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Featured Review: Adrenaline and vasopressin for cardiac arrest

Lun, 11/26/2018 - 12:47

Authors of this new Cochrane review addressed the question, “Do the drugs adrenaline or vasopressin improve survival in cardiac arrest?”

Cardiac arrest occurs when someone's heart unexpectedly stops beating. Without any treatment, death occurs within minutes. Treatments that are proven to work in cardiac arrest include cardiopulmonary resuscitation and giving an electric shock (defibrillation). If these treatments don't work drugs such as adrenaline and vasopressin are injected (usually into a vein) to try to restart the heart. The early scientific evidence which led to their use came largely from small studies in animals. Whilst some human studies have shown that these drugs can help restart the heart initially, research also suggests they may have harmful effects on the brain.

The reviewers identified 26 randomised clinical trials, involving 21,704 participants, which examined the effect of adrenaline or vasopressin on patient survival after cardiac arrest that occurred in and out of hospital and in adults and children. Some studies compared adrenaline in standard doses (1mg) with placebo (dummy medication); some examined standard dose versus high dose adrenaline; and others compared vasopressin alone or vasopressin with adrenaline to standard doses of adrenaline.

The studies found evidence that adrenaline was effective at restarting the heart and helping people recover enough to go home from hospital. However, there was no evidence that any of the drugs improved survival with good neurological outcome.

The overall quality of evidence ranged from high for studies comparing adrenaline with placebo; to at best moderate, but mainly low or very low for the other comparisons, due to potential bias within the studies. Many of these studies were conducted more than twenty years ago and the findings from older studies may not reflect current practice. The studies examined the drugs in many different situations (in and outside of hospitals, different doses, adults and children) which can make combining their findings misleading.

The author’s of the review concluded, “Neither high dose adrenaline nor the addition of vasopressin were superior to standard dose adrenaline in improving patient outcomes after cardiac arrest. Standard dose adrenaline can restart the heart and improves survival to hospital discharge – but it is not necessarily good at improving neurological outcomes. It seems adrenaline is good for the heart but not for the brain.”

Monday, January 28, 2019

2018 Cochrane Governing Board election: Voting now open

Jue, 11/22/2018 - 20:22

Dear Cochrane Members,
 
Voting is now open for the current Governing Board election.

Visit elections.cochrane.org to view the candidates standing, read their Candidate Statements, and cast your votes.

We’ll be sending a series of reminders before voting closes on 10 December 2018 at 12:00 GMT. Next week on the Cochrane Community website, we’ll be interviewing the candidates about their motivation to stand for election, providing you with another opportunity to get to know candidates before voting.

All members as defined by the Membership Terms & Conditions are entitled to vote in this election. To check your membership status, please see https://join.cochrane.org/your-membership. If you have questions about your status, you can email membership@cochrane.org.

Questions about any aspects of the elections process can be raised with Lucie Binder, Senior Advisor to the CEO (Governance & Management) and Electoral Officer for this election.

Friday, November 23, 2018

Cochrane Review Group Networks launch their two-year strategic plans

Jue, 11/22/2018 - 18:44

Engaging professionals, patients and policy makers with Cochrane reviews for greater impact.

Cochrane’s primary role is to produce and publish ‘high-quality, relevant, up-to-date systematic reviews and other synthesized research evidence’ to support inform healthcare decisions. This is possible through the sheer dedication and hard work of the Cochrane community, including the author teams and the editorial support and guidance given to them by Cochrane Review Groups (CRGs).

During the last 12 months, Cochrane has created eight new Networks of Cochrane Review Groups, responsible for the efficient and timely production of high-quality systematic reviews that address the most important research questions for decision makers.

The CRG Networks within Cochrane, each have a Network team comprising of a Senior Editor, Associate Editor, and a Network Support Fellow.

Now, following comprehensive consultation and finalization with their CRG community at Cochrane’s Edinburgh Colloquium in September, the Network’s Senior and Associate Editors are delighted to announce their strategic plans that will guide their work over the next two years:

The CRG Network’s Strategic Plans are based on five key objectives:

  1. Supporting review production and capacity
  2. Evaluating Network scope and prioritisation of topic
  3. Fostering collaboration within the Network and with the wider Cochrane community
  4. Supporting knowledge translation to increase the impact of Cochrane review
  5. Ensuring accountability and sustainability of the Network

This is an exciting new development for Cochrane, working collectively to improve review production and editorial processes, which in turn aim to improve the quality of Cochrane reviews. These strategic plans also mean that the review questions chosen are the right ones for professionals, patients and policymakers, and are prioritized through interaction with relevant stakeholders, leading to higher impact in adoption in health guidelines and policies in the future.

We will regularly monitor and evaluate the implementation of these strategic plans and will publish our results with the Cochrane community every three months.

 

Thursday, November 22, 2018

International Day of Persons with Disabilities

Lun, 11/19/2018 - 19:00

Join us December 3 to increase awareness of diverse abilities, promote inclusion for those with disabilities, and highlight Cochrane evidence around this subject.

The United Nations recognizes International Day of Persons with Disabilities (IDPD) each year on December 3. This day increases awareness of diverse abilities and promotes inclusion for those  with disabilities, and is an opportunity to highlight the latest Cochrane evidence around this subject.

Rehabilitation is a health strategy aimed at enabling people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides disabled people with the tools they need to attain independence and self-determination. The Cochrane Rehabilitation Field was established in 2016 and serves as a bridge between all the stakeholders in Rehabilitation and Cochrane. Cochrane Rehabilitation will on one side drive evidence and methods developed by Cochrane to the world of Rehabilitation and on the other convey priorities, needs and specificities of Rehabilitation to Cochrane.

Monday, December 3, 2018

Governing Board elections November 2018: Announcing the candidates standing

Jue, 11/15/2018 - 16:28

Following a period of nominations, we’re very pleased that 19 candidates are standing for election to the Governing Board in this election. They are listed on elections.cochrane.org and here you can read more about the them, why they’re standing for election, and what they plan to do for Cochrane if elected.

There are four (4) positions available on the Board for this election, which is open to Cochrane Members. Candidates do not have to be a leader of a Cochrane Group and the Board is looking for a diverse and international range of candidates. Voting will open on 22 November 2018 and close on 10 December 2018 (12:00 GMT).

All members as defined by the Membership Terms & Conditions will be entitled to vote in the election. To check your membership status, please see https://join.cochrane.org/your-membership. If you have questions about your status, you can email membership@cochrane.org. Instructions on how to vote will be sent to you on 22 November 2018.

Cochrane places high regard on minimizing bias, promoting access, and enabling wide participation. For these reasons, canvassing for specific candidates is prohibited. It should be noted that:

  • Any Cochrane individual, Group or committee may encourage members to participate in elections without endorsing specific candidates;
  • Cochrane leaders or leadership committees (such as Executives) should not publicly endorse specific candidates.

Questions about any aspects of the elections process, or concerns about a candidate’s eligibility, can be raised with Lucie Binder, Senior Advisor to the CEO (Governance & Management) and Electoral Officer for this election.

Best wishes to all candidates standing!

Thursday, November 15, 2018

Podcast: How accurate are diagnostic tools for autism spectrum disorder in preschool children?

Mié, 11/14/2018 - 20:04

There are more than 20 Cochrane Reviews of interventions that might be used in the care of children with autism spectrum disorder. In July 2018, these were added to with an assessment of the accuracy of tests for this condition. Senior author, Katrina Williams from the Department of Paediatrics at the University of Melbourne in Australia, tells us what they found in this podcast.

"Doing our review, we wanted to answer the question: How accurate are tools for diagnosing autism spectrum disorder, which I’ll refer to as autism, in preschool children? And we’ve reached the conclusion that they are not accurate enough. This is important because we need to diagnose autism correctly so that children with autism can access timely support and education and children who don’t have autism avoid unnecessary investigations and treatments.

We found relevant evidence for three diagnostic tools: the Autism Diagnostic Inventory, which is a carer interview and is known as the ADI-R; the Autism Diagnostic Observation Scale, known as the ADOS, which is based on observing the child while they do structured tasks and the Childhood Autism Rating Scale, or CARS, which combines an interview with un-structured observation. 

The 13 relevant studies were mainly from high income countries and included preschool children with language difficulties, developmental delay, intellectual disability, or a mental health problem, presenting to a clinical service or enrolling in a research study. The studies varied in quality and it’s likely that they appear to be more accurate in making diagnoses in these research studies than they would be in routine practice, which means we need to be cautious about the findings.

The largest amount of evidence was for ADOS, with 12 analyses and a total of more than 1600 children. We found it to be the best for identifying children who have autism, but it was similar to CARS and ADI-R in falsely diagnosing autism. To put this into numbers, the pooled analyses for ADOS gave a summary sensitivity of 0.94, meaning that it identified autism in 94 of every 100 children with it, and a summary specificity of 0.80, meaning that it would diagnose autism in 20 children out of 100 without it. This means that if we used ADOS to examine 100 children, 74 of who truly had autism, it would detect autism correctly in 70 but would also suggest that five of the children without autism actually had it. This makes it especially important to think about two specific settings in which these tools might be used. These are services that assess many children who do not have autism and those looking after children with intellectual disability, because a higher proportion of these children are likely to receive an incorrect diagnosis. 

In thinking about the implications of our findings, it’s important to note that autism tools that are currently considered 'diagnostic' were not designed to make an autism diagnosis and are not sufficient for that. A diagnosis involves consideration of several factors, such as whether behaviours are in keeping with the child’s communication ability and intelligence, and the exclusion of causes that require genetic testing and a detailed understanding of the child’s environment. Also, families need more than diagnoses relating to autism to understand their child’s strengths and challenges and to work with professionals to access the supports and interventions they need. That’s why child health specialists are urging a more dimensional neurodevelopmental approach than the tools we found evidence for when young children are being assessed, and we would encourage such approaches."

 

Monday, November 19, 2018

New research finds omega-3 fatty acids reduce the risk of premature birth

Mié, 11/14/2018 - 17:16

A new Cochrane Review published today has found that increasing the intake of omega-3 long-chain polyunsaturated fatty acids (LCPUFA) during pregnancy reduces the risk of premature births.

Premature birth is the leading cause of death for children under 5 years old worldwide, accounting for close to one million deaths annually. Premature babies are at higher risk of a range of long-term conditions including visual impairment, developmental delay and learning difficulties.

‘We know premature birth is a critical global health issue, with an estimated 15 million babies born too early each year,’ explains Cochrane Pregnancy and Childbirth lead author Associate Professor Philippa Middleton.

‘While the length of most pregnancies is between 38 and 42 weeks, premature babies are those born before the 37 week mark – and the earlier a baby is born, the greater the risk of death or poor health.’

The author team took a close look at long-chain omega-3 fats and their role in reducing the risk of premature births – particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) found in fatty fish and fish oil supplements. They looked at 70 randomised trials and found that for pregnant women, increasing the daily intake of long-chain omega-3s:

  • lowers the risk of having a premature baby (less than 37 weeks) by 11% (from 134 per 1000 to 119 per 1000 births
  • lowers the risk of having an early premature baby (less than 34 weeks) by 42% (from 46 per 1000 to 27 per 1000 births)
  • reduces the risk of having a small baby (less than 2500g) by 10%

‘There are not many options for preventing premature birth, so these findings are very important for pregnant women, babies and the health professionals who care for them,’ Philippa says. ‘We don’t yet fully understand the causes of premature labour, so predicting and preventing early birth has always been a challenge. This is one of the reasons omega-3 supplementation in pregnancy is of such great interest to researchers around the world.’

The Cochrane review published today was first undertaken back in 2006, and concluded there wasn’t enough evidence to support the routine use of omega-3 fatty acid supplements during pregnancy. Over a decade on, this updated review concludes that there’s high quality evidence for omega-3 supplementation being an effective strategy for preventing preterm birth.

‘Many pregnant women around the world are already taking omega-3 supplements by personal choice rather than as a result of advice from health professionals,’ Philippa says. ‘It’s worth noting though that many supplements currently on the market don’t contain the optimal dose or type of omega-3 for preventing premature birth. Our review found the optimum dose was a daily supplement containing between 500 and 1000 milligrams (mg) of long-chain omega-3 fats (containing at least 500mg of DHA) starting at 12 weeks of pregnancy.’

‘Ultimately we hope this review will make a real contribution to the evidence base we need to reduce premature births, which continue to be one of the most pressing and intractable maternal and child health problems in every country around the world.’

A team from SAHMRI, including Cochrane researchers from the omega-3 review, have used the findings from this review to develop resources and information about omega-3 fatty acids for pregnant women and health professionals that can be accessed online at www.sahmriresearch.org/omega3.

Citation: Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews 2018, Issue 11 . Art. No.: CD003402. DOI: 10.1002/14651858.CD003402.pub3

Media contacts:

Shauna Hurley
Communications and Media Manager
Cochrane Australia
Email: shauna.hurley@monash.edu
Phone: 0400 018 570

Katie Abbotts
External Communications and Media Officer
Cochrane 
Email: kabbotts@cochrane.org or pressoffice@cochrane.org
Phone: 44 7810 504380

 

Thursday, November 15, 2018

TaskExchange: a new hub for Cochrane Consumers

Mié, 11/14/2018 - 16:54

Are you interested in volunteering for Cochrane? TaskExchange is Cochrane’s new hub to help you find ways in which you can contribute. Would you be interested in finding out more? We are holding two webinars for consumers and patients, carers and other non-scientists who may be interested in being involved in producing Cochrane evidence.

The webinars have been co-organised on behalf of the Cochrane Consumer Network by members of Cochrane's Membership, Learning and Support team, and the team behind Cochrane’s TaskExchange platform.

Dr Emily Steele, the TaskExchange Community Engagement and Partnerships Manager, will introduce TaskExchange and show potential consumer volunteers how to use the platform to find projects that suit their interests and skills. The session will include a live demonstration and Q & A, and will be hosted by Cochrane’s Consumer Engagement Officer, Richard Morley.

This webinar will be held on two separate dates to cover global time zones.

Monday 3rd December 21:00 UTC [check the time in your time zone]
Wednesday 5th December 09:00 UTC [check the time in your time zone]

Find out more and sign up here.

You can also sign up and start using TaskExchange right now!

Wednesday, November 14, 2018

Four major policy issues for Cochrane: recent correspondence with the Governing Board

Mié, 11/14/2018 - 15:32

A group of Cochrane members recently submitted a letter to the Board detailing “four major policy issues for Cochrane”.

You’re invited to read their letter and the Board’s response.

To learn more about the Cochrane Council, the organization’s representative body for Cochrane members, please visit the resources on Cochrane Community: https://community.cochrane.org/organizational-info/people/cochrane-council

Wednesday, November 14, 2018

Podcast: Bedside examination tests to detect beforehand adults who are likely to be difficult to intubate

Mar, 11/13/2018 - 20:18

Patients who require general anaesthesia or ventilation to help them breathe while in intensive care, need a clear airway. This is usually achieved by inserting a tube to help air reach their lungs and a new Cochrane Review from May 2018 examines the evidence for different tests to help doctors assess how difficult this might be for patients with no immediately obvious problems with their breathing. We asked one of the authors, Jasmin Arrich from the Medical University of Vienna in Austria, to tell us what they found.

"Placing a tube into the patient’s airway, or tracheal intubation, is the best way to ensure that their airway stays clear and that air can get into their lungs during general anaesthesia, or when they need ventilation or oxygenation for other reasons. Before intubation, it’s common practice to determine if the patient has a difficult airway, which is a potentially life-threatening situation because they will not be able to breathe, and will quickly die.

There are several bedside airway examination tests to help doctors to anticipate possible difficulties before intubation and such tests are used every day by clinicians all across the world. However, there is little information about which test is most useful and we have investigated this further by reviewing the validity of different tests for detecting a difficult airway in patients with no apparent airway abnormalities.

We found no less than 133 eligible studies involving more than 840,000 patients on four continents. Most of the studies included patients undergoing elective surgery, and, overall, the evidence was of moderate to high quality. All studies focused on the assessment of predictors that would indicate if a patient was likely to have difficult face mask ventilation, laryngoscopy or intubation. 

When we pooled the results, we found high variability among the tests. The upper lip bite test for diagnosing difficult laryngoscopy provided a summary sensitivity of 67%, which was higher than any of the other tests. However, this suggests that even this, the most sensitive test in the studies we reviewed, correctly identifies the presence of a problem only two-thirds of the time. The modified Mallampati test had the highest sensitivity for detecting difficult tracheal intubation, but its summary sensitivity of 51% means that it fails to identify the problem in nearly half the patients for whom it will be difficult to insert the tube.

In summary, bedside airway examination tests for detecting a difficult airway are intended as screening tests and are expected to miss only very few patients with a potential problem. They are recommended in airway management guidelines around the world, but we have found that they often fail to meet their goal and that most are little better than simply flipping a coin to decide if the patient has a difficult airway. On the other hand, the tests were consistently better at showing that a patient did not have a difficult airway when there really did not have one, but this is of little relevance in this context. In conclusion, therefore, standard bedside airway examination tests for difficult airways in patients with no apparent airway abnormalities do not appear to be good screening tests, and we urge great caution in their use and interpretation."

Tuesday, November 13, 2018

Cochrane's 30 under 30: Joel Pollet

Mar, 11/13/2018 - 12:05

Cochrane is made up of 13,000 members and over 50,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all. 

Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of a new series called, Cochrane’s “30 under 30." 

In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world. 

We will be hearing from them in a series of interviewees published over the coming months.

 We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact kabbotts@cochrane.org.  Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.

Name: Joel Pollet
Age: 26 
OccupationPhysiotherapist
Program: Cochrane Rehabilitation field

How did you first hear about Cochrane? 
The first time I heard about Cochane was at University, while I was studying for my graduation thesis looking for the best evidences available on Stroke rehabilitation. In doing it I found and read my first Cochrane Systematic Review, which provided me a lot of information for my thesis project and also for my work after the studies. 

How did you become involved with Cochrane? What is your background? 
I graduated as Physiotherapist in 2016 at University of Brescia, Italy. I got more familiar with Cochrane’s world right after my graduation,  as my thesis supervisor offered me the opportunity to work with him for Cochrane 

What do you do in Cochrane? 
I work in the headquarters of the Cochrane Rehabilitation field, where my colleagues and I manage and assist the work of the Director, Coordinator and committees of our field: Communication, Education, Publication, Methodology and Review Tagging. Our aim is to create and perform activities of knowledge translation for all the world of Rehabilitation. As part of my work I assist with some colleagues the creation of an ebook on Cochrane Systematic Reviews in the rehabilitation area, that are summarized for different audience. 

What specifically do you enjoy about working for Cochrane and what have you learnt? 
I particularly enjoy the possibility given to everyone to express their opinion and thoughts taking more into consideration the contents rather than their background or age. Since I’m in Cochrane I learnt a lot about how to consider evidence, how to evaluate it, and how to spread this evidence using different tools. 

What are your future plans? 
The chance I had two years ago of working within Cochrane Rehabilitation also changed my future plans. I had thought I would have worked as a physiotherapist, now I still know that I want to do it but with more consciousness of how to do it. But first I’d like to do a PhD in neurological rehabilitation as it is my favourite field of action; then I hope to have the opportunity author a Cochrane Systematic Review on this topic and last but not least keep on working for Cochrane Rehabilitation.  



In your personal experience, what one thing could Cochrane do better to improve its global profile? 
In my opinion Cochrane is doing a great job trying to improve its global profile, however I think it could strengthen it's relationship with clinicians, in particular attempt to develop as many knowledge translation tools as possible in order to make all the evidence produced as accessible and comprehensible as possible for those people.

What do you hope for Cochrane for the future? 
The best I hope for Cochrane’s future is an improvement in the review production, especially with a more open sight to the clinical needs of High quality evidence, as we all know that Cochrane with its high quality reviews is able to do. 

How important is it that young people get involved in Cochrane?
From my point of view, the presence of young people in Cochrane is fundamental, the training and experience made by young researchers in Cochrane is key to keep the activity and aims of Cochrane alive in the future. 

A right generational exchange is the basis for every organisation that wants to pursuit its activities and mission over the years, and this can be done only involving and stimulate the young people to get involved in Cochrane, a community comprised of people from all over the world, with different backgrounds and different ages who can give as many diverse perspectives. 

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….? 
The collaboration with Cochrane showed me how Cochrane offers many different ways and tools to get involved in its activities, via Taskexchange for example, or with the activities of the different centres and fields. Starting from simple tasks like translating few pages or identifying RCTs, to authoring reviews or managing knowledge translation projects.

Tuesday, December 18, 2018

Cochrane's 30 under 30: Lara A Kahale

Mar, 11/13/2018 - 11:53

Cochrane is made up of 11,000 members and over 35,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all. 

Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of a new series called, Cochrane’s “30 under 30." 

In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world. 

We will be hearing from them in a series of interviewees published over the coming months.

 We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact kabbotts@cochrane.org.  Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.

Name: Lara A Kahale
Age: 28
Occupation: AUB GRADE center coordinator at the American University of Beirut Medical Center, Beirut, Lebanon
Program: PhD candidate in Epidemiology at Utrecht University, Utrecht, the Netherlands

How did you first hear about Cochrane? 
I was first introduced to Cochrane as a research assistant at the Clinical Research Institute at the American University of Beirut Medical Center (AUBMC) in 2012. The concept of systematic reviews was still very novel at AUBMC and in Lebanon. During my time there, I undertook Cochrane training modules on how to conduct systematic reviews and meta-analyses. I was very impressed with the rigorous methods described in these modules. 

How did you become involved with Cochrane? What is your background? 
As a registered nurse, I was trained to make clinical decisions based on evidence. Instead of just searching or reading the evidence, Cochrane paved the way for me to contribute to evidence synthesis. My first experience as an author with Cochrane was gained through the process of  leading updates of six Cochrane systematic reviews on “anticoagulation with patients with cancer” with the Gynaecological, Neuro-oncology and Orphan Cancer Group (GNOC). This project allowed me to apply what I had learned in the modules as well as increase my knowledge and update my skills. It also allowed me to forge a very positive and beneficial relationship with the GNOC editorial team.  

What do you do in Cochrane? 
I am a Cochrane author on six systematic reviews with the GNOC Group and one review with the Cochrane Neonatal Group. 

I was one of two lead authors, who in conjunction with the GNOC Group and the Project Transform Team, successfully participated in the Living Systematic Review Evidence pilot project. This process enables reviews to be continually updated, incorporating relevant new evidence as it becomes available. The concept of living evidence synthesis are of increasing interest to Cochrane’s stakeholders and are intended to provide a means seamless way to connect evidence and practice. This approach has only recently been possible due developments in linked data and machine learning. Our initial goal was to produce one living systematic review but due to the incredible commitment of the author team and support from the GNOC Group and Project Transform Team, we currently have three LSRs published on the Cochrane Library. 

What specifically do you enjoy about working for Cochrane and what have you learnt? 
Cochrane facilitates reaching out to and learning from experts in the field of evidence-based research. In particular, attending the annual Cochrane Colloquia is hugely motivating on a personal level and hugely beneficial for my continued learning. Through networking, I can easily follow-up and learn innovative and impactful work. Since the very first Colloquium I attended in 2014, I have felt like a “Cochranite”.  

What are your future plans? 
My future plans are to continue contributing to evidence synthesis and guideline development and adaptation. Also, I look forward to teaching evidence-based medicine after I complete my PhD studies. 

In your personal experience, what one thing could Cochrane do better to improve its global profile? 
One thing that I think Cochrane could do better is to increase funding opportunities to the members to undertake short-term visits to peer members to further their research experience and learn new techniques. This scheme would build research links and develop ongoing scientific collaboration. 

What do you hope for Cochrane for the future? 
I hope that Cochrane continues on providing this familial atmosphere for members as this is one of its major strengths. Also, I hope that Cochrane branch is established in the Middle East, a region in need for high-quality evidence that could serve its numerous health-related challenges.  I would be very happy to be involved in any future discussions around this goal.  

How important is it that young people get involved in Cochrane? 
With the exponential growth of seeking medical information via the internet, it is tremendously important for young people to benefit from the concept of evidence-based practice. Cochrane very well facilitates this, especially with the availability of excellent learning packages.   

Cochrane can help young people differentiate between trust-worthy and unreliable information. 

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….? 
Cochrane has provided several platforms for encouraging young people to get engaged like Cochrane crowd, task exchange, etc. Also, thanks to the spirit of openness, one can easily contact managing editors of any Cochrane group or network and receive answers on how to get involved. Last but not least, attending Colloquia is the most impactful method to see things in action and sign-up to any activity or project that advances one’s professional development. 

Monday, December 10, 2018

Cochrane's 30 under 30: Andres Viteri Garcia

Mar, 11/13/2018 - 11:19

Cochrane is made up of 11,000 members and over 35,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all. 

Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of a new series called, Cochrane’s “30 under 30." 

In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world. 

We will be hearing from them in a series of interviewees published over the coming months.

 We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact kabbotts@cochrane.org.  Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.Name: Andres Viteri Garcia
Age: 25
Program: Associate Researcher at Cochrane Ecuador - Iberoamerican Network and Lecturer of Biostatistics and Evidence-based  practice at UTE University.

How did you first hear about Cochrane? 
It was 2016, I was doing a social service year in the Ecuadorian Amazon Jungle and my former mentor at the University told me about a research conference that was going to be held in Quito (Ecuador’s capital). It was the XV Annual Meeting of the Iberoamerican Cochrane Network at UTE University, after attending the conference and some workshops I confirmed that besides practicing dentistry I wanted to become a researcher. 

How did you become involved with Cochrane? What is your background? 
After attending the conference of the Iberoamerican Network and showing my interest in systematic reviews and the methods involved in them I was offered a position as a junior researcher at the Ecuadorian Cochrane Centre in 2017. 

I am a first graduated dentist from Universidad Central del Ecuador, and a Master of Clinical Research Applied to Health Sciences at Autonomous University of Barcelona. I have been working in dentistry research since I was an undergrad and in methodology research for about two years. Further more, I had the chance to work as a research intern at the Iberoamerican Cochrane Centre (Barcelona-Spain) for one year and also doing a student elective at Cochrane UK (Oxford-UK) last summer. Currently I work as a lecturer of Evidence-Based Dentistry and Biostatistics at UTE University and as an associate researcher at the Ecuadorian Cochrane Centre (Quito-Ecuador) 

What do you do in Cochrane? 
My main role is to undertake systematic reviews; however, I am also involved in dissemination of evidence through the Wikipedia-Cochrane project, Students for Best Evidence initiative, and a new network of Iberoamerican’s dentists interested in help to develop the “Oral Health Evidence Ecosystem” within the Cochrane Oral Health Group. 


What specifically do you enjoy about working for Cochrane and what have you learnt? 

What I love the most about Cochrane is the collaborative spirit of its members. I can’t think in any other research initiative where you can literally e-mail the leaders of your field, present yourself, propose projects and actually get a response and a lot of feedback. 
 
What are your future plans? 
I am planning to continue doing clinical research and also starting my PhD studies within the next year. 

In your personal experience, what one thing could Cochrane do better to improve its global profile? 
In my point of view, Cochrane could make more efforts to be known in the Universities that offer health related degrees, especially in developing countries. 

What do you hope for Cochrane for the future? 
I believe that even when Cochrane is doing a great job, we should be working better to translate evidence into clinical practice among all areas of knowledge, especially in the countries where Cochrane is not yet well known. 

How important is it that young people get involved in Cochrane 
It’s crucial! Young people, even when inexperienced, can contribute a lot to the organization. Also, if we manage to attract more people in the early stages of their carriers its more likely that they will be willing to assess and apply the best evidence into their clinical practice. 

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start? 
You are welcome to join us! There is not “too little” contribution. Please think about your skills and look out for some tasks that fit your interests and skills in Cochrane Crowd  or Cochrane TaskExchange and if you are interested in further contributions you can contact your local Cochrane Centre.

Tuesday, November 20, 2018

Featured Review: Improving the implementation of health-promoting policies and practices in workplaces

Mar, 11/13/2018 - 09:44

Implementation strategies are meant to improve the adoption and integration of evidence-based health interventions into routine policies and practices within specific settings. 

This review examined whether using these strategies improved the implementation of policies and practices in the workplace promoting:

  • Healthy eating
  • Physical activity
  • Weight control
  • Tobacco cessation
  • Prevention of risky alcohol consumption

The review authors also wanted to know if these strategies changed employees' health behaviours, caused any unintended effects, and were good value for money.

Workplaces are a good setting for programmes that aim to improve health-related behaviours like diet, physical activity and tobacco use, as adults spend a long time at work each day. However, these kinds of workplace-based interventions are often poorly implemented, limiting their potential impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to increase their impact on chronic disease prevention. Examples may include a workplace healthy catering policy, employee gym membership subsidies, or tobacco control policies.

The review authors found six eligible studies, mostly in the USA with workplaces focused in the manufacturing, industrial, and services-based sectors. 

Lead author Professor Luke Wolfenden said,

“The findings of the review do not provide clear evidence regarding the impact of implementation strategies on workplace health-promoting policy and practice implementation or on employee health behaviours. Further research is required to meet the need to develop the implementation evidence base, ensuring policies, practices and programs designed to improve employee health are applied and can yield their intended benefits.”

Wednesday, November 14, 2018

Featured Review: Home-based chemical bleaching of teeth in adults

Lun, 11/12/2018 - 12:56

Authors from Cochrane Oral Health asked the question, “What evidence is available regarding the different home-based chemically-induced bleaching agents in whitening teeth?” The recently published Cochrane Review is an update on a previous version, published in 2006.

There has been an increasing demand for whiter teeth. Home-based whitening products with a bleaching action have become popular and are available to patients from a dentist or purchased by patients themselves over-the-counter. A variety of whitening products are available which include:

  • hydrogen peroxide
  • carbamide peroxide
  • sodium percarbonate
  • sodium hexametaphosphate
  • sodium tripolyphosphate
  • calcium peroxide

These agents are supplied in different concentrations and are used with different methods of application (gel in tray, strips, paint-on gel, chewing gum, and mouthwash), which have varying application times and duration of treatment.

 The authors included 71 trials that involved 3,780 adults who underwent teeth whitening procedures with various bleaching agents using different methods of application, length of application and duration of treatment. 26 studies compared a bleaching agent to placebo and 51 studies compared one bleaching agent to another bleaching agent.

Lead author, Prashanti Eachempati, said: “The bleaching agents whitened teeth compared to placebo over a short time period (from 2 weeks to 6 months). However, the evidence currently available is insufficient to draw reliable conclusions regarding the superiority of home-based bleaching compositions or any particular method of application or concentration or application time or duration of use. Well-planned randomised controlled trials need to be conducted by standardising methods of application, concentrations, application times and duration of treatment.”

“The overall certainty of the evidence was low to very low for all comparisons. This was because most of the comparisons were reported in single trials with small sample sizes and event rates. There was an unclear risk of bias in most of the trials."

Wednesday, December 19, 2018

Cochrane Classmate webinar: 20 Nov 2018

Jue, 11/08/2018 - 17:23

Cochrane Classmate could change how evidence production is taught in classrooms around the world.

 Brought to you by the Cochrane Crowd team, Classmate is a trainers’ toolkit that allows you to create exciting, interactive tasks that help your students learn about evidence production. It is easy to use, and its first release is now available free of charge to anyone interested. Join the growing number of teachers and trainers using this innovative online learning environment.

This webinar will introduce you to Classmate, including how to create a learning activity, invite students to that activity, and monitor their progress.  You’ll see the modules currently available on Classmate and hear about others launching soon.

Tuesday 20th November 12.30-1.30pm GMT

Learn more at classmate.cochrane.org/

 

Support for Project Transform was provided by Cochrane and the National Health and Medical Research Council of Australia (APP1114605). The contents of the published material are solely the responsibility of the Administering Institution, a Participating Institution or individual authors and do not reflect the views of the NHMRC.

 

Thursday, November 8, 2018

Vivli seeks Program Assistant – Boston, MA, USA

Jue, 11/08/2018 - 15:22

 

Vivli, the Center for Global Clinical Research, is seeking a seasoned Program Assistant to assist with the day-to-day organizational coordination, user support and communications. The position is full-time, ideally based in the Boston area, with the ability to work remotely several days a week. Individual must be a self-starter, experienced and able to work independently in a fast-paced start-up environment.

For more information, please see the full job advertisement.

Thursday, November 8, 2018 Category: Jobs

User views of Cochrane Knowledge Translation

Mié, 11/07/2018 - 20:50

In Cochrane we define ‘Knowledge Translation’ as the process of supporting the use of health evidence from Cochrane systematic reviews by those who need it to make health decisions.  We do this by involving evidence users in the production and dissemination of Cochrane evidence, sharing it in multiple and accessible formats, and working with decision makers to help them be able to use it in practice.

Listening to the views of those who use Cochrane evidence to support their health decision-making is a critical part in being able to respond to their needs.

At Cochrane’s annual Colloquium in Edinburgh recently, we took the opportunity to ask some of those people who use Cochrane’s evidence what they thought about Knowledge Translation, why it was important to them, and the ways in which Cochrane could help make the most impact. Watch and hear what they said…

Thursday, November 22, 2018

Prematurity Awareness Month

Jue, 11/01/2018 - 20:17

Prematurity Awareness Month is observed every November, with World Prematurity Day on 17 November, to raise awareness of preterm birth and the concerns of preterm babies and their families worldwide. An estimated 15 million babies around the world are born premature each year and more than one million of them do not survive their early birth.

Our review groups Cochrane Neonatal and Cochrane Pregnancy and Childbirth prepare and disseminate evidence-based, regularly updated systematic reviews. The scope of Cochrane Neonatal work covers all randomized controlled trials of interventions involving the baby during the first month after birth. Cochrane Pregnancy and Childbirth covers systematic reviews of interventions that relate to pregnancy and childbirth, and up to 30 days following childbirth, as well as lactation.

Highlighted Resources

 

Monday, November 5, 2018

World Diabetes Day

Jue, 11/01/2018 - 19:32

14 November is World Diabetes Day, which is an annual campaign increase awareness of the disease

World Diabetes Day, on the 14th November every year. The theme for World Diabetes Day 2018 is The Family and Diabetes. The aim is to raise awareness of the impact that diabetes has on the family and support network of those affected, as well as promoting the role of the family in the management, care, prevention and education of diabetes.

The Cochrane Metabolic and Endocrine Disorders group's main area of work is the evaluation of the effects of health-care interventions relevant to the prevention, treatment or management, and rehabilitation of metabolic, nutritional and endocrine disorders, a scope which covers diabetes. They primarily focus on systematic reviews which evaluate patient-important outcomes measures.

To celebrate World Diabetes Day, we have collated a selection of some recent reviews:

Reviews soon to be published:

Monday, November 12, 2018

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