It shows how many allergic reactions can result in asthma-related problems, hay-fever being a case in point. The author's experiences have ranged from the weird to the wonderful and have contributed to the person he has become: This book deals with the remarkable Your food is your medicine and your medicine your food. So said Hippocrates, the father of medicine. Wholesome eating is, in fact, very simple. A balanced diet produces a noticeable increase in energy levels fairly quickly. This book presents a dietary plan for households. Discusses such problems as cholesterol, angina, varicose veins, haemorrhoids, high blood pressure, arteriosclerosis and heart attacks.
In this controversial book, Jan de Vries explores modern miracles as well as the 'miracle of Lourdes'. He discusses witch doctors and what he has personally witnessed in the Far East. He warns against exorcism and talks of the many 'possessed' people he has treated.
Arthritis, psoriasis and related rheumatic diseases are an enormous problem throughout the world. This book shows how these problems can be reversed by a simple nutritional and natural approach in which there are none of the terrible side effects that can sometimes accompany a co Participants entered a clinical question through a free-text dialog box.
On clicking the Start button, they were informed whether they could use DynaMed. If allowed A , a button appeared that would open DynaMed in a new browser window. Opening a new browser window started the timer which was not displayed. Participants were instructed to search, read, and think as appropriate for the situation until they believed they either had found an adequate answer or would not find an answer in a reasonable time.
On search completion, participants returned to the study window and selected Answer Found or Answer Not Found, automatically stopping the timer. Participants were presented with their search time, in minutes and seconds, and could change the time recorded if they were interrupted during searching. All data were recorded by the participants. The content of answers found by participants was not recorded. Based on funding, target enrollment was 50 participants who would each ask 20 questions. We kept the study open as long as possible within the timeline allowed by the grant funding. For each outcome, we conducted a per-question analysis comparing all A questions with all N questions and per-participant analysis of differences in outcomes within each participant.
The results of the per-question analyses are provided as descriptive statistics only because outcomes are not independent of participant, thus violating assumptions used for inferential statistics. This decision was made with statistical consultation before the protocol was submitted for funding, and thus before data collection.
We analyzed the proportion of questions for which an answer was found. For the effect of searching on clinical decision making, we analyzed the proportion of questions for which an answer was found and made a difference, the proportion of questions for which an answer was not found and would have made a difference, and total points assigned for overall impact on decision making.
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We analyzed median search times for all questions, questions for which answers were found, and questions for which answers were not found. Median times were used because times did not follow a normal distribution. For the per-participant analysis of proportion of questions answered, we determined the proportion of A questions answered, the proportion of N questions answered, and the difference between these proportions for each participant. This difference was used for statistical analysis.
Because this difference was based on paired, nonnormally distributed data, we used the Wilcoxon signed rank test, 13 a nonparametric analog of the paired t test. Per-participant analyses for all other outcomes eg, proportions of questions for which answers made a difference, median search times were conducted in the same manner.
A normality test was performed on each outcome before Wilcoxon signed rank tests were used, and no outcomes followed a normal distribution. Our null hypothesis for each analysis was that the median difference equals zero and the sum of positive differences equals the sum of negative differences.
All analyses were conducted using intention-to-treat principles based on random assignment, regardless of whether participants used the DynaMed database. To avoid conflicts of interest, the coinvestigator DSW and statistician BG had full access to all the data and veto-level involvement in inclusion and exclusion decisions for all participants and data. Analysis was conducted by the statistician at an academic center. Eighty-two participants enrolled between January 20, , and April 28, Sixteen entered no questions.
Two previous DynaMed users were excluded. Four participants were excluded because they did not understand instructions, recorded inaccurate data, and did not respond to requests for clarification. The remaining 60 participants entered questions between January 22, , and June 23, Their questions varied widely in subject area, complexity, and clarity ie, participants often typed in brief phrases insufficient to determine the actual question.
Participants could list multiple resources. Pairs for which there was no difference were excluded from the analysis. Participants answered Of the A questions, participants searched DynaMed for Answers were found for Of the answers found in the A state, Of the answers found in the N state, Among the questions for which answers were not found, answers to The per-participant analysis found no significant differences between A and N states.
Books by Jan De Vries
For the overall impact on clinical decision making, participants generated points from questions in the A state and points from questions in the N state. Time data were invalid and not recalled by the participant for 3 questions. Among the remaining questions, the median time for overall searching whether or not an answer was found was similar in A and N states 4. Median times were similar in A and N states for both successful and unsuccessful searches. This randomized trial shows that a database of synthesized evidence helps primary care clinicians answer more of their clinical questions and find more answers that change clinical decision making.
Demonstrating the advantage of any single resource would be difficult using this study design because clinicians found answers to a high proportion of their questions in the control N state. Although previous studies suggested that primary care clinicians fail to find answers to many of their questions, these studies predated frequent Internet use and included questions for which answers were not sought. Search times were the same with and without DynaMed. Finding more answers in the same time suggests that DynaMed increases the efficiency of answering clinical questions.
Allocation concealment with per-question randomization is a major advance for studies evaluating use of databases for answering clinical questions. Trials using per-participant randomization may be confounded by variations between participants and the effects of resource availability on question recognition and selection. Participants in this study could still introduce bias if they applied differing levels of search thoroughness or answer interpretation based on whether they could use DynaMed.
Excluding previous DynaMed users and participants who have relationships with medical references avoids known biases, but unrecognized confounders cannot be excluded. One would expect that adding a resource without limiting use of existing resources would increase the proportion of questions answered. But some participants recorded No Answer Found after searching DynaMed without searching their usual sources.
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Books by Jan De Vries - Wheelers Books
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