The Quality of the Evidence According to GRADE Is Predominantly Low or Very Low in Oral Health Systematic Reviews

OBJECTIVES The main objective was to assess the credibility of the evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) in oral health systematic reviews on the Cochrane Database of Systematic Reviews (CDSR) and elsewhere. STUDY DESIGN AND SETTING Systematic Reviews or meta-analyses (January 2008-December 2013) from 14 high impact general dental and specialty dental journals and the Cochrane Database of Systematic Reviews were screened for meta-analyses. Data was collected at the systematic review, meta-analysis and trial level. Two reviewers applied and agreed on the GRADE rating for the selected meta-analyses. RESULTS From the 510 systematic reviews initially identified 91 reviews (41 Cochrane and 50 non-Cochrane) were eligible for inclusion. The quality of evidence was high in 2% and moderate in 18% of the included meta-analyses with no difference between Cochrane and non-Cochrane reviews, journal impact factor or year of publication. The most common domains prompting downgrading of the evidence were study limitations (risk of bias) and imprecision (risk of play of chance). CONCLUSION The quality of the evidence in oral health assessed using GRADE is predominantly low or very low suggesting a pressing need for more randomised clinical trials and other studies of higher quality in order to inform clinical decisions thereby reducing the risk of instituting potentially ineffective and/or harmful therapies.

Ocean acidification affects growth but not nutritional quality of the seaweed Fucus vesiculosus (Phaeophyceae, Fucales)

Understanding the ecological implications of global climate change requires investigations of not only the direct effects of environmental change on species performance but also indirect effects that arise from altered species interactions. We performed CO2 perturbation experiments to investigate the effects of ocean acidification on the trophic interaction between the brown seaweed Fucus vesiculosus and the herbivorous isopod Idotea baltica. We predicted faster growth of F. vesiculosus at elevated CO2-concentrations and higher carbon content of the algal tissue. We expected that I. baltica has different consumption rates on algae that have been grown at different CO2 levels and that the isopods remove surplus carbon metabolically by enhanced respiration. Surprisingly, growth of F. vesiculosus as well as the C:N-ratio of the algal tissue were reduced at high CO2-levels. The changes in the elemental composition had no effect on the consumption rates and the respiration of the herbivores. An additional experiment showed that consumption of F. vesiculosus by the isopod Idotea emarginata was independent of ocean acidification and temperature. Our results could not reveal any effects of ocean acidification on the per capita strength of the trophic interaction between F. vesiculosus and its consumers. However, reduced growth of the algae at high CO2-concentrations might reduce the capability of the seaweed to compensate losses due to intense herbivory.

Reconnaissance of the geology and ground-water resources of the La Prele area, Converse County, Wyoming, with a section on the chemical quality of the ground water,

Mode of access: Internet.

Preimpoundment water quality of the Wild Rice River, Norman County, Minnesota /

Bibliography: p. 35-36.

An assessment of the water quality of the Rock River Basin derived from a biological investigation /

"Prepared for the Illinois Environmental Protection Agency."

An assessment of the water quality of the Cache River Basin derived from a biological investigation /

"Prepared for the Illinois Environmental Protection Agency."

Geology, hydrogeology, and water quality of the karst regions of southwestern Illinois and Southeastern Missouri /

"33rd annual meeting, April 1999 North-Central section, Geological Society of America" --cover.

Study of the quality of the preparation and performance of educational personnel : external reactor panel reports /

Cover title.

An assessment of the water quality of the Mississippi River Basin-north derived from a biological investigation /

"Prepared for the Illinois Environmental Protection Agency."

An assessment of the water quality of the Wabash River basin derived from a biological investigation /

"Prepared for the Illinois Environmental Protection Agency."

A small tract entitled A candid and impartial exposition of the various opinions on the subject of the comparative quality of the wheat and flour in the northern and southern sections of the United States, with a view to develop the true cause of the difference. To which are added instructions showing how to improve the character of the northern flour to an equality with that of the South; and preserve the latter from that depreciation which, in some places, it is of late so evidently undergoing;

Mode of access: Internet.

Report of the commissioners appointed to inquire into the property and income of the universities of Oxford and Cambridge, and of the colleges and halls therein;

Mode of access: Internet.

Management practices on public lands: hearings, Ninety-second Congress, first [and second] session[s], on S. 350, a bill to authorize the Secretary of the Interior and the Secretary of Agriculture to Institute Programs designed to reforest and restore the quality of public and private forest lands; to enhance and expand recreational opportunity on such lands; to provide financial incentives to improve management of state and private forest lands; to establish a federal forest lands management fund; to facilitate public participation in Federal Resource Management; and to enhance the quality of the environment ad the resources of the public lands; [and] S. 1734, a bill to provide for comprehensive management of the nation's forest lands through the application of sound forest practices, and for other purposes.

Frank Church, subcommittee chairman.

The Ohio gazetteer, and traveler's guide : containing a description of the several towns, townships and counties, with their water courses, roads, improvements, mineral productions, &c. &c. : together with an appendix, or general register, embracing tables of roads and distances, of post offices, their location and distance from the capital of the state, and of the United States, of works of internal improvement, of the several officers of state, their residence, &c., of the colleges and their officers, of banks, their officers and capital, &c. &c. /

"A continuation of the work of the late John Kilbourn"--P. [iii].