The use of acupuncture in dentistry: a review of the scientific validity of published papers. Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes: a systematic review 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association Taking CHARGE: A self-management program for women following breast cancer treatment. All in the Family: systematic reviews, rapid reviews, scoping reviews, realist reviews, and more An intervention to increase use and effectiveness of self-care measures for breast cancer chemotherapy patients. Feasibility pilot on medication adherence and knowledge in ambulatory patients with gastrointestinal cancer. Robustness of empirical search strategies for clinical content in MEDLINE Digital Education in Health Professions: The Need for Overarching Evidence Synthesis A Pan-Canadian practice guideline: prevention, screening, assessment, and treatment of sleep disturbances in adults with cancer Danish Breast Cancer Cooperative Group – DBCG: History, organization, and status of scientific achievements at 30-year anniversary Indications for compression therapy in venous and lymphatic disease consensus based on experimental data and scientific evidence. Under the auspices of the IUP. Rating the strength of scientific evidence: relevance for quality improvement programs. Checking in healthcare safety: theoretical basis and practical application. Sarcopenia in ovarian cancer patients, oncologic outcomes revealing the importance of clinical nutrition: review of literature. The diffusion of an evidence-based disease guidance system for managing stroke A methodology for conducting retrospective chart review research in child and adolescent psychiatry.
OBJECTIVE To review the scientific validity of published papers on the efficacy of acupuncture in dentistry based on predefined method ological criteria . MATERIAL S A literature search performed by the Royal Society of Medicine and the University Library , Copenhagen , Denmark was able to identify 74 papers written in English , German , Danish , Swedish , Norwegian , Italian , French and Russian published between 1966 and 1996 . The search words were : acupuncture and electro-acupuncture , r and omised controlled trials ( RCT ) , dental pain , postoperative dental pain , painrelieving in dentistry , and dental analgesia . Among the 74 listed papers , 48 papers were review ed in the following language s : English , Danish , Swedish , Norwegian and German . Fifteen papers were excluded because they were written in French , Italian or Russian ; 11 papers were excluded because the abstract clearly indicated the paper was not a RCT or the paper was of a general nature without relevance to acupuncture . METHODS To assess the method ological quality of the included papers , all papers were scored on the basis of predefined criteria . A total of 92 points could be achieved and on the basis of this scale papers were rated as : Excellent ( 85 - 100 % ) , Good ( 70 - 84 % ) , Fair ( 60 - 69 % ) and Bad ( < 60 % ) . MAIN OUTCOME Fifteen out of 48 papers met the inclusion criteria . RESULTS Only one study met the criteria with more than 85 % . Five studies met the criteria with 70 - 84 % . Three studies met the criteria with 60 - 69 % . Six studies did not meet the criteria . Acupuncture in 11 out of 15 studies proved effective in the treatment of  temperom and ibular dysfunction ( TMD )  and as analgesia . Four studies showed no effect of acupuncture . CONCLUSION The value of acupuncture as an analgesic must be question ed . The effect of acupuncture in treating TMD and facial pain seems real and acupuncture could be a valuable alternative to orthodox treatment Executive summary Background As a chronic condition , the prevalence of Type 2 diabetes is increasing worldwide and adherence to oral medications , an essential component of self‐management , has been shown to improve glycaemic control . However compliance with oral medication adherence remains poor . Educating people with Type 2 diabetes is an important strategy to enhance self‐management ability , including medication‐taking behaviour . Objectives The overall objective of the review was to determine the effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes . Inclusion criteria Types of participants Studies involving adults over 18 years old with Type 2 diabetes , with or without co‐morbidities , currently taking oral hypoglycaemic medication without insulin treatment , and with aglycated haemoglobin ( HbA1c ) > 7.0 % prior to the intervention were considered . Aglycated haemoglobin ( HbA1c ) concentration of less than 7.0 % , is important in order to delay or prevent diabetes‐related complications . Participants could be from the primary , tertiary or acute care setting . Types of intervention The review focused on various forms of educational interventions delivered by healthcare professionals aim ed at improving participants ’ knowledge . Types of outcomes The review evaluated outcomes measuring oral hypoglycaemic adherence including HbA1c , fasting blood glucose levels and other relevant indicators . Types of studies Studies that were r and omized controlled trials ( RCTs ) or case‐control studies were considered . Search strategy A three‐stage search strategy was employed . Papers in English and between the years 1990‐2009 were search ed in the following data bases : CINAHL , Medline , Mosby 's Nursing Consult , PsycINFO , PubMed , ScienceDirect , Scopus , TRIP and Web of Science . Full text was retrieved when the titles and abstract s of studies fulfilled the inclusion criteria . Method ological quality Full papers were assessed for method ological quality independently by two review ers using critical appraisal checklists from the Joanna Briggs Institute ( JBI ) . A third review er was consulted whenever there were disagreements between the two review ers . Data collection / extraction Details of each study included in the review were extracted using st and ardized data extraction forms developed by JBI . Extraction was conducted independently by two review ers . Data synthesis Meta‐ analysis was not possible due to method ological and statistical heterogeneity of the included studies . Hence study findings are presented in narrative form . Results Seven studies included in the final review consisted of seven RCTs . Five studies concluded that the educational intervention was effective in promoting oral hypoglycaemic adherence compared to usual care . These included pharmacist‐led interventions , individual diabetes education provided by nurses and diabetes group education based on a self‐management approach . Similarities among these interventions were provision of information on oral hypoglycaemic medication and the need for regular education sessions . However , small sample s in some studies limited generalization of results . Conclusions Implication s for practice Increased knowledge of oral hypoglycaemic issues and reinforcement of the importance of medication adherence were useful in promoting adherence . Regular education sessions allow individuals to reinforce information and educators to identify barriers to medication adherence . Educational interventions focusing on self‐management strategies appear more likely to achieve positive outcomes . Implication s for research Further trials involving larger sample s and population s with poor glycaemic control are needed . The effects of educational interventions , influence of additional take‐home written material , the optimal interval length of follow‐up and duration of education sessions , and specific processes of individual or group education which have been identified as effective need further exploration Purpose — The aim of this guideline is to provide a focused up date of the current recommendations for the  endovascular  treatment of  acute ischemic stroke . When there is overlap , the recommendations made here supersede those of previous guidelines . Methods — This focused up date analyzes results from 8 r and omized , clinical trials of endovascular treatment and other relevant data published since 2013 . It is not intended to be a complete literature review from the date of the previous guideline publication but rather to include pivotal new evidence that justifies changes in current recommendations . Members of the writing committee were appointed by the American Heart Association/American Stroke Association Stroke Council ’s Scientific Statement Oversight Committee and the American Heart Association/American Stroke Association Manuscript Oversight Committee . Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process . Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence . Prerelease review of the draft guideline was performed by 6 expert peer review ers and by the members of the Stroke Council Scientific Statement Oversight Committee and Stroke Council Leadership Committee . Results — Evidence -based guidelines are presented for the selection of patients with acute ischemic stroke for endovascular treatment , for the endovascular procedure , and for systems of care to facilitate endovascular treatment . Conclusions — Certain endovascular procedures have been demonstrated to provide clinical benefit in selected patients with acute ischemic stroke . Systems of care should be organized to facilitate the delivery of this care The purpose of the study was to develop and evaluate Taking CHARGE , a self-management intervention design ed to facilitate successful transitions to survivorship after breast cancer treatment . The Taking CHARGE intervention involves a two-pronged approach building on self-regulation principles to ( 1 ) equip women with self-management skills to address concerns following breast cancer treatment , and ( 2 ) provide information about common survivorship topics . The program involved four intervention contacts , two small group meetings and two individualized telephone sessions , delivered by nurse/health educators . This paper focuses on the process evaluation findings from a preliminary test of the Taking CHARGE intervention conducted with 25 women , aged 34 - 66 years , completing breast cancer treatment , who were r and omly assigned to the intervention group . The process evaluation was conducted to obtain systematic information about the relevance and usefulness of the self-regulation approach , informational aspects , and program delivery . The findings indicated that intervention group participants found the Taking CHARGE program to be timely , relevant , and to have high utility in dealing with concerns that exist following breast cancer treatment . The process evaluation findings provide early evidence of the usefulness of the Taking CHARGE intervention for successful transition to survivorship following breast cancer treatment Three years ago , we founded this journal focusing on publishing systematic review s , systematic review protocol s , and associated method ological development papers . Systematic review s , which developed in the social sciences in the 1970s , began to gain rapid momentum during the 1990s in response to concerns by policymakers and clinicians about the scientific validity of the prevailing paradigm of traditional narrative review s written by authoritative experts . What distinguished systematic review s was the use of formal explicit methods , in other words pre-specification , of what exactly was the question to be answered , how evidence was search ed for and assessed , and how it was synthesized in order to reach the conclusion . Importantly , these formal methods were described as part of the review itself in a Methods section . In turn , these methods themselves became the subject of hypothesis-testing studies , as investigators sought how best to search for evidence , assess studies for quality or risk of bias , determine under what conditions meta- analysis was justified , and how to best determine and characterize our confidence in the conclusions . The results of these hypothesis-testing studies led over time to improvements in the methods we use for systematic review s. Thus , systematic review s and this journal are part of an ever-evolving process whose foundations are rooted in the scientific method . Today , new forms of review s are appearing . These have emerged in response to policymakers and other stakeholders ’ needs for information , sometimes emergently or urgently , for which the existing systematic review model does not quite fit . Hence , the rapid review , when time is of the essence ; the scoping review , when what is needed is not detailed answers to specific questions but rather an overview of a broad field ; the evidence map , a cousin of scoping review s that commonly has a specific visual presentation of the evidence across a broad field ; and the realist review , where the question of interest includes how and why complex social interventions work in certain situations , rather than assume they either do or do not work at all . As Editors , we regularly get contacted by prospect i ve authors asking whether realist review s , or scoping review s , etc . , are “ within the scope ” for Systematic Review s , and therefore we judge it an opportune time to state our position on this matter . It is our view that all of these new forms of review s are related to systematic review s , similar to the way that different biological Species within the same Family are related to each other . We consider “ systematic review s ” to be the Family and the different forms of review s to be the different species . Just as in the biological classification , where the related organisms must share certain characteristics , so too must the different types of review s share a common characteristic . In this case , what is shared is their foundation in the scientific method , with their methods articulated in advance in sufficient detail that the review can be reproduced by others . A further defining feature is that there are scholars devoted to improving the methods over time via hypothesis-testing studies . Systematic Review s has responded to these emerging techniques and already publishes papers reporting methods and findings from the systematic review family and has for example published an extremely popular series on rapid review s. We would like to consoli date this position and invite su bmi ssion of these new species of review s , as long as they meet the qualifications just listed . We expect this process of evolution to continue and to refine the methods such that in 10 years ’ time , there will appear new , as yet unimagined species of review s— and perhaps some current species of review will become extinct . Thus , it is with the scientific method , which we believe is the foundation that unites the Family of systematic review Outpatient chemotherapy treatment shifts the managing of side effects from health care providers to patients and families . The primary purpose of this quasi-experimental study was to determine whether women who receive an intervention of three telephone calls and oral and written self-care measures for specific side effects  will use more self-care measures and have higher effectiveness scores as measured by the  Exercise of Self-Care Question naire ( ESCQ ) after treatment 4 than women who receive st and ard care . A second purpose was to determine if women scoring higher on the  Exercise of Self-Care Agency ( ESCA ) Scale before chemotherapy used more and effective self-care measures during chemotherapy than women scoring lower on this scale . Forty-eight women beginning chemotherapy for breast cancer completed the ESCA pretreatment and were interviewed using the  ESCQ  during a sequence of therapy . The experimental group ( n = 26 ) received additional self-care measures . Subjects with higher ESCA scores before chemotherapy treatment used more  self-care measures  to alleviate chemotherapy side effects . A telephone call and written self-care measures after the second , third , and fourth chemotherapy treatments did not increase use or effectiveness of self-care measures . The implication s of assessing patients ' self-care agency before chemotherapy are discussed and a nursing intervention recommended PURPOSE / OBJECTIVES To evaluate the feasibility of face-to-face education , a nurse-initiated telephone call , and patient use of medication diaries to support patients ' self-reported medication adherence and knowledge of oral chemotherapy . DESIGN Descriptive , feasibility pilot study . SETTING An outpatient oncology unit at a National Cancer Institute- design ated comprehensive cancer center . SAMPLE 30 patients with gastrointestinal cancer who were prescribed at least one oral chemotherapy agent . METHODS Participants received verbal and written education and a nurse-initiated educational telephone call within 72 hours of receiving education . Each was asked to complete a medication diary at home during the first cycle and the eight-item Morisky Medication Adherence Scale ( MMAS-8 ) at the end of the first cycle of oral chemotherapy . MAIN RESEARCH VARIABLES Verbal and written education , telephone contacts , drug diary , self-reported medication adherence , and patient knowledge . FINDINGS Most patients ( n = 29 ) received both verbal and written education , participated by telephone ( n = 25 ) , and completed the medication diaries ( n = 21 ) correctly . Seventeen participants documented side effects within the first 72 hours of treatment initiation , with eight participants needing additional assistance with management of side effects . At the end of the first cycle of therapy , MMAS-8 adherence scores were high ( X = 7.89 , SD = 0.55 ) . CONCLUSIONS This study demonstrated the feasibility of a nurse-initiated educational and monitoring protocol for patients with gastrointestinal cancer receiving oral chemotherapy . In addition , the adapted MMAS-8 was a feasible adherence measure . IMPLICATION S FOR NURSING Pilot findings support targeted nurse interventions with face-to-face and telephone education to enhance self-monitoring and adherence for patients with gastrointestinal cancer receiving oral chemotherapy BACKGROUND It is important for clinical end users of MEDLINE to be able to retrieve articles that are both scientifically sound and directly relevant to clinical practice . The use of method ologic search filters ( such as " r and om allocation " for sound studies of medical interventions ) has been advocated to improve the accuracy of search ing for such studies . Method ologic search filters have been tested in previous MEDLINE files but indexing continues to evolve and the operating characteristics of these search filters in current MEDLINE files are unknown . OBJECTIVE To determine the robustness of empirical search strategies developed in 1991 for detecting clinical content in MEDLINE in the year 2000 . DESIGN A survey based on a h and search of 171 core health care journals using predetermined quality indicators for scientific merit and clinical relevance . METHODS 6 trained , experienced research assistants read all issues of 171 journals for the publishing year 2000 . Each article was rated using purpose and quality indicators and categorized into clinical ly relevant original studies , review articles , general papers , or case reports . The original and review articles were then categorized as ' pass ' or ' fail ' for method ologic rigor in the areas of therapy/ quality improvement , diagnosis , prognosis , causation , economics , clinical prediction , and qualitative and review articles . Search strategies developed in 1991 were tested in the 2000 data base . MAIN OUTCOME MEASURES Sensitivity , specificity , precision , and accuracy of the search strategies . RESULTS Search strategies developed in 1991 generally performed at least as well in 2000 for both best single terms and combinations of terms for high-sensitivity MEDLINE search es for studies of treatment , prognosis , etiology and diagnosis . For example , the accuracy of " clinical trial ( pt ) " rose from 91.6 % to 94.4 % ( P<0.05 ) for retrieving high- quality studies of treatments . CONCLUSION Most MEDLINE search strategies developed in 1991 are robust when search ing in the publishing year 2000 Synthesizing evidence from r and omized controlled trials of  digital health education  poses some challenges . These include a lack of clear categorization of digital health education in the literature ; constantly evolving concepts , pedagogies , or theories ; and a multitude of methods , features , technologies , or delivery setting s. The Digital Health Education Collaboration was established to evaluate the evidence on digital education in health professions ; inform policymakers , educators , and students ; and ultimately , change the way in which these professionals learn and are taught . The aim of this paper is to present the overarching methodology that we use to synthesize evidence across our digital health education review s and to discuss challenges related to the process . For our research , we followed Cochrane recommendations for the conduct of systematic review s ; all review s are reported according to the PRISMA ( Preferred Reporting Items for Systematic Review s and Meta-Analyses ) guidance . This included assembling experts in various digital health education fields ; identifying gaps in the evidence base ; formulating focused research questions , aims , and outcome measures ; choosing appropriate search terms and data bases ; defining inclusion and exclusion criteria ; running the search es jointly with librarians and information specialists ; managing abstract s ; retrieving full-text versions of papers ; extracting and storing large data sets , critically appraising the quality of studies ; analyzing data ; discussing findings ; drawing meaningful conclusions ; and drafting research papers . The approach used for synthesizing evidence from digital health education trials is commonly regarded as the most rigorous benchmark for conducting systematic review s. Although we acknowledge the presence of certain biases ingrained in the process , we have clearly highlighted and minimized those biases by strictly adhering to scientific rigor , method ological integrity , and st and ard operating procedures . This paper will be a valuable asset for research ers and method ologists undertaking systematic review s in digital health education Purpose This study aims to provide recommendations on the optimal strategies and interventions for the prevention , screening , assessment , and management of  cancer-related sleep disturbance ( insomnia and insomnia syndrome ) in adult cancer population s. Methods A systematic search of the published health literature was conducted to identify r and omized controlled trials , clinical practice guidelines , systematic review s , and other guidance documents . The Sleep Disturbance Expert Panel [ comprised of nurses , psychologists , primary care physicians , oncologists , physicians specialized in sleep disturbances , research ers , and guideline method ologists ] review ed , discussed , and approved the final version of the guideline . Health care professionals across Canada were asked to provide feedback through an external review process . Results Three clinical practice guidelines and 12 r and omized controlled trials were identified as the evidence base . Overall , despite the paucity of evidence , the evidence and expert consensus suggest that it is important to screen and assess adult cancer patients for sleep disturbances using st and ardized screening tools on a routine basis . While prevention of sleep disturbance is the desired objective , cognitive behavioral therapies are effective in improving sleep outcomes . As part of the external review with 16 health care providers , 81 % indicated that they agreed with the recommendations as written . Conclusions Sleep difficulty is a prevalent problem in cancer population s that needs greater recognition by health professionals . Prevention , screening , assessment , and treatment strategies supported by the best available evidence are critical . Recommendations and care path algorithms for practice are offered DBCG ( Danish Breast Cancer Cooperative Group ) constitutes a multidisciplinary organization established in 1975 by the Danish Surgical Society . The purpose involves first and foremost a nation-wide st and ardization of breast cancer treatment based on novel therapeutic principles , collaboration between experts h and ling diagnostic work-up , surgery , radiotherapy , medical oncology , and basic research , and , further , complete registration of relevant clinical data in a national data base attached to DBCG . Data are processed by the Secretariat personnel composed of statisticians , data managers , and data secretaries making current analyses of outcome results feasible . DBCG is run by the Executive Committee consisting of expert members appointed by their respective society . From 1978 the DBCG project gained widely accession from participating units , and since then nearly all newly diagnosed breast cancer incident cases are reported and registered in the national data base . Today , the data base includes approximately 80 000 incidents of primary breast cancer . Annually , the Secretariat receives roughly 1.5 million parameters to be entered into the data base . Over time DBCG has generated seven treatment programmes including in situ lesions and primary invasive breast cancer . Prob and s are subdivided into risk groups based on a given risk pattern and allocated to various treatment programmes accordingly . The scientific initiatives are conducted in the form of register- and cohort analysis or r and omized trials in national or international protocol ized setting s. Yearly , about 4 000 new incident cases of primary invasive breast cancer and about 200 in situ lesions enter the national programmes . Further , about 600 women with hereditary disposition of breast cancer are registered and evaluated on a risk scale . The main achievements result ed in a reduction of relative risk of death amounting up to 20 % and increased 5-year overall survival ascending from 60 % to roughly 80 % . This article is partly based on a Danish paper to be published in the Centenary Jubilee book of the Danish Surgical Society , 2008 AIM The aim of this study was to review published literature concerning the use of compression treatments in the management of venous and lymphatic diseases and establish where reliable evidence exists to justify the use of medical compression and where further research is required to address areas of uncertainty . METHODS The authors search ed medical literature data bases and review ed their own collection s of papers , monographs and books for papers providing information about the effects of compression and r and omized clinical trials of compression devices . Papers were classified in accordance with the recommendations of the GRADE group to categorize their scientific reliability . Further classification was made according to the particular clinical problem that was addressed in the papers . The review included papers on compression stockings , b and ages and intermittent pneumatic compression devices . RESULTS The International Compression Club met once in Vienna and corresponded by email in order to reach an agreement of how the data should be interpreted . A wide range of compression levels was reported to be effective . Low levels of compression 10 - 30 mmHg applied by stockings are effective in the management of telangiectases after sclerotherapy , varicose veins in pregnancy , the prevention of edema and deep vein thrombosis ( DVT ) . High levels of compression produced by b and aging and strong compression stockings ( 30 - 40 mmHg ) are effective at healing leg ulcers and preventing progression of post-thrombotic syndrome as well as in the management of lymphedema . In some areas no reliable evidence was available to permit recommendations of level of compression or duration of treatment . These included : management of varicose veins to prevent progression , following surgical treatment or sclerotherapy for varicose veins , and the level of compression required to treat acute DVT . CONCLUSION This review shows that whilst good evidence for the use of compression is available in some clinical indications , there is much still to be discovered . Little is know about dosimetry in compression , for how long and at what level compression should be applied . The differing effects of elastic and short-stretch compression are also little understood OBJECTIVE To summarize an extensive review of systems for grading the quality of research articles and rating the strength of bodies of evidence , and to highlight for health professionals and decision-makers concerned with quality measurement and improvement the available " best practice s " tools by which these steps can be accomplished . DESIGN Drawing on an extensive review of checklists , question naires , and other tools in the field of evidence -based practice , this paper discusses clinical , management , and policy rationale s for rating strength of evidence in a quality improvement context , and documents best practice s methods for these tasks . RESULTS After review of 121 systems for grading the quality of articles , 19 systems , mostly STUDY DESIGN specific , met a priori scientific st and ards for grading systematic review s , r and omized controlled trials , observational studies , and diagnostic tests ; eight systems ( of 40 review ed ) met similar st and ards for rating the overall strength of evidence . All can be used as is or adapted for particular types of evidence reports or systematic review s. CONCLUSIONS Formally grading study quality and rating overall strength of evidence , using sound instruments and procedures , can produce reasonable levels of confidence about the science base for parts of quality improvement programs . With such information , health care professionals and administrators concerned with quality improvement can underst and better the level of science ( versus only clinical consensus or opinion ) that supports practice guidelines , review criteria , and assessment s that feed into quality assurance and improvement programs . New systems are appearing and research is needed to confirm the conceptual and practical underpinnings of these grading and rating systems , but the need for those developing systematic review s , practice guidelines , and quality or audit criteria to underst and and undertake these steps is becoming increasingly clear PURPOSE Healthcare includes important processes such as checking to reduce errors . Checking is a prescribed part of many patient care activities with many checks being performed during one hospital admission . Some may be st and ard but unwritten practice s , whereas others are laid down in official guidance . Errors in the bedside checking procedure are the commonest cause of mis-transfusion , so more thorough checking could prevent adverse events . This paper aims to explore and enhance underst and ing regarding healthcare checking procedures . In doing so it seeks to identify a further research agenda . DESIGN / METHODOLOGY /APPROACH The computerised data bases CINAHL , PsycLIT , EMBASE , PubMed , PsycINFO and MEDLINE were search ed using specific indexing terms and free text including " bedside , peri-operative safety , theatre checking and checklists " . Only English publications were included . FINDINGS Like any human activity , checking is part of personality and behaviour . There are several psychological factors relevant to patient safety , including : memory , prospect i ve memory , automaticity and responsibility . All are relevant to healthcare . RESEARCH LIMITATIONS / IMPLICATION S B and olier criteria have not explicitly been used within this review but have been met . It would be beneficial for future review s to explicitly state how B and olier criteria are met . This would possibly enhance the publications ' scientific quality . PRACTICAL IMPLICATION S There is much to learn regarding interacting factors that influence healthcare checking procedures  and ultimately checking performance . The authors recommend that relationships between checking and personality should be explored . Furthermore , exploring how healthcare " mindfulness " might be promoted and what reminder/checking strategies healthcare staff already use in their day-to-day work routines should be examined . ORIGINALITY/VALUE Several psychological factors involved in checking and its relevance to healthcare and patient safety are identified . Additionally , recommendations for further research are indicated INTRODUCTION Ovarian cancer is the leading cause of death among gynecological malignancies . Its usual clinical manifestation is at advanced stages , with nutritional impairment , weight loss , and a consequent decline in skeletal muscle mass and strength ( defined as sarcopenia ) . The relationship between sarcopenia and decreased survival was demonstrated not only in ovarian cancer but also in other cancer types , such as hepatocellular , pancreatic , lung , colon , cervical , metastatic breast , and renal cancer . The aim of this study is to review the current evidence regarding the relationship between sarcopenia and the surgical and oncological outcomes in ovarian cancer patients . METHODS The systematic search was performed according to the Preferred Reporting Items for Systematic Review s and Meta-Analyses ( PRSIMA ) statement . The terms " SARCOPENIA " AND " OVARIAN CANCER " were systematic ally used to search PubMed and Scopus data bases . Original reports in English language were identified , with the purpose to include all relevant papers regarding the role of sarcopenia and indicators of skeletal muscle quality assessment in gynecological ovarian cancer . RESULTS A total of 9 studies were considered eligible for the present review . The strength of recommendation was moderate and the level of evidence was low in all selected articles . No prospect i ve studies were conducted and most of the papers were case-control series comparing ovarian cancer sarcopenic population vs. non sarcopenic population . CONCLUSIONS Sarcopenia appears to have an important role in oncological outcomes of ovarian cancer patients . However , sarcopenia occurrence during disease history and mechanisms underlying the possible impairment in prognosis should be better investigated . Prospect i ve trials are awaited in order to obtain a better insight in this topic This paper describes the diffusion of an evidence -based stroke guidance system ( SGS ) in a field setting through participatory research . SGS enables physicians to review relevant evidence -based literature , from which patient orders are generated for managing cerebrovascular accident . The paper focuses on the question ' what are the barriers and enablers to adopting SOS ? ' The research site consisted of eight hospitals within two health regions in Alberta , with 47 physicians as the intended users . The data sources consisted of surveys , education sessions , design feedback , field observations , and usage logs . Preliminary results revealed an initial slow rate of adoption that gradually improved with the influence of clinical champions , more effective communication , sustained education , round-the-clock support and continued system refinement . These initial findings suggest that models of technological diffusion can help us better underst and the complexities of changing physician practice behaviors INTRODUCTION Retrospective research has become largely undervalued and underutilized in child and adolescent psychiatry with the increasing singular focus on r and omized control trials , despite the wealth of clinical ly relevant data available in historical medical records . In this paper a systematic and scientific approach to chart review research methodology for psychiatry is described . METHOD Informed by available literature , a method ological stepwise approach for retrospective chart review was developed . RESULTS A nine step method aim ed at maximizing benefits and minimizing limitations is discussed . CONCLUSIONS Retrospective chart review is an important methodology with distinct advantages and has the potential to provide psychiatry with valuable research opportunities . This method of study should not be lost in the field of psychiatry
Attempts to prevent dysgeusia through the prophylactic use of zinc sulfate or amifostine have been of limited benefit .
Nutritional counseling may be helpful to some patients in minimizing the symptoms of dysgeusia .
Conclusions Dysgeusia is a common oral side effect of cancer therapy ( radiotherapy , chemotherapy , or combined modality therapy ) and often impacts negatively on quality of life .
From the current literature , there does not appear to be a predictable way of preventing or treating dysgeusia
Purpose The purpose was to review relevant scientific papers written since 1989 which focused on the prevalence and management of  dysgeusia as an oral side effect of cancer treatment .