Do Cochrane summaries help student midwives understand the findings of Cochrane systematic reviews: the BRIEF randomised trial

BACKGROUND: Abstracts and plain language summaries (PLS) are often the first, and sometimes the only, point of contact between readers and systematic reviews. It is important to identify how these summaries are used and to know the impact of different elements, including the authors' conclusions. The trial aims to assess whether (a) the abstract or the PLS of a Cochrane Review is a better aid for midwifery students in assessing the evidence, (b) inclusion of authors' conclusions helps them and (c) there is an interaction between the type of summary and the presence or absence of the conclusions.

METHODS: Eight hundred thirteen midwifery students from nine universities in the UK and Ireland were recruited to this 2 × 2 factorial trial (abstract versus PLS, conclusions versus no conclusions). They were randomly allocated to one of four groups and asked to recall knowledge after reading one of four summary formats of two Cochrane Reviews, one with clear findings and one with uncertain findings. The primary outcome was the proportion of students who identified the appropriate statement to describe the main findings of the two reviews as assessed by an expert panel.

RESULTS: There was no statistically significant difference in correct response between the abstract and PLS groups in the clear finding example (abstract, 59.6 %; PLS, 64.2 %; risk difference 4.6 %; CI -0.2 to 11.3) or the uncertain finding example (42.7 %, 39.3 %, -3.4 %, -10.1 to 3.4). There was no significant difference between the conclusion and no conclusion groups in the example with clear findings (conclusions, 63.3 %; no conclusions, 60.5 %; 2.8 %; -3.9 to 9.5), but there was a significant difference in the example with uncertain findings (44.7 %; 37.3 %; 7.3 %; 0.6 to 14.1, p = 0.03). PLS without conclusions in the uncertain finding review had the lowest proportion of correct responses (32.5 %). Prior knowledge and belief predicted student response to the clear finding review, while years of midwifery education predicted response to the uncertain finding review.

CONCLUSIONS: Abstracts with and without conclusions generated similar student responses. PLS with conclusions gave similar results to abstracts with and without conclusions. Removing the conclusions from a PLS with uncertain findings led to more problems with interpretation.

Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews

Background Physical rehabilitation interventions aim to ameliorate the effects of critical illness-associated muscle dysfunction in survivors. We conducted an overview of systematic reviews (SR) evaluating the effect of these interventions across the continuum of recovery.

Methods Six electronic databases (Cochrane Library, CENTRAL, DARE, Medline, Embase, and Cinahl) were searched. Two review authors independently screened articles for eligibility and conducted data extraction and quality appraisal. Reporting quality was assessed and the Grading of Recommendations Assessment, Development and Evaluation approach applied to summarise overall quality of evidence.

Results Five eligible SR were included in this overview, of which three included meta-analyses. Reporting quality of the reviews was judged as medium to high. Two reviews reported moderate-to-high quality evidence of the beneficial effects of physical therapy commencing during intensive care unit (ICU) admission in improving critical illness polyneuropathy/myopathy, quality of life, mortality and healthcare utilisation. These interventions included early mobilisation, cycle ergometry and electrical muscle stimulation. Two reviews reported very low to low quality evidence of the beneficial effects of electrical muscle stimulation delivered in the ICU for improving muscle strength, muscle structure and critical illness polyneuropathy/myopathy. One review reported that due to a lack of good quality randomised controlled trials and inconsistency in measuring outcomes, there was insufficient evidence to support beneficial effects from physical rehabilitation delivered post-ICU discharge.

Conclusions Patients derive short-term benefits from physical rehabilitation delivered during ICU admission. Further robust trials of electrical muscle stimulation in the ICU and rehabilitation delivered following ICU discharge are needed to determine the long-term impact on patient care. This overview provides recommendations for design of future interventional trials and SR.

A definition of literary literacy: a content analysis of literature syllabuses and interviews with Portuguese lecturers of literature

The aim of this paper is to present a definition of literary literacy in the context of majors in languages, literatures and cultures, in Portugal. A definition of literary literacy was deduced from a content analysis of primary data sources and from the theoretical underpinnings of the transactional theory of reading. The primary data sources are fourteen Portuguese and English literature syllabuses from four Portuguese universities (Lisboa, Nova, Coimbra and Porto) and twelve interviews with Portuguese university lecturers of literature. Based on the findings of a content analysis of both syllabuses and interviews, from the lecturers‘ point of view, a literary literate student doing a major in languages, literatures and cultures must, above all, be able to contextualize literary texts and their authors both historically and culturally, must be able to present an interpretation as a coherent text, and must be able to do and organize bibliographical research.

The rise and demise of a book-review magazine interpreting the cultural work of Books in Canada (1971-2008)

This interdisciplinary study examines the contribution that a book-review magazine makes to the cultural identity of its readers. It is the result of reflections on the cultural work of Books in Canada , on whether or not this periodical was a cultural worksite and if that is the case how it performed that cultural work. In addition, it interrogates factors that may have contributed to the magazine's demise. The study affirms that Books in Canada, a cultural enterprise from 1971 to 2008, mirrored and helped to shape book and literary culture in Canada through its circulation, through the personalities of its editors, through its front covers and through its reviewers and their reviews. Furthermore, it proposes that the demise of the enterprise was due to a combination of factors. The study begins with an introduction to book reviewing and special-interest magazines. Chapter I examines the interplay between selected visual and textual contents published in Books in Canada in its founding years. These components reflected and helped to fuel the cultural nationalism that was sweeping Canada subsequent to the 1967 World's Fair in Montreal. There were also persistent rumours and comments about the magazine that caused certain"cracks in the foundation" to appear. Chapter II compares the aims and editorial challenges of Val Clery, founder of Books in Canada , with those of Adrien Thério, founder of Lettres québécoises, and of the editors of the magazines' twentieth-anniversary issues, Paul Stuewe in the case of the former and André Vanasse in the case of the latter. Evidence in the content of the magazine, editorial and otherwise, indicated that the"contracts" that the editors made with their readers over the years were similar, to reflect and shape a cultural identity, but the result of their"projects," that is, the nature of those identities, was distinctly different. Evidently then, personal aims, preferences and political leanings of editors can have a major impact on the content of a book-review magazine and thus on the cultural work that it does. Therefore, in Chapter III, I focus on selected contents published during the tenures of two of Books in Canada 's key editors, Paul Stuewe and Olga Stein, in order to understand ways that their choices constituted a form of cultural work. The second part of this chapter moves from an analysis of the cultural work of editors to an examination of the cultural work of reviewers. Here, through a close-reading of a selection of reviews published in Books in Canada, and in other periodicals, I argue that reviewers do cultural work in the way that they negotiate their presence in a review, and in how they signal that presence through lexical choices and through the degree of intellectual interaction that they invite. Intellectual interaction is at the core of Chapter IV.This chapter consists of close readings of some of the"billboards" of the enterprise, that is, the front covers of Books in Canada , in order to show how these important components do cultural work by requiring readers to make an intellectual leap from image to text. Chapter V suggests that book reviews, the company's"bills of goods," do cultural work in much the same way as the paratexts of a book. One of my own reviews is offered as a case-study along with a number of other reviews of how central components of a book-review magazine do cultural work through the illocutionary force of their sentences. The first part of Chapter VI, the final chapter, measures the legacy of the magazine, in particular, the annual Books in Canada First Novel Award. Created in 1976, this prize is awarded to the author of the novel judged by a Books in Canada prize committee to be the best first novel in English of the year. The second part of Chapter VI sheds light on factors that may have contributed to the closure of the enterprise, including the copyright uproar that accompanied the agreement that Adrian Stein, publisher of Books in Canada and Olga Stein's husband, made in 2001 with the online book merchant, Amazon.com. Furthermore, this penultimate section of the study suggests that one of the most important factors in the magazine's demise was the decision by the Steins to exploit their position as owners, publisher, and editor of a book-review periodical, a government-subsidized one at that, to publish their own lengthy pre-trial defense of Conrad Black. The chapter then zooms back from the particular to the general with a broader consideration of the impact of technology and globalization on the book industry and on the ability of Books in Canada to survive in any form, print or digital.

Examining how post-secondary L2 readers make use of background knowledge when reading literary texts an exploratory study

Literary texts offer rich opportunities for language learning. However, can second language (L2) learners fully understand L2 literary texts? According to Bernhardt (2001):"the act of reading in a second language is extremely tricky -- is even trickier with literary texts that are inherently ambiguous, full of metaphor and intertextual relations to texts to which the readers have no access" (p.198). In other words, L2 readers are often poorly equipped grammatically, linguistically and culturally to cope with literary texts in which it might be difficult to recognize figurative language, to comprehend metaphors, to identify underlying cultural assumptions and above all to think critically while navigating those complexities. Therefore, during the reading process, L2 readers encounter gaps in the text which necessarily compel them to use whatever background knowledge they possess in order to create meaning. The purpose of this research is to see exactly how post-secondary L2 readers use their existing background knowledge to understand literary texts and what they do when confronted with text passages for which they lack such knowledge.

Where and how to find data on safety: what do systematic reviews of complementary therapies tell us?

Background: Successfully identifying relevant data for systematic reviews with a focus on safety may require retrieving information from a wider range of sources than for ‘effectiveness’ systematic reviews. Searching for safety data continues to prove a major challenge. Objectives: To examine search methods used in systematic reviews of safety and to investigate indexing. Methods: Systematic reviews focusing on safety of complementary therapies and related interventions were retrieved from comprehensive searches of major databases. Data was extracted on search strategies, sources used and indexing in major databases. Safety related search terms were compared against index terms available on major databases. Data extraction by one researcher using a pre-prepared template was checked for accuracy by a second researcher. Results: Screening of 2563 records resulted in 88 systematic reviews being identified. Information sources used varied with the type of intervention being addressed. Comparison of search terms with available index terms revealed additional potentially relevant terms that could be used in constructing search strategies. Seventy-nine reviews were indexed on PubMed, 84 on EMBASE, 21 on CINAHL, 15 on AMED, 6 on PsycINFO, 2 on BNI and HMIC. The mean number of generic safety-related indexing terms on PubMed records was 2.6. For EMBASE the mean number was 4.8 with at least 61 unique terms being employed. Most frequently used indexing terms and subheadings were adverse effects, side effects, drug interactions and herb-drug interactions. Use of terms specifically referring to safety varied across databases. Conclusions: Investigation of search methods revealed the range of information sources used, a list of which may prove a valuable resource for those planning to conduct systematic reviews of safety. The findings also indicated that there is potential to improve safety-related search strategies. Finally, an insight is provided into indexing of and most effective terms for finding safety studies on major databases.

The Invention of Hebrew Prose: Literary Language and the Dilemmas of Mimesis, pt. 3, sect. 1

DIscussion of how the Hebrew literary language developed and how it is used to create a reality.

The Invention of Hebrew Prose: Literary Language and the Dilemmas of Mimesis, pt. 3, sect. 2

DIscussion of how the Hebrew literary language developed and how it is used to create a reality

The Invention of Hebrew Prose: Literary Language and the Dilemmas of Mimesis, pt. 2

DIscussion of how the Hebrew literary language developed and how it is used to create a reality.

The Invention of Hebrew Prose: Literary Language and the Dilemmas of Mimesis, pt. 1

DIscussion of how the Hebrew literary language developed and how it is used to create a reality