Strategies in assessing the need for updating evidence-based guidelines for six clinical topics: an exploration of two search methodologies

BACKGROUND: Because of the expense of updating practice guidelines, recent attention has focused on approaches that can reliably assess any updating required. Shekelle et al. (Journal of the American Medical Association 2001, 286, 1461-7) proposed using limited literature searches with expert involvement to reduce resources used in assessing whether a guideline needs updating. OBJECTIVES: This study compared Shekelle's method and the traditional systematic review method regarding comprehensiveness and effort. METHODS: Two research teams translated critical key questions on screening test treatments and outcomes to Medical Subjects Headings (MeSH) and search strategies. They refined Shekelle's method over three iterations, seeking greater efficiency. Using both methods independently, teams assessed the need to update six topics from the 1996 Guide to Clinical Preventive Services (US Preventive Services Task Force). Outcomes included completeness of study identification, importance of missed studies and effort involved. RESULTS: The revised review approach produced fewer citations than the traditional approach and saved time, identifying fewer eligible studies than the traditional approach. None of the studies missed was rated important by the experts consulted. CONCLUSIONS: The revised review approach provides an acceptable method for judging whether a guideline requires updating. Librarians were an integral part of the research process that streamlined the searches.     

Anne Sexton《小红帽》诗中的后现代元素

Transformations是自白派女诗人Annie Sexton最著名的诗集.诗集以后现代角度重构了格林童话的17个故事,揭示了现代社会浪漫、纯真与意义泯灭的反童话的本质.文章以<小红帽>为例从这首诗解构性创作观念和体现重构趋势的写作手法两方面分析了这首诗中的后现代元素.     

做那个最动听的音符

我家附近的徐师傅三四岁时得了麻疹,家里请师傅给他打灯火,他怕,乱动,结果打错了穴位。从那以后,他不幸得了面瘫,成了个面容丑陋的人。因为长相丑陋,他受到过很多人的歧视,上小学时被看不惯他的同学打落了牙齿;因为长相丑陋,他遭遇过很多不公平的待遇,有过几次失败的婚姻。长得丑陋不是他的错,因为丑陋而发生的很多痛苦他却不得不承受。尽管这样,他还是对生活充满了期待。问他为什么能这样乐观地面对生活,他说他十几岁时的一天下大雨,他没带雨伞,被雨淋得浑身湿透。     

第一次去夏令营

妈妈,帮我叠一下被子。婆婆,我想吃红烧鱼。爸爸,来陪我下一盘棋嘛……唉,我这个小皇帝又开始提要求了。没办法,谁让我们家只有我一个孩子呢。我想,许多小朋友都和我一样,是小皇帝、小公主。不知道你     

瘦舅舅是怎么变成胖舅舅的

我的舅舅年轻的时候很艰苦,非常瘦,但随着时代的变迁,生活条件的改善,现在的舅舅生活宽裕,且拥有了一个“气势磅礴”的将军肚,我把舅舅以前的相片拿给4岁的表妹,表妹瞅了半天,生硬地蹦出两个字———“叔叔”,全家人都笑开了。咦?瘦舅舅是怎么变成胖舅舅的呢?正巧,今晚舅舅和舅妈在我家吃饭,我给你们说说舅舅这一晚上吃饭的经历,你们就全明白了。开始吃饭了,舅舅吃饭的速度那可谓是一鸣惊人(用词不太恰当),他拿汤泡着饭,配着鸭肉(还是那种骨头少肉多的部位)及其他蔬菜飞快地往嘴里填,妈妈见了,说:“吃饭怎么这么吃啊?饭不要拿汤泡,对胃不好,…     

Hostile attribution of intent and aggressive behavior: a meta-analysis

A meta-analytic review was conducted to explain divergent findings on the relation between children's aggressive behavior and hostile attribution of intent to peers. Forty-one studies with 6,017 participants were included in the analysis. Ten studies concerned representative samples from the general population, 24 studies compared nonaggressive to extremely aggressive nonreferred samples, and 7 studies compared nonreferred samples with children referred for aggressive behavior problems. A robust significant association between hostile attribution of intent and aggressive behavior was found. Effect sizes differed considerably between studies. Larger effects were associated with more severe aggressive behavior, rejection by peers as one of the selection criteria, inclusion of 8- to-12-year-old participants, and absence of control for intelligence. Video and picture presentation of stimuli were associated with smaller effect sizes than was audio presentation. Staging of actual social interactions was associated with the largest effects. The importance of understanding moderators of effect size for theory development is stressed.     

Do the effects of computer-assisted practice differ for children with reading disabilities with and without IQ-achievement discrepancy?

This study was designed to assess whether the effects of computer-assisted practice on visual word recognition differed for children with reading disabilities (RD) with or without aptitude-achievement discrepancy. A sample of 73 Spanish children with low reading performance was selected using the discrepancy method, based on a standard score comparison (i.e., the difference between IQ and achievement standard scores). The sample was classified into three groups: (1) a group of 14 children with dyslexia (age M = 103.85 months; SD = 8.45) who received computer-based reading practice; (2) a group of 31 "garden-variety" (GV) poor readers (age M = 107.06 months; SD = 6.75) who received the same type of instruction; and (3) a group of 28 children with low reading performance (age M = 103.33 months; SD = 9.04) who did not receive computer-assisted practice. Children were pre- and posttested in word recognition, reading comprehension, phonological awareness, and visual and phonological tasks. The results indicated that both computer-assisted intervention groups showed improved word recognition compared to the control group. Nevertheless, children with dyslexia had more difficulties than GV poor readers during computer-based word reading under conditions that required extensive phonological computation, because their performance was more affected by low-frequency words and long words. In conclusion, we did not find empirical evidence in favor of the IQ-achievement discrepancy definition of reading disability, because IQ did not differentially predict treatment outcomes.     

骂人水平段位标准

初段:心里很想骂,但又不知怎样骂,终于开始骂了,但又骂得不疼不痒,不咸不淡,口中喃喃不知所云,被骂者也是一头雾水,但毕竟是骂出了口,也算是具备了骂手的最基本的条件,故此类骂手可评为初段。     

小魔女韩冰,在多哈神采飞扬

成长轨迹 北京时间2006年12月3日21时,第15届(多哈)亚运会体操女子团体比赛开始角逐.     

王朝遗珠

在一段惬意的传奇消失殆尽之后,唯有他们是经历了冠军球队的兴衰或重建,在最后守着球队荣辱门槛的人。