSE: In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of randomized, controlled trials aimed to evaluate the available evidence for the effectiveness of the Bobath Concept in stroke rehabilitation. Method- A systematic literature search was conducted in the bibliographic databases MEDLINE and CENTRAL (March 2008) and by screening the references of selected publications (including reviews). Studies in which the effects of the Bobath Concept were investigated were classified into the following domains: sensorimotor control of upper and lower limb; sitting and standing, balance control, and dexterity; mobility; activities of daily living; health-related quality of life; and cost-effectiveness. Due to methodological heterogeneity within the selected studies, statistical pooling was not considered. Two independent researchers rated all retrieved literature according to the Physiotherapy Evidence Database (PEDro) scale from which a best evidence synthesis was derived to determine the strength of the evidence for both effectiveness of the Bobath Concept and for its superiority over other approaches.RESULTS: The search strategy initially identified 2263 studies. After selection based on predetermined criteria, finally, 16 studies involving 813 patients with stroke were included for further analysis. There was no evidence of superiority of Bobath on sensorimotor control of upper and lower limb, dexterity, mobility, activities of daily living, health-related quality of life, and cost-effectiveness. Only limited evidence was found for balance control in favor of Bobath. Because of the limited evidence available, no best evidence synthesis was applied for the health-related quality-of-life domain and cost-effectiveness.CONCLUSIONS: This systematic review confirms that overall the Bobath Concept is not superior to other approaches. Based on best evidence synthesis, no evidence is available for the superiority of any approach. This review has highlighted many methodological shortcomings in the studies reviewed; further high-quality trials need to be published. Evidence-based guidelines rather than therapist preference should serve as a framework from which therapists should derive the most effective treatment.
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Little has been published regarding the training of academic developers themselves to support internationalization of the curriculum (IoC) initiatives. However, higher education institutions around the globe are responding to strategic demands for IoC which prepare students as ‘world-ready’ graduates. We employed qualitative research synthesis to identify recent journal articles which consider current trends in academic development to support IoC. Despite their diversity, we found common themes in the five selected studies. Our discussion and recommendations weave these themes with Betty Leask’s five-stage model of the process of IoC and Cynthia Joseph’s call for a pedagogy of social justice. “This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal for Academic Development on 19/11/15, available online: https://doi.org/10.1080/1360144X.2019.1691559.
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Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners’ expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients’ experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.
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Een verpleegkundige die evidence-based handelt, maakt gebruik van zowel wetenschappelijk onderzoek als zijn eigen professionele ervaringskennis, gecombineerd met de kennis en voorkeuren van de patiënt. Een gangbare benadering om dit evidence-based handelen in de praktijk te krijgen, is het ontwikkelen van een richtlijn om deze vervolgens in de gezondheidszorg te implementeren. Hoewel deze werkwijze gangbaar is, is ze slechts beperkt succesvol. Inmiddels is er beginnend bewijs dat cultuur en leiderschap sleutelelementen zijn bij het implementeren van richtlijnen, zodat er meer nodig is om professioneel gedrag te veranderen dan de professional ‘bloot stellen’ aan een richtlijn. Een dergelijke gedragsverandering is een complex proces, omdat dit handelen onderhevig is aan zowel intrinsieke (persoonsgebonden) als extrinsieke (contextgebonden) factoren.
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DOEL. Dit artikel beoogt een kritische analyse te geven van de manier waarop het begrip Evidence Based Practice in de literatuur doorgaans wordt ingevuld, waarna mogelijkheden worden geschetst de in het artikel geconstateerde bezwaren te ondervangen. METHODE. Er is literatuuronderzoek gedaan naar de manier waarop EBP in de literatuur wordt ingevuld. RESULTAAT. Hoewel in de literatuur met betrekking tot EBP wordt aangegeven dat het handelen van professionals gebaseerd zou moeten zijn op een integratie van wetenschappelijk onderzoek, klinische expertise en cliëntenvoorkeuren, krijgt de bron van het wetenschappelijk onderzoek de meeste nadruk. Binnen dit wetenschappelijk onderzoek wordt kwantitatief onderzoek bovendien doorgaans hoger gewaardeerd dan kwalitatief onderzoek. De andere kennisbronnen (deskundigheid van de cliënt en expertise van de verpleegkundige) die bij EBP worden onderscheiden, blijven veelal onderbelicht. DISCUSSIE EN CONCLUSIE. De manier waarop EBP meestal wordt ingevuld en geïmplementeerd brengt een aantal beperkingen met zich mee. Voorbeelden hiervan zijn de beperkte aandacht voor: de kern van het verplegen, de interactie tussen de cliënt en de verpleegkundige, de context of de cultuur waarin de zorgverlening plaatsvindt, het benutten van de ervaringsdeskundigheid van de cliënt en de expertise van de verpleegkundige zelf. In het artikel worden suggesties gegeven om deze beperkingen te ondervangen, zodat EBP inderdaad de integratie wordt van de verschillende kennisbronnen die in de literatuur worden onderscheiden en EBP met mogelijk meer succes kan worden geïmplementeerd.
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