A realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective: To determine what, how, for whom, why, and in what circumstances educational interventions to improve the delivery of nutrition care by doctors and other healthcare professionals work?

Design: Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched Medline, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar, and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms, and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations.

Results: Over half of the 46 studies from which we extracted data originated from the US. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in both developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included: feeling competent; feeling confident and comfortable; having greater self-efficacy; being less inhibited by barriers in healthcare systems; and feeling that nutrition care was accepted and recognised.

Conclusion: These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.

Report on Iowa State University of Science and Technology, Ames, Iowa for the year ended June 30, 2015

Report on Iowa State University of Science and Technology, Ames, Iowa for the year ended June 30, 2015

Lateral epicondylitis and physical exposure at work? A review of prospective studies and meta-analysis

International audience

Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting

Background: The Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context. Methods: A systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: "Analytic Hierarchy Process," "Analytical Hierarchy Process," "multi-criteria decision analysis," "multiple criteria decision," "stated preference," and "pairwise comparison." In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies' reporting. Results: The systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30 %), followed by the US (25.6 %). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria. Conclusion: The AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how inconsistent answers should be dealt with, and how the outcome and stability of the results should be presented. In addition, we need new insights to determine which target group can best handle the challenges of the AHP. © 2015 Schmidt et al.

Relationship between IL-10 gene -819C/T polymorphism and the risk of inflammatory bowel disease: a meta-analysis.

Background: The -819C/T polymorphism in interleukin 10 (IL-10) gene has been reported to be associated with inflammatory bowel disease (IBD) ,but the previous results are conflicting. Materials and Methods: The present study aimed at investigating the association between this polymorphism and risk of IBD using a meta-analysis.PubMed,Web of Science,EMBASE,google scholar and China National Knowledge Infrastructure (CNKI) databases were systematically searched to identify relevant publications from their inception to April 2016.Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using fixed- or random-effects models. Results: A total of 7 case-control studies containing 1890 patients and 2929 controls were enrolled into this meta-analysis, and our results showed no association between IL-10 gene -819C/T polymorphism and IBD risk(TT vs. CC:OR=0.81,95%CI 0.64- 1.04;CT vs. CC:OR=0.92,95%CI 0.81-1.05; Dominant model: OR=0.90,95%CI 0.80-1.02; Recessive model: OR=0.84,95%CI 0.66-1.06). In a subgroup analysis by nationality, the -819C/T polymorphism was not associated with IBD in both Asians and Caucasians. In the subgroup analysis stratified by IBD type, significant association was found in Crohn’s disease(CD)(CT vs. CC:OR=0.68,95%CI 0.48-0.97). Conclusion: In summary, the present meta-analysis suggests that the IL-10 gene -819C/T polymorphism may be associated with CD risk.

An address ... delivered at the meeting [of the American association for the advancement of science] held at Dubuque, Iowa, August 1872.

cover-title

What can the philosophy of science contribute to the ethics of science and technology?

Nascida para permitir que seus criadores possam atender suas próprias necessidades, a técnica científica sempre desempenhou papel significativo na civilização humana. Este é o contexto em que podemos vislumbrar o advento da tecnociência moderna, que tem contribuído significativamente para o incremento do controle humano sobre a natureza. Este estudo tem por objetivo analisar, sob o enfoque da bioética, reflexões sobre como a filosofia da ciência entende a neutralidade da ciência e sua convergência com a racionalidade epistêmica, bem como relacionar essas reflexões ao processo de tomada de decisões na administração da tecnociência. O estudo levantou dúvidas sobre a capacidade do conhecimento tecnocientífico para legitimar e justificar as decisões no âmbito dos sistemas de ciência e tecnologia nacionais, sinalizando assim a necessidade de promover ligação entre a auto-regulação tecnocientífico e hetero-regulação bioética. ______________________________________________________________________________ ABSTRACT

The role of science and technology management companies in the set-up and coordination of multi-partners scientific alliances

Mestrado em Economia e Gestão de Ciência, Tecnologia e Inovação

Chromium supplementation in patients with type 2 diabetes and high risk of type 2 diabetes: a meta-analysis of randomized controlled trials

Introduction: Chromium is an essential trace mineral for carbohydrate and lipid metabolism, which is currently prescribed to control diabetes mellitus. Results of previous systematic reviews and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent. Aim: The objective of this meta-analysis was to assess the effects on metabolic profiles and safety of chromium supplementation in type 2 diabetes mellitus and cholesterol. Methods: Literature searches in PubMed, Scopus and Web of Science were made by use of related terms-keywords and randomized clinical trials during the period of 2000-2014. Results: Thirteen trials fulfilled the inclusion criteria and were included in this systematic review. Total doses of Cr supplementation and brewer's yeast ranged from 42 to 1,000 µg/day, and duration of supplementation ranged from 30 to 120 days. The analysis indicated that there was a significant effect of chromium supplementation in diabetics on fasting plasma glucose with a weighted average effect size of -29.26 mg/dL, p = 0.01, CI 95% = -52.4 to -6.09; and on total cholesterol with a weighted average effect size of -6.7 mg/dL, p = 0.01, CI 95% = -11.88 to -1.53. Conclusions: The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes. Chromium supplementation may additionally improve total cholesterol levels.

The specific shapes of gender imbalance in scientific authorships : a network approach

Gender differences in collaborative research have received little at- tention when compared with the growing importance that women hold in academia and research. Unsurprisingly, most of bibliomet- ric databases have a strong lack of directly available information by gender. Although empirical-based network approaches are often used in the study of research collaboration, the studies about the influence of gender dissimilarities on the resulting topological outcomes are still scarce. Here, networks of scientific subjects are used to characterize patterns that might be associated to five categories of authorships which were built based on gender. We find enough evidence that gen- der imbalance in scientific authorships brings a peculiar trait to the networks induced from papers published in Web of Science (WoS) in- dexed journals of Economics over the period 2010-2015 and having at least one author affiliated to a Portuguese institution. Our re- sults show the emergence of a specific pattern when the network of co-occurring subjects is induced from a set of papers exclusively au- thored by men. Such a male-exclusive authorship condition is found to be the solely responsible for the emergence that particular shape in the network structure. This peculiar trait might facilitate future network analyses of research collaboration and interdisciplinarity.

Evolution of emerging iPS cell-based therapies for age-related macular degeneration (AMD)

Stem cell-based regenerative medicine is poised to revolutionize the way diseases are treated. In recent years, induced pluripotent stem (iPS) cells, a newly stem cell species, has attracted significant attention. This paper seeks to understand the pathways along which emerging clinical research efforts in the field of iPS cells is evolved. In particular, the empirical case of age-related macular degeneration (AMD) is used, which is the world-pioneering clinical application of iPS cells. In line with the literature, this study explores the interrelations between three different pathways, such as biomedical scientific understanding, development of medical technologies, and learning in clinical practice. For this, a techmining approach is used including co-term, co-citation, and direct citation methods. Scientific publications indexed in the Thomson Reuters' Web of Science and Elsevier's Scopus databases form the basis of the study. This research first explores the iPS cell research landscape through the construction of a co-term map, particularly stressing the location and intensity of disease-tackling efforts; then focus on the evolution of scientific knowledge on AMD through co-citation networks and the main path algorithm on direct citations. At the researcher level, the development of four different research groups working on cell therapies for AMD is evaluated through the software CitNetExplorer. By integrating these approaches, the result shows a wider picture of the complexities inherent in the translation of knowledge into revolutionary clinical methods.

Assessment of the elderly’s functional ability to manage theirmedication: a systematic literature review

Background The evaluation of the elderly’s ability to manage medication through the use of a validated tool can be a significant step in identifying inabilities and needs, with the objective of increasing their self-care skills, and promoting successful aging. Aim of the review To identify studies assessing the elderly’s functional ability to manage their own medication. Method For the search strategy, the PICO method was used: P—Population(elderly), I—Instruments (tools for assessing medication management ability), C—Context (community) and O—Outcomes (functional ability to manage medication). Thefinal search query was run in MEDLINE/PubMed,CINAHL Plus, ISI Web of Science and Scopus. The whole process was developed according to the PRISMA statement. Results The search retrieved 8051 records. In each screening stage, the selection criteria were applied to eliminate records where at least one of the exclusion criteria was verified. At the end of this selection, we obtained a total of 18 papers (17 studies). The results allow the conclusion to be drawn that studies use several different instruments, most of them not validated. The authors agree that medication management abilities decrease as cognitive impairment increases, even if a lot of studies assess only the physical dimension. DRUGS was the instrument most often used. Conclusion Older adults’ ability to manage their medication should be assessed using tools specifically built and validate for the purpose. DRUGS (which uses the real regimen taken by the elderly) was the most widely used assessment instrument in the screened studies.

Connecting works of art within the semantic web of symbolic meanings

My doctoral research is about the modelling of symbolism in the cultural heritage domain, and on connecting artworks based on their symbolism through knowledge extraction and representation techniques. In particular, I participated in the design of two ontologies: one models the relationships between a symbol, its symbolic meaning, and the cultural context in which the symbol symbolizes the symbolic meaning; the second models artistic interpretations of a cultural heritage object from an iconographic and iconological (thus also symbolic) perspective. I also converted several sources of unstructured data, a dictionary of symbols and an encyclopaedia of symbolism, and semi-structured data, DBpedia and WordNet, to create HyperReal, the first knowledge graph dedicated to conventional cultural symbolism. By making use of HyperReal's content, I showed how linked open data about cultural symbolism could be utilized to initiate a series of quantitative studies that analyse (i) similarities between cultural contexts based on their symbologies, (ii) broad symbolic associations, (iii) specific case studies of symbolism such as the relationship between symbols, their colours, and their symbolic meanings. Moreover, I developed a system that can infer symbolic, cultural context-dependent interpretations from artworks according to what they depict, envisioning potential use cases for museum curation. I have then re-engineered the iconographic and iconological statements of Wikidata, a widely used general-domain knowledge base, creating ICONdata: an iconographic and iconological knowledge graph. ICONdata was then enriched with automatic symbolic interpretations. Subsequently, I demonstrated the significance of enhancing artwork information through alignment with linked open data related to symbolism, resulting in the discovery of novel connections between artworks. Finally, I contributed to the creation of a software application. This application leverages established connections, allowing users to investigate the symbolic expression of a concept across different cultural contexts through the generation of a three-dimensional exhibition of artefacts symbolising the chosen concept.

Relativistic Twin: Generazione Automatica di Digital Twin in un ambiente Web of Things

Con l’avvento dell’Industry 4.0, l’utilizzo dei dispositivi Internet of Things (IoT) è in continuo aumento. Le aziende stanno spingendo sempre più verso l’innovazione, andando ad introdurre nuovi metodi in grado di rinnovare sistemi IoT esistenti e crearne di nuovi, con prestazioni all’avanguardia. Un esempio di tecniche innovative emergenti è l’utilizzo dei Digital Twins (DT). Essi sono delle entità logiche in grado di simulare il reale comportamento di un dispositivo IoT fisico; possono essere utilizzati in vari scenari: monitoraggio di dati, rilevazione di anomalie, analisi What-If oppure per l’analisi predittiva. L’integrazione di tali tecnologie con nuovi paradigmi innovativi è in rapido sviluppo, uno tra questi è rappresentato dal Web of Things (WoT). Il Web of Thing è un termine utilizzato per descrivere un paradigma che permette ad oggetti del mondo reale di essere gestiti attraverso interfacce sul World Wide Web, rendendo accessibile la comunicazione tra più dispositivi con caratteristiche hardware e software differenti. Nonostante sia una tecnologia ancora in fase di sviluppo, il Web of Thing sta già iniziando ad essere utilizzato in molte aziende odierne. L’elaborato avrà come obiettivo quello di poter definire un framework capace di integrare un meccanismo di generazione automatica di Digital Twin su un contesto Web of Thing. Combinando tali tecnologie, si potrebbero sfruttare i vantaggi dell’interoperabilità del Web of Thing per poter generare un Digital Twin, indipendentemente dalle caratteristiche hardware e software degli oggetti da replicare.