Institution
University of Saskatchewan
Education•Saskatoon, Saskatchewan, Canada•
About: University of Saskatchewan is a education organization based out in Saskatoon, Saskatchewan, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 25021 authors who have published 52579 publications receiving 1483049 citations. The organization is also known as: USask.
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31 Jan 2004TL;DR: The Global Ordovician Biodiversification Event (GOBE) was undoubtedly one of the most significant evolutionary events in the history of the marine biosphere as discussed by the authors, however, it was not paralleled by an increase in the abundance of bioturbation structures.
Abstract: The Global Ordovician Biodiversification Event (GOBE) was undoubtedly one of the most significant evolutionary events in the history of the marine biosphere. A continuous increase in ichnodiversity occurs through the Ordovician in both shallow- and deep-marine environments. The earlier view that early Paleozoic deep-marine ichnofaunas are of low alpha diversity has been challenged by discoveries of moderately diverse associations. Interestingly, however, the increase in global ichnodiversity through the Ordovician is not paralleled by an increase in ichnodisparity of bioturbation structures. In fact, whereas global ichnodiversity in the Ordovician almost doubled Cambrian levels, Ordovician ichnodisparity of bioturbation structures is roughly similar to that resulting from the Cambrian explosion. Macroboring organisms also display significant evolutionary innovation and diversification in shallow-water hardgrounds and other carbonate substrates, resulting in the Ordovician Bioerosion Revolution. Along with this macroboring ichnodiversity and ichnodisparity increase is a significant rise in the rate of bioerosion in carbonate substrates. Ichnofaunal changes in lower-shoreface and offshore siliciclastic deposits through the Ordovician reveal faunal turnovers resulting from the evolutionary radiation. Lower Ordovician deposits tend to be dominated by abundant trilobite-produced trace fossils. Middle to Upper Ordovician shallow-marine ichnofaunas tend to show more varied behavioral patterns and trilobite trace fossils are rarely the dominant components. During the early Paleozoic, the tiering structure of ichnofaunas became more complex, as a result of both the addition of deeper tiers and of a wider variety of biogenic structures in previously occupied tiers. Infaunalization by deposit feeders in offshore siliciclastic environments was most likely diachronous, with the establishment of a mid-tier infauna first in Laurentia and Baltica, and only subsequently in Gondwana.
722 citations
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University of British Columbia1, Stanford University2, University of Washington3, University of Guelph4, University of Saskatchewan5, American Museum of Natural History6, University of Victoria7, University of Wyoming8, University of Waterloo9, International Union for Conservation of Nature and Natural Resources10, Oregon State University11, Memorial University of Newfoundland12, Cornell University13, Colorado State University14, Slippery Rock University of Pennsylvania15, Georgia State University16
TL;DR: In this paper, the authors examine the scope and purpose of eighteen subfields of classic, interdisciplinary and applied conservation social sciences and articulates ten distinct contributions that the social sciences can make to understanding and improving conservation.
717 citations
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TL;DR: For different esters from the same vegetable oil, methyl esters were the most volatile, and the volatility decreased as the alkyl group grew bulkier, however, the bio-diesels were considerably less volatile than the conventional diesel fuels.
716 citations
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Dalhousie University1, Hackensack University Medical Center2, University of Washington3, University of Rochester Medical Center4, Pfizer5, Columbia University6, University of Bath7, Boston Children's Hospital8, National Institutes of Health9, Food and Drug Administration10, Uppsala University11, Oregon Health & Science University12, Merck & Co.13, AstraZeneca14, University of Toronto15, University of Saskatchewan16, Vanderbilt University Medical Center17, Children's Hospital of Wisconsin18, Endo International plc19, University of California, Los Angeles20
TL;DR: Based on systematic review and consensus of experts, core domains and measures for clinical trials to treat pain in children and adolescents were defined to assist in comparison and pooling of data and promote evidence-based treatment.
715 citations
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TL;DR: It is uncertain whether interventions to improve adoption of SDM are effective given the low quality of the evidence, but any intervention that actively targets patients, healthcare professionals, or both, is better than none.
Abstract: Background
Shared decision making (SDM) is a process by which a healthcare choice is made jointly by the practitioner and the patient and is said to be the crux of patient-centred care. Policy makers perceive SDM as desirable because of its potential to a) reduce overuse of options not clearly associated with benefits for all (e.g., prostate cancer screening); b) enhance the use of options clearly associated with benefits for the vast majority (e.g., cardiovascular risk factor management); c) reduce unwarranted healthcare practice variations; d) foster the sustainability of the healthcare system; and e) promote the right of patients to be involved in decisions concerning their health. Despite this potential, SDM has not yet been widely adopted in clinical practice.
Objectives
To determine the effectiveness of interventions to improve healthcare professionals’ adoption of SDM.
Search methods
We searched the following electronic databases up to 18 March 2009: Cochrane Library (1970-), MEDLINE (1966-), EMBASE (1976-), CINAHL (1982-) and PsycINFO (1965-). We found additional studies by reviewing a) the bibliographies of studies and reviews found in the electronic databases; b) the clinicaltrials.gov registry; and c) proceedings of the International Shared Decision Making Conference and the conferences of the Society for Medical Decision Making. We included all languages of publication.
Selection criteria
We included randomised controlled trials (RCTs) or well-designed quasi-experimental studies (controlled clinical trials, controlled before and after studies, and interrupted time series analyses) that evaluated any type of intervention that aimed to improve healthcare professionals' adoption of shared decision making. We defined adoption as the extent to which healthcare professionals intended to or actually engaged in SDM in clinical practice or/and used interventions known to facilitate SDM. We deemed studies eligible if the primary outcomes were evaluated with an objective measure of the adoption of SDM by healthcare professionals (e.g., a third-observer instrument).
Data collection and analysis
At least two reviewers independently screened each abstract for inclusion and abstracted data independently using a modified version of the EPOC data collection checklist. We resolved disagreements by discussion. Statistical analysis considered categorical and continuous primary outcomes. We computed the standard effect size for each outcome separately with a 95% confidence interval. We evaluated global effects by calculating the median effect size and the range of effect sizes across studies.
Main results
The reviewers identified 6764 potentially relevant documents, of which we excluded 6582 by reviewing titles and abstracts. Of the remainder, we retrieved 182 full publications for more detailed screening. From these, we excluded 176 publications based on our inclusion criteria. This left in five studies, all RCTs. All five were conducted in ambulatory care: three in primary clinical care and two in specialised care. Four of the studies targeted physicians only and one targeted nurses only. In only two of the five RCTs was a statistically significant effect size associated with the intervention to have healthcare professionals adopt SDM. The first of these two studies compared a single intervention (a patient-mediated intervention: the Statin Choice decision aid) to another single intervention (also patient-mediated: a standard Mayo patient education pamphlet). In this study, the Statin Choice decision aid group performed better than the standard Mayo patient education pamphlet group (standard effect size = 1.06; 95% CI = 0.62 to 1.50). The other study compared a multifaceted intervention (distribution of educational material, educational meeting and audit and feedback) to usual care (control group) (standard effect size = 2.11; 95% CI = 1.30 to 2.90). This study was the only one to report an assessment of barriers prior to the elaboration of its multifaceted intervention.
Authors' conclusions
The results of this Cochrane review do not allow us to draw firm conclusions about the most effective types of intervention for increasing healthcare professionals' adoption of SDM. Healthcare professional training may be important, as may the implementation of patient-mediated interventions such as decision aids. Given the paucity of evidence, however, those motivated by the ethical impetus to increase SDM in clinical practice will need to weigh the costs and potential benefits of interventions. Subsequent research should involve well-designed studies with adequate power and procedures to minimise bias so that they may improve estimates of the effects of interventions on healthcare professionals' adoption of SDM. From a measurement perspective, consensus on how to assess professionals' adoption of SDM is desirable to facilitate cross-study comparisons.
712 citations
Authors
Showing all 25277 results
Name | H-index | Papers | Citations |
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Tomas Hökfelt | 158 | 1033 | 95979 |
Frederick Wolfe | 119 | 417 | 101272 |
Christopher G. Goetz | 116 | 651 | 59510 |
John P. Giesy | 114 | 1162 | 62790 |
Helmut Kettenmann | 104 | 380 | 40211 |
Paul M. O'Byrne | 104 | 605 | 56520 |
Susan S. Taylor | 104 | 518 | 42108 |
Keith A. Hobson | 103 | 653 | 41300 |
Mark S. Tremblay | 100 | 541 | 43843 |
James F. Fries | 100 | 369 | 83589 |
Gordon McKay | 97 | 661 | 61390 |
Jonathan D. Adachi | 96 | 589 | 31641 |
Wenjun Zhang | 96 | 976 | 38530 |
William C. Dement | 96 | 340 | 43014 |
Chris Ryan | 95 | 971 | 34388 |