A review of research on techniques for lifting low-lying objects: 2. Evidence for a correct technique

Teaching 'correct' lifting technique is common, with squat lifting generally recommended. However the available evidence is less clear about which technique should be favoured. The purpose of this paper was to present an accessible synthesis of the evidence to assist professionals in their decision about whether to teach a specific technique for lifting objects lying on or near the ground. Squat, stoop and semi-squat techniques are described and the psychophysical, physiological, biomechanical, psychological, performance and clinical evidence for each technique summarised. Evidence for other lifting guidelines is also presented. It is concluded that no one technique has clear evidence and that a work design approach should be the prime focus of intervention. Recommendations for correct lifting technique guidelines are given for where technique training must be provided.     

Effectiveness of water-based exercise in people living with Parkinson’s disease: a systematic review

This systematic review summarizes the relatively scant literature concerning the effectiveness of water-based exercise (WBE) interventions in people with Parkinson’s disease (PD). Databases MEDLINE, EMBASE, PEDro, Scopus, and SportDiscus were searched from the earliest available date to December 2011. Studies had to meet the following selection criteria: (1) the target population was patients with PD; (2) the effects of a WBE intervention (as the primary intervention) were tested; (3) the abstract of the research was available in English. Selected studies were subject to unmasked quality assessment by applying a methodological scoring with a possible maximum score of 15 points. Twelve studies met the inclusion criteria, although only three of them achieved a methodological quality score above 10 points. Collectively, the data showed that WBE has some beneficial short-term effects on the impact that PD has on the patients (mainly on their motor symptoms and on their functional mobility), as well as on their quality of life. This review provides evidence that WBE is safe for patients with PD, but there is a lack of hard evidence regarding its beneficial effects. Further randomized and controlled trials with larger sample sizes are required.     

A cross-national study of a method for researching non-profit organisational effectiveness

Are there criteria that define non-profit organisation effectiveness? If the criteria can be identified, is it possible to use them in a comparative study to assess whether and in what way the use of the criteria may vary between nations? This study addresses both questions. The study uses the factorial survey method and is based on the social constructionist conception that effectiveness is created as an ongoing and sometimes contested outcome of a social judgement process. We illustrate the method with samples from the US and UK and compare the results. The results establish the value of the factorial survey method. Analyses show that both US and UK respondents use percentage expenditures on fund-raising, advocacy emphasis, change in financial surplus and unit cost of services as effectiveness criteria. There is evidence that voluntarism is a more important criterion in the US and that advocacy is more important in the UK.     

Evidence‐Based Management: Implications for Nonprofit Organizations

The article reviews evidence‐based management and its implications for practice and teaching. My focus is on strategic decision making in nonprofit organizations. Evidence‐based management is a process that includes framing the question, finding evidence, assuring accuracy, applicability, and actionability of evidence until the evidence is the best available.     

Do Family Meetings Improve Measurable Outcomes for Patients,Carers, or Health Systems? A Systematic Review

Abstract

Family meetings are a common intervention in acute and subacute inpatient care settings. The aim of this systematic review was to investigate the quantitative research exploring the impact of inpatient family meetings on patient, carer, or service outcomes. A search of electronic databases (Medline, Cinahl, Embase, PubMed, and Psychinfo) was conducted from the earliest available time until July 2012. Inclusion and exclusion criteria were applied, and quality assessment of included articles was conducted. Eight studies were included in the final selection. Results indicate that there is some low-to-moderate quality evidence that inpatient family meetings reduce psychological distress of family carers and assist in meeting their information and support needs. There is weak evidence that inpatient family meetings may help to reduce readmission rates and facilitate entry to continuing care programs.     

Evidence-based exposure criteria for work-related musculoskeletal disorders as a tool to assess physical job demands

Despite worldwide attention, musculoskeletal disorders (MSDs) remain a substantial concern at work. To support ergonomists to assess the work-related risk factors for MSDs, several instruments are available. Unfortunately, many of these instruments are not supported by evidence-based exposure criteria for particular MSDs. For effective prevention of MSDs, it is important to know to what extent work-related risk factors are present in the work situation. The Netherlands Center for Occupational Diseases (NCOD) develops evidence-based criteria documents for the assessment of work-related MSDs. The exposure criteria of these documents can be used on a group level to support ergonomists in their assessment of the physical job demands that are associated with work-related MSDs. At the moment the NCOD has exposure criteria for the assessment of 22 work-related MSDs, for instance on the work-relatedness of upper extremity disorders, non-specific low back pain or patellar tendinopathy. The use of these exposure criteria enables ergonomist to better assess the work-related risks of MSDs as a starting point for effective prevention.     

Why a universal population‐level approach to the prevention of child abuse is essential

This paper argues for the importance of adopting a population‐level approach to promote more effective parenting and to reduce the risk of child maltreatment. Family‐based interventions based on social learning principles have been shown to make a useful contribution in the treatment of child maltreatment. However, typically such programmes have been used to treat parents who have already become involved in the child protection system. We argue that the creation of community‐wide support structures to support positive parenting is needed to reduce the prevalence of child maltreatment. Such an approach requires several criteria to be met. These include having knowledge about the prevalence rates for the targeted child outcomes sought, knowledge about the prevalence of various parenting and family risk factors, evidence that changing family risk factors reduces the prevalence of targeted problems, having culturally appropriate, cost‐effective, evidence‐based interventions available and making these widely accessible. Copyright © 2003 John Wiley & Sons, Ltd.     

Reconsidering the ‘idea’ of evidence in evidence-based policy and practice

Evidence-based policy and practice (EBP) has become an important social work conceptual framework. Yet, the core EBP concept, the concept of evidence, remains ill-defined. I propose a modification of the concept of evidence as applied to EBP effectiveness questions. As a basis for this reformulation ideas about evidence are examined from cross-disciplinary and multidisciplinary perspectives including epistemology, philosophy of science, evidence-science, and law. I propose that for EBP effectiveness questions: (1) to be considered ‘relevant evidence’ an explanatory connection between an intervention and an outcome must be established rather than a mere association; (2) the EBP definition of ‘best available evidence’ should include total available evidence (rather than a subset) about effectiveness, causal roles (i.e., mechanisms), and support factors and be inclusive of high-quality experimental and observational studies as well as high-quality mechanistic reasoning; (3) the familiar five-step EBP process should be expanded to include formulation of warranted, evidence-based arguments and that evidence appraisal be guided by three high level criteria of relevance, credibility, and strength rather than rigid evidence hierarchies; (4) comparative effectiveness research strategies, especially pragmatic controlled studies, hold promise for providing relevant and actionable evidence needed for policy and practice decision-making and successful implementation.     

Antidepressants for neuroenhancement in healthy individuals: a systematic review

Neuroenhancement offers the prospect of improving the cognitive, emotional and motivational functions of healthy individuals. Of all the conceivable interventions, psychopharmacology provides the most readily available ones, such as antidepressants which are thought to make people “better than well”. However, up until now, whether they possess such an enhancing ability remains controversial and therefore in this systematic review we will evaluate the effect and safety of modern antidepressants in healthy individuals. A search of MEDLINE and EMBASE databases and cross-references was carried out and the pharmaceutical industry was contacted for suitable data. Trials published in any language through the third week of July 2007 were regarded. Included were single or double blind randomised or quasi-randomised controlled trials that compared a placebo to one or more of the following antidepressants: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, moclobemide, paroxetine, reboxetine, sertraline or venlafaxine in any dose or dosing schedule. Eligible studies were those involving healthy people of any age and either sex who showed no evidence of a psychiatric disorder, cognitive decline or other disease. One hundred thirty-five articles met our inclusion criteria reporting single dose trials and trials with repeated drug administration. Sixty-five of these articles were eligible for a statistical analysis. Based on a linear mixed model, a meta-analysis and a fixed effects meta-regression were performed. Pooling of results by meta-analysis was stratified by the outcome measures (a) mood, (b) emotional processing, (c) wakefulness, (d) attention, (e) memory, and (f) executive functions. On a significance level of p < 0.05 the following significant results emerged: After a single dose of an antidepressant, a significant effect was shown in two of the analysed outcomes. Firstly, there was a small yet significant negative effect on wakefulness. On memory, a positive effect after several measurements was found, but this result could be traced to the results of the one study out of all included studies, which had that many assessment points. The analysis of trials with repeated drug administration (mean duration 14 days, standard deviation 9) yielded the following effects: on mood, a non-significant positive effect was detected that was continuously increasing and reached significance at the last assessment point. Regarding attention, a fluctuating effect was found, while for memory, the fact that the two groups started with a group difference confounded the results. For wakefulness there was no significant effect in any particular assessment point, while for emotional processing and executive functions, the small number of studies did not allow for any effect to emerge. In summary, no consistent evidence for enhancing effects of antidepressants could be found. There is little evidence so far to support the popular opinion that antidepressants have a positive effect on the mood of healthy individuals after repeated administration. No evidence of a significant adverse event profile could be found. The studies included in this systematic review not only provide insufficient evidence for or against any effect in healthy people, but they are inapt to be used for answering this question. This may be explained by the fact that most of them were not designed to examine neuroenhancement effects. The growing public interest in neuroenhancement stands in stark contrast to the paucity of data on enhancement effects of available psychopharmacological agents.     

Interventions for youth aging out of care: A scoping review

Youth aging out the child welfare system are being transitioned out of the child welfare system with few interventions in place to support their move to independence. In developed countries, compared to their peers, youth aging out of care face poorer outcomes when it comes to education, employment, and housing. A better understanding of the effectiveness of the existing interventions that support youth in care is warranted. This paper presents a critical scoping review of the available evidence on interventions available to youth who are aging out of the child welfare system and identifies gaps for future research. Arksey and O'Malley's framework for scoping reviews shaped the process of this review. A total of thirteen databases were searched resulting in the retrieval of 1978 articles. Of the 1978 retrieved, only 68 met the review's criteria. Studies included were in English, described an intervention that was implemented and evaluated in developed countries, and published within the last 20 years. Interventions were categorized as: housing, employment, education, mentorship, independent living, and health. The majority of studies fell under the independent living category which provide cohesive resources to improve education, housing, and employment. Studies evaluating these programs generally reported positive outcomes on youth's ability to complete their education and attain part- or full-time employment. Methods of evaluations were found to be methodologically weak with respect to determining the effectiveness of interventions in ensuring youth's successful transitions to independence. Future research should look at longitudinal outcomes of youth and cost-benefit analysis of supporting youth transitioning out of the child welfare system. Recommendations also include policy changes extending the age of eligibility for youth transitioning out of the child welfare system.     

Language impairments among youth offenders: A systematic review

Low levels of verbal intelligence have long been associated with risk for early onset antisocial behavior, however considerably less is known about the deficits in specific language skills that may characterize antisocial youth. Youth offenders represent a particularly high priority group for research into such deficits, as the juvenile justice system involves a range of high-stakes situations that rely upon the application of language skills. Our aim was to conduct a systematic review of the evidence currently available regarding the discrete language skills of youth offenders, spanning structural, pragmatic, expressive and receptive language domains. Seventeen studies meeting search criteria were identified, 16 of which reported on independent samples. Findings from these studies provide considerable evidence that youth offenders perform poorly on language measures relative to age matched peers. Study results are examined in relation to three key questions: (1) How strong is the association between language impairments and youth offending? (2) Are some language skills or modalities more impaired than others in youth offender populations; and (3) What biopsychosocial factors have been shown to influence the relationship between language impairments and youth offending? Implications for policy and practice are discussed, along with directions for future research.     

Empirically based conversion factors for calculating couple-years of protection

Couple-years of protection (CYP) is one of several commonly used indicators to assess international family planning efforts. It has been the subject of much debate, relating in part to the specific conversion factors used to translate the quantity of the respective contraceptive methods distributed to a single measure of protection. This article outlines a comprehensive effort to revisit those conversion factors based on the best available empirical evidence. In most instances, the analysis supports previously established standard conversion factors. However, there are two notable departures. Fewer condoms and spermicides are recommended for each CYP (120 vs. 150), primarily because coital frequency among condom users is lower than previously assumed. Furthermore, for sterilization, the authors recommend the use of country or region-specific conversion factors. Every program evaluation indicator has strengths and weaknesses, and the best program evaluation efforts use a variety of indicators. If CYP is used to evaluate programs, however, the authors believe that the conversion factors presented reflect the best available evidence.     

Emotional harm and neglect: the legal response

This paper reports on a study of the extent to which child protection applications brought to the Melbourne Children's Court in Victoria, Australia, were based on emotional/psychological harm or neglect of a child and what factors were presented as evidence of harm or neglect. The study examined records of 208 court‐ordered pre‐trial conferences heard in the court between February and July 2002. What was found was that, although cases involving emotional abuse have increased in terms of child protection applications, they remain cases that are difficult to decide. While in 1998/9 emotional harm was a ground in 25.7% of child protection matters completed in the Family Division of the Children's Court of Victoria, legal decision‐makers are reluctant to make a finding of child abuse in these cases because there is less accuracy in the determination of emotional harm and negligible legal criteria available to guide decision‐making. Copyright © 2006 John Wiley & Sons, Ltd.     

Reliability of work-related assessments

Insufficient evidence of the reliability of work-related assessments is a major concern in this area of practice. Despite this concern there has been ongoing development of new assessments, while existing assessments have been revised, modified and updated and others are no longer used or available. OBJECTIVES: The purpose of this study was to determine the extent and quality of evidence for the reliability of work-related assessments. STUDY DESIGN: This study examined available literature and sources in order to review the extent which reliability has been established for 28 work-related assessments. RESULTS: The levels of evidence and reliability are presented for each assessment. This indicates that a number of commercially available work-related assessments have insufficient evidence of reliability. For the limited number of work-related assessments with an adequate level of evidence on which to judge their reliability, most demonstrate a moderate to good level. Few assessments, however, have demonstrated levels of reliability sufficient for clinical (and legal) purposes. CONCLUSION: With this study clinicians will be able to examine their options with regard to the reliability of the assessments they choose to use. Interpretation of changes in test results can be considered in the light of the evidence for the reliability of the instrument used.     

Developing an objective approach to assessing allegations of sexual abuse

The decision to prosecute in a case of alleged child sexual abuse is a function of whether it is in the child's and the public's interest and whether the case is likely to be successful. This in turn rests largely upon what the child says during a joint investigative interview, the adequacy of that interview in terms of whether it meets the necessary legal requirements and whether other evidence is available, and the weight given to it. This paper describes an approach to evaluating what a child says during the interview which has been used widely in Europe to aid the decision-making process of teams and courts in their dealings with allegations of child sexual abuse. It is concluded that despite a number of methodological problems with the technique, known as statement validity analysis, joint investigating teams and the Crown Prosecution Service are likely to find it of assistance in clarifying their decision-making concerning children's evidence and, in particular, whether it is likely to be sufficiently strong to succeed within our current legal framework.     

The Impact of Pregnancy and Childbirth on Sexual Behaviors: A Systematic Review

The purpose of this review was to examine and synthesize the available quality evidence to provide researchers, educators, and clinicians an overview of what is known about sexual behaviors during pregnancy and the year after childbirth. Search engines were used to identify peer-reviewed, English-language articles that met the inclusion criteria. A total of 56 prospective, retrospective, and qualitative studies published after 1996 were reviewed. A gradual decline in vaginal intercourse from prepregnancy to first trimester to third trimester was found. Most couples resume vaginal intercourse by eight weeks after childbirth, but this behavior does not occur at prepregnancy frequencies until closer to 12 months postchildbirth. Future studies should consider assessing sexual behaviors beyond vaginal intercourse and increase efforts in recruitment of diverse samples including non-White, nonheterosexual pregnant individuals, and partners of pregnant individuals.     

Modelling interactions among offenders: A latent space approach for interdependent ego-networks

Illegal markets are notoriously difficult to study. Police data offer an increasingly exploited source of evidence. However, their secondary nature poses challenges for researchers. A key issue is that researchers often have to deal with two sets of actors: targeted and non-targeted. This work develops a latent space model for interdependent ego-networks purposely created to deal with the targeted nature of police evidence. By treating targeted offenders as egos and their contacts as alters, the model (a) leverages on the full information available and (b) mirrors the specificity of the data collection strategy. The paper then applies this approach to analyse a real-world example of illegal markets, namely the smuggling of migrants. To this end, we utilise a novel dataset of 21,555 phone conversations wiretapped by the police to study interactions among offenders.     

Elder abuse research: a systematic review

The purpose of this research was to provide a systematic review of, and assign an evidence grade to, the research articles on elder abuse. Sixteen health care and criminal justice literature databases were searched. Publications were reviewed by at least two independent readers who graded each from A (evidence of well-designed meta-analysis) to D (evidence from expert opinion or multiple case reports) on the quality of the evidence gained from the research. Of 6,676 titles identified in the search, 1,700 publications met inclusion criteria; omitting duplicates, 590 publications were annotated and graded.     

Elder Abuse Research: A Systematic Review

The purpose of this research was to provide a systematic review of, and assign an evidence grade to, the research articles on elder abuse. Sixteen health care and criminal justice literature databases were searched. Publications were reviewed by at least two independent readers who graded each from A (evidence of well-designed meta-analysis) to D (evidence from expert opinion or multiple case reports) on the quality of the evidence gained from the research. Of 6,676 titles identified in the search, 1,700 publications met inclusion criteria; omitting duplicates, 590 publications were annotated and graded.