Treating Insomnia: A Review of Patient Perceptions Toward Treatment.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Saini, Bandana

2016-01-01

Patient views about their treatment for insomnia often dictate outcome. This review explores the literature relating to the patients' global perceptions toward treatment for insomnia. A strategic literature search was conducted using five databases (PubMed, CINAHL, Medline, PsycINFO, and Embase). The 57 research articles included for this review were mapped out chronologically across three key stages of treatment-seeking (pretreatment appraisal, actual treatment experiences, and posttreatment evaluation). Patient perceptions played an important role across these three key stages and influenced subsequent health behaviors such as the initiation of help-seeking, treatment uptake, treatment adherence, and treatment adjustment. Patients' perceptions toward treatment were heavily grounded by their psychosocial contexts. Clinical implications and future directions for including patient-centered metrics in mainstream practice and research are discussed.

Shared Decision-Making for Cancer Care Among Racial and Ethnic Minorities: A Systematic Review

PubMed Central

Mead, Erin L.; Doorenbos, Ardith Z.; Javid, Sara H.; Haozous, Emily A.; Alvord, Lori Arviso; Flum, David R.

2013-01-01

To assess decision-making for cancer treatment among racial/ethnic minority patients, we systematically reviewed and synthesized evidence from studies of “shared decision-making,” “cancer,” and “minority groups,” using PubMed, PsycInfo, CINAHL, and EMBASE. We identified significant themes that we compared across studies, refined, and organized into a conceptual model. Five major themes emerged: treatment decision-making, patient factors, family and important others, community, and provider factors. Thematic data overlapped categories, indicating that individuals’ preferences for medical decision-making cannot be authentically examined outside the context of family and community. The shared decision-making model should be expanded beyond the traditional patient–physician dyad to include other important stakeholders in the cancer treatment decision process, such as family or community leaders. PMID:24134353

Effectiveness of massage therapy for shoulder pain: a systematic review and meta-analysis.

PubMed

Yeun, Young-Ran

2017-05-01

[Purpose] This study performed an effect-size analysis of massage therapy for shoulder pain. [Subjects and Methods] The database search was conducted using PubMed, CINAHL, Embase, PsycINFO, RISS, NDSL, NANET, DBpia, and KoreaMed. The meta-analysis was based on 15 studies, covering a total of 635 participants, and used a random effects model. [Results] The effect size estimate showed that massage therapy had a significant effect on reducing shoulder pain for short-term efficacy (SMD: -1.08, 95% CI: -1.51 to -0.65) and for long-term efficacy (SMD: -0.47, 95% CI: -0.71 to -0.23). [Conclusion] The findings from this review suggest that massage therapy is effective at improving shoulder pain. However, further research is needed, especially a randomized controlled trial design or a large sample size, to provide evidence-based recommendations.

Chronic Pain and Cognitive Behavioral Therapy: An Integrative Review.

PubMed

Knoerl, Robert; Lavoie Smith, Ellen M; Weisberg, James

2016-05-01

Cognitive behavioral therapy (CBT) is often used to treat chronic pain; however, more information is needed about what are the most efficacious dose and delivery methods. The aims of this review were to determine (a) which CBT doses, delivery methods, strategies, and follow-up periods have been explored in recent intervention studies of individuals with chronic pain and (b) whether the outcomes described in the selected studies were consistent with recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials. The CINAHL, EMBASE, PubMed, PsycInfo, and SCOPUS databases were searched for randomized controlled trials published from 2009 to 2015 testing CBT for adults with chronic pain. Thirty-five studies were included in this review. Results revealed that CBT reduced pain intensity in 43% of trials, the efficacy of online and in-person formats were comparable, and military veterans and individuals with cancer-related chronic pain were understudied. © The Author(s) 2015.

Critical interpretive synthesis of barriers and facilitators to TB treatment in immigrant populations.

PubMed

Lin, S; Melendez-Torres, G J

2017-10-01

To systematically review studies of TB treatment experiences in immigrant populations, using Critical Interpretive Synthesis (CIS). On 26 October 2014, MEDLINE, CINAHL, Embase, LILACS, and PsycINFO were systematically searched. Grey literature and reference lists were hand-searched. Initial papers included were restricted to studies of immigrant patient perspectives; after a model was developed, a second set of papers was included to test the emerging theory. Of 1761 studies identified in the search, a total of 29 were included in the synthesis. Using those studies, we developed a model that suggested treatment experiences were strongly related to the way both individuals and societies adjusted to immigration ('acculturation strategies'). Relationships with healthcare workers and immigration policies played particularly significant roles in TB treatment. This review emphasised the roles of repatriation policy and healthcare workers in forming experiences of TB treatment in immigrant populations. © 2017 John Wiley & Sons Ltd.

An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice.

PubMed

Guo, Ping; Watts, Kim; Wharrad, Heather

2016-04-01

The aim of this study was to provide evidence of the impact of mobile technologies among healthcare professionals in education and practice settings. Integrative literature review. Electronic databases including MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC and Web of Science were searched for papers published between 2002-2012. Quantitative studies were critically evaluated based on Thomas et al .'s framework, while the consolidated criteria for reporting qualitative research was used to appraise the rigour of the qualitative studies. Seventeen quantitative and three qualitative studies were included. The findings suggest a largely positive influence of mobile technologies on various clinical practice and educational outcomes. However, robust evidence was limited. Use of mobile technologies in health care are associated with improvements in access to information, accuracy and efficiency, evidence-based decision making at the point of care and enhancement in performance, confidence and engagement in different contexts.

The influence of stress responses on surgical performance and outcomes: Literature review and the development of the surgical stress effects (SSE) framework.

PubMed

Chrouser, Kristin L; Xu, Jie; Hallbeck, Susan; Weinger, Matthew B; Partin, Melissa R

2018-02-22

Surgical adverse events persist despite several decades of system-based quality improvement efforts, suggesting the need for alternative strategies. Qualitative studies suggest stress-induced negative intraoperative interpersonal dynamics might contribute to performance errors and undesirable patient outcomes. Understanding the impact of intraoperative stressors may be critical to reducing adverse events and improving outcomes. We searched MEDLINE, psycINFO, EMBASE, Business Source Premier, and CINAHL databases (1996-2016) to assess the relationship between negative (emotional and behavioral) responses to acute intraoperative stressors and provider performance or patient surgical outcomes. Drawing on theory and evidence from reviewed studies, we present the Surgical Stress Effects (SSE) framework. This illustrates how emotional and behavioral responses to stressors can influence individual surgical provider (e.g. surgeon, nurse) performance, team performance, and patient outcomes. It also demonstrates how uncompensated intraoperative threats and errors can lead to adverse events, highlighting evidence gaps for future research efforts. Published by Elsevier Inc.

Women's expectations and experiences regarding e-health treatment: A systematic review.

PubMed

Verhoeks, Carmen; Teunissen, Doreth; van der Stelt-Steenbergen, Anke; Lagro-Janssen, Antoine

2017-08-01

There is a gap in knowledge of women's perceptions of e-health treatment. This review aims to investigate women's expectations and experiences regarding e-health. A search was conducted in MEDLINE, EMBASE, CINAHL and PsycInfo in March 2016. We included articles published between 2000 and March 2016, reporting on e-health interventions. The initial search yielded 2987 articles. Eventually, 16 articles reporting on 16 studies were included. Barriers to e-health treatment were lower for women than barriers to face-to-face treatment, such as feelings of shame and time constraints. Women were able to develop an online therapeutic relationship. As reduced feelings of obligation and lack of motivation were women's greatest challenges in completing e-health treatment, they expressed a wish for more support during e-health treatment, preferably blended care. e-Health lowers the threshold for women to seek healthcare. Combining e-health interventions with face-to-face sessions may enhance women's motivation to complete treatment.

A systematic review--physical activity in dementia: the influence of the nursing home environment.

PubMed

Anderiesen, Hester; Scherder, Erik J A; Goossens, Richard H M; Sonneveld, Marieke H

2014-11-01

Most older persons with dementia living in nursing homes spend their days without engaging in much physical activity. This study therefore looked at the influence that the environment has on their level of physical activity, by reviewing empirical studies that measured the effects of environmental stimuli on the physical activity of nursing home residents suffering from dementia. The electronic databases PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Library were used for the search. The search covered studies published between January 1993 and December 2012, and revealed 3187 abstracts. 326 studies were selected as potentially relevant; of these, 24 met all the inclusion criteria. Positive results on the residents' levels of physical activity were found for music, a homelike environment and functional modifications. Predominantly positive results were also found for the small-scale group living concepts. Mixed results were found for bright or timed light, the multisensory environment and differences in the building footprint. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Effects of herbal and dietary supplements on cognition in menopause: a systematic review.

PubMed

Clement, Yuri N; Onakpoya, Igho; Hung, Shao K; Ernst, Edzard

2011-03-01

Many postmenopausal women use herbal remedies and dietary supplements to counteract menopausal symptoms, including the decline in cognitive function. The aim of this systematic review is to evaluate the evidence regarding the efficacy of herbal and dietary supplements on cognition in menopause. Randomized clinical trials (RCTs) of herbal medicines and dietary supplements were identified using the Medline, EMBASE, AMED, PsycINFO, CINAHL and The Cochrane Library 2010 (Issue 2) electronic databases and by hand searches. Data were independently extracted and evaluated by two reviewers. Risk of bias was assessed by two independent reviewers using the Cochrane Collaboration tool. Twelve RCTs were included and five of these suggest that isoflavone, soy and Gingko biloba supplementation may improve cognition in postmenopausal women. However, most of the included studies had serious methodological flaws which demand a cautious interpretation of these findings. The evidence that herbal and dietary supplements might positively affect the cognitive decline during the menopause is not compelling. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis.

PubMed

Stallman, Helen M; Kohler, Mark

2016-01-01

Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for 'sleepwalking' OR 'somnambulism' in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%-10.3%). The current prevalence rate of sleepwalking-within the last 12 months-was significantly higher in children 5.0% (95% CI 3.8%-6.5%) than adults 1.5% (95% CI 1.0%-2.3%). There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed.

Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis

PubMed Central

Kohler, Mark

2016-01-01

Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for ‘sleepwalking’ OR ‘somnambulism’ in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%–10.3%). The current prevalence rate of sleepwalking—within the last 12 months—was significantly higher in children 5.0% (95% CI 3.8%–6.5%) than adults 1.5% (95% CI 1.0%–2.3%). There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed. PMID:27832078

Macronutrients and the FTO gene expression in hypothalamus; a systematic review of experimental studies.

PubMed

Doaei, Saeid; Kalantari, Naser; Mohammadi, Nastaran Keshavarz; Tabesh, Ghasem Azizi; Gholamalizadeh, Maryam

The various studies have examined the relationship between FTO gene expression and macronutrients levels. In order to obtain better viewpoint from this interactions, all of existing studies were reviewed systematically. All published papers have been obtained and reviewed using standard and sensitive keywords from databases such as CINAHL, Embase, PubMed, PsycInfo, and the Cochrane, from 1990 to 2016. The results indicated that all of 6 studies that met the inclusion criteria (from a total of 428 published article) found FTO gene expression changes at short-term follow-ups. Four of six studies found an increased FTO gene expression after calorie restriction, while two of them indicated decreased FTO gene expression. The effect of protein, carbohydrate and fat were separately assessed and suggested by all of six studies. In Conclusion, The level of FTO gene expression in hypothalamus is related to macronutrients levels. Future research should evaluate the long-term impact of dietary interventions. Copyright © 2017. Published by Elsevier B.V.

Search Filter Precision Can Be Improved By NOTing Out Irrelevant Content

PubMed Central

Wilczynski, Nancy L.; McKibbon, K. Ann; Haynes, R. Brian

2011-01-01

Background: Most methodologic search filters developed for use in large electronic databases such as MEDLINE have low precision. One method that has been proposed but not tested for improving precision is NOTing out irrelevant content. Objective: To determine if search filter precision can be improved by NOTing out the text words and index terms assigned to those articles that are retrieved but are off-target. Design: Analytic survey. Methods: NOTing out unique terms in off-target articles and testing search filter performance in the Clinical Hedges Database. Main Outcome Measures: Sensitivity, specificity, precision and number needed to read (NNR). Results: For all purpose categories (diagnosis, prognosis and etiology) except treatment and for all databases (MEDLINE, EMBASE, CINAHL and PsycINFO), constructing search filters that NOTed out irrelevant content resulted in substantive improvements in NNR (over four-fold for some purpose categories and databases). Conclusion: Search filter precision can be improved by NOTing out irrelevant content. PMID:22195215

Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors.

PubMed

Tuong, William; Larsen, Elizabeth R; Armstrong, April W

2014-04-01

This systematic review examines the effectiveness of videos in modifying health behaviors. We searched PubMed (1975-2012), PsycINFO (1975-2012), EMBASE (1975-2012), and CINAHL (1983-2012) for controlled clinical trials that examined the effectiveness of video interventions in changing health behaviors. Twenty-eight studies comprised of 12,703 subjects were included in the systematic review. Video interventions were variably effective for modifying health behaviors depending on the target behaviors to be influenced. Video interventions appear to be effective in breast self-examination, prostate cancer screening, sunscreen adherence, self-care in patients with heart failure, HIV testing, treatment adherence, and female condom use. However, videos have not shown to be effective in influencing addiction behaviors when they are not tailored. Compared to loss-framing, gain-framed messages may be more effective in promoting certain types of health behavior change. Also, video modeling may facilitate learning of new behaviors and can be an important consideration in future video interventions.

Thiamine for prevention and treatment of Wernicke-Korsakoff Syndrome in people who abuse alcohol.

PubMed

Day, Ed; Bentham, Peter W; Callaghan, Rhiannon; Kuruvilla, Tarun; George, Sanju

2013-07-01

Autopsy studies suggest that Wernicke-Korsakoff syndrome (WKS) is not a rare disorder, particularly in individuals who abuse alcohol. Thiamine has been established as the treatment of choice for over 50 years, but uncertainty remains about appropriate dosage and duration. Current practice guidelines are based on case reports and clinical experience. This is an update of a review first published in 2004 and last updated in 2008. • To assess the efficacy of thiamine in preventing and treating the manifestations of WKS due to excess alcohol consumption. • To determine the optimum form, dose and duration of thiamine treatment for this indication. ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 6 September 2012 using the term thiamine OR aneurine. ALOIS contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trial databases and grey literature sources. Any randomised trials comparing thiamine with alternative interventions or comparing different thiamine regimens (varying in formulation, dose or duration of administration). All abstracts were independently inspected by two reviewers (ED and PWB), and relevant articles were retrieved and assessed for methodological quality using criteria provided in the Cochrane Handbook for Systematic Reviews of Interventions. Two studies were identified that met the inclusion criteria, but only one contained sufficient data for quantitative analysis. Ambrose (2001) randomly assigned participants (n = 107) to one of five doses of intramuscular thiamine and measured outcomes after 2 days of treatment. We compared the lowest dose (5 mg/day) with each of the other four doses. A significant difference favoured 200 mg/day compared with the 5-mg/day dose in determining the number of trials needed to meet inclusion criteria on a delayed alternation test (mean difference (MD) -17.90, 95% confidence interval (CI) -35.4 to -0.40, P = 0.04). No significant differences emerged when the other doses were compared with 5 mg/day. The pattern of results did not reflect a simple dose-response relationship. The study had methodological shortcomings in design and in the presentation of results that limited further analysis. Evidence from randomised controlled clinical trials is insufficient to guide clinicians in determining the dose, frequency, route or duration of thiamine treatment for prophylaxis against or treatment of WKS due to alcohol abuse.

Non-pharmacological interventions to manage fatigue and psychological stress in children and adolescents with cancer: an integrative review.

PubMed

Lopes-Júnior, L C; Bomfim, E O; Nascimento, L C; Nunes, M D R; Pereira-da-Silva, G; Lima, R A G

2016-11-01

Cancer-related fatigue (CRF) is the most stressful and prevalent symptom in paediatric oncology patients. This integrative review aimed to identify, analyse and synthesise the evidence of non-pharmacological intervention studies to manage fatigue and psychological stress in a paediatric population with cancer. Eight electronic databases were used for the search: PubMed, Web of Science, CINAHL, LILACS, EMBASE, SCOPUS, PsycINFO and the Cochrane Library. Initially, 273 articles were found; after the exclusion of repeated articles, reading of the titles, abstracts and the full articles, a final sample of nine articles was obtained. The articles were grouped into five categories: physical exercise, healing touch, music therapy, therapeutic massage, nursing interventions and health education. Among the nine studies, six showed statistical significance regarding the fatigue and/or stress levels, showing that the use of the interventions led to symptoms decrease. The most frequently tested intervention was programmed physical exercises. It is suggested that these interventions are complementary to conventional treatment and that their use can indicate an improvement in CRF and psychological stress. © 2015 John Wiley & Sons Ltd.

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals.

PubMed

Colquhoun, Heather L; Lamontagne, Marie-Eve; Duncan, Edward As; Fiander, Michelle; Champagne, Catherine; Grimshaw, Jeremy M

2017-03-01

To determine the types and effectiveness of interventions to increase the knowledge about, attitudes towards, and use of standardized outcome measures in rehabilitation professionals. An electronic search using Medline, EMBASE, PsycINFO, CINAHL, Ergonomics Abstracts, Sports Discus. The search is current to February 2016. All study designs testing interventions were included as were all provider and patient types. Two reviewers independently conducted a title and abstract review, followed by a full-text review. Two reviewers independently extracted a priori variables and used consensus for disagreements. Quality assessment was conducted using the Assessment of Quantitative Studies published by the Effective Public Health Practice Group. We identified 11 studies involving at least 1200 providers. Nine of the studies showed improvements in outcome measure use rates but only three of these studies used an experimental or quasi-experimental design. Eight of the studies used an educational approach in the intervention and three used audit and feedback. Poor intervention description and quality of studies limited recommendations. Increased attention to testing interventions focused on known barriers, matched to behavior change techniques, and with stronger designs is warranted.

Clozapine in borderline personality disorder: a review of the evidence.

PubMed

Beri, Anand; Boydell, Jane

2014-05-01

Borderline personality disorder (BPD) is a serious mental disorder that is difficult to treat. Possible targets for pharmacotherapy include affective symptoms, cognitive disturbances, and impulsive, self-injurious behaviors. Although many of the medications tested for treatment of BPD have been demonstrated to be useful, no clear pharmacologic treatment has emerged. Clozapine is one of the medications that has been evaluated for the treatment of severe BPD. The aim of this review is to summarize the evidence examining the effectiveness of clozapine in the treatment of BPD. A comprehensive search of the health science databases PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Google Scholar was performed for studies describing the use of clozapine in the treatment of BPD. After the initial search, no randomized controlled trials evaluating the effectiveness of clozapine in BPD were identified. Therefore, case reports and case series were reviewed, with 12 articles selected for final review. This review suggests that clozapine may be a beneficial treatment option for BPD especially in controlling symptom severity, psychotic symptoms, impulsivity, self-mutilation, number of days on enhanced observation, use of restraint, and overall functioning.

The effects of Tai Chi on physical function and well-being among persons with Parkinson's Disease: A systematic review.

PubMed

Ćwiękała-Lewis, Klaudia J; Gallek, Matthew; Taylor-Piliae, Ruth E

2017-04-01

Current medical treatments for Parkinson's disease (PD) are mainly palliative, though research indicates Tai Chi exercise improves physical function and well-being. An electronic database search of PubMed, CINAHL, Web of Science, Cochrane Library, PsycINFO and Embase was conducted, to examine current scientific literature for potential benefits of Tai Chi on physical function and well-being among persons with PD. A total of 11 studies met the inclusion criteria: 7 randomized clinical trials and 4 quasi-experimental studies. PD participants (n = 548) were on average age 68 years old and 50% women. Overall, participants enrolled in Tai Chi had better balance and one or more aspect of well-being, though mixed results were reported. Further research is needed with more rigorous study designs, larger sample sizes, adequate Tai Chi exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Chi, before widespread recommendations can be made. Copyright © 2016 Elsevier Ltd. All rights reserved.

Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward

PubMed Central

George, Usha; Thomson, Mary S.; Chaze, Ferzana; Guruge, Sepali

2015-01-01

The Mental Health Commission of Canada’s (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O’Malley (Int J Soc Res Methodol 8:19–32, 2005). Over two decades of relevant literature on immigrants’ health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed. PMID:26516884

Benefits and harms of direct to consumer advertising: a systematic review.

PubMed

Gilbody, S; Wilson, P; Watt, I

2005-08-01

Direct to consumer advertising is increasingly used by the pharmaceutical industry, but its benefits and harms have yet to be summarised in a comprehensive and rigorous manner. A systematic review was conducted of robust evaluations of the impact (positive and negative) of direct to consumer advertising. A broad range of databases and data sources (including Cinahl, Embase, HMIC, HSRProj, Medline, PsycInfo, and the internet) were searched from inception to 2004. From 2853 citations only four reports were found that met the strict inclusion criteria and provided usable results. Direct to consumer advertising is associated with increased prescription of advertised products and there is substantial impact on patients' request for specific drugs and physicians' confidence in prescribing. No additional benefits in terms of health outcomes were demonstrated. Direct to consumer advertising is banned in most countries, and the research evidence tends to support the negative impact that is feared by those who support a legislative ban. Further research is needed into the clinical and economic impact of direct to consumer advertising in healthcare systems.

Benefits and harms of direct to consumer advertising: a systematic review

PubMed Central

Gilbody, S; Wilson, P; Watt, I

2005-01-01

Background: Direct to consumer advertising is increasingly used by the pharmaceutical industry, but its benefits and harms have yet to be summarised in a comprehensive and rigorous manner. Methods: A systematic review was conducted of robust evaluations of the impact (positive and negative) of direct to consumer advertising. A broad range of databases and data sources (including Cinahl, Embase, HMIC, HSRProj, Medline, PsycInfo, and the internet) were searched from inception to 2004. Results: From 2853 citations only four reports were found that met the strict inclusion criteria and provided usable results. Direct to consumer advertising is associated with increased prescription of advertised products and there is substantial impact on patients' request for specific drugs and physicians' confidence in prescribing. No additional benefits in terms of health outcomes were demonstrated. Discussion: Direct to consumer advertising is banned in most countries, and the research evidence tends to support the negative impact that is feared by those who support a legislative ban. Further research is needed into the clinical and economic impact of direct to consumer advertising in healthcare systems. PMID:16076787

Management of type 2 diabetes in Asian Indians: a review of the literature.

PubMed

Joseph, Letha M; Berry, Diane; Jessup, Ann

2015-04-01

Type 2 diabetes mellitus (T2DM) is increasing in Asian Indians globally. In this article, we review published studies of interventions designed to prevent T2DM or improve self-management in South Asian Indians. A PubMed, CINAHL, Medline, EMBASE, Psycinfo, Family & Society Studies Worldwide, Web of Science, and Consumer Health Complete search was conducted using the following search terms: type 2 diabetes mellitus, Asian Indian continental ancestry group, therapy, treatment, management, care, intervention, self-care, exercise, diet, and lifestyle. The review included pilot or full intervention studies examining the prevention and/or management of T2DM and qualitative studies analyzing the influence of various ethnic factors on the prevention and management of T2DM. Seventeen studies met the inclusion criteria. They examined the influence of culture and religion and the effectiveness of individual and community-based education and lifestyle improvement programs, exercise, and complementary therapies. Few programs led to the improved long-term management of T2DM. Further research is needed to develop ethnic-specific interventions. © The Author(s) 2014.

Yoga and quality-of-life improvement in patients with breast cancer: a literature review.

PubMed

Levine, Alison Spatz; Balk, Judith L

2012-01-01

Women undergoing treatment for breast cancer often turn to complementary and alternative medicine (CAM), including yoga, for improvement of mood, quality of life (QOL), sleep, and treatment-related side effects. The extant literature was reviewed to examine the clinical effects of yoga practice on QOL for patients with breast cancer. QOL was defined as physical well-being, social functioning, emotional health, and function-al adaptation. Seven databases, including PubMed, Ovid MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Library, and Web of Science were used to search for studies of patients with breast cancer that included a yoga intervention and QOL assessment. Attention was paid to assessing study population, outcome variables, the type of yoga intervention used, and methodological strengths and limitations. Seventy-one articles were identified that fit the search criteria. Although the literature provided evidence of QOL benefits of yoga for patients with breast cancer, no specific aspect of yoga was identified as being most advantageous. Although participation in yoga programs appeared to benefit patients with breast cancer, greater methodological rigor is required to understand the mechanisms that contribute to their effectiveness.

Dysmobility syndrome: current perspectives.

PubMed

Hill, Keith D; Farrier, Kaela; Russell, Melissa; Burton, Elissa

2017-01-01

A new term, dysmobility syndrome, has recently been described as a new approach to identify older people at risk of poor health outcomes. The aim was to undertake a systematic review of the existing research literature on dysmobility syndrome. All articles reporting dysmobility syndrome were identified in a systematic review of Medline (Proquest), CINAHL, PubMed, PsycInfo, EMBASE, and Scopus databases. Key characteristics of identified studies were extracted and summarized. The systematic review identified five papers (three cross-sectional, one case control, and one longitudinal study). No intervention studies were identified. Prevalence of dysmobility syndrome varied between studies (22%-34% in three of the studies). Dysmobility syndrome was shown to be associated with reduced function, increased falls and fractures, and a longitudinal study showed its significant association with mortality. Early research on dysmobility syndrome indicates that it may be a useful classification approach to identify older people at risk of adverse health outcomes and to target for early interventions. Future research needs to standardize the optimal mix of measures and cut points, and investigate whether balance performance may be a more useful factor than history of falls for dysmobility syndrome.

Managing attention deficit hyperactivity disorder in adults using illicit psychostimulants: A systematic review.

PubMed

Cook, Jon; Lloyd-Jones, Martyn; Arunogiri, Shalini; Ogden, Edward; Bonomo, Yvonne

2017-09-01

Attention deficit hyperactivity disorder and stimulant use disorder commonly co-exist, and appropriate treatments have not been well established. To provide guidance for treatment of co-existing attention deficit hyperactivity disorder and stimulant use disorder. A systematic review of published English articles using MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane, utilising consistent search terms. Randomised controlled trials, comparing any treatment arm with a control group, for participants meeting Diagnostic and Statistical Manual of Mental Disorders or equivalent criteria for both attention deficit hyperactivity disorder and stimulant use disorder. Eight trials were identified for inclusion in this review. Four of eight studies showed improvement in attention deficit hyperactivity disorder outcome measures compared with placebo. Two of six studies that reported substance use outcomes showed improvement in treatment arms compared with placebo. Studies to show effect tended to be those with the highest treatment dosage. Evidence for the efficacy of treatment of patients with comorbid stimulant use disorder and attention deficit hyperactivity disorder is limited. Promising outcomes need replication in further studies utilising higher treatment dosage.

Effectiveness of teaching strategies on the development of critical thinking in undergraduate nursing students: a meta-analysis.

PubMed

Oliveira, Larissa Bertacchini de; Díaz, Leidy Johanna Rueda; Carbogim, Fábio da Costa; Rodrigues, Adriano Rogério Baldacin; Püschel, Vilanice Alves de Araújo

2016-04-01

To evaluate the effectiveness of teaching strategies used for development of critical thinking (CT) in undergraduate nursing students. Systematic review with meta-analysis based on the recommendations of the Joanna Briggs Institute . Searches were conducted in the following databases: PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, LILACS, Cochrane CENTRAL, PsycINFO, ERIC, and a database of theses from four continents. The initial selection and evaluation of studies and assessment of methodological quality was performed by two reviewers independently. Twelve randomized clinical trials were included in the study. In the meta-analysis of the four studies included that evaluated the strategy of problem-based learning (PBL), compared to lectures, the effectiveness of PBL was demonstrated with statistical significance (SMD = 0.21 and 95% CI = 0.01 to 0.42; p = 0.0434) for the development of CT in undergraduate nursing students, and the studies were homogeneous (chi-square = 6.10, p = 0.106). The effectiveness of PBL was demonstrated in the increase of overall CT scores. Further studies need to be conducted in order to develop, implement and evaluate teaching strategies that are guided in high methodological rigor, and supported in theoretical models of teaching and learning. Avaliar a efetividade das estratégias de ensino utilizadas para o desenvolvimento do pensamento crítico (PC) em estudantes de graduação em Enfermagem. Revisão sistemática com metanálise baseada nas recomendações do Joanna Briggs Institute. A busca foi realizada nas bases de dados PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, LILACS, Cochrane CENTRAL, PsycINFO e ERIC e de banco de teses dos quatro continentes. A seleção e avaliação inicial dos estudos e a avaliação da qualidade metodológica foi realizada por dois revisores de forma independente. Incluídos 12 ensaios clínico randomizados. Na metanálise, dos quatro estudos incluídos que avaliaram a estratégia do Problem Based Learning (PBL), comparada a palestras, foi demonstrada a efetividade do PBL, estatisticamente significativa (SMD=0,21 e 95% IC=0,01-0,42; p=0,0434) para o desenvolvimento do PC em estudantes de graduação em Enfermagem e os estudos eram homogêneos (Qui-quadrado=6,10, p=0,106). Foi demonstrada a efetividade do PBL no aumento dos escores de PC global. Novos estudos precisam ser feitos com o objetivo de desenvolver, implementar e avaliar estratégias de ensino, que sejam pautadas em alto rigor metodológico e amparadas em modelos teóricos de ensino-aprendizagem.

Economics of Palliative Care for Hospitalized Adults With Serious Illness: A Meta-analysis.

PubMed

May, Peter; Normand, Charles; Cassel, J Brian; Del Fabbro, Egidio; Fine, Robert L; Menz, Reagan; Morrison, Corey A; Penrod, Joan D; Robinson, Chessie; Morrison, R Sean

2018-06-01

Economics of care for adults with serious illness is a policy priority worldwide. Palliative care may lower costs for hospitalized adults, but the evidence has important limitations. To estimate the association of palliative care consultation (PCC) with direct hospital costs for adults with serious illness. Systematic searches of the Embase, PsycINFO, CENTRAL, PubMed, CINAHL, and EconLit databases were performed for English-language journal articles using keywords in the domains of palliative care (eg, palliative, terminal) and economics (eg, cost, utilization), with limiters for hospital and consultation. For Embase, PsycINFO, and CENTRAL, we searched without a time limitation. For PubMed, CINAHL, and EconLit, we searched for articles published after August 1, 2013. Data analysis was performed from April 8, 2017, to September 16, 2017. Economic evaluations of interdisciplinary PCC for hospitalized adults with at least 1 of 7 illnesses (cancer; heart, liver, or kidney failure; chronic obstructive pulmonary disease; AIDS/HIV; or selected neurodegenerative conditions) in the hospital inpatient setting vs usual care only, controlling for a minimum list of confounders. Eight eligible studies were identified, all cohort studies, of which 6 provided sufficient information for inclusion. The study estimated the association of PCC within 3 days of admission with direct hospital costs for each sample and for subsamples defined by primary diagnoses and number of comorbidities at admission, controlling for confounding with an instrumental variable when available and otherwise propensity score weighting. Treatment effect estimates were pooled in the meta-analysis. Total direct hospital costs. This study included 6 samples with a total 133 118 patients (range, 1020-82 273), of whom 93.2% were discharged alive (range, 89.0%-98.4%), 40.8% had a primary diagnosis of cancer (range, 15.7%-100.0%), and 3.6% received a PCC (range, 2.2%-22.3%). Mean Elixhauser index scores ranged from 2.2 to 3.5 among the studies. When patients were pooled irrespective of diagnosis, there was a statistically significant reduction in costs (-$3237; 95% CI, -$3581 to -$2893; P < .001). In the stratified analyses, there was a reduction in costs for the cancer (-$4251; 95% CI, -$4664 to -$3837; P < .001) and noncancer (-$2105; 95% CI, -$2698 to -$1511; P < .001) subsamples. The reduction in cost was greater in those with 4 or more comorbidities than for those with 2 or fewer. The estimated association of early hospital PCC with hospital costs may vary according to baseline clinical factors. Estimates may be larger for primary diagnosis of cancer and more comorbidities compared with primary diagnosis of noncancer and fewer comorbidities. Increasing palliative care capacity to meet national guidelines may reduce costs for hospitalized adults with serious and complex illnesses.

Provision of a surgeon's performance data for people considering elective surgery.

PubMed

Henderson, Amanda; Henderson, Simon

2015-02-09

A consumer model of health supports that people undergoing elective surgery should be informed about the past operative performance of their surgeon before making two important decisions: 1. to consent to the proposed surgery, and 2. to have a particular doctor perform the surgery. This information arguably helps empower patients to participate in their care. While surgeons' performance data are available in some settings, there continues to be controversy over the provision of such data to patients, and the question of whether consumers should, or want to, be provided with this information. To assess the effects of providing a surgeon's performance data to people considering elective surgery on patient-based and service utilisation outcomes. For the original review, we searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2009, Issue 4); MEDLINE (Ovid) (1950 to 28 September 2009); EMBASE (Ovid) (1988 to 28 September 2009); PsycINFO (Ovid) (1806 to 28 September 2009); CINAHL (EBSCO) (1982 to 20 October 2009); Current Contents (Ovid) (1992 to 23 November 2009); and ProQuest Dissertations and Theses (1861 to 20 October 2009).For this update, we searched: CENTRAL (2009 to 3 March 2014); MEDLINE (Ovid) (2009 to 3 March 2014); EMBASE (Ovid) (2009 to 3 March 2014); PsycINFO (Ovid) (2009 to 9 March 2014); CINAHL (EBSCO) (2009 to 9 March 2014), Current Contents (Web of Science) (November 2009 to 21 March 2014), and ProQuest Dissertations and Theses (2009 to 21 March 2014). We applied no language restrictions. Randomised controlled trials (RCTs), cluster RCTs, quasi-RCTs and controlled before and after studies (CBAs), in which an individual surgeon's performance data were provided to people considering elective surgery. We considered the CBAs for inclusion from 2009 onwards. Two review authors (AH, SH) independently assessed all titles, abstracts, or both of retrieved citations. We identified no studies for inclusion. Consequently, we conducted no data collection or analysis. We found no studies that met the inclusion criteria; therefore, there are no results to report on the effect of the provision of a surgeon's performance data for people considering elective surgery. We found no studies reporting the impact of the provision of a surgeon's performance data for people considering elective surgery. This is an important finding in itself. While the public reporting of a surgeon's performance is not a new concept, the efficacy of this data for individual patients has not been empirically tested. A review of qualitative studies or new primary qualitative research may be useful to determine what interventions are currently in use and explore the attitudes of consumers and professionals towards such interventions.

Patient safety and systematic reviews: finding papers indexed in MEDLINE, EMBASE and CINAHL.

PubMed

Tanon, A A; Champagne, F; Contandriopoulos, A-P; Pomey, M-P; Vadeboncoeur, A; Nguyen, H

2010-10-01

To develop search strategies for identifying papers on patient safety in MEDLINE, EMBASE and CINAHL. Six journals were electronically searched for papers on patient safety published between 2000 and 2006. Identified papers were divided into two gold standards: one to build and the other to validate the search strategies. Candidate terms for strategy construction were identified using a word frequency analysis of titles, abstracts and keywords used to index the papers in the databases. Searches were run for each one of the selected terms independently in every database. Sensitivity, precision and specificity were calculated for each candidate term. Terms with sensitivity greater than 10% were combined to form the final strategies. The search strategies developed were run against the validation gold standard to assess their performance. A final step in the validation process was to compare the performance of each strategy to those of other strategies found in the literature. We developed strategies for all three databases that were highly sensitive (range 95%-100%), precise (range 40%-60%) and balanced (the product of sensitivity and precision being in the range of 30%-40%). The strategies were very specific and outperformed those found in the literature. The strategies we developed can meet the needs of users aiming to maximise either sensitivity or precision, or seeking a reasonable compromise between sensitivity and precision, when searching for papers on patient safety in MEDLINE, EMBASE or CINAHL.

The Effectiveness of Suicide Prevention Education Programs for Nurses.

PubMed

Ferguson, Monika S; Reis, Julie A; Rabbetts, Lyn; Ashby, Heather-Jean; Bayes, Miriam; McCracken, Tara; Ross, Christine; Procter, Nicholas G

2018-03-01

Education to improve health professionals' responses to suicide is considered an important suicide prevention strategy. However, the effectiveness of this approach for nurses is unclear. To systematically review the peer-reviewed literature regarding the effectiveness of suicide prevention education programs for nurses. Nine academic databases (CINAHL, Cochrane Reviews & Trials, Embase, Informit Health Collection, Joanna Briggs Institute, Medline, PsycINFO, Scopus, and Web of Science) were searched in November 2016, utilizing search terms related to suicide, education, and nurses, with no limits placed on publication date or study design. The search yielded 5,456 identified articles, 11 of which met the inclusion criteria. Studies were primarily quantitative (RCTs n = 3; quasi-experimental n = 6; qualitative n = 2), and involved nurses (range = 16-561) working in a diversity of settings, particularly hospitals (n = 9). Studies revealed positive changes in nurses' competence, knowledge, and attitudes associated with training over the short term. The heterogeneity of education programs and methodological weaknesses of included studies limit the conclusions drawn. There is a moderate body of evidence to support the effectiveness of suicide prevention education programs for nurses. Future research should examine longer-term changes in clinical practice and strategies for continuing education, with more rigorous study designs.

Using patients' charts to assess medical trainees in the workplace: a systematic review.

PubMed

Al-Wassia, Heidi; Al-Wassia, Rolina; Shihata, Shadi; Park, Yoon Soo; Tekian, Ara

2015-04-01

The objective of this review is to summarize and critically appraise existing evidence on the use of chart stimulated recall (CSR) and case-based discussion (CBD) as an assessment tool for medical trainees. Medline, Embase, CINAHL, PsycINFO, Educational Resources Information Centre (ERIC), Web of Science, and the Cochrane Central Register of Controlled Trials were searched for original articles on the use of CSR or CBD as an assessment method for trainees in all medical specialties. Four qualitative and three observational non-comparative studies were eligible for this review. The number of patient-chart encounters needed to achieve sufficient reliability varied across studies. None of the included studies evaluated the content validity of the tool. Both trainees and assessors expressed high level of satisfaction with the tool; however, inadequate training, different interpretation of the scoring scales and skills needed to give feedback were addressed as limitations for conducting the assessment. There is still no compelling evidence for the use of patient's chart to evaluate medical trainees in the workplace. A body of evidence that is valid, reliable, and documents the educational effect in support of the use of patients' charts to assess medical trainees is needed.

Whole dietary patterns to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

PubMed

Teo, Lynn; Crawford, Cindy; Yehuda, Rachel; Jaghab, Danny; Bingham, John J; Gallon, Matthew D; O'Connell, Meghan L; Chittum, Holly K; Arzola, Sonya M; Berry, Kevin

2017-06-01

Optimizing cognitive performance, particularly during times of high stress, is a prerequisite to mission-readiness among military personnel. It has been of interest to determine whether such performance could be enhanced through diet. This systematic review assesses the quality of the evidence for whole dietary patterns across various outcomes related to cognitive function in healthy adult populations to develop research recommendations for the military. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language were eligible. Fifteen included trials were assessed for methodological quality, and descriptive data were extracted. Of the 6 acceptable-quality studies, 1 demonstrated statistically nonsignificant results, whereas the other 5 showed conflicting results across the cognitive outcomes assessed. Due to the heterogeneity across the included studies, no recommendations could be reached concerning whether certain whole dietary patterns have an effect on cognitive outcomes in healthy populations. Specific recommendations for future research are offered. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Key elements of high-quality practice organisation in primary health care: a systematic review.

PubMed

Crossland, Lisa; Janamian, Tina; Jackson, Claire L

2014-08-04

To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care settings. Although there are some validated tools available to primary care that identify and build quality, most are single-strategy approaches developed outside health care settings. There are currently no validated organisational improvement tools, designed specifically for primary health care, which combine all elements of practice improvement and whose use does not require extensive external facilitation.

Systematic review of meaning in life assessment instruments.

PubMed

Brandstätter, Monika; Baumann, Urs; Borasio, Gian Domenico; Fegg, Martin Johannes

2012-10-01

The construct of "meaning in life" (MiL) has raised the interest of clinicians working in psycho-oncology and end-of-life care. It has become a topic of scientific investigation where diverse assessment approaches have been applied. We present a comprehensive systematic review of existing MiL assessment instruments. Electronic searches of articles published in English peer-reviewed journals were performed in Psycinfo, Medline, Embase and Cinahl. Instruments are appraised with regard to ten measurement properties. In total, 59 nomothetic and idiographic MiL instruments were identified. Most instruments were developed in North America and meet basic psychometric criteria. They assess presence of and search for MiL, crisis and sources of MiL, meaning making, meaningful activity, MiL in the context of illness, breadth, depth, and other structural indicators. These aspects are largely consistent with existing MiL definitions. Nine out of 59 instruments included cancer populations in test development. This overview of available instruments underscores the complexity of the construct and might assist researchers to select an appropriate instrument for their research needs. Finally, it points to the need for more integrative theorizing and research on MiL. Copyright © 2012 John Wiley & Sons, Ltd.

Effectiveness of training in evidence-based medicine skills for healthcare professionals: a systematic review.

PubMed

Hecht, Lars; Buhse, Susanne; Meyer, Gabriele

2016-04-04

Basic skills in evidence-based medicine (EbM) are indispensable for healthcare professionals to promote consumer-centred, evidence-based treatment. EbM training courses are complex interventions - a fact that has not been methodologically reflected by previous systematic reviews. This review evaluates the effects of EbM training for healthcare professionals as well as the quality of reporting of such training interventions. We searched PubMed, EMBASE, CINAHL, Cochrane Library, ERIC, Campbell Library and PsycINFO up to 9/2014. Randomised controlled trials, controlled clinical trials as well as before-after trials were included. Authors were contacted in order to obtain missing data. Two independent reviewers extracted data and assessed risk of bias. We reviewed 14.507 articles; n = 61 appeared potentially eligible; n = 13 involving 1,120 participants were included. EbM training shows some impact on knowledge and skills, whereas the impact on practical EbM application remains unclear. Risk of bias of included trials raises uncertainty about the effects. Description of complex interventions was poor. EbM training has some positive effects on knowledge and skills of healthcare professionals. Appropriate methods for development, piloting, evaluation, reporting and implementation of the training should be applied.

Text mining applications in psychiatry: a systematic literature review.

PubMed

Abbe, Adeline; Grouin, Cyril; Zweigenbaum, Pierre; Falissard, Bruno

2016-06-01

The expansion of biomedical literature is creating the need for efficient tools to keep pace with increasing volumes of information. Text mining (TM) approaches are becoming essential to facilitate the automated extraction of useful biomedical information from unstructured text. We reviewed the applications of TM in psychiatry, and explored its advantages and limitations. A systematic review of the literature was carried out using the CINAHL, Medline, EMBASE, PsycINFO and Cochrane databases. In this review, 1103 papers were screened, and 38 were included as applications of TM in psychiatric research. Using TM and content analysis, we identified four major areas of application: (1) Psychopathology (i.e. observational studies focusing on mental illnesses) (2) the Patient perspective (i.e. patients' thoughts and opinions), (3) Medical records (i.e. safety issues, quality of care and description of treatments), and (4) Medical literature (i.e. identification of new scientific information in the literature). The information sources were qualitative studies, Internet postings, medical records and biomedical literature. Our work demonstrates that TM can contribute to complex research tasks in psychiatry. We discuss the benefits, limits, and further applications of this tool in the future. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The Relationship Between Online Social Networking and Depression: A Systematic Review of Quantitative Studies.

PubMed

Baker, David A; Algorta, Guillermo Perez

2016-11-01

Online social networking sites (SNSs) such as Facebook, Twitter, and MySpace are used by billions of people every day to communicate and interact with others. There has been increasing interest in the potential impact of online social networking on wellbeing, with a broadening body of new research into factors associated with both positive and negative mental health outcomes such as depression. This systematic review of empirical studies (n = 30) adds to existing research in this field by examining current quantitative studies focused on the relationship between online social networking and symptoms of depression. The academic databases PsycINFO, Web of Science, CINAHL, MEDLINE, and EMBASE were searched systematically using terms related to online social networking and depression. Reporting quality was critically appraised and the findings discussed with reference to their wider implications. The findings suggest that the relationship between online social networking and symptoms of depression may be complex and associated with multiple psychological, social, behavioral, and individual factors. Furthermore, the impact of online social networking on wellbeing may be both positive and negative, highlighting the need for future research to determine the impact of candidate mediators and moderators underlying these heterogeneous outcomes across evolving networks.

Prediction of driving capacity after traumatic brain injury: a systematic review.

PubMed

Ortoleva, Claudia; Brugger, Camille; Van der Linden, Martial; Walder, Bernhard

2012-01-01

To review the current evidence on predictors for the ability to return to driving after traumatic brain injury. Systematic searches were conducted in MEDLINE, PsycINFO, EMBASE, and CINAHL up to March 1, 2010. Studies were rigorously rated for their methodological content and quality and standardized data were extracted from eligible studies. We screened 2341 articles, of which 7 satisfied our inclusion criteria. Five studies were of limited quality because of undefined, unrepresentative samples and/or absence of blinding. Studies mentioned 38 candidate predictors and tested 37. The candidate predictors most frequently mentioned were "selective attention" and "divided attention" in 4/7 studies, and "executive functions" and "processing speed," both in 3/7 studies. No association with driving was observed for 19 candidate predictors. Eighteen candidate predictors from 3 domains were associated with driving capacity: patient and trauma characteristics, neuropsychological assessments, and general assessments; 10 candidate predictors were tested in only one study and 8 in more than one study. The results of associations were contradictory for all but one: time between trauma and driving evaluation. There is no sound basis at present for predicting driving capacity after traumatic brain injury because most studies have methodological limitations.

Educational and home-environment asthma interventions for children in urban, low-income, minority families.

PubMed

Welker, Kristen; Nabors, Laura; Lang, Myia; Bernstein, Jonathan

2018-02-08

This review examined the impact of environmental change and educational interventions targeting young children from minority groups living in urban environments and who were from low-income families. A scoping methodology was used to find research across six databases, including CINAHL, ERIC, PsycINFO, PubMed, MEDLINE, and EMBASE. 299 studies were identified. Duplicates were removed leaving 159 studies. After reviewing for inclusion and exclusion criteria, 23 manuscripts were identified for this study: 11 featured home-environment change interventions and 12 emphasized education of children. Studies were reviewed to determine key interventions and outcomes for children. Both environmental interventions and educational programs had positive outcomes. Interventions did not always impact health outcomes, such as emergency department visits. Results indicated many of the environmental change and education interventions improved asthma management and some symptoms. A multipronged approach may be a good method for targeting both education and change in the home and school environment to promote the well-being of young children in urban areas. New research with careful documentation of information about study participants, dose of intervention (i.e., number and duration of sessions, booster sessions) and specific intervention components also will provide guidance for future research.

Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review.

PubMed

Bertapelli, Fabio; Pitetti, Ken; Agiovlasitis, Stamatis; Guerra-Junior, Gil

2016-10-01

Children with Down syndrome (DS) are more likely to be overweight or obese than the general population of youth without DS. To review the prevalence of overweight and obesity and their determinants in youth with DS. The health consequences and the effectiveness of interventions were also examined. A search using MEDLINE, Embase, Web of Science, Scopus, CINAHL, PsycINFO, SPORTDiscus, LILACS, and COCHRANE was conducted. From a total of 4280 studies, we included 45 original research articles published between 1988 and 2015. The combined prevalence of overweight and obesity varied between studies from 23% to 70%. Youth with DS had higher rates of overweight and obesity than youths without DS. Likely determinants of obesity included increased leptin, decreased resting energy expenditure, comorbidities, unfavorable diet, and low physical activity levels. Obesity was positively associated with obstructive sleep apnea, dyslipidemia, hyperinsulinemia, and gait disorder. Interventions for obesity prevention and control were primarily based on exercise-based programs, and were insufficient to achieve weight or fat loss. Population-based research is needed to identify risk factors and support multi-factorial strategies for reducing overweight and obesity in children and adolescents with DS. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does patient coaching make a difference in patient-physician communication during specialist consultations? A systematic review.

PubMed

Alders, Irèn; Smits, Carolien; Brand, Paul; van Dulmen, Sandra

2017-05-01

To systematically review the literature on the effectiveness of a patient coach intervention on patient - physician communication in specialists consultations. PubMed, Cochrane, PsycInfo, Cinahl and Embase were searched until November 2015. Included were papers describing interventions directed at adult outpatients in secondary care with a variety of somatic diseases. Outcomes had to be measured in communication effectivity from a patient's perspective. Seventeen publications met the inclusion criteria (involving 3787 patients), describing 13 unique interventions. Most interventions were single one-on-one sessions taking between 20 and 40min before consultation. Research quality in ten studies was high. These studies showed significant improvement on immediate, intermediate and long term patient - physician communication. We found limited evidence suggesting an improvement of patient - physician communication by having multiple patient coaching encounters during which questions are prepared and rehearsed and consultations are evaluated and reflected upon, sometimes supported by audio recording the consultation. The results of this review contribute to the (re-)design of an effective model for patient coaching, a profile and training approach of patient coaches. Future research should aim at determining which patients will benefit most from coaching interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evidence for the impact of quality improvement collaboratives: systematic review

PubMed Central

2008-01-01

Objective To evaluate the effectiveness of quality improvement collaboratives in improving the quality of care. Data sources Relevant studies through Medline, Embase, PsycINFO, CINAHL, and Cochrane databases. Study selection Two reviewers independently extracted data on topics, participants, setting, study design, and outcomes. Data synthesis Of 1104 articles identified, 72 were included in the study. Twelve reports representing nine studies (including two randomised controlled trials) used a controlled design to measure the effects of the quality improvement collaborative intervention on care processes or outcomes of care. Systematic review of these nine studies showed moderate positive results. Seven studies (including one randomised controlled trial) reported an effect on some of the selected outcome measures. Two studies (including one randomised controlled trial) did not show any significant effect. Conclusions The evidence underlying quality improvement collaboratives is positive but limited and the effects cannot be predicted with great certainty. Considering that quality improvement collaboratives seem to play a key part in current strategies focused on accelerating improvement, but may have only modest effects on outcomes at best, further knowledge of the basic components effectiveness, cost effectiveness, and success factors is crucial to determine the value of quality improvement collaboratives. PMID:18577559

Expert searching in health librarianship: a literature review to identify international issues and Australian concerns.

PubMed

Lasserre, Kaye

2012-03-01

The traditional role of health librarians as expert searchers is under challenge. The purpose of this review is to establish health librarians' views, practices and educational processes on expert searching. The search strategy was developed in LISTA and then customised for ten other databases: ALISA, PubMed, Embase, Scopus, Web of Science, CINAHL, ERIC, PsycINFO, Cochrane Library and Google Scholar. The search terms were (expert search* OR expert retriev* OR mediated search* OR information retriev*) AND librar*. The searches, completed in December 2010 and repeated in May 2011, were limited to English language publications from 2000 to 2011 (unless seminal works). Expert searching remains a key role for health librarians, especially for those supporting systematic reviews or employed as clinical librarians answering clinical questions. Although clients tend to be satisfied with searches carried out for them, improvements are required to effectively position the profession. Evidence-based guidelines, adherence to transparent standards, review of entry-level education requirements and a commitment to accredited, rigorous, ongoing professional development will ensure best practice. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

Computer-tailored dietary behaviour change interventions: a systematic review

PubMed Central

Neville, Leonie M.; O'Hara, Blythe; Milat, Andrew J.

2009-01-01

Improving dietary behaviours such as increasing fruit and vegetable consumption and reducing saturated fat intake are important in the promotion of better health. Computer tailoring has shown promise as a strategy to promote such behaviours. A narrative systematic review was conducted to describe the available evidence on ‘second’-generation computer-tailored primary prevention interventions for dietary behaviour change and to determine their effectiveness and key characteristics of success. Systematic literature searches were conducted through five databases: Medline, Embase, PsycINFO, CINAHL and All EBM Reviews and by examining the reference lists of relevant articles to identify studies published in English from January 1996 to 2008. Randomized controlled trials or quasi-experimental designs with pre-test and post-test behavioural outcome data were included. A total of 13 articles were reviewed, describing the evaluation of 12 interventions, seven of which found significant positive effects of the computer-tailored interventions for dietary behaviour outcomes, one also for weight reduction outcomes. Although the evidence of short-term efficacy for computer-tailored dietary behaviour change interventions is fairly strong, the uncertainty lies in whether the reported effects are generalizable and sustained long term. Further research is required to address these limitations of the evidence. PMID:19286893

Assessing Health Care Access and Use among Indigenous Peoples in Alberta: a Systematic Review.

PubMed

Nader, Forouz; Kolahdooz, Fariba; Sharma, Sangita

2017-01-01

Alberta's Indigenous population is growing, yet health care access may be limited. This paper presents a comprehensive review on health care access among Indigenous populations in Alberta with a focus on the health care services use and barriers to health care access. Scientific databases (PubMed, EMBASE, CINAHL, and PsycINFO) and online search engines were systematically searched for studies and grey literature published in English between 2000 and 2013 examining health care services access, use and barriers to access among Indigenous populations in Alberta. Information on health care services use and barriers to use or access was synthesized based on the MOOSE guidelines. Overall, compared to non-Indigenous populations, health care use rates for hospital/emergency room services were higher and health care services use of outpatient specialists was lower among Indigenous peoples. Inadequate numbers of Indigenous health care professionals; a lack of cross-cultural training; fear of foreign environments; and distance from family and friends were barriers to health care use and access. Inequity in social determinants of health among Indigenous peoples and inadequate "health services with prevention approaches," may contribute to present health disparities between Indigenous and non-Indigenous populations in the province.

Cocaine and thrombosis: a narrative systematic review of clinical and in-vivo studies

PubMed Central

Wright, Nat MJ; Martin, Matthew; Goff, Tom; Morgan, John; Elworthy, Rebecca; Ghoneim, Shariffe

2007-01-01

Purpose To systematically review the literature pertaining to the link between cocaine and either arterial or venous thrombosis. Procedures Narrative systematic review of Medline, CINAHL, Embase, Psycinfo and Cochrane databases supplemented by hand trawling of relevant journals and reference lists up to April 2007. In-vivo studies and those with clinical endpoints were included in the review. Results A total of 2458 abstracts led to 186 full-text papers being retrieved. 15 met the criteria for inclusion in the review. The weight of evidence would support cocaine as a pro-thrombotic agent. There is evidence of it activating thrombotic pathways. The effect of cocaine upon clinical endpoints has not been quantified though there is evidence of an association between cocaine and myocardial infarction particularly amongst young adults. Cocaine may also be a causal agent in cerebrovascular accident though studies lacked sufficient power to determine a statistically significant effect. There is a gap in the evidence pertaining to the issue of cocaine and venous thrombosis. Conclusion Clinicians should consider questioning for cocaine use particularly amongst young adults who present with cardiac symptoms. More epidemiological work is required to quantify the effect of cocaine upon both arterial and venous clotting mechanisms. PMID:17880705

What causes racial disparities in very preterm birth? A biosocial perspective.

PubMed

Kramer, Michael R; Hogue, Carol R

2009-01-01

Very preterm birth (<32 weeks' gestation) occurs in approximately 2% of livebirths but is a leading cause of infant mortality and morbidity in the United States. African-American women have a 2-fold to 3-fold elevated risk compared with non-Hispanic white women for reasons that are incompletely understood. This paper reviews the evidence for the biologic and social patterning of very preterm birth, with attention to leading hypotheses regarding the etiology of the racial disparity. A systematic review of the literature in the MEDLINE, CINAHL, PsycInfo, and EMBASE indices was conducted. The literature to date suggests a complex, multifactorial causal framework for understanding racial disparities in very preterm birth, with maternal inflammatory, vascular, or neuroendocrine dysfunction as proximal pathways and maternal exposure to stress, racial differences in preconceptional health, and genetic, epigenetic, and gene-environment interactions as more distal mediators. Interpersonal and institutionalized racism are mechanisms that may drive racially patterned differences. Current literature is limited in that research on social determinants and biologic processes of prematurity has been generally disconnected. Improved etiologic understanding and the potential for effective intervention may come with better integration of these research approaches.

Psychological treatment for vaginal pain: does etiology matter? A systematic review and meta-analysis.

PubMed

Flanagan, Esther; Herron, Katherine A; O'Driscoll, Ciarán; Williams, Amanda C de C

2015-01-01

Classification of vaginal pain within medical or psychiatric diagnostic systems draws mainly on the presumed presence or absence (respectively) of underlying medical etiology. A focus on the experience of pain, rather than etiology, emphasizes common ground in the aims of treatment to improve pain and sexual, emotional, and cognitive experience. Thus, exploring how vaginal pain conditions with varying etiology respond to psychological treatment could cast light on the extent to which they are the same or distinct. To examine the combined and relative efficacy of psychological treatments for vaginal pain conditions. A systematic search of EMBASE, MEDLINE, PsycINFO, and CINAHL was undertaken. Eleven randomized controlled trials were entered into a meta-analysis, and standardized mean differences and odds ratios were calculated. Effect sizes for individual psychological trial arms were also calculated. Main outcome measures were pain and sexual function. Equivalent effects were found for psychological and medical treatments. Effect sizes for psychological treatment arms were comparable across vaginal pain conditions. Effectiveness was equivalent regardless of presumed medical or psychiatric etiology, indicating that presumed etiology may not be helpful in selecting treatment. Research recommendations and clinical implications are discussed. © 2014 International Society for Sexual Medicine.

Promoting a Culture of Safety as a Patient Safety Strategy

PubMed Central

Weaver, Sallie J.; Lubomksi, Lisa H.; Wilson, Renee F.; Pfoh, Elizabeth R.; Martinez, Kathryn A.; Dy, Sydney M.

2015-01-01

Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions used to promote safety culture or climate in acute care settings. The authors searched MEDLINE, CINAHL, PsycINFO, Cochrane, and EMBASE to identify relevant English-language studies published from January 2000 to October 2012. They selected studies that targeted health care workers practicing in inpatient settings and included data about change in patient safety culture or climate after a targeted intervention. Two raters independently screened 3679 abstracts (which yielded 33 eligible studies in 35 articles), extracted study data, and rated study quality and strength of evidence. Eight studies included executive walk rounds or interdisciplinary rounds; 8 evaluated multicomponent, unit-based interventions; and 20 included team training or communication initiatives. Twenty-nine studies reported some improvement in safety culture or patient outcomes, but measured outcomes were highly heterogeneous. Strength of evidence was low, and most studies were pre–post evaluations of low to moderate quality. Within these limits, evidence suggests that interventions can improve perceptions of safety culture and potentially reduce patient harm. PMID:23460092

End-of-life expectations and experiences among nursing home patients and their relatives--a synthesis of qualitative studies.

PubMed

Fosse, Anette; Schaufel, Margrethe Aase; Ruths, Sabine; Malterud, Kirsti

2014-10-01

Synthesize research about patients' and relatives' expectations and experiences on how doctors can improve end-of-life care in nursing homes. We systematically searched qualitative studies in English in seven databases (Medline, Embase, PsycINFO, CINAHL, Ageline, Cochrane Systematic Reviews and Cochrane Trials). We included 14 publications in the analysis with meta-ethnography. Patients and families emphasized the importance of health personnel anticipating illness trajectories and recognizing the information and palliation needed. Family members who became proxy decision-makers reported uncertainty and distress when guidance from health personnel was lacking. They worried about staff shortage and emphasized doctor availability. Relatives and health personnel seldom recognized patients' ability to consent, and patients' preferences were not always recognized. Nursing home patients and their relatives wanted doctors more involved in end-of-life care. They expected doctors to acknowledge their preferences and provide guidance and symptom relief. High-quality end-of-life care in nursing homes relies on organization, funding and skilled staff, including available doctors who are able to recognize illness trajectories and perform individualized Advance Care Planning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cognitive impairment among prostate cancer patients: An overview of reviews.

PubMed

Treanor, C J; Li, J; Donnelly, M

2017-11-01

To identify and clarify definitions and methods of measuring cancer-related cognitive impairment among prostate cancer patients treated with androgen deprivation therapy (ADT) and to assess the incidence and prevalence of cognitive impairment. A systematic review of Medline, EMBASE, PubMed, PsycINFO and CINAHL up to December 2015 was undertaken to identify English-language reviews. A total of 28 reviews were identified describing 20 primary studies. There were no studies of incidence. Reported prevalence rates varied between 10% and 69%. Cognitive domains impaired by ADT included: verbal memory, visuospatial ability and executive functions. Cognitive impairment was infrequently defined and four definitions were reported. A variety of measures and methods were used to assess cognitive function including neuropsychological tests, self-report measures and clinical assessments. The finding that, often, one measure was used to assess more than one aspect of cognition is likely to have contributed to imprecise estimates. There is a need to agree a definition of cognitive impairment in the clinical epidemiology of cancer and to standardise the selection of measures in order to aid accurate assessment and fair comparisons across studies regarding the prevalence of cognitive impairment among prostate cancer patients. © 2017 John Wiley & Sons Ltd.

The role of the therapeutic alliance on pain relief in musculoskeletal rehabilitation: A systematic review.

PubMed

Taccolini Manzoni, Ana Carolina; Bastos de Oliveira, Naiane Teixeira; Nunes Cabral, Cristina Maria; Aquaroni Ricci, Natalia

2018-02-05

The aim of this systematic review was to investigate the role of therapeutic alliance in pain relief in patients with musculoskeletal disorders treated by physiotherapy. Manual and database searches (Medline, Embase, ISI Web of Knowledge, CINAHL, PEDro, Lilacs, Cochrane Library, and PsycINFO) were performed with no restrictions of language and publication date. We included prospective studies with samples of patients undergoing physiotherapy for musculoskeletal conditions, with one measure of therapeutic alliance and the outcome pain. Methodological quality was assessed by the Methodological Index for Nonrandomized Studies and the Cochrane tool for risk of bias. Six articles from four studies were included out of the 936 manuscripts identified. All studies used samples composed of patients with chronic low back pain. Two studies applied therapeutic alliance incentive measures during treatment and reported significant improvement in pain. The remaining studies, without alliance incentives, showed divergence regarding the relationship between the therapeutic alliance and pain. Methodological quality analysis determined low risk of bias of the studies. A lack of studies on the therapeutic alliance regarding musculoskeletal physiotherapy was verified. Existing studies fail to provide evidence of a strong relationship between the therapeutic alliance and pain relief.

Hormone Replacement Therapy and Opioid Tapering for Opioid-Induced Hypogonadism Among Patients with Chronic Noncancer Pain: A Systematic Review.

PubMed

AminiLari, Mahmood; Manjoo, Priya; Craigie, Samantha; Couban, Rachel; Wang, Li; Busse, Jason W

2018-05-02

To systematically review evidence addressing the efficacy of testosterone replacement therapy (TRT) and opioid tapering for opioid-induced hypogonadism among patients with chronic noncancer pain. Systematic review of randomized controlled trials (RCTs) and observational studies. We searched MEDLINE, CINAHL, AMED, CENTRAL, CINAHL, DARE, EMBASE, and PsycINFO through August 2017. Eligible studies enrolled ≥10 patients with chronic noncancer pain and opioid-induced hypogonadism and reported the effect of TRT or opioid tapering on a patient-important outcome collected ≥14 days after treatment. Pairs of reviewers independently screened for eligible studies, assessed risk of bias, and extracted data. We used the GRADE approach to rate quality of evidence. Of 666 abstracts reviewed, five studies including one RCT (N = 84) and four observational studies (N = 157) were eligible. No studies explored the effect of opioid tapering for opioid-induced hypogonadism. Very low-quality evidence found that TRT was associated with improvements in pain (median reduction of 2 points on the 11-point numerical rating scale for pain; 95% confidence interval [CI] = -1.4 to -2.6; minimally important difference [MID] = 2 points), and emotional functioning (mean increase of 9 points on the 100-point SF-36 Mental Component Summary score; 95% CI = 4.40 to 13.60; MID = 5 points). Low-quality evidence suggested that TRT had no effect on sleep quality, sexual function, physical functioning, role functioning, or social functioning; very low-quality evidence suggested no association with depressive symptoms. Low-quality to very low-quality evidence suggests that TRT may improve pain and emotional functioning, but not other outcomes, in chronic noncancer pain patients with opioid-induced hypogonadism.

Prevalence of Dysphagia in People with Intellectual Disability: A Systematic Review

ERIC Educational Resources Information Center

Robertson, Janet; Chadwick, Darren; Baines, Susannah; Emerson, Eric; Hatton, Chris

2017-01-01

Dysphagia (feeding and swallowing disorder) is associated with serious health complications and psychosocial sequelae. This review summarizes international research relating to the prevalence of dysphagia in people with intellectual disability. Studies published from 1990 to July 2016 were identified using Medline, Cinahl, PsycINFO, Web of…

Online and mobile technologies for self-management in bipolar disorder: A systematic review.

PubMed

Gliddon, Emma; Barnes, Steven J; Murray, Greg; Michalak, Erin E

2017-09-01

Internet (eHealth) and smartphone-based (mHealth) approaches to self-management for bipolar disorder are increasingly common. Evidence-based self-management strategies are available for bipolar disorder and provide a useful framework for reviewing existing eHealth/mHealth programs to determine whether these strategies are supported by current technologies. This review assesses which self-management strategies are most supported by technology. Based on 3 previous studies, 7 categories of self-management strategies related to bipolar disorder were identified, followed by a systematic literature review to identify existing eHealth and mHealth programs for this disorder. Searches were conducted by using PubMed, CINAHL, PsycINFO, EMBASE, and the Cochrane Database of Systematic Reviews for relevant peer-reviewed articles published January 2005 to May 2015. eHealth and mHealth programs were summarized and reviewed to identify which of the 7 self-management strategy categories were supported by eHealth or mHealth programs. From 1,654 publications, 15 papers were identified for inclusion. From these, 9 eHealth programs and 2 mHealth programs were identified. The most commonly supported self-management strategy categories were "ongoing monitoring," "maintaining hope," "education," and "planning for and taking action"; the least commonly supported categories were "relaxation" and "maintaining a healthy lifestyle." eHealth programs appear to provide more comprehensive coverage of self-management strategies compared with mHealth programs. Both eHealth and mHealth programs present a wide range of self-management strategies for bipolar disorder, although individuals seeking comprehensive interventions might be best served by eHealth programs, while those seeking more condensed and direct interventions might prefer mHealth programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

"Research protocol: a synthesis of qualitative studies on the process of adaptation to dependency in elderly persons and their families"

PubMed Central

2010-01-01

Background Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. Methods/Design Objectives: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment. A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. Discussion This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts. PMID:20738846

Care delivery and self-management strategies for children with epilepsy.

PubMed

Lindsay, Bruce; Bradley, Peter M

2010-12-08

Epilepsy care for children has been criticised for its lack of impact. Various service models and strategies have been developed in response to perceived inadequacies in care provision for children and their families. We set out to compare the effectiveness of specialist or dedicated teams or individuals in the care of children with epilepsy with usual care services. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library February issue, 2010), MEDLINE (1950 to March 2010), EMBASE (1988 to May 2006*), PsycINFO (1806 to March 2010) and CINAHL (1982 to March 2010).*Please note that as we currently do not have access to EMBASE, we have been unable to update this aspect of our searching. We included randomised controlled trials, controlled or matched trials, cohort studies or other prospective studies with a control group, or time series studies. Each review author independently selected studies, extracted data and assessed the quality of included studies. Four trials and five reports are included in this review. They report on four different education and counselling programmes for children, children and parents, or teenagers and parents. Each programme showed some benefits for the well-being of children with epilepsy, but each trial had methodological flaws and no single programme was evaluated by more than one study. While each of the programmes in this review showed some benefit to children with epilepsy their impacts were extremely variable. No programme showed benefits across the full range of outcomes. No study appears to have demonstrated any detrimental effects but the evidence in favour of any single programme is insufficient to make it possible to recommend one programme rather than another. More trials, carried out by independent research teams, are needed.

Physical Activity and Nutrition Health Promotion Interventions: What Is Working for People with Intellectual Disabilities?

ERIC Educational Resources Information Center

Heller, Tamar; McCubbin, Jeffrey A.; Drum, Charles; Peterson, Jana

2011-01-01

A scoping review of studies on physical activity and nutrition health promotion interventions for individuals with intellectual disabilities was conducted. Searches included MEDLINE, PsycINFO, and CINAHL databases from 1986 through July 2006. The final number included 11 articles comprising 12 studies. Generally, this review indicated some…

Postural Care for People with Intellectual Disabilities and Severely Impaired Motor Function: A Scoping Review

ERIC Educational Resources Information Center

Robertson, Janet; Baines, Susannah; Emerson, Eric; Hatton, Chris

2018-01-01

Background: Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function. Method: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and…

Prevalence and profile of musculoskeletal injuries in ballet dancers: A systematic review and meta-analysis.

PubMed

Smith, Toby O; Davies, Leigh; de Medici, Akbar; Hakim, Allan; Haddad, Fares; Macgregor, Alex

2016-05-01

To determine the prevalence of musculoskeletal disorders and anatomical regions which are most frequently injured in ballet dancers. Published (AMED, CiNAHL, EMBASE, SPORTDiscus, psycINFO, MEDLINE, the Cochrane Library) and grey literature databases (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials and the UK National Research Register Archive) were searched from their inception to 25th May 2015 for papers presenting data on injury prevalence in ballet dancers. Two reviewers independently identified all eligible papers, data extracted and critically appraised studies. Study appraisal was conducted using the CASP appraisal tool. Pooled prevalence data with 95% confidence intervals were estimated to determine period prevalence of musculoskeletal disorders and anatomical regions affected. Nineteen studies were eligible, reporting 7332 injuries in 2617 ballet dancers. The evidence was moderate in quality. Period prevalence of musculoskeletal injury was 280% (95% CI: 217-343%). The most prevalent musculoskeletal disorders included: hamstring strain (51%), ankle tendinopathy (19%) and generalized low back pain (14%). No papers explored musculoskeletal disorders in retired ballet dancers. Whilst we have identified which regions and what musculoskeletal disorders are commonly seen ballet dancers. The long-term injury impact of musculoskeletal disorders in retired ballet dancers remains unknown. Copyright © 2016 Elsevier Ltd. All rights reserved.

Literature review on monitoring technologies and their outcomes in independently living elderly people.

PubMed

Peetoom, Kirsten K B; Lexis, Monique A S; Joore, Manuela; Dirksen, Carmen D; De Witte, Luc P

2015-07-01

To obtain insight into what kind of monitoring technologies exist to monitor activity in-home, what the characteristics and aims of applying these technologies are, what kind of research has been conducted on their effects and what kind of outcomes are reported. A systematic document search was conducted within the scientific databases Pubmed, Embase, Cochrane, PsycINFO and Cinahl, complemented by Google Scholar. Documents were included in this review if they reported on monitoring technologies that detect activities of daily living (ADL) or significant events, e.g. falls, of elderly people in-home, with the aim of prolonging independent living. Five main types of monitoring technologies were identified: PIR motion sensors, body-worn sensors, pressure sensors, video monitoring and sound recognition. In addition, multicomponent technologies and smart home technologies were identified. Research into the use of monitoring technologies is widespread, but in its infancy, consisting mainly of small-scale studies and including few longitudinal studies. Monitoring technology is a promising field, with applications to the long-term care of elderly persons. However, monitoring technologies have to be brought to the next level, with longitudinal studies that evaluate their (cost-) effectiveness to demonstrate the potential to prolong independent living of elderly persons. [Box: see text].

Patient-Related Determinants of Glycaemic Control in People with Type 2 Diabetes in the Gulf Cooperation Council Countries: A Systematic Review.

PubMed

Alramadan, Mohammed J; Afroz, Afsana; Hussain, Sultana Monira; Batais, Mohammed Ali; Almigbal, Turky H; Al-Humrani, Hassan Ahmad; Albaloshi, Ahmed; Romero, Lorena; Magliano, Dianna J; Billah, Baki

2018-01-01

The aim of this systematic review is to assess patient-related factors affecting glycaemic control among people with type 2 diabetes in the Arabian Gulf Council countries. MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases were searched from their date of inception to May 2016. Two researchers independently identified eligible studies and assessed the risk of bias. A total of 13 studies met the inclusion criteria. One study was population based, six recruited participants from multiple centres, and the remaining were single centred. The majority of the studies were of low to moderate quality. Factors associated with poor glycaemic control include longer duration of diabetes, low level of education, poor compliance to diet and medication, poor attitude towards the disease, poor self-management behaviour, anxiety, depression, renal impairment, hypertension, and dyslipidaemia. Healthcare providers should be aware of these factors and provide appropriate education and care especially for those who have poor glycaemic control. Innovative educational programs should be implemented in the healthcare systems to improve patient compliance and practices. A variation in the results of the included studies was observed, and some potentially important risk factors such as dietary habits, physical activity, family support, and cognitive function were not adequately addressed. Further research is needed in this area.

Standardization of search methods for guideline development: an international survey of evidence-based guideline development groups.

PubMed

Deurenberg, Rikie; Vlayen, Joan; Guillo, Sylvie; Oliver, Thomas K; Fervers, Beatrice; Burgers, Jako

2008-03-01

Effective literature searching is particularly important for clinical practice guideline development. Sophisticated searching and filtering mechanisms are needed to help ensure that all relevant research is reviewed. To assess the methods used for the selection of evidence for guideline development by evidence-based guideline development organizations. A semistructured questionnaire assessing the databases, search filters and evaluation methods used for literature retrieval was distributed to eight major organizations involved in evidence-based guideline development. All of the organizations used search filters as part of guideline development. The medline database was the primary source accessed for literature retrieval. The OVID or SilverPlatter interfaces were used in preference to the freely accessed PubMed interface. The Cochrane Library, embase, cinahl and psycinfo databases were also frequently used by the organizations. All organizations reported the intention to improve and validate their filters for finding literature specifically relevant for guidelines. In the first international survey of its kind, eight major guideline development organizations indicated a strong interest in identifying, improving and standardizing search filters to improve guideline development. It is to be hoped that this will result in the standardization of, and open access to, search filters, an improvement in literature searching outcomes and greater collaboration among guideline development organizations.

Optimising treatment resources for OCD: a review of the evidence base for technology-enhanced delivery.

PubMed

Lovell, Karina; Bee, Penny

2011-12-01

Obsessive-compulsive disorder (OCD) is a chronic and disabling mental health problem. Only a minority of people receive evidence-based psychological treatments, and this deficit has prompted an increasing focus on delivering cognitive behaviour therapy (CBT) in new and innovative ways. To conduct a scoping review of the published evidence base for CBT-based interventions incorporating a health technology in the treatment of OCD. The questions posed by the review were (a) are technology-assisted treatments clinically effective, (b) are patient outcomes durable and (c) are more innovative services deemed acceptable by those individuals who engage in them? Scoping review of published studies using any study design examining CBT interventions incorporating a health technology for OCD. Electronic databases searched included MEDLINE (1966-2010), PsycInfo (1967-2010), EMBASE (1980-2010) and CINAHL databases (1982-2010). Thirteen studies were identified, of these, five used bibliotherapy, five examined computerised CBT (cCBT), two investigated telephone delivered CBT and one evaluated video conferencing. Overall studies were small and methodologically flawed, which precludes definitive conclusions of clinical effectiveness, durability or stakeholder satisfaction. To date the evidence base for technology-enhanced OCD treatments has undergone limited development. Future research should seek to overcome the methodological shortcomings of published work by conducting large-scale trials that incorporate clinical, cost and acceptability outcomes.

Effects of Exergaming in People with Dementia: Results of a Systematic Literature Review

PubMed Central

van Santen, Joeke; Dröes, Rose-Marie; Holstege, Marije; Henkemans, Olivier Blanson; van Rijn, Annelies; de Vries, Ralph; van Straten, Annemieke; Meiland, Franka

2018-01-01

Background: Physical exercise benefits functioning, health, and well-being. However, people living with dementia in particular hardly engage in exercise. Exergaming (exercise and gaming) is an innovative, fun, and relatively safe way of exercising in a virtual reality or gaming environment. It may help people living with dementia overcome barriers they can experience regarding regular exercise activities. Objective: This systematic literature review aims to provide an overview of the cost-effectiveness of exergaming and its effects on physical, cognitive, emotional, and social functioning, as well as the quality of life in people living with dementia. Methods: PubMed, Embase, Cinahl, PsycINFO, the Cochrane Library, and the Web of Science Core Collection were searched. Selection of studies was carried out by at least two independent researchers. Results: Three studies were found to be eligible and were included in this review. Two of these showed some statistically significant effects of exergaming on physical, cognitive, and emotional functioning in people living with dementia, although based on a very small sample. No articles were found about the cost-effectiveness of exergaming. Conclusions: Only a few controlled studies have been conducted into the effectiveness of exergaming, and these show very little significant benefits. More well-designed studies are necessary to examine the effects of exergaming. PMID:29689716

Dysphagia is a common and serious problem for adults with mental illness: a systematic review.

PubMed

Aldridge, Kristy J; Taylor, Nicholas F

2012-03-01

Adults with mental illness may experience a higher incidence of dysphagia and choking due to factors such as medication side effects and behavioural abnormalities. The aim of this study was to determine the frequency of dysphagia and the most effective interventions for this population. Studies published up to August 2010 were sought via a comprehensive electronic database search (CINAHL, PsycINFO, MEDLINE, PubMed, Cochrane, and Embase). Studies reporting dysphagia frequency or dysphagia intervention outcomes in adults with mental illness were included. Two reviewers independently assessed study eligibility and quality, and the results were synthesised descriptively. Ten studies were identified, each describing dysphagia frequency or death due to choking asphyxiation. No studies evaluating intervention effectiveness were identified. Study quality was limited by subjective assessment of outcomes. Six studies presented dysphagia frequencies ranging from 9 to 42% in varying subgroups. Four studies presented the frequency of choking asphyxiation death, including a large survey that concluded that adults with organic mental illness were 43 times more likely to die of this cause than the general population. Dysphagia is a common and significant cause of morbidity and mortality in adults with mental illness and our review found that there is a lack of studies evaluating the effectiveness of intervention techniques.

Socioeconomic Differences in Informed Decisions About Down Syndrome Screening: A Systematic Review and Research Agenda.

PubMed

Smith, Sian K; Sousa, Mariana S; Essink-Bot, Marie-Louise; Halliday, Jane; Peate, Michelle; Fransen, Mirjam

2016-08-01

Supporting pregnant women to make informed choices about Down syndrome screening is widely endorsed. We reviewed the literature on: (a) the association between socioeconomic position and informed choices and decision-making about Down syndrome screening, and (b) the possible mediating variables (e.g., health literacy, numeracy skills, behavioral and communication variables) that might explain the relationship. EMBASE, MEDLINE, PubMed, CINAHL, and PsycINFO were searched from January 1999 to September 2014. The methodological quality of studies was determined by predefined criteria regarding the research aims, study design, study population and setting, measurement tools, and statistical analysis. A total of 33 studies met the inclusion criteria. Women from lower socioeconomic groups experience greater difficulties making informed choices about Down syndrome screening compared to women from higher socioeconomic groups. Most studies focus on individual dimensions of informed decision-making rather than assessing elements in conjunction with one another. Few studies have explored why there are socioeconomic differences in women's ability to make informed screening decisions. Future work is needed to identify mediating variables in this pathway. Systematic evidence-based intervention development to improve communication, understanding, and decision-making about Down syndrome screening is needed to ensure that women have an equal opportunity to make an informed choice about screening regardless of their socioeconomic position.

Unexplained Absences and Risk of Death and Injury Among Nursing Home Residents: A Systematic Review.

PubMed

Woolford, Marta H; Weller, Carolina; Ibrahim, Joseph E

2017-04-01

Unexplained absence of nursing home (NH) residents is one of the most challenging issues related to the care of older people. The aim of this review was to examine the death and injury outcomes of unexplained absence of NH residents. We searched MEDLINE, CINAHL, EMBASE, PsycINFO, AgeLine, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Data on death and injury were collated, and aggregate proportions were calculated where possible. Nine studies were identified; most (n = 6) were conducted in the United States. Persons with dementia formed the study population in all studies. There were 1440 individual unexplained absences reported across the 9 studies. We calculated a rate of 82 deaths and 61 injuries per 1000 incidents of unexplained absence. Extreme temperatures were the most common cause of death. Most individuals left by foot, and were found within a 1-mile radius of place last seen in green vegetation and waterways. This review provides valuable insight into death and injury outcomes. Further studies are recommended to improve understanding and prevent adverse outcomes. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident.

PubMed

Martín-Valero, Rocío; De La Casa Almeida, Maria; Casuso-Holgado, Maria Jesus; Heredia-Madrazo, Alfonso

2015-11-01

This systematic review examines levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke. Benefits from different levels of force and resistance in respiratory muscles are shown in this population. This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) directives and was completed in November 2014. The search limits were studies published in English between 2004 and 2014. Relevant studies were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Initially, 20 articles were identified. After analyzing all primary documents, 14 studies were excluded. Only 6 studies were relevant to this review. Three different types of interventions were found (maximum inspiratory training, controlled training, and nonintervention) in 3 different groups. One specific study compared 3 inspiratory muscle training groups with a group of breathing exercises (diaphragmatic exercises with pursed lips) and a control group. Future long-term studies with larger sample sizes are needed. It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program. Copyright © 2015 by Daedalus Enterprises.

Contribution of ethics education to the ethical competence of nursing students: educators' and students' perceptions.

PubMed

Cannaerts, Nancy; Gastmans, Chris; Dierckx de Casterlé, Bernadette

2014-12-01

To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. A total of 15 articles with a quantitative, qualitative, or mixed-methods design published between January 1992 and March 2012 were analyzed. According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments. © The Author(s) 2014.

[Measuring Participation - Discussion of the Theoretical Foundations of Current Assessment Instruments].

PubMed

Gebhard, B; Fink, A

2015-09-01

For children and adolescents social participation is a central goal of rehabilitation processes. Available measurements and evaluation tools are exposed to the problem that the theoretical foundation of the construct of participation is still unclear as well as differentiation from activity in the International Classification of Functioning, Disabilities and Health (ICF/ICF-CY) of the WHO is not made sufficiently. The objectives of this article were (1) to illustrate the scientific discussions on the term and understanding of participation from rehabilitation science perspectives and (2) to conclude implications for practice and science. A systematic search for participation instruments was performed in MEDLINE, CINAHL, PsycINFO, ERIC und EMBASE in August 2014. The available instruments are based on very different definitions of participation. The discussion about the term seems to be not yet complete. A major demand is a better operationalization of activity and participation according to the ICF/ICF-CY in the instruments. Before using an existing instrument, the transferability should be tested for the own context. The theoretical assumptions of participation in conjunction to ICF/ICF-CY as well as the objectives of the instrument should all be clearly understood before using an existing instrument but also before the development of new instruments. © Georg Thieme Verlag KG Stuttgart · New York.

The effectiveness of interventions to treat hypothalamic obesity in survivors of childhood brain tumours: a systematic review.

PubMed

Wang, K-W; Chau, R; Fleming, A; Banfield, L; Singh, S K; Johnston, D L; Zelcer, S M; Rassekh, S R; Burrow, S; Valencia, M; de Souza, R J; Thabane, L; Samaan, M C

2017-08-01

Survivors of childhood brain tumours (SCBT) are at risk of type 2 diabetes and cardiovascular diseases. Obesity is a major driver of cardiometabolic diseases in the general population, and interventions that tackle obesity may lower the risk of these chronic diseases. The goal of this systematic review was to summarize current evidence for the presence of interventions to manage obesity, including hypothalamic obesity, in SCBT. The primary outcome of this review was the body mass index z-score change from baseline to the end of the intervention and/or follow-up. Literature searches were conducted in PsycINFO, CINAHL, the Cochrane Library, Medline, SPORTDiscus, EMBASE and PubMed. Two reviewers completed study evaluations independently. Eleven publications were included in this systematic review (lifestyle intervention n = 2, pharmacotherapy n = 6 and bariatric surgery n = 3). While some studies demonstrated effectiveness of interventions to manage obesity in SCBT and alter markers of obesity and cardiometabolic risk, the evidence base was limited and of low quality, and studies focused on hypothalamic obesity. We conclude that there is urgent need to conduct adequately powered trials of sufficient duration, using existing and novel therapies to manage obesity, reduce the burden of cardiometabolic disorders and improve outcomes in SCBT. © 2017 World Obesity Federation.

The Evidence Base for Interventions Targeting Individuals With Work-Related PTSD: A Systematic Review and Recommendations.

PubMed

Torchalla, Iris; Strehlau, Verena

2018-03-01

The purpose of this study was to summarize the evidence base for interventions targeting individuals with work-related posttraumatic stress disorder (PTSD), to make recommendations for clinicians and administrative decision makers involved in their rehabilitation, and to guide future research in this area. Particular attention was given to studies that were conducted in naturalistic clinical settings or in a workers' compensation claim context. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, PsycINFO, CINAHL, PILOTS, and EMBASE identified 11 articles. Study populations included railroad personnel, police officers, disaster workers, and individuals with industrial injuries. Interventions included trauma-focused cognitive-behavioral therapy and eye movement desensitization and reprocessing. Several studies specifically targeted workers who had failed to return to work (RTW) after standard PTSD treatment. The results suggest that psychotherapy interventions are beneficial for helping clients recover from PTSD symptoms and RTW. In studies that reported on work status, RTW rates increased over time and generally lay between 58% and 80% across follow-up time points. Narrative impressions were supplemented by calculation of Risk Differences for individuals working at pretreatment versus posttreatment. Clinical consideration, methodological issues limiting the current body of work, and recommendations for future research are discussed.

Physical health care monitoring for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew; Mala, Shereen; Bachner, Mick

2010-03-17

Current guidance suggests that we should monitor the physical health of people with serious mental illness and there has been a significant financial investment over recent years to provide this. To assess the effectiveness of physical health monitoring as a means of reducing morbidity, mortality and reduction in quality of life in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (October 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised or quasi-randomised clinical trials focusing on physical health monitoring versus standard care or comparing i) self monitoring vs monitoring by health care professional; ii) simple vs complex monitoring; iii) specific vs non-specific checks iv) once only vs regular checks or v) comparison of different guidance. The authors (GT, AC, SM) independently screened search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. We did not identify any randomised trials which assessed the effectiveness of physical health monitoring in people with serious mental illness. There is no evidence from randomised trials to support current guidance and practice. Guidance and practice are based on expert consensus, clinical experience and good intentions rather than high quality evidence.

Maternal obesity in Africa: a systematic review and meta-analysis.

PubMed

Onubi, Ojochenemi J; Marais, Debbi; Aucott, Lorna; Okonofua, Friday; Poobalan, Amudha S

2016-09-01

Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a 'double burden', especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

Maternal obesity in Africa: a systematic review and meta-analysis

PubMed Central

Onubi, Ojochenemi J.; Marais, Debbi; Aucott, Lorna; Okonofua, Friday; Poobalan, Amudha S.

2016-01-01

Background Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a ‘double burden’, especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. Methods MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Results Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. Conclusions These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects. PMID:26487702

Rhythmic auditory cueing to improve walking in patients with neurological conditions other than Parkinson's disease--what is the evidence?

PubMed

Wittwer, Joanne E; Webster, Kate E; Hill, Keith

2013-01-01

To investigate whether synchronising over-ground walking to rhythmic auditory cues improves temporal and spatial gait measures in adults with neurological clinical conditions other than Parkinson's disease. A search was performed in June 2011 using the computerised databases AGELINE, AMED, AMI, CINAHL, Current Contents, EMBASE, MEDLINE, PsycINFO and PUBMED, and extended using hand-searching of relevant journals and article reference lists. Methodological quality was independently assessed by two reviewers. A best evidence synthesis was applied to rate levels of evidence. Fourteen studies, four of which were randomized controlled trials (RCTs), met the inclusion criteria. Patient groups included those with stroke (six studies); Huntington's disease and spinal cord injury (two studies each); traumatic brain injury, dementia, multiple sclerosis and normal pressure hydrocephalus (one study each). The best evidence synthesis found moderate evidence of improved velocity and stride length of people with stroke following gait training with rhythmic music. Insufficient evidence was found for other included neurological disorders due to low study numbers and poor methodological quality of some studies. Synchronising walking to rhythmic auditory cues can result in short-term improvement in gait measures of people with stroke. Further high quality studies are needed before recommendations for clinical practice can be made.

Self-harm and ethnicity: A systematic review.

PubMed

Al-Sharifi, Ali; Krynicki, Carl R; Upthegrove, Rachel

2015-09-01

This review will focus on the rates, clinical characteristics, risk factors and methods of self-harm and suicide in different ethnic groups in the United Kingdom, providing an update synthesis of recent literature. Studies that met the inclusion criteria between 2003 and 2013 were reviewed using the following databases: MEDLINE, PsycINFO, EMBASE and CINAHL. The methodological quality of each study was then assessed using a structured scoring system. A total of 2,362 articles were retrieved, 10 of which matched the inclusion criteria were reviewed. Significant differences were found in the rates of self-harm between ethnic groups with Asian males being least likely to self-harm and Black females being most likely to self-harm. Also, Black and South Asian people were less likely to repeat self-harm. Factors that may help protect or predispose individuals to self-harm or attempt suicide (such as religion, mental health and coping styles) also differ between ethnic groups. There are clear ethnic differences in self-harm and suicide, which may be affected by factors such as cultural pressures and prevalence of mental illness. An awareness of these differences is vital to help prevent further attempts of self-harm and suicide. Further research into differences between ethnic and cultural groups and self-harm continues to be important. © The Author(s) 2015.

Self-reported barriers to medication adherence among chronically ill adolescents: a systematic review.

PubMed

Hanghøj, Signe; Boisen, Kirsten A

2014-02-01

To investigate self-reported barriers to medication adherence among chronically ill adolescents, and to investigate whether barriers are unique to specific chronic diseases or more generic across conditions. A systematic search of Web of Science, PubMed, Embase, PsycINFO, and CINAHL from January 2000 to May 2012 was conducted. Articles were included if they examined barriers to medication intake among chronically ill adolescents aged 13-19 years. Articles were excluded if adolescent's views on barriers to adherence were not separated from younger children's or caregiver's views. Data was analyzed using a thematic synthesis approach. Of 3,655 records 28 articles with both quantitative, qualitative, and q-methodology study designs were included in the review. The synthesis led to the following key themes: Relations, adolescent development, health and illness, forgetfulness, organization, medicine complexity, and financial costs. Most reported barriers to adherence were not unique to specific diseases. Some barriers seem to be specific to adolescence; for example, relations to parents and peers and adolescent development. Knowledge and assessment of barriers to medication adherence is important for both policy-makers and clinicians in planning interventions and communicating with adolescents about their treatment. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Long-Term Positive and Negative Psychological Late Effects for Parents of Childhood Cancer Survivors: A Systematic Review

PubMed Central

Ljungman, Lisa; Cernvall, Martin; Grönqvist, Helena; Ljótsson, Brjánn; Ljungman, Gustaf; von Essen, Louise

2014-01-01

Increasing survival rates in childhood cancer have yielded a growing population of parents of childhood cancer survivors (CCSs). This systematic review compiles the literature on positive and negative long-term psychological late effects for parents of CCSs, reported at least five years after the child's diagnosis and/or two years after the end of the child's treatment. Systematic searches were made in the databases CINAHL, EMBASE, PsycINFO, and PubMed. Fifteen studies, published between 1988 and 2010, from 12 projects were included. Thirteen studies used quantitative methodology, one quantitative and qualitative methodology, and one qualitative methodology. A total of 1045 parents participated in the reviewed studies. Mean scores were within normal ranges for general psychological distress, coping, and family functioning. However, a substantial subgroup reported a clinical level of general psychological distress, and 21–44% reported a severe level of posttraumatic stress symptoms. Worry, disease-related thoughts and feelings, marital strains, as well as posttraumatic growth was reported. Several factors were associated with the long-term late effects, such as parents' maladaptive coping during earlier stages of the childs disease trajectory and children's current poor adjustment. Quality assessments of reviewed studies and clinical implications of findings are discussed and recommendations for future research are presented. PMID:25058607

A systematic review of standing and treadmill desks in the workplace.

PubMed

MacEwen, Brittany T; MacDonald, Dany J; Burr, Jamie F

2015-01-01

Standing and treadmill desks are intended to reduce the amount of time spent sitting in today's otherwise sedentary office. Proponents of these desks suggest that health benefits may be acquired as standing desk use discourages long periods of sitting, which has been identified as an independent health risk factor. Our objectives were thus to analyze the evidence for standing and treadmill desk use in relation to physiological (chronic disease prevention and management) and psychological (worker productivity, well-being) outcomes. A computer-assisted systematic search of Medline, PubMed, PsycINFO, SPORTDiscus, CINAHL, CENTRAL, and EMBASE databases was employed to identify all relevant articles related to standing and treadmill desk use. Treadmill desks led to the greatest improvement in physiological outcomes including postprandial glucose, HDL cholesterol, and anthropometrics, while standing desk use was associated with few physiological changes. Standing and treadmill desks both showed mixed results for improving psychological well-being with little impact on work performance. Standing and treadmill desks show some utility for breaking up sitting time and potentially improving select components of health. At present; however, there exist substantial evidence gaps to comprehensively evaluate the utility of each type of desk to enhance health benefits by reducing sedentary time. Copyright © 2014 Elsevier Inc. All rights reserved.

Changing the culture of neurodisability through language and sensitivity of providers: Creating a safe place for LGBTQIA+ people.

PubMed

Moreno, Alexander; Laoch, Ari; Zasler, Nathan D

2017-01-01

There is an increasing interest in sexual and gender diversity in neurorehabilitation. Healthcare professionals wanting to improve their practice know the importance of understanding the needs and expectations of specific communities. To critically review the literature about neurological disorders in people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+). Systematic search in electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Scopus, and Web of Science) and identification of relevant studies. Quantitative and qualitative findings are summarized and reported by neurological disorders: a) neurodisability/epilepsy (17.7%), b) intellectual disability/autism spectrum disorders (19.6%), c) dementia/HIV-related dementia (39.2%), d) spinal cord injury (7.8%), and e) traumatic brain injury/stroke (15.7%). LGBTQIA+ people with neurodisabilities and their partners/families of choice can conceal their sexual orientation or gender identity for fear of diminished quality of care. Their invisibility translates into health disparities, lack of policies and services that meet their unique needs. Dementia is the most common neurodisability documented in LGBTQIA+ people. We provide recommendations to increase LGBTQIA+ cultural competency for clinical practice, research, and policy to help different stakeholders to promote a positive change in the culture of neurodisability.

Men’s Mental Health Promotion Interventions: A Scoping Review

PubMed Central

Seaton, Cherisse L.; Bottorff, Joan L.; Jones-Bricker, Margaret; Oliffe, John L.; DeLeenheer, Damen; Medhurst, Kerensa

2017-01-01

There is an increasing need for mental health promotion strategies that effectively engage men. Although researchers have examined the effectiveness of diverse mental wellness interventions in male-dominated industries, and reviewed suicide prevention, early intervention, and health promotion interventions for boys and men, few have focused on sex-specific program effects. The purpose of this review was to (a) extend the previous reviews to examine the effectiveness of mental health promotion programs in males, and (b) evaluate the integration of gender-specific influences in the content and delivery of men’s mental health promotion programs. A search of MEDLINE, CINAHL, PsycINFO, and EMBASE databases for articles published between January 2006 and December 2016 was conducted. Findings from the 25 included studies indicated that a variety of strategies offered within (9 studies) and outside (16 studies) the workplace show promise for promoting men’s mental health. Although stress was a common area of focus (14 studies), the majority of studies targeted multiple outcomes, including some indicators of positive well-being such as self-efficacy, resilience, self-esteem, work performance, and happiness/quality of life. The majority of programs were offered to both men and women, and six studies explicitly integrated gender-related influences in male-specific programs in ways that recognized men’s interests and preferences. PMID:28884637

Efficacy, Feasibility, and Acceptability of Perinatal Yoga on Women's Mental Health and Well-Being: A Systematic Literature Review.

PubMed

Sheffield, Karen M; Woods-Giscombé, Cheryl L

2016-03-01

Perinatal major depressive disorder affects 20% of women, while perinatal anxiety affects 10% of women. Although pharmacological treatment has shown effectiveness, many pregnant women are concerned about potential adverse effects on the fetus, maternal-infant bonding, and child development. Approximately 38% of American adults use complementary and alternative medicine, including yoga and other mind-body strategies. Although complementary and alternative medicine has been less studied in the perinatal population, it potentially offers women and their providers alternatives to traditional medication for treatment of perinatal depression and anxiety. Thus, the purpose of this systematic review was to examine existing empirical literature on yoga and its effects on women's health and well-being during the perinatal period. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systemic literature reviews, literature searches using relevant search terms were performed in four major electronic databases: CINAHL, PubMed, PsycINFO, and EMBASE. Thirteen publications met inclusion criteria. Results indicated that yoga interventions are generally effective in reducing anxiety and depression in pregnant women. The use of yoga in the perinatal period shows promise in improving mental health and well-being for women and infants. This review can inform future yoga intervention studies and clinical practice with the perinatal population. © The Author(s) 2015.

What does the literature suggest about what carers need from mental health services for their own wellbeing? A Systematic Review.

PubMed

Susanti, Herni; Lovell, Karina; Mairs, Hilary

2018-02-01

The aim of this study was to examine prior studies relating to carers' needs from mental health services for their own wellbeing. A systematic approach was adopted for the literature review. The databases searched included MEDLINE, PSycINFO, EMBASE, and CINAHL, involving the use of search terms such as carers, mental health, and needs. The search was conducted in April 2012 and updated in December 2015. In total, 40 published papers were included in the review and were subsequently assessed for quality. For the data synthesis, a thematic analysis approach was employed to integrate the quantitative and qualitative evidence relating to carers' needs. Twenty-five of the reviewed studies were qualitative, 12 were quantitative, and 3 were mixed. Four major carer needs emerged from the synthesis: (1) holistic wellbeing of service users, (2) holistic wellbeing of carers, (3) supportive attitudes of professionals, and (4) carer involvement. All four of these needs, in fact, revolved around the carers' ill relatives. The studies reviewed suggest that while carers of people suffering from mental illness have a range of needs, they generally fail to offer straightforward information about their own needs. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Effective return-to-work interventions after acquired brain injury: A systematic review.

PubMed

Donker-Cools, Birgit H P M; Daams, Joost G; Wind, Haije; Frings-Dresen, Monique H W

2016-01-01

To gather knowledge about effective return-to-work (RTW) interventions for patients with acquired brain injury (ABI). A database search was performed in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library using keywords and Medical Subject Headings. Studies were included if they met inclusion criteria: adult patients with non-progressive ABI, working pre-injury and an intervention principally designed to improve RTW as an outcome. The methodological quality of included studies was determined and evidence was assessed qualitatively. Twelve studies were included, of which five were randomized controlled trials and seven were cohort studies. Nine studies had sufficient methodological quality. There is strong evidence that work-directed interventions in combination with education/coaching are effective regarding RTW and there are indicative findings for the effectiveness of work-directed interventions in combination with skills training and education/coaching. Reported components of the most effective interventions were tailored approach, early intervention, involvement of patient and employer, work or workplace accommodations, work practice and training of social and work-related skills, including coping and emotional support. Effective RTW interventions for patients with ABI are a combination of work-directed interventions, coaching/education and/or skills training. These interventions have the potential to facilitate sustained RTW for patients with ABI.

Outcomes of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease: a systematic review.

PubMed

Morris, Meg E; Perry, Alison; Bilney, Belinda; Curran, Andrea; Dodd, Karen; Wittwer, Joanne E; Dalton, Gregory W

2006-09-01

This article describes a systematic review and critical evaluation of the international literature on the effects of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease (PwMND). The results were interpreted using the framework of the International Classification of Functioning, Disability and Health. This enabled us to summarize therapy outcomes at the level of body structure and function, activity limitations, participation restrictions, and quality of life. Databases searched included MEDLINE, PUBMED, CINAHL, PSYCInfo, Data base of Abstracts of Reviews of Effectiveness (DARE), The Physiotherapy Evidence data base (PEDro), Evidence Based Medicine Reviews (EMBASE), the Cochrane database of systematic reviews, and the Cochrane Controlled Trials Register. Evidence was graded according to the Harbour and Miller classification. Most of the evidence was found to be at the level of "clinical opinion" rather than of controlled clinical trials. Several nonrandomized small group and "observational studies" provided low-level evidence to support physical therapy for improving muscle strength and pulmonary function. There was also some evidence to support the effectiveness of speech pathology interventions for dysarthria. The search identified a small number of studies on occupational therapy for PwMND, which were small, noncontrolled pre-post-designs or clinical reports.

Mental and Physical Health Correlates of Discrimination Against People Who Inject Drugs: A Systematic Review.

PubMed

Couto Cruz, Camila E; Salom, Caroline; Maravilla, Joemer; Alati, Rosa

2018-05-01

The perception that people who use illicit drugs are deviant has contributed to the stigmatization of this population. The primary aim of this review is to examine the links among injection-related discrimination, mental health, physical health, and quality of life in people who inject drugs. We also identify settings, perpetrators of discrimination, and coping strategies developed by people who inject drugs to deal with the issue. Online databases MEDLINE (PubMed), EMBASE, CINAHL (EbscoHost), and PsycINFO (APA PsycNET) were searched for articles focusing on injection-related discrimination against people who inject drugs. Findings were compared for consistency. Qualitative and quantitative articles were evaluated separately. Eleven articles were included in the final review. Several links between discrimination and negative health outcomes were identified. Discrimination was associated with engagement in risky injecting behavior as well as psychological distress. The perpetrators of discrimination against people who inject drugs included general community members and service providers. Attempts to hide addiction was the main strategy used to cope with discrimination. Injection-related discrimination was associated with higher psychological distress levels, unhealthy behaviors, and low quality of life in people who inject drugs. By addressing the stigma of deviance, discrimination and associated negative health outcomes may be reduced.

Linguistic validation and reliability properties are weak investigated of most dementia-specific quality of life measurements-a systematic review.

PubMed

Dichter, Martin Nikolaus; Schwab, Christian G G; Meyer, Gabriele; Bartholomeyczik, Sabine; Halek, Margareta

2016-02-01

For people with dementia, the concept of quality of life (Qol) reflects the disease's impact on the whole person. Thus, Qol is an increasingly used outcome measure in dementia research. This systematic review was performed to identify available dementia-specific Qol measurements and to assess the quality of linguistic validations and reliability studies of these measurements (PROSPERO 2013: CRD42014008725). The MEDLINE, CINAHL, EMBASE, PsycINFO, and Cochrane Methodology Register databases were systematically searched without any date restrictions. Forward and backward citation tracking were performed on the basis of selected articles. A total of 70 articles addressing 19 dementia-specific Qol measurements were identified; nine measurements were adapted to nonorigin countries. The quality of the linguistic validations varied from insufficient to good. Internal consistency was the most frequently tested reliability property. Most of the reliability studies lacked internal validity. Qol measurements for dementia are insufficiently linguistic validated and not well tested for reliability. None of the identified measurements can be recommended without further research. The application of international guidelines and quality criteria is strongly recommended for the performance of linguistic validations and reliability studies of dementia-specific Qol measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

A Systematic Review of Posttraumatic Growth in Survivors of Interpersonal Violence in Adulthood.

PubMed

Elderton, Anna; Berry, Alexis; Chan, Carmen

2015-10-11

This review critically evaluates the literature on posttraumatic growth in survivors of interpersonal violence, integrating the findings from 12 quantitative and 4 qualitative studies. The following databases were searched using predetermined terms: AMED, EMBASE, MEDLINE, PsycINFO, BNI, CINAHL, and Web of Knowledge. The review's findings suggest that the mean prevalence of growth in interpersonal violence survivors is around 71% (range 58-99%). The highest level of growth was consistently experienced in the "appreciation of life" domain. However, survivors reported growth in the four remaining domains: "personal strength," "new possibilities," "experience of relationships with others," and "outlook on life." The nature of the relationship between growth and distress was inconsistent across studies. A combination of pretrauma, peritrauma, and posttrauma variables were found to be related to the degree of growth survivors experienced. Methodological weaknesses of the quantitative studies included the predominant use of retrospective, cross-sectional, correlational designs, discrepancy in the measurement of growth, insufficient sample sizes for power calculations in five studies and limited external validity. Qualitative findings were limited by sampling methods, insufficient information about interview schedules, the lack of credibility checks, and evidence of reflexivity demonstrated by some studies. Implications for practice, policy, and future research are discussed. © The Author(s) 2015.

The Effectiveness of Mobile Phone Text Messaging in Improving Medication Adherence for Patients with Chronic Diseases: A Systematic Review.

PubMed

Ershad Sarabi, Roghayeh; Sadoughi, Farahnaz; Jamshidi Orak, Roohangiz; Bahaadinbeigy, Kambiz

2016-05-01

Medication non-adherence is a commonly observed problem in the self-administration of treatment, regardless of the disease type. Text messaging reminders, as electronic reminders, provide an opportunity to improve medication adherence. In this study, we aimed to provide evidence addressing the question of whether text message reminders were effective in improving patients' adherence to medication. We carried out a systematic literature search, using the five electronic bibliographic databases: PubMed, Embase, PsycINFO, CINAHL, and the Cochrane central register of controlled trials. Studies were included on the basis of whether they examined the benefits and effects of short-message service (SMS) interventions on medication adherence. The results of this systematic review indicated that text messaging interventions have improved patients' medication adherence rate (85%, 29.34). Included in the review, those who had problems with adherence, or those whom text messaging was most helpful had HIV, asthma, diabetes, schizophrenia and heart disease (73.5%). The period of intervention varied from 1 week to 14 months. The most common study design was randomized controlled trials (RCTs) (66%) carried out in the developed countries. This study demonstrated the potential of mobile phone text messaging for medication non-adherence problem solving.

Dietary mobile apps and their effect on nutritional indicators in chronic renal disease: a systematic review.

PubMed

Lai, Janice; Porter, Judi

2015-05-10

Dietary apps for mobile technology are becoming increasingly available and can assist in recording food and fluid intake for nutrition assessment or monitoring. Patients with chronic renal disease, particularly those on dialysis, are required to make significant dietary changes. This study systematically reviews the current literature to assess whether dietary mobile apps improve dietary intake and clinical outcomes in the renal population, specifically those with Chronic Kidney Disease levels 3-5, including dialysis. A systematic search of Medline Complete, CINAHL, Embase, PsycINFO and the Cochrane Library was performed and supplemented by manual searches of citation and reference lists. Of the 712 studies considered, five were eligible for inclusion in this review. The quality of each included study was assessed using a Quality Criteria Checklist for Primary Research. Among five studies (two RCTs and three case studies/reports), none found significant changes in nutrient intake, biochemical markers or intradialytic weight gain, through the use of dietary mobile apps. The included studies show potential for clinical benefits of mobile app interventions in a renal population. However there is a need for additional rigorous trials to demonstrate if there is a clinical benefit to mobile phone app interventions in this population. This article is protected by copyright. All rights reserved.

Effects of healthcare professional delivered early feeding interventions on feeding practices and dietary intake: A systematic review.

PubMed

Matvienko-Sikar, Karen; Toomey, Elaine; Delaney, Lisa; Harrington, Janas; Byrne, Molly; Kearney, Patricia M

2018-04-01

Childhood obesity is a global public health challenge. Parental feeding practices, such as responsive feeding, are implicated in the etiology of childhood obesity. This systematic review aimed to examine of effects of healthcare professional-delivered early feeding interventions, on parental feeding practices, dietary intake, and weight outcomes for children up to 2 years. The role of responsive feeding interventions was also specifically examined. Databases searched included: CINAHL, the Cochrane Library, EMBASE, Medline, PubMed, PsycINFO, and Maternity and Infant Care. participants are parents of children ≤2 years; intervention includes focus on early child feeding to prevent overweight and obesity; intervention delivered by healthcare professionals. Sixteen papers, representing 10 trials, met inclusion criteria for review. Six interventions included responsive feeding components. Interventions demonstrated inconsistent effects on feeding practices, dietary intake, and weight outcomes. Findings suggest some reductions in pressure to eat and infant consumption of non-core beverages. Responsive feeding based interventions demonstrate greater improvements in feeding approaches, and weight outcomes. The findings of this review highlight the importance of incorporating responsive feeding in healthcare professional delivered early feeding interventions to prevent childhood obesity. Observed inconsistencies across trials may be explained by methodological limitations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of the Andersen's health care utilization framework to secondary complications of spinal cord injury: a scoping review.

PubMed

Guilcher, Sara J T; Craven, B Cathy; McColl, Mary Ann; Lemieux-Charles, Louise; Casciaro, Tiziana; Jaglal, Susan B

2012-01-01

The purpose of this scoping review was to identify research priority areas related to secondary complications and associated health care use for individuals with spinal cord injury (SCI). Peer-reviewed journals were identified using CINAHL, MEDLINE, PubMed, Embase, Social Sciences Abstracts, Social Works Abstract and PsycInfo search engines. Key references were hand searched. A total of 289 abstracts were identified from the initial search strategy. We removed studies that did not measure health care and those that did not involve analytical investigation. The selected 31 studies were reviewed in detail using a coding template based on the domains and sub-components of the Andersen model (i.e. environmental, population characteristics, health behavior and outcome). Most studies measured predisposing characteristics (e.g., age, gender) and need characteristics (e.g., level of injury). There was a notable absence of environmental characteristics (e.g., health system, neighborhood variables), enabling characteristics and health behaviors (beyond diet and nutrition). We identified a gap in the SCI literature. Future research should focus on longitudinal study designs with more representation of non-traumatic spinal cord injury, as well as utilizing more advanced statistical analyses (i.e., multivariate level) to adjust for confounding variables.

A behavioural approach in the development of work-related interventions for cancer survivors: an exploratory review.

PubMed

Duijts, S F A; Bleiker, E M A; Paalman, C H; van der Beek, A J

2017-09-01

The application of behavioural change models and theories has not been studied, and behavioural determinants have not been considered, in the context of cancer and work. The aim of this study is to assess the relevance of a behavioural approach in the development of work-related interventions for cancer survivors. Two search strategies were conducted to identify studies on (1) lifestyle interventions (exercise, smoking, alcohol intake and diet), based on behavioural models and theories, in cancer survivors; (2) behavioural determinants regarding work. Medline, Embase, PsycInfo, CINAHL and the Cochrane Controlled Trial Register were searched (2000-2015). Studies were assessed on their eligibility, and findings were listed and categorised. Thirty-four studies exploring lifestyle interventions in cancer survivors were retrieved. The behavioural change models and theories most regularly used were the Transtheoretical Model and Social Cognitive Theory. Furthermore, 26 studies on the role of behavioural determinants regarding work were found. The most frequently considered determinants were self-efficacy, social norms, workers' expectations towards work or recovery, attitude, motivation and meaning of work. The results indicate the significance of behavioural change models and theories and of behavioural determinants in related research areas, which encourages a behavioural approach in the development of work-related interventions for cancer survivors. © 2016 John Wiley & Sons Ltd.

Suicidality in obsessive compulsive disorder (OCD): a systematic review and meta-analysis.

PubMed

Angelakis, Ioannis; Gooding, Patricia; Tarrier, Nichoas; Panagioti, Maria

2015-07-01

Although a growing number of studies have examined the frequency of suicidal thoughts and behaviors in individuals with obsessive compulsive disorder (OCD), there is controversy about the frequency and burden of suicidality in OCD. This is the first systematic review aimed at examining the association between suicidality and OCD and at providing evidence about psychological mechanisms that may underlie suicidality in those with OCD. Five electronic bibliographic databases were searched up to April 2014: Medline, PsycINFO, Embase, Web of Science and CINAHL. Meta-analysis using random effects models was conducted. Forty-eight studies were included in the systematic review. The pooled effect size across 30 independent comparisons revealed a moderate to high, significant association between suicidality and OCD (Hedges' g=0.66, 95% confidence interval 0.49-0.82) which persisted across different types of suicidality including suicidal ideation and suicide attempts. Comorbid Axis I disorders, increased severity of comorbid depressive and anxiety symptoms, increased severity of obsessions, feelings of hopelessness and past history of suicide attempts were associated with worsening levels of suicidality in OCD. There was no indication for publication bias but the methodological quality of the studies was low. The theoretical, research and clinical implications of these findings are emphasized. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of vibration on spasticity in individuals with spinal cord injury: a scoping systematic review.

PubMed

Sadeghi, Mahsa; Sawatzky, Bonita

2014-11-01

The objective of this systematic review was to evaluate how whole-body vibration (WBV) or focal vibration (FV) would change spasticity in individuals with spinal cord injury (SCI). A search was conducted of MEDLINE, EMBASE, CINAHL, and PsycINFO electronic databases. A hand search was conducted of the bibliographies of articles and journals relevant to the research question. The inclusion criteria were three or more individuals, 17 yrs or older, with SCI who experience spasticity, and WBV or FV application. The evidence level of all ten identified studies (195 SCI subjects) was low on the basis of Centre for Evidence Based Medicine level of evidence. WBV (n = 1) and FV (n = 9) were applied to assess the effects of vibration on different measures of spasticity in individuals with SCI. FV application resulted in a short-term spasticity reduction lasting for a maximum of 24 hrs. Neurophysiologic measures showed H-reflex inhibition in individuals with SCI after FV application. WBV resulted in a decrease in spasticity lasting for 6-8 days after the last vibration session. WBV and FV might decrease spasticity for a short period, but no evidence-based recommendation can be drawn from the literature to guide rehabilitation medicine clinicians to manage spasticity with vibration application.

Health Professionals’ Alcohol-Related Professional Practices and the Relationship between Their Personal Alcohol Attitudes and Behavior and Professional Practices: A Systematic Review

PubMed Central

Bakhshi, Savita; While, Alison E.

2013-01-01

Health professionals’ personal health behaviors have been found to be associated with their practices with patients in areas such as smoking, physical activity and weight management, but little is known in relation to alcohol use. This review has two related strands and aims to: (1) examine health professionals’ alcohol-related health promotion practices; and (2) explore the relationship between health professionals’ personal alcohol attitudes and behaviors, and their professional alcohol-related health promotion practices. A comprehensive literature search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, British Nursing Index, Web of Science, Scopus and Science Direct (2007–2013) identified 26 studies that met the inclusion criteria for Strand 1, out of which six were analyzed for Strand 2. The findings indicate that health professionals use a range of methods to aid patients who are high-risk alcohol users. Positive associations were reported between health professionals’ alcohol-related health promotion activities and their personal attitudes towards alcohol (n = 2), and their personal alcohol use (n = 2). The findings have some important implications for professional education. Future research should focus on conducting well-designed studies with larger samples to enable us to draw firm conclusions and develop the evidence base. PMID:24366045

A review of factors affecting patient satisfaction with nurse led triage in emergency departments.

PubMed

Rehman, Salma Abdul; Ali, Parveen Azam

2016-11-01

To determine the factors that affect patient satisfaction with nurse-led-triage in EDs using a systematic review. Nurses' involvement in the triage services provided in the Emergency Department has been an integral part of practice for several decades in some countries. Although studies exploring patient satisfaction with nurse-led ED triage exist, no systematic review of this evidence is available. MEDLINE, CINAHL, PsycInfo, EMBASE, the Cochrane Library, Joanna Briggs Library and Google Scholar were searched (January 1980-June 2013). Eighteen studies that met the inclusion criteria were reviewed. Factors that affect patient satisfaction with nurse-led-triage include nurses' abilities to provide patient centred care, communication skills, nurses' caring abilities, concern for the patient and competence in diagnosing and treating the health problem. Other factors include availability and visibility of nurses, provision of appropriate health related information in a jargon-free language, nurses' ability to answer questions, and an ability to provide patients with an opportunity to ask questions. There is continued scope for nurse-led-triage services in the ED. Patients are generally satisfied with the service provided by nurses in EDs and report a willingness to see the same professional again in the future if needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pharmacological interventions for self-injurious behaviour in adults with intellectual disabilities: Abridged republication of a Cochrane systematic review.

PubMed

Gormez, A; Rana, F; Varghese, S

2014-07-01

We aimed to determine clinical effectiveness of pharmacological interventions for self-injurious behaviour in adults with intellectual disability. We searched the following databases: CENTRAL; MEDLINE; EMBASE; PsycINFO; CINAHL; SCI; SSCI; Conference Proceedings Citation Index - Science; Conference Proceedings Citation Index - Social Science and Humanities; ZETOC; World Cat .We also searched ClinicalTrials.gov,ICTRP and the reference lists of included trials. We included randomised controlled trials that examined drug interventions versus placebo for self-injurious behaviour. We found five double-blind, placebo-controlled trials, which included a total of 50 people. Four trials compared the effects of naltrexone versus placebo and one trial clomipramine versus placebo. We did not identify any relevant placebo-controlled trials for other drugs. We presented a narrative summary, as meta-analysis was not appropriate due to differences in study designs, differences between interventions and heterogeneous outcome measures. There was weak evidence in included trials that any active drug was more effective than placebo for people with intellectual disability demonstrating self-injurious behaviour. Due to sparse data, an absence of power and statistical significance, and high risk of bias for four of the included trials, we are unable to reach any definite conclusions about the relative benefits of naltrexone or clomipramine compared to placebo. © The Author(s) 2014.

Prevalence of menopausal symptoms in Asian midlife women: a systematic review.

PubMed

Islam, M Rakibul; Gartoulla, P; Bell, R J; Fradkin, P; Davis, S R

2015-04-01

To systematically review published articles for the prevalence of menopausal symptoms in Asian women. A comprehensive and systematic literature search was performed using MEDLINE, EMBASE, PsycINFO, CINAHL, SCOPUS and Google scholar in June 2013 to retrieve all English-language studies that included information on the prevalence of menopausal symptoms in women living in Asian countries. Risk of bias of included studies was assessed using a risk-of-bias tool explicitly designed for the systematic review of prevalence studies. Twenty-three independent studies met our inclusion criteria. Physical symptoms were the most prevalent symptoms compared to psychological, vasomotor and sexual symptoms. There was a wide variation in the prevalence of all symptoms across the menopausal stages due to the differences in modes of recruitment, study design, sampling procedures, the time frame over which symptoms were assessed and use of different diagnostic or screening tools. A high level of bias was observed for both external and internal validity for most studies. Although there is a wide variation in the reported prevalence of menopausal symptoms, physical symptoms predominate, followed by psychological symptoms, vasomotor symptoms and sexual symptoms. Further studies of representative samples are necessary to understand whether the variations in prevalence reporting are a function of methodological issues or due to ethnic, cultural or other socioeconomic differences.

Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review

PubMed Central

Fernando, Eresha; Fraser, Michelle; Hendriksen, Jane; Kim, Corey H.

2017-01-01

Purpose: People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood. A review is needed to determine a fall risk profile for this population. The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia. Methods: Articles published between January 1988 and October 2014 in EMBASE, PubMed, PsycINFO, and CINAHL were searched. Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment, prospective cohort design, detailed fall definition, falls as the primary outcome, and multi-variable regression analysis. Two authors independently reviewed and extracted data on study characteristics, quality assessment, and outcomes. Adjusted risk estimates were extracted from the articles. Results: A total of 17 studies met the inclusion criteria. Risk factors were categorized into demographic, balance, gait, vision, functional status, medications, psychosocial, severity of dementia, and other. Risk factors varied with living setting and were not consistent across all studies within a setting. Conclusion: Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors, some shared with older adults in general and others unique to the disease. Risk factors vary between community- and institution-dwelling samples of adults with dementia or cognitive impairment. PMID:28539696

Intelligence assessments for children with cerebral palsy: a systematic review.

PubMed

Yin Foo, Rebecca; Guppy, Max; Johnston, Leanne M

2013-10-01

Cerebral palsy (CP) is defined as a primary disorder of posture and movement; however, approximately 45% of children with CP also have an intellectual impairment. Prevalence estimates are limited by a lack of guidelines for intelligence testing. This systematic review aims to identify and examine intelligence assessments for children with CP. Electronic databases (PubMed, PsycINFO, Web of Science, CINAHL, EMBASE, and ERIC) were searched to identify assessments that (1) measured intellectual function, (2) in children aged 4 to 18 years, (3) with CP, and (4) with psychometrics available. Searches yielded 48 assessments, of which nine provided psychometric data for children with CP. The included tests were the Columbia Mental Maturity Scale, the Leiter International Performance Scale, the Peabody Picture Vocabulary Test, the Pictorial Test of Intelligence, the Raven's Coloured Progressive Matrices, the Stanford-Binet Intelligence Scales, the Wechsler Adult Intelligence Scale, the Wechsler Intelligence Scale for Children, and the Wechsler Preschool and Primary Scale of Intelligence. Intelligence assessments in children with CP lack reliability data, consensus regarding validity data, and population-specific norms. Research is required to establish psychometrics for children with CP. For children with higher motor involvement and/or communication and/or visual impairments, multiple options are required to assess intelligence appropriately. © 2013 Mac Keith Press.

A systematic review of women's satisfaction and regret following risk-reducing mastectomy.

PubMed

Braude, Lucy; Kirsten, Laura; Gilchrist, Jemma; Juraskova, Ilona

2017-12-01

A systematic review of quantitative and qualitative studies, to describe patient satisfaction and regret associated with risk-reducing mastectomies (RRM), and the patient-reported factors associated with these among women at high risk of developing breast cancer. Studies were identified using Medline, CINAHL, Embase and PsycInfo databases (1995-2016). Data were extracted and crosschecked for accuracy. Article quality was assessed using standardised criteria. Of the 1657 unique articles identified, 30 studies met the inclusion criteria (n=23 quantitative studies, n=3 qualitative studies, n=4 mixed-method studies). Studies included were cross-sectional (n=23) or retrospective (n=7). General satisfaction with RRM, decision satisfaction and aesthetic satisfaction were generally high, although some women expressed regret around their decision and dissatisfaction with their appearance. Factors associated with both patient satisfaction and regret included: post-operative complications, body image changes, psychological distress and perceived inadequacy of information. While satisfaction with RRM was generally high, some women had regrets and expressed dissatisfaction. Future research is needed to further explore RRM, and to investigate current satisfaction trends given the ongoing improvements to surgical and clinical practice. Offering pre-operative preparation, decisional support and continuous psychological input may help to facilitate satisfaction with this complex procedure. Copyright © 2017 Elsevier B.V. All rights reserved.

Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol

PubMed Central

von Kobyletzki, Laura Beate; Beckman, Linda; Smeeth, Liam; McKee, Martin; Abuabara, Katrina; Langan, Sinead

2017-01-01

Introduction Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the association between specific allergic diseases and educational attainment. The aim of this study is to systematically review the literature on allergic diseases, educational attainment and occupational status, and if possible, calculate meta-analytic summary estimates for the associations. Methods Systematic electronic searches in Medline, EMBASE, Cochrane, Cumulative Index to Nursing & Allied Health Literature (CINAHL), PsycINFO and education Resources Information Center (ERIC); hand search in reference lists of included papers and conference reports; search for unpublished studies in clinical trial registers and the New York Academy of Medicine Grey Literature Report; data extraction; and study quality assessment (Newcastle-Ottawa Scale) will be performed. Analysis Data will be summarised descriptively, and meta-analysis including meta-regression to explore sources of heterogeneities will be performed if possible. Ethics and dissemination Dissemination in a peer-reviewed, open-access, international scientific journal is planned. PROSPERO registration number CRD42017058036. PMID:29025838

ABCs of SLEEPING: A review of the evidence behind pediatric sleep practice recommendations.

PubMed

Allen, Stephanie L; Howlett, Melissa D; Coulombe, J Aimée; Corkum, Penny V

2016-10-01

The ABCs of SLEEPING mnemonic was developed to serve as an organizing framework for common pediatric sleep recommendations. The mnemonic stands for 1) age appropriate bedtimes and wake-times with consistency, 2) schedules and routines, 3) location, 4) exercise and diet, 5) no electronics in the bedroom or before bed, 6) positivity 7) independence when falling asleep and 8) needs of child met during the day, 9) equal great sleep. This review examines the empirical evidence behind the practices and recommendations captured by the ABCs of SLEEPING mnemonic for children aged 1 to 12. A search was conducted of key electronic databases (PubMed, PsycINFO, CINAHL, & EMBASE) to identify English articles that included the concepts of sleep, insomnia, and/or bedtime. 77 articles were eligible for inclusion and were coded to extract key details and findings regarding the relations between sleep practices identified in the ABCs of SLEEPING mnemonic and sleep outcomes. Findings provided preliminary support for many of the recommendations that are commonly made to families regarding healthy sleep practices. However, more robust investigations are needed to better understand the causal contributions of healthy sleep practices to the onset and maintenance of children's sleep problems. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors that promote or hinder young disabled people in work participation: a systematic review.

PubMed

Achterberg, T J; Wind, H; de Boer, A G E M; Frings-Dresen, M H W

2009-06-01

The aim of this systematic review was to study factors which promote or hinder young disabled people entering the labor market. We systematically searched PubMed (by means of MESH and text words), EMBASE, PsycINFO, Web of Science and CINAHL for studies regarding (1) disabled patients diagnosed before the age of 18 years and (2) factors of work participation. Out of 1,268 retrieved studies and 28 extended studies from references and four from experts, ten articles were included. Promoting factors are male gender, high educational level, age at survey, low depression scores, high dispositional optimism and high psychosocial functioning. Female and low educational level gives high odds of unemployment just like low IQ, inpatient treatment during follow up, epilepsy, motor impairment, wheelchair dependency, functional limitations, co-morbidity, physical disability and chronic health conditions combined with mental retardation. High dose cranial radiotherapy, type of cancer, and age of diagnosis also interfered with employment. Of the promoting factors, education appeared to be important, and several physical obstructions were found to be hindering factors. The last mentioned factors can be influenced in contrast to for instance age and gender. However, to optimize work participation of this group of young disabled it is important to know the promoting or hindering influence for employment.

The Use of Errorless Learning Strategies for Patients with Alzheimer's Disease: A Literature Review

ERIC Educational Resources Information Center

Li, Ruijie; Liu, Karen P. Y.

2012-01-01

The aim of this article was to review the evidence of errorless learning on learning outcomes in patients with early-stage Alzheimer's disease. A computer-aided literature search from 1999 to 2011 was carried out using MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and PsycArticles. Keywords included…

Prevalence of Chronic Health Conditions in Children with Intellectual Disability: A Systematic Literature Review

ERIC Educational Resources Information Center

Oeseburg, Barth; Dijkstra, Geke J.; Groothoff, Johan W.; Reijneveld, Sijmen A.; Jansen, Danielle E. M. C.

2011-01-01

A systematic review of the prevalence rates of chronic health conditions in populations of children with intellectual disability was provided. We identified 2,994 relevant studies by searching Medline, Cinahl, and PsycINFO databases from 1996 to 2008. We included the 31 studies that had sufficient methodological quality. The 6 most prevalent…

Determining the Effectiveness of Alternative Seating Systems for Students with Attention Difficulties: A Systematic Review

ERIC Educational Resources Information Center

Gochenour, Brittany; Poskey, Gail A.

2017-01-01

A student's ability to attend in the classroom is an important factor in determining academic success. This systematic review examined the effects of an alternative seating system on improving attention in students with attention difficulties. Databases searched included CINAHL, Medline, PsycINFO, OTSeeker, Cochrane Library, and Google Scholar.…

Community Participation of People with an Intellectual Disability: A Review of Empirical Findings

ERIC Educational Resources Information Center

Verdonschot, M. M. L.; de Witte, L. P.; Reichrath, E.; Buntinx, W. H. E.; Curfs, L. M. G.

2009-01-01

Study design: A systematic review of the literature. Objectives: To investigate community participation of persons with an intellectual disability (ID) as reported in empirical research studies. Method: A systematic literature search was conducted for the period of 1996-2006 on PubMed, CINAHL and PSYCINFO. Search terms were derived from the…

Impact of Environmental Factors on Community Participation of Persons with an Intellectual Disability: A Systematic Review

ERIC Educational Resources Information Center

Verdonschot, Manon M. L.; de Witte, L. P.; Reichrath, E.; Buntinx, W. H. E.; Curfs, L. M. G.

2009-01-01

Study Design: A systematic review of the literature. Objectives: To describe which environmental factors have an impact on community participation of persons with an intellectual disability. Methods: A systematic literature search was conducted for the period of 1996-2006 in Pubmed, CINAHL and PSYCINFO. Search terms were derived from the…

Neurofeedback in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Holtmann, Martin; Steiner, Sabina; Hohmann, Sarah; Poustka, Luise; Banaschewski, Tobias; Bolte, Sven

2011-01-01

Aim: To review current studies on the effectiveness of neurofeedback as a method of treatment of the core symptoms of autism spectrum disorders (ASD). Method: Studies were selected based on searches in PubMed, Ovid MEDLINE, EMBASE, ERIC, and CINAHL using combinations of the following keywords: "Neurofeedback" OR "EEG Biofeedback" OR "Neurotherapy"…

Barriers to Physical Activity for People with Long-Term Neurological Conditions: A Review Study

ERIC Educational Resources Information Center

Mulligan, Hilda F.; Hale, Leigh A.; Whitehead, Lisa; Baxter, G. David

2012-01-01

People with disability are insufficiently physically active for health. This study identified the volume, quality, and findings of research that exposes environmental and personal barriers of physical activity participation for people with neurological conditions. CINAHL, Sport Discus, EMBASE, Medline, and AMED were systematically searched between…

Melatonin in Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Rossignol, Daniel A.; Frye, Richard E.

2011-01-01

Aim: The aim of this study was to investigate melatonin-related findings in autism spectrum disorders (ASD), including autistic disorder, Asperger syndrome, Rett syndrome, and pervasive developmental disorders, not otherwise specified. Method: Comprehensive searches were conducted in the PubMed, Google Scholar, CINAHL, EMBASE, Scopus, and ERIC…

Computer-Based Education for Patients with Hypertension: A Systematic Review

ERIC Educational Resources Information Center

Saksena, Anuraag

2010-01-01

Objective: To evaluate the benefits of using computer-based interventions to provide patient education to individuals with hypertension. Methods: MEDLINE, Web of Knowledge, CINAHL, ERIC, EMBASE, and PsychINFO were searched from 1995 to April 2009 using keywords related to "computers," "hypertension," "education," and "clinical trial." Additional…

The Association between Databases for Indexing Studies Intended for an Exercise Meta-Analysis of Arthritis Randomized Controlled Trials

PubMed Central

Kelley, George A.; Kelley, Kristi S.

2012-01-01

Objective. The purpose of this study was to determine the database indexing of randomized controlled trials (RCTs) for a meta-analysis addressing the effects of exercise on pain and physical function in adults with arthritis and other rheumatic diseases (AORD). Methods. The number, percentage, and 95% confidence intervals (CIs) for included articles at initial and follow-up periods were calculated from PubMed, EMBASE, CENTRAL, CINAHL, SPORTDiscus, and DAO databases. The number needed to review (NNR) was also calculated along with the number of articles retrieved by expert review. Cross-referencing from reviews and included articles also occurred. Results. Thirty-four of 36 articles (94.4%, 95% CI, 81.3–99.3) were located by database searching. PubMed and CENTRAL yielded 32 of 36 articles (88.9%, 73.9–96.9). Two articles not identified in any of the other databases were found in either CINAHL or SPORTDicsus. Two other articles were located by scanning the reference lists of review articles. The NNR ranged from 2 (CINAHL) to 118 (SPORTDiscus). More articles were identified in EMBASE at follow-up (36%, 12.1–42.2 versus 86.1%, 70.5–95.3). Conclusions. Searching multiple databases and cross-referencing from reviews was important for identifying RCTs addressing the effects of exercise on pain and physical function in adults with AORD. PMID:22924128

The Association between Databases for Indexing Studies Intended for an Exercise Meta-Analysis of Arthritis Randomized Controlled Trials.

PubMed

Kelley, George A; Kelley, Kristi S

2012-01-01

Objective. The purpose of this study was to determine the database indexing of randomized controlled trials (RCTs) for a meta-analysis addressing the effects of exercise on pain and physical function in adults with arthritis and other rheumatic diseases (AORD). Methods. The number, percentage, and 95% confidence intervals (CIs) for included articles at initial and follow-up periods were calculated from PubMed, EMBASE, CENTRAL, CINAHL, SPORTDiscus, and DAO databases. The number needed to review (NNR) was also calculated along with the number of articles retrieved by expert review. Cross-referencing from reviews and included articles also occurred. Results. Thirty-four of 36 articles (94.4%, 95% CI, 81.3-99.3) were located by database searching. PubMed and CENTRAL yielded 32 of 36 articles (88.9%, 73.9-96.9). Two articles not identified in any of the other databases were found in either CINAHL or SPORTDicsus. Two other articles were located by scanning the reference lists of review articles. The NNR ranged from 2 (CINAHL) to 118 (SPORTDiscus). More articles were identified in EMBASE at follow-up (36%, 12.1-42.2 versus 86.1%, 70.5-95.3). Conclusions. Searching multiple databases and cross-referencing from reviews was important for identifying RCTs addressing the effects of exercise on pain and physical function in adults with AORD.

Mapping the literature of diagnostic medical sonography.

PubMed Central

Walcott, B M

1999-01-01

Diagnostic medical sonography has been evolving as a recognized allied health occupation since the early 1970s, but no bibliometric studies of the literature of the field have been published. This study, part of the Medical Library Association Nursing and Allied Health Resources Section's Project for Mapping the Literature of Allied Health, attempted to identify the core journals in diagnostic medical sonography and determine how well these journals are indexed by MEDLINE, EMBASE/Excerpta Medica, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Citation analysis was done using the three journals listed for the field by the Brandon/Hill list. Characteristics of two of these three journals affected the results to the extent that more data should be gathered to reach conclusions about the literature of diagnostic medical sonography as a whole. Results of the analysis do suggest that the literature of echocardiography, which is a special area of diagnostic medical sonography, is indexed much more completely by MEDLINE and EMBASE/Excerpta Medica than by CINAHL. Suggestions are made for librarians making collection development decisions in this area of allied health. PMID:10427429

Altering the Prosodic Features of Motherese to Promote Joint Attention in Language-Delayed Children. EBP Briefs. Volume 12, Issue 1

ERIC Educational Resources Information Center

Fredman, Traci

2017-01-01

Clinical Question: For children ages birth to 3 years diagnosed with a language delay or disorder, to what extent does the prosodic component of motherese aid in establishing joint attention (JA)? Method: Systematic Review. Study Sources: ASHA, Web of Science, CINAHL, MEDLINE, EBSCO, PubMed, PsycINFO, and ERIC. Search Terms: motherese, infant…

An assessment of the efficacy of searching in biomedical databases beyond MEDLINE in identifying studies for a systematic review on ward closures as an infection control intervention to control outbreaks.

PubMed

Kwon, Yoojin; Powelson, Susan E; Wong, Holly; Ghali, William A; Conly, John M

2014-11-11

The purpose of our study is to determine the value and efficacy of searching biomedical databases beyond MEDLINE for systematic reviews. We analyzed the results from a systematic review conducted by the authors and others on ward closure as an infection control practice. Ovid MEDLINE including In-Process & Other Non-Indexed Citations, Ovid Embase, CINAHL Plus, LILACS, and IndMED were systematically searched for articles of any study type discussing ward closure, as were bibliographies of selected articles and recent infection control conference abstracts. Search results were tracked, recorded, and analyzed using a relative recall method. The sensitivity of searching in each database was calculated. Two thousand ninety-five unique citations were identified and screened for inclusion in the systematic review: 2,060 from database searching and 35 from hand searching and other sources. Ninety-seven citations were included in the final review. MEDLINE and Embase searches each retrieved 80 of the 97 articles included, only 4 articles from each database were unique. The CINAHL search retrieved 35 included articles, and 4 were unique. The IndMED and LILACS searches did not retrieve any included articles, although 75 of the included articles were indexed in LILACS. The true value of using regional databases, particularly LILACS, may lie with the ability to search in the language spoken in the region. Eight articles were found only through hand searching. Identifying studies for a systematic review where the research is observational is complex. The value each individual study contributes to the review cannot be accurately measured. Consequently, we could not determine the value of results found from searching beyond MEDLINE, Embase, and CINAHL with accuracy. However, hand searching for serendipitous retrieval remains an important aspect due to indexing and keyword challenges inherent in this literature.

The effect of exercise on fatigue and physical functioning in breast cancer patients during and after treatment and at 6 months follow-up: A meta-analysis.

PubMed

Juvet, L K; Thune, I; Elvsaas, I K Ø; Fors, E A; Lundgren, S; Bertheussen, G; Leivseth, G; Oldervoll, L M

2017-06-01

Breast cancer is the leading cause of cancer in women worldwide. Exercise interventions may improve physical and psychological factors during and after active breast cancer treatment. The aim of this systematic review was to assess the current knowledge regarding the efficacy of physical exercise with respect to fatigue and self-reported physical functioning. Systematic searches in Cochrane Library, Medline, Embase, Cinahl, PsycINFO, AMED and PEDro. After assessing the quality of the studies, we identified 25 randomized controlled trials that included 3418 breast cancer patients. An increase in physical functioning and a decrease in fatigue were observed after a physical exercise intervention, with an SMD of 0.27 (0.12, 0.41) and -0.32 (-0.49, - 0.14), respectively. There were slightly higher improvements in physical functioning and fatigue when the patients received the intervention after adjuvant breast cancer treatment. The 6-month follow-up data showed a small favourable difference for the physical exercise group for both physical functioning and fatigue. This systematic review found that an exercise intervention program can produce short-term improvements in physical functioning and can reduce fatigue in breast cancer patients. However, more studies are needed to confirm the time-dependent observations in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinician and educator experiences of facilitating students' transition back to school following acquired brain injury: A qualitative systematic review.

PubMed

Hartman, Laura R; Duncanson, Michelle; Farahat, Sarah Marie; Lindsay, Sally

2015-01-01

Transition back to school following paediatric acquired brain injury (ABI) is complex. It must be facilitated by healthcare and educational professionals, who need to work together to return affected students to learning. This qualitative systematic review synthesizes qualitative studies on clinicians' and educators' experiences of facilitating hospital-to-school transitions following ABI. A search was conducted using seven electronic databases (CINAHL, Cochrane, EMBASE, ERIC, HealthSTAR, MEDLINE, PsycINFO) and key resources were manually reviewed. Publications selected for inclusion had a sample of clinicians and/or educators who worked with children/youth with ABI and focused on hospital-to-school transition processes from the professionals' perspectives. The initial search returned 4761 publications. Of those, 10 met the inclusion criteria. Six main themes emerged across those publications. Three related to transition barriers: (1) lack of training and education regarding transition processes; (2) lack of communication between stakeholders; and (3) lack of preparation for transition. The remaining three presented items that both facilitate and/or impede the transition process: (4) supports available; (5) linking agents; and (6) policies and procedures guiding transition. Clinicians and educators called for collaboration and communication to support students' transition back to school. Further inquiry into designated linking agents and policies that facilitate hospital-to-school transitions for students following ABI may address these lacking areas.

Emergency department-based interventions for women suffering domestic abuse: a critical literature review.

PubMed

Ansari, Sereena; Boyle, Adrian

2017-02-01

Domestic abuse represents a serious public health and human rights concern. Interventions to reduce the risk of abuse include staff training and standardized documentation improving detection and adherence to referral pathways. Interventional studies have been conducted in primary care, maternity and outpatient settings. Women disclosing abuse in emergency departments differ from women attending other healthcare settings, and it is unclear whether these interventions can be transferred to the emergency care setting. This review examines interventional studies to evaluate the effectiveness of emergency department-based interventions in reducing domestic abuse-related morbidity. Medline, EMBASE, CINAHL, PsycINFO and Cochrane Library were searched, according to prespecified selection criteria. Study quality was assessed using the Jadad scale. Of 273 search results, nine were eligible for review. Interventions involving staff training demonstrated benefits in subjective measures, such as staff knowledge regarding abuse, but no changes in clinical practice, based on detection and referral rates. When staff training was implemented in conjunction with supporting system changes - for example, standardized documentation for assessment and referral - clinically relevant improvements were noted. Interventions centred around staff training are insufficient to bring about improvements in the management and, thus, outcome of patients suffering abuse. Instead, system changes, such as standardized documentation and referral pathways, supported by training, may bring about beneficial changes. It remains uncertain whether surrogate outcomes employed by most studies translate to changes in abuse-related morbidity: the ultimate goal.

Antipsychotic-induced akathisia in delirium: A systematic review

PubMed Central

FORCEN, FERNANDO ESPI; MATSOUKAS, KONSTANTINA; ALICI, YESNE

2017-01-01

Objective Akathisia is a neuropsychiatric syndrome characterized by subjective and objective restlessness. It is a common side effect in patients taking antipsychotics and other psychotropics. Patients with delirium are frequently treated with antipsychotic medications that are well known to induce akathisia as a side effect. However, the prevalence, phenomenology, and management of akathisia in patients with delirium remain largely unknown. The purpose of this review was to examine the medical literature in order to establish the current state of knowledge regarding the prevalence of antipsychotic-induced akathisia in patients with delirium. Method A systematic review of the literature was conducted using the EMBASE, MEDLINE, PsycINFO, and CINAHL databases. Some 10 studies addressing the incidence of akathisia in patients taking antipsychotic medication for delirium were identified and included in our review. Results The included studies reported a variable prevalence of antipsychotic-induced akathisia. A higher prevalence was found in patients taking haloperidol. Among atypical antipsychotics, paliperidone and ziprasidone were associated with a higher risk of akathisia. The risk for akathisia appeared to be a dose-related phenomenon. Significance of results Studies using specific scales for evaluation of akathisia in delirium are lacking. Some populations, such as patients with cancer or terminally ill patients in palliative care settings taking antipsychotics for the treatment of delirium, could be at higher risk for development of akathisia as a side effect. PMID:26087817

Interprofessional Team Training at the Prelicensure Level: A Review of the Literature.

PubMed

Nelson, Sioban; White, Catriona F; Hodges, Brian D; Tassone, Maria

2017-05-01

The authors undertook a descriptive analysis review to gain a better understanding of the various approaches to and outcomes of team training initiatives in prelicensure curricula since 2000. In July and August 2014, the authors searched the MEDLINE, PsycINFO, Embase, Business Source Premier, and CINAHL databases to identify evaluative studies of team training programs' effects on the team knowledge, communication, and skills of prelicensure students published from 2000 to August 2014. The authors identified 2,568 articles, with 17 studies meeting the selection criteria for full text review. The most common study designs were single-group, pre/posttest studies (n = 7), followed by randomized controlled or comparison trials (n = 6). The Situation, Background, Assessment, Recommendation communication tool (n = 5); crisis resource management principles (n = 6); and high-fidelity simulation (n = 4) were the most common curriculum bases used. Over half of the studies (n = 9) performed training with students from more than one health professions program. All but three used team performance assessments, with most (n = 8) using observed behavior checklists created for that specific study. The majority of studies (n = 16) found improvements in team knowledge, communication, and skills. Team training appears effective in improving team knowledge, communication, and skills in prelicensure learners. Continued exploration of the best method of team training is necessary to determine the most effective way to move forward in prelicensure interprofessional team education.

Psychological responses, coping and supporting needs of healthcare professionals as second victims.

PubMed

Chan, S T; Khong, P C B; Wang, W

2017-06-01

To provide an overview of healthcare professionals' psychological responses, coping strategies and supporting needs in the aftermath of an adverse event, thus informing health policy implications and future research in this aspect. Trauma experienced by healthcare professionals as second victims potentially provokes intense emotional distress, detrimental professional outcomes and imposes harsh long-term effects. A systematic literature review was performed to synthesize the experiences and needs of second victims who are healthcare professionals being traumatized by an unanticipated adverse event, medical error or patient-related injury. CINAHL, Embase, PsycINFO, PubMed and Scopus databases were searched for relevant articles published in English from January 2000 to October 2015. Data extraction was performed for the 30 studies selected. Second victims experienced enduring intense negative psychological responses. They adopted multiple coping mechanisms and desired emotional and informational support. Second victims experience substantial psychological impact which can be mitigated with supportive environments. It is imperative that subsequent research consider the potential factors affecting second victims' emotional experience, efficacy of coping strategies in facilitating recovery and obtain a comprehensive understanding of second victims' experience. Nursing and health management's role in establishing organizational support structures is necessary to meet second victims' needs. This existing knowledge is significant to guide policy makers in developing a holistic and effective second victim support programme. © 2016 International Council of Nurses.

Return to work following spinal cord injury: a review.

PubMed

Lidal, Ingeborg Beate; Huynh, Tuan Khai; Biering-Sørensen, Fin

2007-09-15

To review literature on return to work (RTW) and employment in persons with spinal cord injury (SCI), and present employment rates, factors influencing employment, and interventions aimed at helping people with SCI to obtain and sustain productive work. A systematic review for 2000 - 2006 was carried out in PubMed/Medline, AMED, (ISI) Web of Science, EMBASE, CINAHL, PsycInfo and Sociological abstracts database. The keywords 'spinal cord injuries', 'spinal cord disorder', 'spinal cord lesion' or 'spinal cord disease' were cross-indexed with 'employment', 'return to work', 'occupation' or 'vocational'. Out of approximately 270 hits, 110 references were used, plus 13 more found elsewhere. Among individuals with SCI working at the time of injury 21 - 67% returned to work after injury. RTW was higher in persons injured at a younger age, had less severe injuries and higher functional independence. Employment rate improved with time after SCI. Persons with SCI employed ranged from 11.5% to 74%. Individuals who sustained SCI during childhood or adolescence had higher adult employment rates. Most common reported barriers to employment were problems with transportation, health and physical limitations, lack of work experience, education or training, physical or architectural barriers, discrimination by employers, and loss of benefits. Individuals with SCI discontinue working at younger age. This review confirmed low employment rates after SCI. Future research should explore interventions aimed at helping people with SCI to obtain and sustain productive work.

Phytochemicals to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

PubMed

Teo, Lynn; Crawford, Cindy; Snow, James; Deuster, Patricia A; Bingham, John J; Gallon, Matthew D; O'Connell, Meghan L; Chittum, Holly K; Arzola, Sonya M; Berry, Kevin

2017-06-01

Optimizing cognitive performance and preventing cognitive impairments that result from exposure to high-stress situations are important to ensure mission-readiness for military personnel. This systematic review assesses the quality of the evidence for plant-based foods and beverages, or their phytochemical constituents, across various outcomes related to cognitive function in healthy adult populations to develop research recommendations for the military. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language were eligible. Twenty-five trials were included and assessed for methodological quality, and descriptive data were extracted. The acceptable (n = 16) to high-quality (n = 4) studies produced either no statistically significant effect or mixed results for enhancing cognitive function. The evidence suggested that healthy populations do not experience significant changes in cognitive performance when consuming soy- and non-soy-sourced isoflavones or cocoa. Heterogeneity among other interventions precluded reaching formal conclusions surrounding the evidence. Research recommendations are offered, including conducting more studies on the effect of plant-based interventions on populations reflective of military populations when exposed to military-like situations. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Omega-3 polyunsaturated fatty acids to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

PubMed

Teo, Lynn; Crawford, Cindy; Yehuda, Rachel; Jaghab, Danny; Bingham, John J; Chittum, Holly K; Gallon, Matthew D; O'Connell, Meghan L; Arzola, Sonya M; Berry, Kevin

2017-06-01

There has been interest in identifying whether nutrients might help optimize cognitive performance, especially for the military tasked with ensuring mission-readiness. This systematic review assesses the quality of the evidence for n-3 polyunsaturated fatty acids (PUFAs) across various outcomes related to cognitive function in healthy adult populations in order to develop research recommendations concerning n-3 PUFAs for mission-readiness. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language were eligible. Thirteen included trials were assessed for methodological quality, and descriptive data were extracted. Of the acceptable-quality (n = 8) and high-quality (n = 1) studies, 2 produced no statistically significant results, 5 produced mixed results, and 2 did not report between-group results. Results indicate that ingestion of n-3 PUFAs does not significantly alter cognitive performance in cognitively healthy persons. Studies exposing subjects to adverse circumstances that would be most relevant for drawing conclusions specifically for the military population are lacking. Several research recommendations are offered to enhance understanding of the role of fatty acids on cognitive functioning. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Childhood socioeconomic position and adult leisure-time physical activity: a systematic review.

PubMed

Elhakeem, Ahmed; Cooper, Rachel; Bann, David; Hardy, Rebecca

2015-07-03

Regular leisure-time physical activity (LTPA) benefits health and is thought to be less prevalent in lower socioeconomic groups. Evidence suggests that childhood socioeconomic circumstances can impact on adult health and behaviour however, it is unclear if this includes an influence on adult LTPA. This review tested the hypothesis that a lower childhood socioeconomic position (SEP) is associated with less frequent LTPA during adulthood. Studies were located through a systematic search of MEDLINE, Embase, PsycINFO, CINAHL and SPORTDiscus and by searching reference lists. Eligible studies were English-language publications testing the association between any indicator of childhood SEP and an LTPA outcome measured during adulthood. Forty-five papers from 36 studies, most of which were European, were included. In most samples, childhood SEP and LTPA were self-reported in midlife. Twenty-two studies found evidence to support the review's hypothesis and thirteen studies found no association. Accounting for own adult SEP partly attenuated associations. There was more evidence of an association in British compared with Scandinavian cohorts and in women compared with men. Results did not vary by childhood SEP indicator or age at assessment of LTPA. This review found evidence of an association between less advantaged childhood SEP and less frequent LTPA during adulthood. Understanding how associations vary by gender and place could provide insights into underlying pathways.

The meaning of leisure for children and young people with physical disabilities: a systematic evidence synthesis.

PubMed

Powrie, Benita; Kolehmainen, Niina; Turpin, Merrill; Ziviani, Jenny; Copley, Jodie

2015-11-01

Participation in leisure has known health benefits. Children and young people (CYP) with physical disabilities demonstrate reduced participation in leisure. To facilitate their meaningful participation, one must understand what leisure means to CYP. The aim of this study was to systematically synthesize evidence from qualitative studies on the meaning of leisure for CYP with physical disabilities. CINAHL, MEDLINE, AMED, EMBASE, PsycINFO, and ERIC were searched periodically from January 2012 until May 2013. Qualitative studies reporting the views of CYP (0-18y) with physical disabilities on leisure participation were included. The analysis involved thematic syntheses, double coding, and established quality appraisal procedures. Twelve studies met inclusion criteria, addressing the leisure experiences of 146 CYP with disabilities. Four themes core to the meaning of leisure for these CYP were (1) 'fun': the enjoyment and pleasure experienced from leisure; (2) 'freedom' of choice and from constraints; (3) 'fulfilment': discovering, developing, and displaying potential; and (4) 'friendship': social connectedness and belonging. The identified themes resonate with the psychological needs outlined by self-determination theory: fun relates to satisfaction and intrinsic motivation; freedom relates to 'autonomy'; fulfilment relates to a belief in 'competence'; and friendship resonates with 'relatedness'. Social context had an impact on all of these themes, indicating that this is an important target for leisure participation interventions. © 2015 Mac Keith Press.

Breastfeeding Duration and the Theory of Planned Behavior and Breastfeeding Self-Efficacy Framework: A Systematic Review of Observational Studies.

PubMed

Lau, Christine Y K; Lok, Kris Y W; Tarrant, Marie

2018-03-01

Introduction Numerous studies have shown that the constructs of the Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB) and Breastfeeding Self-Efficacy (BSE) Framework can effectively identify relationships between maternal psychosocial factors and breastfeeding initiation. However, the ability of these theories to predict breastfeeding duration has not been adequately analyzed. The aim of the review was to examine the utility of the constructs of TRA/TPB and BSE to predict breastfeeding duration. Methods We conducted a literature search using Pubmed (1980-May 2015), Medline (1966-May 2015), CINAHL (1980-May 2015), EMBASE (1980-May 2015) and PsycINFO (1980-May 2015). We selected studies that were observational studies without randomization or blinding, using TRA, TPB or BSE as the framework for analysis. Only studies reporting on breastfeeding duration were included. Results Thirty studies were selected, which include four using TRA, 10 using TPB, 15 using BSE and one using a combination of TPB and BSE. Maternal intention and breastfeeding self-efficacy were found to be important predictors of breastfeeding duration. Inconsistent findings were found in assessing the relationship between maternal attitudes, subjective norms, perceived behavior control and breastfeeding duration. Discussion The inadequacy of these constructs in explaining breastfeeding duration indicates a need to further explore the role of maternal self-determination in breastfeeding behavior.

The role of smartphones in encouraging physical activity in adults

PubMed Central

Stuckey, Melanie I; Carter, Shawn W; Knight, Emily

2017-01-01

Lack of physical activity is a global public health issue. Behavioral change interventions utilizing smartphone applications (apps) are considered a potential solution. The purpose of this literature review was to: 1) determine whether smartphone-based interventions encourage the initiation of, and participation in, physical activity; 2) explore the success of interventions in different populations; and 3) examine the key factors of the interventions that successfully encouraged physical activity. Eight databases (Medline, Scopus, EBM Reviews–Cochrane Central Register of Controlled Trials, EBM Reviews–Cochrane Database of Systematic Reviews, PsycInfo, SportDISCUS, CINAHL, and EMBASE) were searched and studies reporting physical activity outcomes following interventions using smartphone apps in adults were included in the narrative review. Results were mixed with eight studies reporting increased physical activity and ten reporting no change. Interventions did not appear to be successful in specific populations defined by age, sex, country, or clinical diagnosis. There was no conclusive evidence that a specific behavioral theory or behavioral change technique was superior in eliciting behavioral change. The literature remains limited primarily to short-term studies, many of which are underpowered feasibility or pilot studies; therefore, many knowledge gaps regarding the effectiveness of smartphone apps in encouraging physical activity remain. Robust studies that can accommodate the fast pace of the technology industry are needed to examine outcomes in large populations. PMID:28979157

Endocrinology and Adolescence: aerobic exercise reduces insulin resistance markers in obese youth: a meta-analysis of randomized controlled trials.

PubMed

García-Hermoso, Antonio; Saavedra, Jose M; Escalante, Yolanda; Sánchez-López, Mairena; Martínez-Vizcaíno, Vicente

2014-10-01

The purpose of this meta-analysis was to examine the evidence for the effectiveness of aerobic exercise interventions on reducing insulin resistance markers in obese children and/or adolescents. A secondary outcome was change in percentage of body fat. A computerized search was made from seven databases: CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, ERIC, MEDLINE, PsycINFO, and Science Citation Index. The analysis was restricted to randomized controlled trials that examined the effect of aerobic exercise on insulin resistance markers in obese youth. Two independent reviewers screened studies and extracted data. Effect sizes (ES) and 95% confidence interval (CI) were calculated, and the heterogeneity of the studies was estimated using Cochran's Q-statistic. Nine studies were selected for meta-analysis as they fulfilled the inclusion criteria (n=367). Aerobic exercise interventions resulted in decreases in fasting glucose (ES=-0.39; low heterogeneity) and insulin (ES=-0.40; low heterogeneity) and in percentage of body fat (ES=-0.35; low heterogeneity). These improvements were specifically accentuated in adolescents (only in fasting insulin), or through programs lasting more than 12 weeks, three sessions per week, and over 60 min of aerobic exercise per session. This meta-analysis provides insights into the effectiveness of aerobic exercise interventions on insulin resistance markers in the obese youth population. © 2014 European Society of Endocrinology.

The Impact of Relationship Quality on Health-Related Outcomes in Heart Failure Patients and Informal Family Caregivers: An Integrative Review.

PubMed

Hooker, Stephanie A; Grigsby, Megan E; Riegel, Barbara; Bekelman, David B

2015-01-01

Relationships can have positive and negative impacts on health and well-being. Dyadic relationships between heart failure (HF) patients and their informal family caregivers may affect both patient and caregiver outcomes. The aim of this study is to synthesize the literature to date on the associations between HF patient-caregiver relationship quality and communication and patient and caregiver health outcomes. An integrative review of the literature was conducted. Computerized literature searches in Medline, PsycInfo, CINAHL, Web of Science, and EMBASE yielded 13 articles of HF patients and caregivers. Included articles were reviewed and double-coded by 2 independent coders. Included articles measured relationship quality or aspects of communication within an HF patient-caregiver dyad and used both cross-sectional and longitudinal designs. Results of the longest prospective study suggested that better relationship quality between HF patients and their informal family caregivers was related to a reduced risk for mortality in patients. Results of 11 of the 12 other studies were consistent to the reference study, suggesting that better relationship quality and communication were related to reduced mortality, increased health status, less distress, and lower caregiver burden. Relationship quality and communication seem to matter in the health and well-being of both HF patients and their informal family caregivers. More research is needed to elucidate mechanisms and to design effective relationship-focused interventions.

Racial Discrimination and Adverse Birth Outcomes: An Integrative Review.

PubMed

Alhusen, Jeanne L; Bower, Kelly M; Epstein, Elizabeth; Sharps, Phyllis

2016-11-01

This article presents an integrative review of the literature examining the relationship between racial discrimination and adverse birth outcomes. Searches for research studies published from 2009 to 2015 were conducted using PubMed, CINAHL, Scopus, PsycINFO, Web of Science, and Embase. Articles were assessed for potential inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2009 framework. Fifteen studies met criteria for review. The majority of the studies found a significant relationship between racial discrimination and low birth weight, preterm birth, and small for gestational age. Each of the studies that examined more proximal variables related to birth outcomes such as entry into prenatal care, employment opportunities, neighborhood characteristics, or inflammatory markers found significant associations between the specific variables examined and racial discrimination. Participants in qualitative studies discussed experiences of institutional racism with regard to several components of prenatal care including access and quality of care. Racial discrimination is a significant risk factor for adverse birth outcomes. To best understand the mechanisms by which racial discrimination impacts birth outcomes, and to inform the development of effective interventions that eliminate its harmful effects on health, longitudinal research that incorporates comprehensive measures of racial discrimination is needed. Health care providers must fully acknowledge and address the psychosocial factors that impact health outcomes in minority racial/ethnic women. © 2016 by the American College of Nurse-Midwives.

Domestic violence and mental health in older adults.

PubMed

Knight, Lucy; Hester, Marianne

2016-10-01

Domestic violence affects every age group and is present throughout the life span, but, while the mental health impact of domestic violence is clearly established in working age adults, less is known about the nature and impact of domestic violence among older adults. This review, therefore, aimed to synthesize findings on the prevalence, nature, and impact of domestic violence among older adults, and its identification and management. Electronic searches were conducted of Medline, PsycINFO, Cinahl, and Embase to identify studies reporting on the mental health and domestic violence in older adults. Findings suggested that, although prevalence figures are variable, the likely lifetime prevalence for women over the age of 65 is between 20-30%. Physical abuse is suggested to decrease with age, but rates of emotional abuse appear to be stable over the lifespan. Among older adults, domestic violence is strongly associated with physical and mental health problems, and the scarce research comparing the impact of domestic violence across the age cohorts suggests that the physical health of older victims may be more severely affected than younger victims. In contrast, there is evidence that older victims may experience less psychological distress in response to domestic violence than younger victims. Internationally, evidence on the management of domestic violence in older adults is sparse. Findings suggest, however, that identification of domestic violence is poor among older adults, and there are very limited options for onwards referral and support.

[Interventions for promoting physical activity in nursing homes : Systematic review of the effectiveness of universal prevention].

PubMed

Wöhl, C; Siebert, H; Blättner, B

2017-08-01

Among residents of nursing homes, physical activity might be beneficial in maintaining health-related quality of life because impairment is caused in particular by functional decline. The aim is the evaluation of the effectiveness of universal preventive interventions directed at increasing physical activity on activities of daily living in nursing home residents. Relevant studies were identified through database searching in MEDLINE, the Cochrane library, EMBASE, CINAHL, PsycINFO and PEDro. Two review authors independently selected articles, assessed the risk of bias and extracted data. Results were combined in random effects meta-analyses. By including 14 primary studies, nursing home residents participating in physical activities showed a statistically significant greater physical functioning compared to controls (standardized mean difference [SMD] = 0.48, 95% confidence interval [95% CI] 0.26-0.71, p < 0.0001). Subgroup analyses suggest that especially nursing home residents with severe physical and cognitive impairment might benefit from participation in physical activities. Results after non-training periods substantiate the necessity of a sustained implementation. Due to the high risk of bias in included studies, the results must be interpreted with caution. Physical activity for nursing home residents can be effective. Considering the low-quality evidence, performance of high-quality studies is essential in order to verify the statistical results.

Physical health care monitoring for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-01-17

Current guidance suggests that we should monitor the physical health of people with serious mental illness, and there has been a significant financial investment over recent years to provide this. To assess the effectiveness of physical health monitoring, compared with standard care for people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (October 2009, update in October 2012), which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised clinical trials focusing on physical health monitoring versus standard care, or comparing i) self monitoring versus monitoring by a healthcare professional; ii) simple versus complex monitoring; iii) specific versus non-specific checks; iv) once only versus regular checks; or v) different guidance materials. Initially, review authors (GT, AC, SM) independently screened the search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. Forty-two additional citations were identified in October 2012 and screened by two review authors (JX and MW), 11 of which underwent full screening. No relevant randomised trials which assess the effectiveness of physical health monitoring in people with serious mental illness have been completed. We identified one ongoing study. There is still no evidence from randomised trials to support or refute current guidance and practice. Guidance and practice are based on expert consensus, clinical experience and good intentions rather than high quality evidence.

Impact of lower urinary tract symptoms on work productivity in female workers: A systematic review and meta-analysis.

PubMed

Lin, Kuan-Yin; Siu, Ka-Chun; Lin, Kuan-Han

2018-06-28

The aim of this systematic review and meta-analysis was to determine the impact of lower urinary tract symptoms (LUTS) on work productivity in female workers. A comprehensive literature search was conducted using eight electronic databases (MEDLINE, PEDro, CINAHL, Cochrane library, EMBASE, PubMed, Scopus, and PsycINFO) to identify articles published before July 2017 that studied the work productivity in female workers with LUTS. Two reviewers independently assessed the quality of studies using the Joanna Briggs Institute. Meta-analyses were performed on studies having measured work productivity between females with and without LUTS, and odds ratios (ORs) or the mean differences were used. Fourteen articles (n = 48 223 females) were included in the review, and meta-analyses were performed with six of those articles. Lower urinary tract symptoms were significantly associated with work productivity loss (OR = 1.11, 95%CI = 1.06-1.15), presenteeism (OR = 1.10, 95%CI = 1.05-1.14), and activity impairment (OR = 1.11, 95%CI = 1.09-1.14). However, there was no significant difference in the probability of absenteeism between females with and without LUTS (OR = 1.03, 95%CI = 0.94-1.13). Evidence suggests that female workers with LUTS had significantly greater work productivity impairment compared to those without LUTS. © 2018 Wiley Periodicals, Inc.

Air Pressure, Humidity and Stroke Occurrence: A Systematic Review and Meta-Analysis.

PubMed

Cao, Yongjun; Wang, Xia; Zheng, Danni; Robinson, Thompson; Hong, Daqing; Richtering, Sarah; Leong, Tzen Hugh; Salam, Abdul; Anderson, Craig; Hackett, Maree L

2016-07-05

An influence of climate upon stroke risk is biologically plausible and supported by epidemiological evidence. We aimed to determine whether air pressure (AP) and humidity are associated with hospital stroke admission. We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 16 October 2015 to identify relevant population-based observational studies. Where possible, data were pooled for meta-analysis with odds ratios (OR) and corresponding 95% confidence intervals (CI) by means of the random-effect method. We included 11 studies with a total of 314,385 patients. The effect of AP was varied across studies for ischemic stroke (IS) and subarachnoid haemorrhage (SAH). Pooled ORs (95%CI) associated with 1 hPa increase in AP for the risk of IS, intracerebral hemorrhage (ICH) and SAH were 1.00 (0.99-1.01), 1.01 (0.99-1.02) and 1.02 (0.97-1.07) respectively. The pooled ORs (95%CI) associated with 1 percent increase in humidity for the risk of IS and ICH were 1.00 (1.00-1.01) and 1.00 (0.99-1.01) respectively. This review shows that there is no evidence of a relationship between AP or humidity and the occurrence of hospital admission for stroke. Further research is needed to clarify the extent and nature of any relationship between AP, humidity and stroke in different geographical areas.

[Psychosocial interventions in inpatient care : Systematic review of the effectiveness of universal and selective prevention on mental health].

PubMed

Richter, S; Glöckner, J M; Blättner, B

2017-04-27

There are no sufficient findings from synthesized evidence for the effectiveness of psychosocial interventions to improve mental health in inpatient care. A systematic literature search in the databases of MEDLINE, The Cochrane Library, EMBASE, CINAHL, and PsycINFO was carried out, as well as a manual search in Google Scholar and reference lists. Studies which focused on physical or individual activities or therapy or other groups and settings were excluded. The heterogeneity of the studies did not allow meta-analysis. Seven primary studies were included, whose interventions were assigned to the intervention types activation of memories, leisure activities, and social participation. Overall, the quality of studies was rather low. Compared to usual care or the alternative interventions of memory therapy or leisure activities, the positive effects on depressive symptoms, as well as externally assessed and self-reported quality of life or life satisfaction, were not significant. The absence of these measures lead to deterioration of depressive symptoms among residents with dementia. In contrast to memory activation, common leisure activities led to an improvement in wellbeing. One intervention for social participation increased wellbeing and reduced the occurrence of depressive symptoms. There is a considerable need for conceptual-theoretical work and research on the effectiveness of psychosocial interventions, particularly for raising participation among persons in inpatient care facilities.

Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature.

PubMed

Kalamar, Amanda M; Lee-Rife, Susan; Hindin, Michelle J

2016-09-01

Child marriage, defined as marriage before the age of 18 years, is a human rights violation that can have lasting adverse educational and economic impacts. The objective of this review was to identify high-quality interventions and evaluations to decease child marriage in low- and middle-income countries. PubMed, Embase, PsycInfo, CINAHL Plus, Popline, and the Cochrane Databases were searched without language limitations for articles published through November 2015. Gray literature was searched by hand. Reference tracing was used, as well as the unpacking of systematic reviews. Retained articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Eleven high-quality interventions and evaluations were abstracted. Six found positive results in decreasing the proportion married or increasing age at marriage, one had both positive and negative findings, and four had no statistical impact on the proportion married or age at marriage. There is wide range of high-quality, impactful interventions included in this review which can inform researchers, donors, and policy makers about where to make strategic investments to eradicate marriage, a current target of the Sustainable Development Goals. Despite the cultural factors that promote child marriage, the diversity of interventions can allow decision makers to tailor interventions to the cultural context of the target population. Copyright © 2016. Published by Elsevier Inc.

Correlates of weight stigma in adults with overweight and obesity: A systematic literature review.

PubMed

Papadopoulos, Stephanie; Brennan, Leah

2015-09-01

While evidence regarding associations between weight stigma and biopsychosocial outcomes is accumulating, outcomes are considered in isolation. Thus, little is known about their complex relationships. This article extends existing work by systematically reviewing the biopsychosocial consequences of stigma in adults with overweight/obesity. Articles were identified through Medline, CINAHL, PsycINFO, Embase, Web of Science, and Cochrane databases. Independent extraction of articles was conducted using predefined data fields, including data on biopsychosocial correlates in each study. Twenty-three studies published from 2001 and addressing correlates of stigma in adults with overweight/obesity (body mass index ≥25 kg m(-2); 18-65 years) were identified. Numerous biopsychosocial correlates of weight stigma were studied, particularly in treatment-seeking individuals. Available research shows that weight stigma is consistently associated with medication non-adherence, mental health, anxiety, perceived stress, antisocial behavior, substance use, coping strategies, and social support. Biopsychosocial correlates were not considered in combination in research. Psychological correlates were well documented in comparison to biological and social correlates for each weight stigma type. There were some indications that associations are stronger once stigma is internalized. While there is evidence for biopsychosocial correlates of weight stigma, these are not considered in combination in research; thus their inter-relationships are unknown. Conclusions from the review are limited by this and the small number of studies, types of designs, and variables considered. © 2015 The Obesity Society.

Diabetes-related emotional distress instruments: a systematic review of measurement properties.

PubMed

Lee, Jiyeon; Lee, Eun-Hyun; Kim, Chun-Ja; Moon, Seung Hei

2015-12-01

The objectives of this study were to identify all available diabetes-related emotional distress instruments and evaluate the evidence regarding their measurement properties to help in the selection of the most appropriate instrument for use in practice and research. A systematic literature search was performed. PubMed, Embase, CINAHL, and PsycINFO were searched systematically for articles on diabetes-related emotional distress instruments. The Consensus-based Standards for the Selection of Health Measurement Instruments checklist was used to evaluate the methodological quality of the identified studies. The quality of results with respect to the measurement properties of each study was evaluated using Terwee's quality criteria. An ancillary meta-analysis was performed. Of the 2345 articles yielded by the search, 19 full-text articles evaluating 6 diabetes-related emotional distress instruments were included in this study. No instrument demonstrated evidence for all measurement properties. The Problem Areas in Diabetes scale (PAID) was the most frequently studied and the best validated of the instruments. Pooled summary estimates of the correlation coefficient between the PAID and serum glycated hemoglobin revealed a positive but weak correlation. No diabetes-related emotional distress instrument demonstrated evidence for all measurement properties. No instrument was better than another, although the PAID was the best validated and is thus recommended for use. Further psychometric studies of the diabetes-related emotional distress instruments with rigorous methodologies are required. Copyright © 2015 Elsevier Ltd. All rights reserved.

Systematic review found AMSTAR, but not R(evised)-AMSTAR, to have good measurement properties.

PubMed

Pieper, Dawid; Buechter, Roland Brian; Li, Lun; Prediger, Barbara; Eikermann, Michaela

2015-05-01

To summarize all available evidence on measurement properties in terms of reliability, validity, and feasibility of the Assessment of Multiple Systematic Reviews (AMSTAR) tool, including R(evised)-AMSTAR. MEDLINE, EMBASE, Psycinfo, and CINAHL were searched for studies containing information on measurement properties of the tools in October 2013. We extracted data on study characteristics and measurement properties. These data were analyzed following measurement criteria. We included 13 studies, four of them were labeled as validation studies. Nine articles dealt with AMSTAR, two articles dealt with R-AMSTAR, and one article dealt with both instruments. In terms of interrater reliability, most items showed a substantial agreement (>0.6). The median intraclass correlation coefficient (ICC) for the overall score of AMSTAR was 0.83 (range 0.60-0.98), indicating a high agreement. In terms of validity, ICCs were very high with all but one ICC lower than 0.8 when the AMSTAR score was compared with scores from other tools. Scoring AMSTAR takes between 10 and 20 minutes. AMSTAR seems to be reliable and valid. Further investigations for systematic reviews of other study designs than randomized controlled trials are needed. R-AMSTAR should be further investigated as evidence for its use is limited and its measurement properties have not been studied sufficiently. In general, test-retest reliability should be investigated in future studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Validity of instruments to measure physical activity may be questionable due to a lack of conceptual frameworks: a systematic review

PubMed Central

2011-01-01

Background Guidance documents for the development and validation of patient-reported outcomes (PROs) advise the use of conceptual frameworks, which outline the structure of the concept that a PRO aims to measure. It is unknown whether currently available PROs are based on conceptual frameworks. This study, which was limited to a specific case, had the following aims: (i) to identify conceptual frameworks of physical activity in chronic respiratory patients or similar populations (chronic heart disease patients or the elderly) and (ii) to assess whether the development and validation of PROs to measure physical activity in these populations were based on a conceptual framework of physical activity. Methods Two systematic reviews were conducted through searches of the Medline, Embase, PsycINFO, and Cinahl databases prior to January 2010. Results In the first review, only 2 out of 581 references pertaining to physical activity in the defined populations provided a conceptual framework of physical activity in COPD patients. In the second review, out of 103 studies developing PROs to measure physical activity or related constructs, none were based on a conceptual framework of physical activity. Conclusions These findings raise concerns about how the large body of evidence from studies that use physical activity PRO instruments should be evaluated by health care providers, guideline developers, and regulatory agencies. PMID:21967887

Do research studies in the UK reporting child neurodevelopment adjust for the variability of assessors: a systematic review.

PubMed

Khalid, Rahila; Willatts, Peter; Williams, Fiona L R

2016-02-01

Neurodevelopment is a key outcome for many childhood trials and observational studies. Clinically important decisions may rest on finding relatively small differences in neurodevelopment between groups receiving complex and costly interventions. Our purpose was to determine whether studies which measure neurodevelopment report the numbers, training, and auditing of assessors and, for multiple assessor studies, whether the results were adjusted and if so by which method? Electronic searches were conducted using Medline, Embase, Cinahl, PsycINFO, and the Cochrane Library. A study was eligible if it reported neurodevelopmental outcome in children resident in the UK, less than or equal to 18 years and was published between 2000 and 2015. Trials and observational studies were included. Three hundred and seven full papers were reviewed: 52% of papers did not report the number of assessors used; 21% used a single assessor; and 27% used multiple assessors. Thirty-five per cent mentioned that assessors were trained in the use of the neurodevelopmental tool; 13% of assessors were audited; and only 1% of studies adjusted statistically for the number of assessors. At the very least, the quality of reporting the use of assessors in these research publications is poor, while at worst, the variability of assessors may mask the true relationship between an intervention/observation and neurodevelopmental outcome. © 2015 Mac Keith Press.

A Systematic Review of Interventions to Enhance Healthy Lifestyle Behaviors in Adolescents Delivered via Mobile Phone Text Messaging.

PubMed

Loescher, Lois J; Rains, Stephen A; Kramer, Sandra S; Akers, Chelsie; Moussa, Renee

2018-05-01

To systematically review healthy lifestyle interventions targeted to adolescents and delivered using text messaging (TM). PubMed, Embase, CINAHL, PsycINFO, and Web of Science databases. Study Inclusion Criteria: Research articles published during 2011 to 2014; analyses focused on intervention targeting adolescents (10-19 years), with healthy lifestyle behaviors as main variables, delivered via mobile phone-based TM. The authors extracted data from 27 of 281 articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Adolescent and setting characteristics, study design and rigor, intervention effectiveness, challenges, and risk of bias. Across studies, 16 (59.3%) of 27 included non-Caucasians. The gender was split for 22 (81.5%) of 27 studies. Thirteen studies were randomized controlled trials. There was heterogeneity among targeted conditions, rigor of methods, and intervention effects. Interventions for monitoring/adherence (n = 8) reported more positive results than those for health behavior change (n = 19). Studies that only included message delivered via TM (n = 14) reported more positive effects than studies integrating multiple intervention components. Interventions delivered using TM presented minimal challenges, but selection and performance bias were observed across studies. Interventions delivered using TM have the potential, under certain conditions, to improve healthy lifestyle behaviors in adolescents. However, the rigor of studies varies, and established theory and validated measures have been inconsistently incorporated.

Which learning activities enhance physiotherapy practice? A systematic review protocol of quantitative and qualitative studies.

PubMed

Leahy, Edmund; Chipchase, Lucy; Blackstock, Felicity

2017-04-17

Learning activities are fundamental for the development of expertise in physiotherapy practice. Continuing professional development (CPD) encompasses formal and informal learning activities undertaken by physiotherapists. Identifying the most efficient and effective learning activities is essential to enable the profession to assimilate research findings and improve clinical skills to ensure the most efficacious care for clients. To date, systematic reviews on the effectiveness of CPD provide limited guidance on the most efficacious models of professional development for physiotherapists. The aim of this systematic review is to evaluate which learning activities enhance physiotherapy practice. A search of Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO (Psychological Abstracts), PEDro, Cochrane Library, AMED and Educational Resources and Information Center (ERIC) will be completed. Citation searching and reference list searching will be undertaken to locate additional studies. Quantitative and qualitative studies will be included if they examine the impact of learning activities on clinician's behaviour, attitude, knowledge, beliefs, skills, self-efficacy, work satisfaction and patient outcomes. Risk of bias will be assessed by two independent researchers. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Confidence in the Evidence from Reviews of Qualitative research (CERQual) will be used to synthesise results where a meta-analysis is possible. Where a meta-analysis is not possible, a narrative synthesis will be conducted. PROSPERO CRD42016050157.

Prenatal stress and hemodynamics in pregnancy: a systematic review.

PubMed

Levine, Terri A; Alderdice, Fiona A; Grunau, Ruth E; McAuliffe, Fionnuala M

2016-10-01

Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-accepted quality appraisal guidelines. Of 2532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery resistance (RI) and pulsatility (PI) indices, umbilical artery RI, PI, and systolic/diastolic ratio, fetal middle cerebral artery PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.

Utilization of maternal health services among adolescent women in Bangladesh: A scoping review of the literature.

PubMed

Shahabuddin, A S M; Delvaux, Thérèse; Abouchadi, Saloua; Sarker, Malabika; De Brouwere, Vincent

2015-07-01

To understand the health-seeking behaviour of adolescent women in Bangladesh with respect to the use of maternal health services. Literature review of seven electronic databases: PubMed, ISI Web of Knowledge, PsycINFO, Embase, CINAHL, POPLINE and Global Health. Studies published in English between 1990 and 2013 which describe Bangladeshi adolescent women's healthcare-seeking behaviour during pregnancy, delivery and post-partum were included. Twelve studies were included in this review. 11 used quantitative methods and one used a mixed-methods approach. All studies included married adolescent women only. Women with lower educational levels are less likely to seek skilled maternal health services than those with higher levels of education. Use of maternal health services is also less common among rural married adolescent women than women in urban areas. Being part of the richest bands of wealth, having had previous experiences of childbirth and higher women's autonomy positively influence the use of skilled maternal health services among married adolescent women in Bangladesh. Antenatal care is a key predictor of the use of skilled birth attendants for delivery and post-natal care. Maternal health-related programmes should be designed targeting rural and uneducated married adolescent women in Bangladesh. More qualitative investigations are required to broaden our understanding on maternal health-seeking behaviour of both married and unmarried adolescent women. © 2015 John Wiley & Sons Ltd.

Exploring resilience in nursing and midwifery students: a literature review.

PubMed

McGowan, Jennifer E; Murray, Karen

2016-10-01

The aim of this study was to explore the concepts of 'resilience' and 'hardiness' in nursing and midwifery students in educational settings and to identify educational interventions to promote resilience. Resilience in healthcare professionals has gained increasing attention globally, yet to date resilience and resilience education in nursing and midwifery students remain largely under-researched. An integrative literature review was planned, however, only quantitative evidence was identified therefore, a review of quantitative studies was undertaken using a systematic approach. A comprehensive search was undertaken using Medline, CINAHL, Embase, PsycINFO and Maternity and Infant Care databases January 1980-February 2015. Data were extracted using a specifically designed form and quality assessed using an appropriate checklist. A narrative summary of findings and statistical outcomes was undertaken. Eight quantitative studies were included. Research relating to resilience and resilience education in nursing and midwifery students is sparse. There is a weak evidence that resilience and hardiness is associated with slightly improved academic performance and decreased burnout. However, studies were heterogeneous in design and limited by poor methodological quality. No study specifically considered student midwives. A greater understanding of the theoretical underpinnings of resilience in nursing and midwifery students is essential for the development of educational resources. It is imperative that future research considers both nursing and midwifery training cohorts and should be of strong methodological quality. © 2016 John Wiley & Sons Ltd.

Patient's perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: a narrative review

PubMed Central

Clarke, Amy L.; Yates, Thomas; Smith, Alice C.; Chilcot, Joseph

2016-01-01

Patients with chronic kidney disease (CKD) form organized beliefs regarding their illness and treatment. These perceptions influence the coping strategies employed by an individual to manage his/her illness and may act as a predictor for his/her willingness to engage in self-management behaviours. While illness perceptions have been identified as predictors of non-adherence, depression and mortality in dialysis patients, there is a paucity of research in CKD patients not requiring renal replacement therapy. This narrative review synthesizes the existing literature regarding the role of illness perceptions and associated clinical and psychosocial outcomes in non-dialysis CKD patients. Studies were identified following database searches of AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsycINFO and Google Scholar in January 2016. Despite the small evidence base, existing studies indicate that negative illness perceptions are associated with disease progression and a number of psychosocial outcomes in non-dialysis CKD patients. Evidence from other clinical populations suggests that illness perceptions are modifiable through psychological intervention, which may be most effective if delivered early before beliefs have the chance to become more established. Therefore, targeting illness perceptions in the earlier stages of CKD may be optimal. Further studies are now required to ascertain the mechanisms through which illness perceptions predict psychosocial and clinical outcomes in CKD patients and to ultimately test the efficacy of illness perception–based interventions. PMID:27274839

Health Literacy and Heart Failure

PubMed Central

Cajita, Maan Isabella; Cajita, Tara Rafaela; Han, Hae-Ra

2015-01-01

Background Low health literacy affects millions of Americans, putting those who are affected at a disadvantage and at risk for poorer health outcomes. Low health literacy can act as a barrier to effective disease self-management; this is especially true for chronic diseases such as heart failure (HF) that require complicated self-care regimens. Purpose This systematic review examined quantitative research literature published between 1999 and 2014 to explore the role of health literacy among HF patients. The specific aims of the systematic review are to (1) describe the prevalence of low health literacy among HF patients, (2) explore the predictors of low health literacy among HF patients, and (3) discuss the relationship between health literacy and HF self-care and common HF outcomes. Methods A systematic search of the following databases was conducted, PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus, using relevant keywords and clear inclusion and exclusion criteria. Conclusions An average of 39% of HF patients have low health literacy. Age, race/ethnicity, years of education, and cognitive function are predictors of health literacy. In addition, adequate health literacy is consistently correlated with higher HF knowledge and higher salt knowledge. Clinical Implications Considering the prevalence of low health literacy among in the HF population, nurses and healthcare professionals need to recognize the consequences of low health literacy and adopt strategies that could minimize its detrimental effect on the patient's health outcomes. PMID:25569150

Propionibacterium acnes infection after shoulder surgery

PubMed Central

Kadler, Benjamin K.; Mehta, Saurabh S.; Funk, Lennard

2015-01-01

Propionibacterium acnes has been implicated as a cause of infection following shoulder surgery, may occur up to 2 years after the index operation and has been shown to be responsible for up to 56% of shoulder infections after orthopedic implant. Male patients within the population undergoing shoulder surgery are particularly at risk, especially if their shoulder surgery involved prosthesis or was posttraumatic. P. acnes infection can be difficult to diagnose clinically and laboratory techniques require prolonged and specialized cultures. Usual inflammatory markers are not raised in infection with this low virulence organism. Delayed diagnosis with P. acnes infection can result in significant morbidity prior to prosthesis failure. Early diagnosis of P. acnes infection and appropriate treatment can improve clinical outcomes. It is important to be aware of P. acnes infection in shoulder surgery, to evaluate risk factors, to recognize the signs of P. acnes infection, and to promptly initiate treatment. The signs and symptoms of P. acnes infection are described and discussed. Data were collected from PubMed™, Web of Science, and the NICE Evidence Healthcare Databases - AMED (Ovid), BNI (Ovid), CINAHL (EBSCO), Embase (Ovid), HMIC: DH-Data and Kings Fund (Ovid), Medline (Ovid), and PsycINFO (Ovid). The search terms used were “P. acnes,” “infection,” “shoulder,” and “surgery.” In this review, we summarize the current understanding of the prevention and management of P. acnes infection following shoulder surgery. PMID:26622132

Resilience and the rehabilitation of adult spinal cord injury survivors: A qualitative systematic review.

PubMed

Kornhaber, Rachel; Mclean, Loyola; Betihavas, Vasiliki; Cleary, Michelle

2018-01-01

To synthesize the qualitative research evidence that explored how survivors of adult spinal cord injury experience and make sense of resilience. Spinal cord injury is often a sudden and unexpected life-changing event requiring complex and long-term rehabilitation. The development of resilience is essential in determining how spinal cord injury survivors negotiate this injury and rehabilitation. A qualitative systematic review and thematic synthesis of the research evidence. CINAHL, PubMed, Embase, Scopus and PsycINFO were searched, no restriction dates were used. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist. Thematic synthesis focused on how survivors of adult spinal cord injury experience and make sense of resilience. Six qualitative research articles reported the experiences of 84 spinal cord injury survivors. Themes identified were: uncertainty and regaining independence; prior experiences of resilience; adopting resilient thinking; and strengthening resilience through supports. Recovery and rehabilitation following spinal cord survivors is influenced by the individual's capacity for resilience. Resilience may be influenced by previous life experiences and enhanced by supportive nursing staff encouraging self-efficacy. Survivors identified the need for active involvement in decision-making about their care to enable a sense of regaining control of their lives. This has the potential to have a significant impact on their self-efficacy and in turn health outcomes. © 2017 John Wiley & Sons Ltd.

Colorectal cancer--applying a gender lens.

PubMed

Oberoi, Devesh V; Jiwa, Moyez; McManus, Alexandra; Hodder, Rupert

2014-01-01

Colorectal cancer (CRC) is a major global health problem with survival varying according to stage at diagnosis. The incidence of CRC is much higher in patients with lower bowel symptoms. The symptoms are non-specific and are commonly experienced in the general population. Biological and environmental factors account for the high incidence and poor prognosis of CRC in men. To review the behavioural factors influencing patient delay in seeking help for lower bowel symptoms using a gender lens. An extensive literature search was performed using various databases including Medline, PubMed, CINAHL Plus, EMBASE and PsycINFO (1993-2013). Various search terms including rectal bleeding, prevalence, colorectal cancer, consultation, help-seeking, gender differences and men were used. A systematic methodology including systematic data extraction and narrative synthesis was applied. Thirty-two studies were included in the review. All studies except four were quantitative. Although there is some evidence that men delay more compared with women, there has not been any major improvement in the help-seeking behaviour for such symptoms over the past two decades. Several behavioural and demographic factors were associated with low rates of help-seeking. There are limited studies focusing on men's help-seeking behaviour for lower bowel symptoms. To facilitate timely help-seeking in men, it is important to understand their patterns of helpseeking for such symptoms. Further research to understand men's help-seeking behaviour is warranted.

Guilt, shame and expressed emotion in carers of people with long-term mental health difficulties: A systematic review.

PubMed

Cherry, Mary Gemma; Taylor, Peter James; Brown, Stephen Lloyd; Rigby, Jake Wilfred; Sellwood, William

2017-03-01

Expressed emotion (EE) is a global index of familial emotional climate, whose primary components are emotional over-involvement (EOI) and critical comments (CC)/hostility. There is a strong theoretical rationale for hypothesising that carers' guilt and shame may be differentially associated with their EOI and CC/hostility respectively. This systematic review investigates the magnitude of these theorised associations in carers of people with long-term mental health difficulties. Electronic searches (conducted in May 2016 across Medline, CINAHL, Embase, PsycINFO and ProQuest) were supplemented with iterative hand searches. Ten papers, reporting data from eight studies, were included. Risk of bias was assessed using a standardised checklist. Relevant data were extracted and synthesised narratively. EOI was positively associated with both guilt and shame, whereas CC/hostility was positively associated with shame. The strength of associations varied depending on whether or not guilt and shame were assessed within the context of the caring relationship. Based on these data, an argument can be made for the refinement, development and evaluation of systemic and individual interventions designed to target carers' guilt and shame. However, more research is needed to clarify the strength of these associations and their direction of effect before firm conclusions can be drawn. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Muscle Strength and Fitness in Pediatric Obesity: a Systematic Review from the European Childhood Obesity Group

PubMed Central

Thivel, David; Ring-Dimitriou, Susanne; Weghuber, Daniel; Frelut, Marie-Laure; O'Malley, Grace

2016-01-01

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A systematic article search was conducted between November 2014 and June 2015 using MEDLINE, EMBASE, CINAHL psycINFO, SPORTDiscus and SocINDEX. Articles published in English and reporting results on muscle strength and muscular fitness in children and adolescents aged 6 to 18 years were eligible. Of 548 identified titles, 36 studies were included for analyses. While laboratory-based studies described higher absolute muscular fitness in youth with obesity compared with their lean peers, these differences are negated when corrected for body weight and lean mass, then supporting field-based investigations. All interventional studies reviewed led to improved muscular fitness in youth with obesity. Children and adolescents with obesity display impaired muscular fitness compared to healthy-weight peers, which seems mainly due to factors such as excessive body weight and increased inertia of the body. Our analysis also points out the lack of information regarding the role of age, maturation or sex in the current literature and reveals that routinely used field tests analysing overall daily muscular fitness in children with obesity provide satisfactory results when compared to laboratory-based data. PMID:26901423

Racial Discrimination and Adverse Birth Outcomes: An Integrative Review

PubMed Central

Alhusen, Jeanne L.; Bower, Kelly; Epstein, Elizabeth; Sharps, Phyllis

2016-01-01

Introduction This article presents an integrative review of the literature examining the relationship between racial discrimination and adverse birth outcomes. Methods Searches for research studies published from 2009 to 2015 were conducted using PubMed, CINAHL, Scopus, PsycINFO, Web of Science, and Embase. Articles were assessed for potential inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2009 framework. Results Fifteen studies met criteria for review. The majority of the studies found a significant relationship between racial discrimination and low birth weight, preterm birth, and small for gestational age. Each of the studies that examined more proximal variables related to birth outcomes such as entry into prenatal care, employment opportunities, neighborhood characteristics, or inflammatory markers found significant associations between the specific variables examined and racial discrimination. Participants in qualitative studies discussed experiences of institutional racism with regard to several components of prenatal care including access and quality of care. Discussion Racial discrimination is a significant risk factor for adverse birth outcomes. To best understand the mechanisms by which racial discrimination impacts birth outcomes, and to inform the development of effective interventions that eliminate its harmful effects on health, longitudinal research that incorporates comprehensive measures of racial discrimination is needed. Health care providers must fully acknowledge and address the psychosocial factors that impact health outcomes in minority racial/ethnic women. PMID:27737504

Diffusion and dissemination of evidence-based dietary srategies for the prevention of cancer

PubMed Central

Ciliska, Donna; Robinson, Paula; Armour, Tanya; Ellis, Peter; Brouwers, Melissa; Gauld, Mary; Baldassarre, Fulvia; Raina, Parminder

2005-01-01

Objective The purpose was to determine what strategies have been evaluated to disseminate cancer control interventions that promote the uptake of adult healthy diet? Methods A systematic review was conducted. Studies were identified by searching MEDLINE, PREMEDLINE, Cancer LIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists and by contacting technical experts. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions in individuals, healthcare providers, or institutions. Studies of children or adolescents only were excluded. Results One hundred one articles were retrieved for full text screening. Nine reports of seven distinct studies were included; four were randomized trials, one was a cohort design and three were descriptive studies. Six studies were rated as methodologically weak, and one was rated as moderate. Studies were not meta-analyzed because of heterogeneity, low methodological quality, and incomplete data reporting. No beneficial dissemination strategies were found except one that looks promising, the use of peer educators in the worksite, which led to a short-term increase in fruit and vegetable intake. Conclusions and Implications Overall, the quality of the evidence is not strong and is primarily descriptive rather than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies, and to compare dissemination and diffusion strategies with different messages and different target audiences. PMID:15819991

Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: a systematic review.

PubMed

Mani, Suresh; Sharma, Shobha; Omar, Baharudin; Paungmali, Aatit; Joseph, Leonard

2017-04-01

Purpose The purpose of this review is to systematically explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders. Method A comprehensive systematic literature review was conducted using a number of electronic databases: PubMed, EMBASE, PsycINFO, Cochrane Library and CINAHL, published between January 2000 and May 2015. The studies examined the validity, inter- and intra-rater reliabilities of TR-based physiotherapy assessment for musculoskeletal conditions were included. Two independent reviewers used the Quality Appraisal Tool for studies of diagnostic Reliability (QAREL) and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool to assess the methodological quality of reliability and validity studies respectively. Results A total of 898 hits were achieved, of which 11 articles based on inclusion criteria were reviewed. Nine studies explored the concurrent validity, inter- and intra-rater reliabilities, while two studies examined only the concurrent validity. Reviewed studies were moderate to good in methodological quality. The physiotherapy assessments such as pain, swelling, range of motion, muscle strength, balance, gait and functional assessment demonstrated good concurrent validity. However, the reported concurrent validity of lumbar spine posture, special orthopaedic tests, neurodynamic tests and scar assessments ranged from low to moderate. Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability, except for lumbar spine posture, orthopaedic special tests, neurodynamic testa and scar assessment.

Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews.

PubMed

Wagner, S L; Koehn, C; White, M I; Harder, H G; Schultz, I Z; Williams-Whitt, K; Warje, O; Dionne, C E; Koehoorn, M; Pasca, R; Hsu, V; McGuire, L; Schulz, W; Kube, D; Wright, M D

2016-01-01

Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.

The Effect of Exercise Training on Resting Concentrations of Peripheral Brain-Derived Neurotrophic Factor (BDNF): A Meta-Analysis

PubMed Central

Dinoff, Adam; Herrmann, Nathan; Swardfager, Walter; Liu, Celina S.; Sherman, Chelsea; Chan, Sarah; Lanctôt, Krista L.

2016-01-01

Background The mechanisms through which physical activity supports healthy brain function remain to be elucidated. One hypothesis suggests that increased brain-derived neurotrophic factor (BDNF) mediates some cognitive and mood benefits. This meta-analysis sought to determine the effect of exercise training on resting concentrations of BDNF in peripheral blood. Methods MEDLINE, Embase, PsycINFO, SPORTDiscus, Rehabilitation & Sports Medicine Source, and CINAHL databases were searched for original, peer-reviewed reports of peripheral blood BDNF concentrations before and after exercise interventions ≥ 2 weeks. Risk of bias was assessed using standardized criteria. Standardized mean differences (SMDs) were generated from random effects models. Risk of publication bias was assessed using funnel plots and Egger’s test. Potential sources of heterogeneity were explored in subgroup analyses. Results In 29 studies that met inclusion criteria, resting concentrations of peripheral blood BDNF were higher after intervention (SMD = 0.39, 95% CI: 0.17–0.60, p < 0.001). Subgroup analyses suggested a significant effect in aerobic (SMD = 0.66, 95% CI: 0.33–0.99, p < 0.001) but not resistance training (SMD = 0.07, 95% CI: -0.15–0.30, p = 0.52) interventions. No significant difference in effect was observed between males and females, nor in serum vs plasma. Conclusion Aerobic but not resistance training interventions increased resting BDNF concentrations in peripheral blood. PMID:27658238

Patient's perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: a narrative review.

PubMed

Clarke, Amy L; Yates, Thomas; Smith, Alice C; Chilcot, Joseph

2016-06-01

Patients with chronic kidney disease (CKD) form organized beliefs regarding their illness and treatment. These perceptions influence the coping strategies employed by an individual to manage his/her illness and may act as a predictor for his/her willingness to engage in self-management behaviours. While illness perceptions have been identified as predictors of non-adherence, depression and mortality in dialysis patients, there is a paucity of research in CKD patients not requiring renal replacement therapy. This narrative review synthesizes the existing literature regarding the role of illness perceptions and associated clinical and psychosocial outcomes in non-dialysis CKD patients. Studies were identified following database searches of AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsycINFO and Google Scholar in January 2016. Despite the small evidence base, existing studies indicate that negative illness perceptions are associated with disease progression and a number of psychosocial outcomes in non-dialysis CKD patients. Evidence from other clinical populations suggests that illness perceptions are modifiable through psychological intervention, which may be most effective if delivered early before beliefs have the chance to become more established. Therefore, targeting illness perceptions in the earlier stages of CKD may be optimal. Further studies are now required to ascertain the mechanisms through which illness perceptions predict psychosocial and clinical outcomes in CKD patients and to ultimately test the efficacy of illness perception-based interventions.

Diffusion and dissemination of evidence-based dietary strategies for the prevention of cancer.

PubMed

Ciliska, Donna; Robinson, Paula; Armour, Tanya; Ellis, Peter; Brouwers, Melissa; Gauld, Mary; Baldassarre, Fulvia; Raina, Parminder

2005-04-08

The purpose was to determine what strategies have been evaluated to disseminate cancer control interventions that promote the uptake of adult healthy diet? A systematic review was conducted. Studies were identified by searching MEDLINE, PREMEDLINE, Cancer LIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists and by contacting technical experts. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions in individuals, healthcare providers, or institutions. Studies of children or adolescents only were excluded. One hundred one articles were retrieved for full text screening. Nine reports of seven distinct studies were included; four were randomized trials, one was a cohort design and three were descriptive studies. Six studies were rated as methodologically weak, and one was rated as moderate. Studies were not meta-analyzed because of heterogeneity, low methodological quality, and incomplete data reporting. No beneficial dissemination strategies were found except one that looks promising, the use of peer educators in the worksite, which led to a short-term increase in fruit and vegetable intake. Overall, the quality of the evidence is not strong and is primarily descriptive rather than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies, and to compare dissemination and diffusion strategies with different messages and different target audiences.

Interventions for improving patients' trust in doctors and groups of doctors.

PubMed

Rolfe, Alix; Cash-Gibson, Lucinda; Car, Josip; Sheikh, Aziz; McKinstry, Brian

2014-03-04

Trust is a fundamental component of the patient-doctor relationship and is associated with increased satisfaction, adherence to treatment, and continuity of care. Our 2006 review found little evidence that interventions improve patients' trust in their doctor; therefore an updated search was required to find out if there is further evidence of the effects of interventions that may improve trust in doctors or groups of doctors. To update our earlier review assessing the effects of interventions intended to improve patients' trust in doctors or a group of doctors. In 2003 we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, Health Star, PsycINFO, CINAHL, LILACS, African Trials Register, African Health Anthology, Dissertation Abstracts International and the bibliographies of studies selected for inclusion. We also contacted researchers active in the field. We updated and re-ran the searches on available original databases (Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library issue 2, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), CINAHL (Ebsco)) as well as Proquest Dissertations and Current Contents for the period 2003 to 18 March 2013. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series of interventions (informative, educational, behavioural, organisational) directed at doctors or patients (or carers) where trust was assessed as a primary or secondary outcome. Two review authors independently extracted data and assessed the risk of bias of included studies. Where mentioned, we extracted data on adverse effects. We synthesised data narratively. We included 10 randomised controlled trials (including 7 new trials) involving 11,063 patients. These studies were all undertaken in North America, and all but two involved primary care.  As expected, there was considerable heterogeneity between the studies.  Interventions were of three main types; three employed additional physician training, four were education for patients and three provided additional information about doctors in terms of financial incentives or consulting style. Additionally, several different measures of trust were employed.The studies gave conflicting results. Trials showing a small but statistically-significant increase in trust included: a trial of physician disclosure of financial incentives; a trial of providing choice of physician based on concordance between patient and physician beliefs about care; a trial of group visits for new inductees into a Health Maintenance Organisation; a trial of training oncologists in communication skills; and a trial of group visits for diabetic patients. However, trust was not affected in a subsequent larger trial of group visits for uninsured people with diabetes, nor with a decision aid for helping choose statins, another trial of disclosure of financial incentives or specifically training doctors to increase trust or cultural competence. There was no evidence of harm from any of the studies. Overall, there remains insufficient evidence to conclude that any intervention may increase or decrease trust in doctors. This may be due in part to the sensitivity of trust instruments, and a ceiling effect, as trust in doctors is generally high. It may be that current measures of trust are insufficiently sensitive. Further trials are required to explore the impact of doctors' specific training or the use of a patient-centred or decision-sharing approach on patients' trust, especially in the areas of healthcare provider choice, and induction into healthcare organisation. International trials would be of particular benefit. The review was constrained by the lack of consistency between trust measurements, timeframes and populations.

Interventions for improving communication with children and adolescents about their cancer.

PubMed

Ranmal, Rita; Prictor, Megan; Scott, J Tim

2008-10-08

Communication with children and adolescents with cancer about their disease and treatment and the implications of these is an important aspect of good quality care. It is often poorly performed in practice. Various interventions have been developed that aim to enhance communication involving children or adolescents with cancer. To assess the effects of interventions for improving communication with children and/or adolescents about their cancer, its treatment and their implications, updating the 2003 version of this review. In April 2006 we updated searches of the following sources: CENTRAL (The Cochrane Library, issue 1 2006); MEDLINE (Ovid), (2003 to March week 5 2006); EMBASE (Ovid) (2003 to 2006 week 13); PsycINFO (Ovid) (2003 to March week 5 2006); CINAHL (Ovid) (2003 to March week 5 2006); ERIC (CSA) (earliest to 2006); Sociological Abstracts (CSA) (earliest to 2006); Dissertation Abstracts: (2002 to 6 April 2006).In 2003 we conducted searches of CENTRAL; MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, Sociological Abstracts and Dissertation Abstracts.For the initial (2001) publication of this review we also searched the following databases: PsycLIT; Cancerlit; Sociofile; Health Management Information Consortium; ASSIA; LISA; PAIS; Information Science Abstracts; JICST; Pascal; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; AMED; MANTIS.We also searched the bibliographies of studies assessed for inclusion, and contacted experts in the field. Randomised and non-randomised controlled trials, and before and after studies, evaluating the effects of interventions for improving communication with children and/or adolescents about their cancer, treatment and related issues. Data relating to the interventions, populations and outcomes studied and the design and methodological quality of included studies were extracted by one review author and checked by another review author. We present a narrative summary of the results. One new study met the criteria for inclusion; in total we have included ten studies involving 438 participants. Studies were diverse in terms of the interventions evaluated, study designs used, types of people who participated and the outcomes measured.One study of a computer-assisted education programme reported improvements in knowledge and understanding about blood counts and cancer symptoms. One study of a CD-ROM about leukaemia reported an improvement in children's feelings of control over their health. One study of art therapy as support for children during painful procedures reported an increase in positive, collaborative behaviour. Two out of two studies of school reintegration programs reported improvements in some aspects of psychosocial wellbeing (one in anxiety and one in depression), social wellbeing (two in social competence and one in social support) and behavioural problems; and one reported improvements in physical competence. One newly-identified study of a multifaceted interactive intervention reported a reduction in distress (as measured by heart rate) related to radiation therapy.Two studies of group therapy, one of planned play and story telling, and one of a self-care coping intervention, found no significant effects on the psychological or clinical outcomes measured. Interventions to enhance communication involving children and adolescents with cancer have not been widely or rigorously assessed. The weak evidence that exists suggests that some children and adolescents with cancer may derive some benefit from specific information-giving programs, from support before and during particular procedures, and from interventions that aim to facilitate their reintegration into school and social activities. More research is needed to investigate the effects of these and other related interventions.

Functioning and Participation of Students with ADHD in Higher Education According to the ICF-Framework

ERIC Educational Resources Information Center

Emmers, Elke; Jansen, Dorien; Petry, Katja; van der Oord, Saskia; Baeyens, Dieter

2017-01-01

Due to an increasing number of students with ADHD in higher education and the difficult course of their academic career, a comprehensive overview of participation and functioning of this group is needed. A comprehensive search was performed in MEDLINE (PubMed), EMBASE, CINAHL and ERIC electronic databases in June 2014. This systematic literature…

A Review of "Wandering" Instruments for People with Dementia Who Get Lost

ERIC Educational Resources Information Center

Bantry White, Eleanor; Montgomery, Paul

2014-01-01

Objectives: This study is the first review to be conducted to evaluate measures of wandering behavior for identifying people with dementia at risk of getting lost. Method: Drawing upon systematic review search strategies, the relevant literature was reviewed for wandering instruments using MEDLINE, Embase, PsycINFO, and Cumulative Index to Nursing…

Acoustic rhinometry in mouth breathing patients: a systematic review.

PubMed

Melo, Ana Carolina Cardoso de; Gomes, Adriana de Oliveira de Camargo; Cavalcanti, Arlene Santos; Silva, Hilton Justino da

2015-01-01

When there is a change in the physiological pattern of nasal breathing, mouth breathing may already be present. The diagnosis of mouth breathing is related to nasal patency. One way to access nasal patency is by acoustic rhinometry. To systematically review the effectiveness of acoustic rhinometry for the diagnosis of patients with mouth breathing. Electronic databases LILACS, MEDLINE via PubMed and Bireme, SciELO, Web of Science, Scopus, PsycInfo, CINAHL, and Science Direct, from August to December 2013, were consulted. 11,439 articles were found: 30 from LILACS, 54 from MEDLINE via Bireme, 5558 from MEDLINE via PubMed, 11 from SciELO, 2056 from Web of Science, 1734 from Scopus, 13 from PsycInfo, 1108 from CINAHL, and 875 from Science Direct. Of these, two articles were selected. The heterogeneity in the use of equipment and materials for the assessment of respiratory mode in these studies reveals that there is not yet consensus in the assessment and diagnosis of patients with mouth breathing. According to the articles, acoustic rhinometry has been used for almost twenty years, but controlled studies attesting to the efficacy of measuring the geometry of nasal cavities for complementary diagnosis of respiratory mode are warranted. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review.

PubMed

olde Hartman, Tim C; Borghuis, Machteld S; Lucassen, Peter L B J; van de Laar, Floris A; Speckens, Anne E; van Weel, Chris

2009-05-01

To study the course of medically unexplained symptoms (MUS), somatisation disorder, and hypochondriasis, and related prognostic factors. Knowledge of prognostic factors in patients presenting persistent MUS might improve our understanding of the naturalistic course and the identification of patients with a high risk of a chronic course. A comprehensive search of Medline, PsycInfo, CINAHL, and EMBASE was performed to select studies focusing on patients with MUS, somatisation disorder, and hypochondriasis, and assessing prognostic factors. Studies focusing on patients with single-symptom unexplained disorder or distinctive functional somatic syndromes were excluded. A best-evidence synthesis for the interpretation of results was used. Only six studies on MUS, six studies on hypochondriasis, and one study on abridged somatisation could be included. Approximately 50% to 75% of the patients with MUS improve, whereas 10% to 30% of patients with MUS deteriorate. In patients with hypochondriasis, recovery rates vary between 30% and 50%. In studies on MUS and hypochondriasis, we found some evidence that the number of somatic symptoms at baseline influences the course of these conditions. Furthermore, the seriousness of the condition at baseline seemed to influence the prognosis. Comorbid anxiety and depression do not seem to predict the course of hypochondriasis. Due to the limited numbers of studies and their high heterogeneity, there is a lack of rigorous empirical evidence to identify relevant prognostic factors in patients presenting persistent MUS. However, it seems that a more serious condition at baseline is associated with a worse outcome.

Exploring the views and experiences of HIV positive patients treated for cancer: a systematic review of the literature.

PubMed

Hainsworth, Emma G; Shahmanesh, Maryam; Stevenson, Fiona

2018-05-01

A systematic review of the literature was conducted to find out what is known about patients' experiences of a dual diagnosis of HIV and cancer. We systematically searched the following databases; MEDLINE (Ovid Version); CINAHL Plus; PsycINFO and EMBASE from inception to June 2016 for studies that included patients with a dual diagnosis of cancer and HIV and focused on patient experiences. Studies with a focus on one illness rather than a dual diagnosis, those that focused on treatment strategies and medical management, epidemiology and pathology studies and comparison studies were all excluded. The full text of the included studies were reviewed. Information on location, sample size, study design and a narrative summary of findings were extracted using a standardised format. Studies were combined thematically. 1777 records were screened by title and abstract using the selection criteria described in the methods. Eight records were reviewed in depth in full text and seven selected as eligible. The selected studies suggest that a dual diagnosis of HIV and cancer has a powerful impact on individuals' behaviour. The experience of stigma was a consistent factor in all patient accounts and the strategy of selective disclosure to access support reveals how patient agency can interplay with stigma. This is an area largely unexplored in the published literature; further research into patients' experiences of a dual diagnosis of HIV and cancer will provide relevant knowledge in order to tailor and improve services.

Antenatal Consultations at Extreme Prematurity: A Systematic Review of Parent Communication Needs.

PubMed

Kharrat, Ashraf; Moore, Gregory P; Beckett, Stéphanie; Nicholls, Stuart G; Sampson, Margaret; Daboval, Thierry

2018-05-01

To synthesize and describe parental expectations on how healthcare professionals should interact with them during a peripartum, antenatal consultation for extremely preterm infants. For this systematic literature review with textual narrative synthesis, we included studies that explored parental perspectives regarding the antenatal consultation for an extremely preterm infant. Electronic searches of Medline, CINAHL, PsycInfo, and Embase were conducted, along with a search of the grey literature. Quality appraisal was conducted using the guide by Walsh and Downe. Two independent reviewers reviewed 783 titles, of which 130 abstracts then 40 full-text articles were reviewed. Final data abstraction includes 19 studies. We predetermined 6 topics of interest (setting, timing, preferred healthcare professional, information, resources, and parents-physician interaction) to facilitate thematic analysis. In consideration of the variability of parents' specific desires, six predetermined topics and additional overarching themes such as perception of support, degree of understanding, hope, spirituality, and decision-making influences emerged. Studies suggest the quality of the antenatal consultation is not purely about information content, but also the manner in which it is provided. Limitations include thematic analysis that can potentially lead to the exclusion of important nuances. Relevant studies may have been missed if published outside the healthcare literature. The findings may inform clinical practice guidelines. This paper includes suggested strategies related to parents' perspectives that may facilitate communication during antenatal consultation for an extremely preterm infant. These strategies may also support parental engagement and satisfaction. Copyright © 2017 Elsevier Inc. All rights reserved.

Physician-patient communication in rheumatology: a systematic review.

PubMed

Georgopoulou, Sofia; Prothero, Louise; D'Cruz, David P

2018-05-01

The nature of physician-patient interaction can have a significant impact on patient outcomes through information-sharing and disease-specific education that can enhance patients' active involvement in their care. The aim of this systematic review was to examine all the empirical evidence pertaining to aspects of physician-patient communication and its impact on patient outcomes. A systematic search of five electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL, and Web of Science) was undertaken from earliest record to December 2016. Studies were eligible if they: (1) included adult participants (18 years or over) with a diagnosis of a rheumatic condition; (2) were of quantitative, qualitative or mixed methods design; (4) were surveys, observational and interventional studies; (5) were published in the English language; and (6) reported findings on either various physician-patient communication aspects alone or in combination with physical and psychological outcomes. Searches identified 455 papers. Following full-text retrieval and assessment for eligibility and quality, ten studies were included in the review; six quantitative, one mixed methods, and three qualitative papers. Higher levels of trust in the physician and active patient participation in the medical consultation were linked to lower disease activity, better global health, less organ damage accrual, greater treatment satisfaction with fewer side effects from the medication, more positive beliefs about control over the disease, and about current and future health. Future research could focus on the design and implementation of interventions incorporating communications skills and patient-education training.

'Informed and uninformed decision making'--women's reasoning, experiences and perceptions with regard to advanced maternal age and delayed childbearing: a meta-synthesis.

PubMed

Cooke, Alison; Mills, Tracey A; Lavender, Tina

2010-10-01

To identify what factors affect women's decisions to delay childbearing, and to explore women's experiences and their perceptions of associated risks. Systematic procedures were used for search strategy, study selection, data extraction and analysis. Findings were synthesised using an approach developed from meta-ethnography. We included qualitative papers, not confined to geographical area (1980-2009). Databases included CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA, MIDIRS, British Nursing Index and the National Research Register. We selected qualitative empirical studies exploring the views and experiences of women of advanced maternal age who were childless or primigravidae with a singleton pregnancy or primiparous. Twelve papers fulfilled the selection criteria and were included for synthesis. Women appear to face an issue of 'informed and uninformed decision making'; those who believe they are informed but may not be, those who are not informed and find out they are at risk once pregnant, and those who are well informed but choose to delay pregnancy anyway. Maternity services could provide information to enable informed choice regarding timing of childbearing. Health professionals need to be mindful of the fact that women delay childbearing for various reasons. A strategy of pre-conception education may be beneficial in informing childbearing decisions. Obstetricians and midwives should be sensitive to the fact that women may not be aware of all the risks associated with delayed childbearing. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Refugee experiences of general practice in countries of resettlement: a literature review.

PubMed

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-03-01

Refugees and asylum seekers often struggle to use general practice services in resettlement countries. To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. © British Journal of General Practice 2015.

Refugee experiences of general practice in countries of resettlement: a literature review

PubMed Central

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-01-01

Background Refugees and asylum seekers often struggle to use general practice services in resettlement countries. Aim To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Design and setting Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Method Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker’s personal experiences of general practice services were identified, coded, and analysed. Results From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor–patient relationships, and problems with the cultural acceptability of medical care. Conclusion The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. PMID:25733438

Effect of exercise on cognitive function in chronic disease patients: a meta-analysis and systematic review of randomized controlled trials.

PubMed

Cai, Hong; Li, Guichen; Hua, Shanshan; Liu, Yufei; Chen, Li

2017-01-01

The purpose of this study was to conduct a meta-analysis and systematic review to assess the effect of exercise on cognitive function in people with chronic diseases. PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, PsycINFO, and three Chinese databases were electronically searched for papers that were published until September 2016. This meta-analysis and systematic review included randomized controlled trials that evaluated the effect of exercise on cognitive function compared with control group for people with chronic diseases. Totally, 35 studies met the inclusion criteria, with 3,113 participants. The main analysis revealed a positive overall random effect of exercise intervention on cognitive function in patients with chronic diseases. The secondary analysis revealed that aerobic exercise interventions and aerobic included exercise interventions had a positive effect on cognition in patients with chronic diseases. The intervention offering low frequency had a positive effect on cognitive function in patients with chronic diseases. Finally, we found that interventions offered at both low exercise intensity and moderate exercise intensity had a positive effect on cognitive function in patients with chronic diseases. The secondary analysis also revealed that exercise interventions were beneficial in Alzheimer's disease patients when grouped by disease type. This meta-analysis and systematic review suggests that exercise interventions positively influence cognitive function in patients with chronic diseases. Beneficial effect was independent of the type of disease, type of exercise, frequency, and the intensity of the exercise intervention.

Mixed methods systematic review exploring mentorship outcomes in nursing academia.

PubMed

Nowell, Lorelli; Norris, Jill M; Mrklas, Kelly; White, Deborah E

2017-03-01

The aim of this study was to report on a mixed methods systematic review that critically examines the evidence for mentorship in nursing academia. Nursing education institutions globally have issued calls for mentorship. There is emerging evidence to support the value of mentorship in other disciplines, but the extant state of the evidence in nursing academia is not known. A comprehensive review of the evidence is required. A mixed methods systematic review. Five databases (MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO) were searched using an a priori search strategy from inception to 2 November 2015 to identify quantitative, qualitative and mixed methods studies. Grey literature searches were also conducted in electronic databases (ProQuest Dissertations and Theses, Index to Theses) and mentorship conference proceedings and by hand searching the reference lists of eligible studies. Study quality was assessed prior to inclusion using standardized critical appraisal instruments from the Joanna Briggs Institute. A convergent qualitative synthesis design was used where results from qualitative, quantitative and mixed methods studies were transformed into qualitative findings. Mentorship outcomes were mapped to a theory-informed framework. Thirty-four studies were included in this review, from the 3001 records initially retrieved. In general, mentorship had a positive impact on behavioural, career, attitudinal, relational and motivational outcomes; however, the methodological quality of studies was weak. This review can inform the objectives of mentorship interventions and contribute to a more rigorous approach to studies that assess mentorship outcomes. © 2016 John Wiley & Sons Ltd.

Systematic review: complementary therapies and employee well-being.

PubMed

Ravalier, J M; Wegrzynek, P; Lawton, S

2016-08-01

A variety of workplace-based interventions exist to reduce stress and increase productivity. However, the efficacy of these interventions is sometimes unclear. To determine whether complementary therapies offered in the workplace improve employee well-being. We performed a systematic literature review which involved an electronic search of articles published between January 2000 and July 2015 from the databases Cochrane Central Register of Controlled Trials, PsycINFO, MEDLINE, AMED, CINAHL Plus, EMBASE and PubMed. We also undertook a manual search of all applicable article reference lists to ensure that no relevant studies were missed. We only selected published, full-length, English-language, peer-reviewed journal articles. Articles had to address the research objective using valid and reliable measures. We excluded articles concerning return to work or whose populations had been adversely affected by work resulting in the development of health issues. We included 10 articles in the review from 131 identified. Mindfulness and meditation-based interventions were most effective in improving workplace health and work performance; the latter demonstrating some evidence of maintaining gains up to 3 months later. The evidence for relaxation interventions was inconclusive. Mindfulness and meditation interventions may be helpful in improving both psychosocial workplace health and work performance, but long-term efficacy has yet to be fully determined. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review.

PubMed

Whitehead, Phillip J; Worthington, Esme J; Parry, Ruth H; Walker, Marion F; Drummond, Avril E R

2015-11-01

To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed 're-ablement' or 'restorative homecare' (n=5/13); and those involving separate components which were not described using this terminology (n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. There is limited evidence that interventions targeted at personal ADL can reduce homecare service users' dependency with activities, the content of evaluated interventions varies greatly. © The Author(s) 2015.

Combination of pharmacotherapy and psychotherapy in the treatment of chronic depression: A systematic review and meta-analysis

PubMed Central

2012-01-01

Background Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences. This review examined whether the combination of pharmacological treatments and psychotherapy is associated with higher effectiveness than pharmacotherapy alone via meta-analysis; and identified possible treatment effect modifiers via meta-regression-analysis. Methods A systematic search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, ISI Web of Science, BIOSIS, PsycINFO, and CINAHL. Primary efficacy outcome was a response to treatment; primary acceptance outcome was dropping out of the study. Only randomized controlled trials were considered. Results We identified 8 studies with a total of 9 relevant comparisons. Our analysis revealed small, but statistically not significant effects of combined therapies on outcomes directly related to depression (BR = 1.20) with substantial heterogeneity between studies (I² = 67%). Three treatment effect modifiers were identified: target disorders, the type of psychotherapy and the type of pharmacotherapy. Small but statistically significant effects of combined therapies on quality of life (SMD = 0.18) were revealed. No differences in acceptance rates and the long-term effects between combined treatments and pure pharmacological interventions were observed. Conclusions This systematic review could not provide clear evidence for the combination of pharmacotherapy and psychotherapy. However, due to the small amount of primary studies further research is needed for a conclusive decision. PMID:22694751

E-cigarettes and equity: a systematic review of differences in awareness and use between sociodemographic groups

PubMed Central

Hartwell, Greg; Thomas, Sian; Egan, Matt; Gilmore, Anna; Petticrew, Mark

2017-01-01

Objective To assess whether electronic cigarette (e-cigarette) awareness, ‘ever use’ and current use vary significantly between different sociodemographic groups. Design Systematic review. Data sources Published and unpublished reports identified by searching seven electronic databases (PubMed, MEDLINE, Web of Science, EMBASE, Global Health, PsycINFO, CINAHL Plus) and grey literature sources. Study selection Systematic search for and appraisal of cross-sectional or longitudinal studies that assessed e-cigarette awareness, ‘ever use’ or current use, and included subgroup analysis of 1 or more PROGRESS Plus sociodemographic groups. No geographical or time restrictions imposed. Assessment by multiple reviewers, with 17% of full articles screened meeting the selection criteria. Data extraction Data extracted and checked by multiple reviewers, with quality assessed using an adapted tool developed by the Joanna Briggs Institute. Data synthesis Results of narrative synthesis suggest broadly that awareness, ‘ever use’ and current use of e-cigarettes may be particularly prevalent among older adolescents and younger adults, males, people of white ethnicity and—particularly in the case of awareness and ‘ever use’—those of intermediate or high levels of education. In some cases, results also varied within and between countries. Conclusions E-cigarette awareness, ‘ever use’ and current use appear to be patterned by a number of sociodemographic factors which vary between different countries and subnational localities. Care will therefore be required to ensure neither the potential benefits nor the potential risks of e-cigarettes exacerbate existing health inequalities. PMID:28003324

What are the Implications for Policy Makers? A Systematic Review of the Cost-Effectiveness of Screening and Brief Interventions for Alcohol Misuse in Primary Care

PubMed Central

Angus, Colin; Latimer, Nicholas; Preston, Louise; Li, Jessica; Purshouse, Robin

2014-01-01

Introduction: The efficacy of screening and brief interventions (SBIs) for excessive alcohol use in primary care is well established; however, evidence on their cost-effectiveness is limited. A small number of previous reviews have concluded that SBI programs are likely to be cost-effective but these results are equivocal and important questions around the cost-effectiveness implications of key policy decisions such as staffing choices for delivery of SBIs and the intervention duration remain unanswered. Methods: Studies reporting both the costs and a measure of health outcomes of programs combining SBIs in primary care were identified by searching MEDLINE, EMBASE, Econlit, the Cochrane Library Database (including NHS EED), CINAHL, PsycINFO, Assia and the Social Science Citation Index, and Science Citation Index via Web of Knowledge. Included studies have been stratified both by delivery staff and intervention duration and assessed for quality using the Drummond checklist for economic evaluations. Results: The search yielded a total of 23 papers reporting the results of 22 distinct studies. There was significant heterogeneity in methods and outcome measures between studies; however, almost all studies reported SBI programs to be cost-effective. There was no clear evidence that either the duration of the intervention or the delivery staff used had a substantial impact on this result. Conclusion: This review provides strong evidence that SBI programs in primary care are a cost-effective option for tackling alcohol misuse. PMID:25225487

Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies.

PubMed

Jamieson, Nathan J; Hanson, Camilla S; Josephson, Michelle A; Gordon, Elisa J; Craig, Jonathan C; Halleck, Fabian; Budde, Klemens; Tong, Allison

2016-03-01

Kidney transplantation offers better outcomes compared to dialysis, but requires patients to adhere to an ongoing and complex self-management regimen. Medication nonadherence remains a leading cause of transplant loss, and inadequate self-management undermines transplantation and other health outcomes. We aimed to describe kidney transplant recipients' motivations, challenges, and attitudes toward self-management. Systematic review and thematic synthesis of qualitative studies. Kidney transplant recipients. MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to October 2014. Thematic synthesis. 50 studies involving 1,238 recipients aged 18 to 82 years across 19 countries were included. We identified 5 themes: empowerment through autonomy (achieving mastery, tracking against tangible targets, developing bodily intuition, routinizing and problem solving, and adaptive coping), prevailing fear of consequences (inescapable rejection anxiety, aversion to dialysis, minimizing future morbidity, trivialization and denial, and defining acceptable risks), burdensome treatment and responsibilities (frustrating ambiguities, inadvertent forgetfulness, intrusive side effects, reversing ingrained behaviors, and financial hardship), overmedicalizing life (dominating focus, evading patienthood, and succumbing to burnout), and social accountability and motivation (demonstrating gratitude toward medical team, indebtedness to donor, and peer learning). Non-English articles were excluded. Self-efficacy and social accountability are motivators for self-management, although adherence can be mentally and physically taxing. Multicomponent interventions incorporating personalized care planning, education, psychosocial support, decision aids, and self-monitoring tools may foster self-management capacity and improve transplantation outcomes. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Caffeine to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

PubMed

Crawford, Cindy; Teo, Lynn; Lafferty, Lynn; Drake, Angela; Bingham, John J; Gallon, Matthew D; O'Connell, Meghan L; Chittum, Holly K; Arzola, Sonya M; Berry, Kevin

2017-06-01

In 2001 the Institute of Medicine (IOM) released a report on the use of caffeine during sustained military operations in which recommendations for research and practice were made. This systematic review serves as an update on the current quality of the evidence and addresses gaps in the current literature surrounding the effects of caffeinated foods and beverages on cognitive functioning in healthy adult populations exposed to military-like moderators. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language since 1998 were eligible. Twenty-five trials were included and assessed for methodological quality, and descriptive data were extracted according to each military-like moderator identified. Moderators included sleep deprivation (n = 17), physical or mental exertion (n = 4), sleep deprivation combined with a sustained military operation (n = 3), and physical exertion combined with low ambient temperature (n = 1). The effects of caffeine supplementation on cognitive functioning in sleep-deprived subjects included improvements in attention and vigilance, complex reaction time, and problem solving and reasoning in the trials reviewed. These findings are consistent with the conclusions reached in the 2001 IOM report. This review contributes to the field by addressing gaps outlined in the IOM report. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Validity of Cognitive Load Measures in Simulation-Based Training: A Systematic Review.

PubMed

Naismith, Laura M; Cavalcanti, Rodrigo B

2015-11-01

Cognitive load theory (CLT) provides a rich framework to inform instructional design. Despite the applicability of CLT to simulation-based medical training, findings from multimedia learning have not been consistently replicated in this context. This lack of transferability may be related to issues in measuring cognitive load (CL) during simulation. The authors conducted a review of CLT studies across simulation training contexts to assess the validity evidence for different CL measures. PRISMA standards were followed. For 48 studies selected from a search of MEDLINE, EMBASE, PsycInfo, CINAHL, and ERIC databases, information was extracted about study aims, methods, validity evidence of measures, and findings. Studies were categorized on the basis of findings and prevalence of validity evidence collected, and statistical comparisons between measurement types and research domains were pursued. CL during simulation training has been measured in diverse populations including medical trainees, pilots, and university students. Most studies (71%; 34) used self-report measures; others included secondary task performance, physiological indices, and observer ratings. Correlations between CL and learning varied from positive to negative. Overall validity evidence for CL measures was low (mean score 1.55/5). Studies reporting greater validity evidence were more likely to report that high CL impaired learning. The authors found evidence that inconsistent correlations between CL and learning may be related to issues of validity in CL measures. Further research would benefit from rigorous documentation of validity and from triangulating measures of CL. This can better inform CLT instructional design for simulation-based medical training.

Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: a systematic review.

PubMed

Peek, Kerry; Sanson-Fisher, Robert; Mackenzie, Lisa; Carey, Mariko

2016-06-01

Physiotherapist prescribed self-management strategies are an important adjunct to 'hands on' treatment. However, treatment outcomes are likely to be related to whether patients adhere to the prescribed strategy. Therefore, physiotherapists should be aware of adherence aiding interventions designed to maximise patient outcomes underpinned by quality research studies. To conduct a systematic review of the interventions used to aid patient adherence to all physiotherapist prescribed self-management strategies. The search included the databases CINAHL, EMBASE, MEDLINE, PUBMED, PSYCINFO, SPORTSDiscus, the Cochrane Central Register of Controlled Trials, PEDro and Mednar for randomised controlled trials (RCTs) published in a peer reviewed journal from inception to November 2014. Data were extracted using a standardised form from twelve included RCTs for patient adherence rates to self-management strategies for interventions used to aid patient adherence and usual care. Two independent reviewers conducted methodological quality assessment. Twelve different interventions to aid patient adherence to exercise were recorded from twelve fair to high quality RCTs. Potential adherence aiding interventions include an activity monitor and feedback system, written exercise instructions, behavioural exercise programme with booster sessions and goal setting. Despite a number of studies demonstrating interventions to positively influence patient adherence to exercise, there is insufficient data to endorse their use in clinical practice. No RCTs examining adherence aiding interventions to self-management strategies other than exercise were identified, indicating a significant gap in the literature. PROSPERO CRD42015014516. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Women's experiences of continuous fetal monitoring - a mixed-methods systematic review.

PubMed

Crawford, Alexandra; Hayes, Dexter; Johnstone, Edward D; Heazell, Alexander E P

2017-12-01

Antepartum stillbirth is often preceded by detectable signs of fetal compromise, including changes in fetal heart rate and movement. It is hypothesized that continuous fetal monitoring could detect these signs more accurately and objectively than current forms of fetal monitoring and allow for timely intervention. This systematic review aimed to explore available evidence on women's experiences of continuous fetal monitoring to investigate its acceptability before clinical implementation and to inform clinical studies. Systematic searching of four electronic databases (Embase, PsycINFO, MEDLINE and CINAHL), using key terms defined by initial scoping searches, identified a total of 35 studies. Following title and abstract screening by two independent researchers, five studies met the inclusion criteria. Studies were not excluded based on language, methodology or quality assessment. An integrative methodology was used to synthesize qualitative and quantitative data together. Forms of continuous fetal monitoring used included Monica AN24 monitors (n = 4) and phonocardiography (n = 1). Four main themes were identified: practical limitations of the device, negative emotions, positive perceptions, and device implementation. Continuous fetal monitoring was reported to have high levels of participant satisfaction and was preferred by women to intermittent cardiotocography. This review suggests that continuous fetal monitoring is accepted by women. However, it has also highlighted both the paucity and heterogeneity of current studies and suggests that further research should be conducted into women's experiences of continuous fetal monitoring before such devices can be used clinically. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review.

PubMed

Han, Claire Jungyoun; Lee, Young Ji; Demiris, George

2017-07-27

Regarding cancer awareness, social media effectively promotes health and supports self-management. Given the diverse study designs, methodologies, and approaches of social media interventions in oncology, it is difficult to determine the effects of social media on cancer prevention and management. We aim to systematically review intervention studies using social media for cancer care. A systematic search, using 7 electronic databases (PubMed, Web of Science, CINAHL, Cochrane Library, Scopus, EMBASE, and PsycINFO), was conducted to identify surveys and interventions using contemporary social media tools with a focus on cancer. Of the 18 selected studies, 7 were randomized controlled trials. Most studies were conducted for all types of cancer, and some were conducted for breast cancer in the United States, with mostly white female participants. Facebook was the most frequently used platform. Most studies targeted healthy participants providing cancer prevention education. With social media platforms as part of a larger intervention, or the main component of interventions, interventions were overall feasible and showed a significant improvement in cancer prevention and management. Social media tools have the potential to be effective in delivering interventions for cancer prevention and management. However, there was a dearth of studies with rigorous study methodologies to test social media effects on various cancer-related clinical outcomes. Social media use in cancer care will facilitate improved communication and support among patients, caregivers, and clinicians and, ultimately, improved patient care. Clinicians need to carefully harness social media to enhance patient care and clinical outcomes.

Systematic review of intervention practices for depression in the workplace.

PubMed

Furlan, Andrea D; Gnam, William H; Carnide, Nancy; Irvin, Emma; Amick, Benjamin C; DeRango, Kelly; McMaster, Robert; Cullen, Kimberley; Slack, Tesha; Brouwer, Sandra; Bültmann, Ute

2012-09-01

Systematic Review. To determine which intervention approaches to manage depression in the workplace have been successful and yielded value for employers in developed economies. We searched MEDLINE, EMBASE, CINAHL, Central, PsycINFO, and Business Source Premier up to June 2010 using search terms in four broad areas: work setting, depression, intervention, and work outcomes. Two independent reviewers selected potential articles that met the following criteria: working age individuals with mild or moderate depression; interventions or programs that were workplace-based or could be implemented and/or facilitated by the employer; inclusion of a comparator group in the analysis; outcomes of prevention, management, and recurrences of work disability or sickness absence, and work functioning. Two reviewers independently reviewed each article for quality and extracted data using standardised forms. Following guidelines from the GRADE Working Group, the quality of evidence addressing each outcome was graded as high, moderate, low, or very low on the basis of six criteria: study design, risk of bias, consistency, generalisability, data precision, and economic benefit. Using this information and following Cochrane Collaboration guidelines, the findings for each intervention were summarised and key messages were developed. We identified ten randomised trials and two non-randomised studies from various countries and jurisdictions that evaluated a wide range of intervention practices. The evidence was graded as "very low" for all outcomes identified. Therefore, no intervention could be recommended. To date, there is insufficient quality of evidence to determine which interventions are effective and yield value to manage depression in the workplace.

Adverse Effects of the Common Treatments for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

PubMed Central

Domecq, Juan Pablo; Prutsky, Gabriela; Mullan, Rebecca J.; Sundaresh, Vishnu; Wang, Amy T.; Erwin, Patricia J.; Welt, Corrine; Ehrmann, David; Montori, Victor M.

2013-01-01

Context: Polycystic ovary syndrome (PCOS) is common among women of childbearing age and the available pharmacological therapies have different side-effect profiles. Objective: We summarized the evidence about the side effects of oral contraceptive pills, metformin, and anti-androgens in women with PCOS. Data Source: Sources included Ovid Medline, OVID EMBASE, OVID Cochrane Library, Web of Science, Scopus, PsycInfo, and CINAHL from inception through April 2011. Study Selection: We included comparative observational studies enrolling women with PCOS who received the agents of choice for at least 6 months and reported adverse effects. Data Extraction: Using a standardized, piloted, and Web-based data extraction form and working in duplicate, we abstracted data from each study and performed meta-analysis when possible. Data Synthesis: We found 22 eligible studies of which 20 were randomized. No study reported severe side effects (eg, lactic acidosis, thromboembolic episodes, liver toxicity, cancer incidence, or pregnancy loss). Meta-analysis demonstrated no significant change in weight in oral contraceptive pills or flutamide users. Indirect evidence from populations without PCOS demonstrated no increased risk of lactic acidosis with metformin, only case reports of liver toxicity with flutamide (no comparative evidence), and increased relative risk difference of venous thromboembolism with oral contraceptive pills but very low absolute risk. Evidence on mortality, cardiovascular mortality, and cancer was inconclusive. Conclusions: Drugs commonly used to treat PCOS appear to be associated with very low risk of severe adverse effects although data are extrapolated from other populations. PMID:24092830

Adverse effects of the common treatments for polycystic ovary syndrome: a systematic review and meta-analysis.

PubMed

Domecq, Juan Pablo; Prutsky, Gabriela; Mullan, Rebecca J; Sundaresh, Vishnu; Wang, Amy T; Erwin, Patricia J; Welt, Corrine; Ehrmann, David; Montori, Victor M; Murad, Mohammad Hassan

2013-12-01

Polycystic ovary syndrome (PCOS) is common among women of childbearing age and the available pharmacological therapies have different side-effect profiles. We summarized the evidence about the side effects of oral contraceptive pills, metformin, and anti-androgens in women with PCOS. Sources included Ovid Medline, OVID EMBASE, OVID Cochrane Library, Web of Science, Scopus, PsycInfo, and CINAHL from inception through April 2011. We included comparative observational studies enrolling women with PCOS who received the agents of choice for at least 6 months and reported adverse effects. Using a standardized, piloted, and Web-based data extraction form and working in duplicate, we abstracted data from each study and performed meta-analysis when possible. We found 22 eligible studies of which 20 were randomized. No study reported severe side effects (eg, lactic acidosis, thromboembolic episodes, liver toxicity, cancer incidence, or pregnancy loss). Meta-analysis demonstrated no significant change in weight in oral contraceptive pills or flutamide users. Indirect evidence from populations without PCOS demonstrated no increased risk of lactic acidosis with metformin, only case reports of liver toxicity with flutamide (no comparative evidence), and increased relative risk difference of venous thromboembolism with oral contraceptive pills but very low absolute risk. Evidence on mortality, cardiovascular mortality, and cancer was inconclusive. Drugs commonly used to treat PCOS appear to be associated with very low risk of severe adverse effects although data are extrapolated from other populations.

Quality of life questionnaires for children with cancer and childhood cancer survivors: a review of the development of available measures.

PubMed

Klassen, Anne F; Strohm, Sonya J; Maurice-Stam, Heleen; Grootenhuis, Martha A

2010-09-01

To identify and appraise all published quality of life (QOL) measures developed for use with children with cancer and childhood cancer survivors. MEDLINE, CINAHL, EMBASE, PsycINFO, CancerLit, and Sociological Abstracts were searched from the inception of each database to 15 June 2009. Included articles were ones that described the development and/or psychometric evaluation of a QOL measure developed for use with children with cancer or childhood cancer survivors. Articles were appraised for adherence to internationally recommended guidelines for item generation, item reduction, and psychometric evaluation. Thirteen QOL questionnaires were identified by our search. Eleven measures are applicable to measuring QOL in children with any type of cancer, and two are specific to children with brain cancer. Four measures can be used to measure QOL in children undergoing cancer treatment, six can be used with children on or off treatment, and three are specific to childhood cancer survivors. While all measures underwent some degree of formal development and validation, item generation often did not involve children with cancer or their parents, and a number of measures did not describe or utilize recommended methods for item reduction and psychometric evaluation. Most of the measures identified in this review were designed to measure QOL concerns of children with any type of cancer and at any time, during treatment or survivorship. Our findings can help researchers and clinicians identify scientifically sound measures.

Contralateral prophylactic mastectomy (CPM): A systematic review of patient reported factors and psychological predictors influencing choice and satisfaction.

PubMed

Ager, Brittany; Butow, Phyllis; Jansen, Jesse; Phillips, Kelly-Anne; Porter, David

2016-08-01

Conduct a systematic review of quantitative and qualitative studies exploring patient reported factors and psychological variables influencing the decision to have contralateral prophylactic mastectomy (CPM), and satisfaction with CPM, in women with early stage breast cancer. Studies were identified via databases: Medline, CINAHL, Embase and PsycINFO. Data were extracted by one author and crosschecked by two additional authors for accuracy. The quality of included articles was assessed using standardised criteria by three authors. Of the 1346 unique citations identified, 17 were studies that met the inclusion criteria. Studies included were primarily cross-sectional and retrospective. No study utilised a theoretical framework to guide research and few studies considered psychological predictors of CPM. Fear of breast cancer was the most commonly cited reason for CPM, followed by cosmetic reasons such as desire for symmetry. Overall, women appeared satisfied with CPM, however, adverse/diminished body image, poor cosmetic result, complications, diminished sense of sexuality, emotional issues and perceived lack of education regarding alternative surveillance/CPM efficacy were cited as reasons for dissatisfaction. Current literature has begun to identify patient-reported reasons for CPM; however, the relative importance of different factors and how these factors relate to the process underlying the decision to have CPM are unknown. Of women who considered CPM, limited information is available regarding differences between those who proceed with or ultimately decline CPM. Copyright © 2016 Elsevier Ltd. All rights reserved.

HIV Point-of-Care Testing in Canadian Settings: A Scoping Review.

PubMed

Minichiello, Alexa; Swab, Michelle; Chongo, Meck; Marshall, Zack; Gahagan, Jacqueline; Maybank, Allison; Hot, Aurélie; Schwandt, Michael; Gaudry, Sonia; Hurley, Oliver; Asghari, Shabnam

2017-01-01

HIV point-of-care testing (POCT) was approved for use in Canada in 2005 and provides important public health benefits by providing rapid screening results rather than sending a blood sample to a laboratory and waiting on test results. Access to test results soon after testing (or during the same visit) is believed to increase the likelihood that individuals will receive their results and improve access to confirmatory testing and linkages to care. This paper reviews the literature on the utilization of HIV POCT across Canadian provinces. We searched OVID Medline, Embase, EBM Reviews, PsycINFO, CINAHL, and 20 electronic grey literature databases. All empirical studies investigating HIV POCT programs in Canada published in French or English were included. Searches of academic databases identified a total of 6,091 records. After removing duplicates and screening for eligibility, 27 records were included. Ten studies are peer-reviewed articles, and 17 are grey literature reports. HIV POCT in Canada is both feasible and accepted by Canadians. It is preferred to conventional HIV testing (ranging from 81.1 to 97%), and users are highly satisfied with the testing process (ranging between 96 and 100%). The majority of studies demonstrate that HIV POCT is feasible, preferred, and accepted by diverse populations in Canada. Losses to follow-up and linkage rates are also good. However, more research is needed to understand how best to scale up HIV POCT in contexts that currently have very limited or no access to testing.

The use of the exit interview to reduce turnover amongst healthcare professionals.

PubMed

Flint, Anndrea; Webster, Joan

2011-01-19

Exit interviews are widely used in healthcare organisations to identify reasons for staff attrition, yet their usefulness in limiting turnover is unclear. To determine the effectiveness of various exit interview strategies in decreasing turnover rates amongst healthcare professionals. We used a comprehensive search strategy including an electronic search of the following databases: DARE, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC (search date: 7 September 2010) and EPOC Specialised Register (search date: 30 September 2009). We also screened the reference lists of included studies and relevant reviews. Randomised controlled trials, controlled clinical trials, controlled before and after studies and interrupted time series studies comparing turnover rates between healthcare professionals who had undergone one form of exit interview with another form of exit interview or with no interview. Two review authors independently assessed trial quality and extracted data. The search identified 1560 citations of which we considered 19 potentially relevant. The two authors independently reviewed the abstracts of these studies and retrieved the full texts of eight studies. We excluded all eight following independent assessment. They were either interviews, commentaries on how to do an exit interview or descriptive studies about reasons for leaving. We found no trials that matched our inclusion criteria. Evidence about the effectiveness of exit interviews to reduce turnover is currently not available. However, exit interviews may provide useful information about the work environment which, in turn, may be useful in the development of interventions to reduce turnover.

Air Pressure, Humidity and Stroke Occurrence: A Systematic Review and Meta-Analysis

PubMed Central

Cao, Yongjun; Wang, Xia; Zheng, Danni; Robinson, Thompson; Hong, Daqing; Richtering, Sarah; Leong, Tzen Hugh; Salam, Abdul; Anderson, Craig; Hackett, Maree L.

2016-01-01

Background/Aims: An influence of climate upon stroke risk is biologically plausible and supported by epidemiological evidence. We aimed to determine whether air pressure (AP) and humidity are associated with hospital stroke admission. Methods: We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 16 October 2015 to identify relevant population-based observational studies. Where possible, data were pooled for meta-analysis with odds ratios (OR) and corresponding 95% confidence intervals (CI) by means of the random-effect method. Results: We included 11 studies with a total of 314,385 patients. The effect of AP was varied across studies for ischemic stroke (IS) and subarachnoid haemorrhage (SAH). Pooled ORs (95%CI) associated with 1 hPa increase in AP for the risk of IS, intracerebral hemorrhage (ICH) and SAH were 1.00 (0.99–1.01), 1.01 (0.99–1.02) and 1.02 (0.97–1.07) respectively. The pooled ORs (95%CI) associated with 1 percent increase in humidity for the risk of IS and ICH were 1.00 (1.00–1.01) and 1.00 (0.99–1.01) respectively. Conclusion: This review shows that there is no evidence of a relationship between AP or humidity and the occurrence of hospital admission for stroke. Further research is needed to clarify the extent and nature of any relationship between AP, humidity and stroke in different geographical areas. PMID:27399733

Knowledge translation and implementation in spinal cord injury: a systematic review.

PubMed

Noonan, V K; Wolfe, D L; Thorogood, N P; Park, S E; Hsieh, J T; Eng, J J

2014-08-01

To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions.

Disasters and Perinatal Health: A Systematic Review

PubMed Central

Harville, EW; Xiong, X; Buekens, P

2012-01-01

Background The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. Methods A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birthweight, congenital anomalies), mental health, and child development. 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. Results Studies addressing the World Trade Center disaster of September 11th and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, though there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. The mother's mental health after a disaster may more strongly influence on child development than any direct effect of disaster-related prenatal stress. Conclusions There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly-exposed women. Future research should focus on under-studied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health. PMID:21375788

Interventions to Improve Hand Hygiene Compliance in the ICU: A Systematic Review.

PubMed

Lydon, Sinéad; Power, Michael; McSharry, Jennifer; Byrne, Molly; Madden, Caoimhe; Squires, Janet Elaine; O'Connor, Paul

2017-11-01

To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included. Data were extracted on the setting, participant characteristics, experimental design, hand hygiene measurement, intervention characteristics, and outcomes. Interventional components were categorized using the Behavior Change Wheel. Methodological quality was examined using the Downs and Black Checklist. Thirty-eight studies were included. The methodological quality of studies was poor, with studies scoring a mean of 8.6 of 24 (SD= 2.7). Over 90% of studies implemented a bundled intervention. The most frequently employed interventional strategies were education (78.9%), enablement (71.1%), training (68.4%), environmental restructuring (65.8%), and persuasion (65.8%). Intervention outcomes were variable, with a mean relative percentage change of 94.7% (SD= 195.7; range, 4.3-1155.4%) from pre to post intervention. This review demonstrates that best practice for improving hand hygiene in ICUs remains unestablished. Future research employing rigorous experimental designs, careful statistical analysis, and clearly described interventions is important.

Interventions for adults with mild intellectual disabilities and mental ill-health: a systematic review.

PubMed

Osugo, M; Cooper, S-A

2016-06-01

People with intellectual disabilities have very high rates of mental ill health. Standard psychosocial interventions designed for the general population may not be accessible for people with mild intellectual disabilities, and drug usage tends to be modified - 'start low and go slow'. This systematic review aims to synthesise the evidence on psychological, pharmacological and electroconvulsive therapy (ECT) interventions for adults with mild intellectual disabilities and mental ill health. PRISMA guidelines were followed. Medline, Embase, PsycINFO and CINAHL were searched, as was grey literature and reference lists of selected papers. Papers were selected based on pre-defined inclusion and exclusion criteria. A proportion of papers were double reviewed. Data was extracted using a structured table. PROSPERO 2015:CRD42015015218. Initially, 18 949 records were identified. Sixteen studies were finally selected for inclusion; seven on psychological therapies, two on group exercise, five on antipsychotics and two on antidepressants. They do not provide definitive evidence for effectiveness of psychosocial interventions, nor address whether starting low and going slow is wise, or causes sub-optimum therapy. There are few evidence-based interventions for people with mild intellectual disabilities and mental ill-health; existing literature is limited in quantity and quality. Group cognitive-behavioural therapies have some supporting evidence - however, further randomised control trials are required, with longer-term follow-up, and larger sample sizes. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing.

PubMed

La Frenais, Francesca L; Bedder, Rachel; Vickerstaff, Victoria; Stone, Patrick; Sampson, Elizabeth L

2018-02-01

To explore global changes in the prescription of analgesic drugs over time in the international long-term care (LTC) population. Systematic review. We included original research articles in English, published and unpublished, that included number of participants, country and year(s) of data collection, and prescription of analgesics (analgesics not otherwise specified, opioids, acetaminophen; scheduled only, or scheduled plus as needed (PRN)). LTC residents. We searched PubMed, EMBASE, CINAHL, International Pharmaceutical Abstracts, PsycINFO, Cochrane, Web of Science, Google Scholar, using keywords for LTC facilities and analgesic medication; hand-searched references of eligible papers; correspondence. Studies were quality rated using an adapted Newcastle-Ottawa scale. Pearson correlation coefficients were generated between percentage of residents prescribed an analgesic and year of data collection. If available, we investigated changes in acetaminophen and opioid prescriptions. Forty studies met inclusion criteria. A moderate correlation (0.59) suggested that scheduled prescription rates for analgesics have increased over time. Similar findings were reflected in scheduled prescriptions for acetaminophen and opioids. No increase was seen when analyzing scheduled plus PRN analgesics. Use of opioids (scheduled plus PRN) appears to have increased over time. Worldwide, use of opioids and acetaminophen has increased in LTC residents. Research is needed to explore whether this reflects appropriate pain management for LTC residents and if PRN medication is used effectively. © 2017 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure.

PubMed

Kane, P M; Murtagh, F E M; Ryan, K; Mahon, N G; McAdam, B; McQuillan, R; Ellis-Smith, C; Tracey, C; Howley, C; Raleigh, C; O'Gara, G; Higginson, I J; Daveson, B A

2015-11-01

Patient-centred care (PCC) is recommended in policy documents for chronic heart failure (CHF) service provision, yet it lacks an agreed definition. A systematic review was conducted to identify PCC interventions in CHF and to describe the PCC domains and outcomes. Medline, Embase, CINAHL, PsycINFO, ASSIA, the Cochrane database, clinicaltrials.gov, key journals and citations were searched for original studies on patients with CHF staged II-IV using the New York Heart Association (NYHA) classification. Included interventions actively supported patients to play informed, active roles in decision-making about their goals of care. Search terms included 'patient-centred care', 'quality of life' and 'shared decision making'. Of 13,944 screened citations, 15 articles regarding 10 studies were included involving 2540 CHF patients. Three studies were randomised controlled trials, and seven were non-randomised studies. PCC interventions focused on collaborative goal setting between patients and healthcare professionals regarding immediate clinical choices and future care. Core domains included healthcare professional-patient collaboration, identification of patient preferences, patient-identified goals and patient motivation. While the strength of evidence is poor, PCC has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF. There is a small but growing body of evidence, which demonstrates the benefits of a PCC approach to care for CHF patients. Research is needed to identify the key components of effective PCC interventions before being able to deliver on policy recommendations.

Protocol for a systematic review of psychological interventions for cancer-related fatigue in post-treatment cancer survivors.

PubMed

Corbett, Teresa; Devane, Declan; Walsh, Jane C; Groarke, AnnMarie; McGuire, Brian E

2015-12-04

Fatigue is a common symptom in cancer patients that can persist beyond the curative treatment phase. Some evidence has been reported for interventions for fatigue during active treatment. However, to date, there is no systematic review on psychological interventions for fatigue after the completion of curative treatment for cancer. This is a protocol for a systematic review that aims to evaluate the effectiveness of psychological interventions for cancer-related fatigue in post-treatment cancer survivors. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database. We will search the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library), PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and relevant sources of grey literature. Randomised controlled trials (RCTs) which have evaluated psychological interventions in adult cancer patients after the completion of treatment, with fatigue as an outcome measure, will be included. Two review authors will independently extract data from the selected studies and assess the methodological quality using the Cochrane Collaboration Risk of Bias Tool. Most existing evidence on cancer-related fatigue is from those in active cancer treatment. This systematic review and meta-analysis will build upon previous evaluations of psychological interventions in people during and after cancer treatment. With the growing need for stage-specific research in cancer, this review seeks to highlight a gap in current practice and to strengthen the evidence base of randomised controlled trials in the area. PROSPERO CRD42014015219.

Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder: a meta-analysis.

PubMed

Shah, Nirav R; Jones, J B; Aperi, Jaclyn; Shemtov, Rachel; Karne, Anita; Borenstein, Jeff

2008-05-01

To systematically review evidence of the treatment benefits of selective serotonin reuptake inhibitors (SSRIs) for symptoms related to severe premenstrual syndrome (PMS) and premenstrual dysphoric disorder. We conducted electronic database searches of MEDLINE, Web of Science, Cochrane Library, Embase, PsycINFO, and Cinahl through March 2007, and hand-searched reference lists and pertinent journals. Studies included in the review were double-blind, randomized, controlled trials comparing an SSRI with placebo that reported a change in a validated score of premenstrual symptomatology. Studies had to report follow-up for any duration longer than one menstrual cycle among premenopausal women who met clinical diagnostic criteria for PMS or premenstrual dysphoric disorder. From 2,132 citations identified, we pooled results from 29 studies (in 19 citations) using random-effects meta-analyses and present results as odds ratios (ORs). Our meta- analysis, which included 2,964 women, demonstrates that SSRIs are effective for treating PMS and premenstrual dysphoric disorder (OR 0.40, 95% confidence interval [CI] 0.31-0.51). Intermittent dosing regimens were found to be less effective (OR 0.55, 95% CI 0.45-0.68) than continuous dosing regimens (OR 0.28, 95% CI 0.18-0.42). No SSRI was demonstrably better than another. The choice of outcome measurement instrument was associated with effect size estimates. The overall effect size is smaller than reported previously. Selective serotonin reuptake inhibitors were found to be effective in treating premenstrual symptoms, with continuous dosing regimens favored for effectiveness.

The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature.

PubMed

Heckemann, B; Zeller, A; Hahn, S; Dassen, T; Schols, J M G A; Halfens, R J G

2015-01-01

Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. Systematic, narrative review. Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Lived Experience of Head and Neck Cancer Patients Receiving Curative Radiotherapy: A Systematic Review and Meta-Ethnography.

PubMed

Fitchett, Russell C; Aldus, Edward J; Fitchett, Lucy R; Cross, Jane

2018-06-08

This review aims to explore, appraise and synthesise the existing evidence of the meaning that head and neck cancer (HNC) patients assign to the experience of receiving curative radiotherapy. Qualitative evidence synthesis was undertaken using meta-ethnography. Published literature was identified using seven databases: AMED, ASSIA, CINAHL, EMBASE, MEDLINE, PubMed and PsycINFO. Databases were searched from January 2005 to April 2017. The strategy was supplemented by grey literature and citation searches. Out of 1403 titles, 57 abstracts and 35 full texts were screened. Ultimately, 8 studies were eligible for inclusion. The evidence base was moderate to strong in quality. Most of the studies showed that HNC patients undergoing radiotherapy have unmet needs. Four related concepts were identified: the disruption to life that the disease and radiotherapy treatment cause; patients' feelings of isolation; the need for patients to make sense of their situation; and the waiting and uncertainty that radiotherapy creates. The current literature suggests that both head and neck cancer and radiotherapy cause disruption in patients' lives. Radiotherapy causes many unpleasant side effects, and in this difficult treatment period, HNC patients feel isolated, uncertain and in need of coping strategies. Therapy radiographers are ideally placed to offer a supportive relationship. By having a deeper understanding of patients' lived experience, radiographers may form stronger relationships and more effectively help patients through their radiotherapy. This article is protected by copyright. All rights reserved.

Gender differences in the learning and teaching of surgery: a literature review

PubMed Central

Josephson, Anna

2014-01-01

Objectives To explore evidence concerning gender differences in teaching and learning in surgery to guide future initiatives. Methods This systematic review was conducted searching in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and PubMed. All studies related to gender differences in surgical education, teaching or learning of surgery at an undergraduate level were included. Data was extracted and critically appraised. Gender differences in learning, teaching, skills acquisition, perceptions and attitudes, interest on surgery, personality and factors influencing interest in surgical careers were differentiated. Results There is an underrepresentation of women in surgical academia, due to lack of role models and gender awareness. It is not clear whether or not gender itself is a factor that affects the learning of surgical tasks. Female students pursuing a surgical career had experienced sexual harassment and gender discrimination that can have an effect on the professional identity formation and specialty choice. There are differences in personality among female and male students interested in surgery. Gender is a determining factor to choose surgery, with a consistent lower proportion of women compared interested in pursuing a surgical career. Mentoring and personality fit are important in medical student’s specialty selection. Female students are more likely to be discouraged from pursuing a surgical career by a lack of female role models. Conclusions Bias against women in surgery still exists. There is a lack of studies that investigate the role of women in the teaching of surgery. PMID:25341220

Effects of substituting nurse practitioners, physician assistants or nurses for physicians concerning healthcare for the ageing population: a systematic literature review.

PubMed

Lovink, Marleen H; Persoon, Anke; Koopmans, Raymond T C M; Van Vught, Anneke J A H; Schoonhoven, Lisette; Laurant, Miranda G H

2017-09-01

To evaluate the effects of substituting nurse practitioners, physician assistants or nurses for physicians in long-term care facilities and primary healthcare for the ageing population (primary aim) and to describe what influences the implementation (secondary aim). Healthcare for the ageing population is undergoing major changes and physicians face heavy workloads. A solution to guarantee quality and contain costs might be to substitute nurse practitioners, physician assistants or nurses for physicians. A systematic literature review. PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL, Web of Science; searched January 1995-August 2015. Study selection, data extraction and quality appraisal were conducted independently by two reviewers. Outcomes collected: patient outcomes, care provider outcomes, process of care outcomes, resource use outcomes, costs and descriptions of the implementation. Data synthesis consisted of a narrative summary. Two studies used a randomized design and eight studies used other comparative designs. The evidence of the two randomized controlled trials showed no effect on approximately half of the outcomes and a positive effect on the other half of the outcomes. Results of eight other comparative study designs point towards the same direction. The implementation was influenced by factors on a social, organizational and individual level. Physician substitution in healthcare for the ageing population may achieve at least as good patient outcomes and process of care outcomes compared with care provided by physicians. Evidence about resource use and costs is too limited to draw conclusions. © 2017 John Wiley & Sons Ltd.

Recommendations on the most suitable quality-of-life measurement instruments for bariatric and body contouring surgery: a systematic review.

PubMed

de Vries, C E E; Kalff, M C; Prinsen, C A C; Coulman, K D; den Haan, C; Welbourn, R; Blazeby, J M; Morton, J M; van Wagensveld, B A

2018-06-08

The objective of this study is to systematically assess the quality of existing patient-reported outcome measures developed and/or validated for Quality of Life measurement in bariatric surgery (BS) and body contouring surgery (BCS). We conducted a systematic literature search in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Database Systematic Reviews and CENTRAL identifying studies on measurement properties of BS and BCS Quality of Life instruments. For all eligible studies, we evaluated the methodological quality of the studies by using the COnsensus-based Standards for the selection of health Measurement INstruments checklist and the quality of the measurement instruments by applying quality criteria. Four degrees of recommendation were assigned to validated instruments (A-D). Out of 4,354 articles, a total of 26 articles describing 24 instruments were included. No instrument met all requirements (category A). Seven instruments have the potential to be recommended depending on further validation studies (category B). Of these seven, the BODY-Q has the strongest evidence for content validity in BS and BCS. Two instruments had poor quality in at least one required quality criterion (category C). Fifteen instruments were minimally validated (category D). The BODY-Q, developed for BS and BCS, possessed the strongest evidence for quality of measurement properties and has the potential to be recommended in future clinical trials. © 2018 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

A systematic review of outcome measures utilised to assess self-management in clinical trials in patients with chronic pain.

PubMed

Banerjee, Anirban; Hendrick, Paul; Bhattacharjee, Purba; Blake, Holly

2018-05-01

The aim of this review was to identify, appraise and synthesise the outcome measures used to assess self-management in patients with chronic pain. Medline, Embase, CINAHL, PsycINFO, the Cochrane Library and Google Scholar were searched to identify quantitative measures used within randomised or non-randomised clinical trials to assess self-management in adults (≥18 years) with chronic pain. 25 RCTs published between 1998 and 2016 were included in this review. Studies included patients with chronic pain, hip/knee osteoarthritis, rheumatoid arthritis, chronic low back pain, fibromyalgia and chronic fatigue syndrome. Included studies utilised 14 different measures assessing a variety of constructs including self-efficacy (n = 19), coping (n = 4), empowerment (n = 2), pain attitude and management (n = 3), self-care (n = 1), role behaviour (n = 1) and multiple constructs of self-management (n = 1). The Chronic Pain Coping Inventory (CPCI) and Health Education Impact Questionnaire (heiQ) cover different self-management related constructs across the physical, mental and social health domains. The review identified 14 measures used as proxy measure to assess self-management in patients with chronic pain. These measures have good content and construct validity, and internal consistency. However additional research is required to develop their reliability, responsiveness and interpretability. Multi-constructs measures (CPCI, heiQ) are suitable for assessing self-management. Copyright © 2017 Elsevier B.V. All rights reserved.

Parent and child asthma illness representations: a systematic review.

PubMed

Sonney, Jennifer T; Gerald, Lynn B; Insel, Kathleen C

2016-06-01

The purpose of this article is to synthesize the current literature on parent and child asthma illness representations and their consequent impact on parent-child asthma shared management. This systematic review was conducted in concordance with the PRISMA statement. An electronic search of five computerized databases (PubMed, PsycINFO, CINAHL, Cochrane, and EMBASE) was conducted using the following key words: asthma, illness representation, and child. Due to the limited number of articles identified, the search was broadened to include illness perceptions as well. Studies were included if they were specific to asthma and included parent and/or child asthma illness representations or perception, were published after 2000, and available in English. Fifteen articles were selected for inclusion. All of the articles are descriptive studies that used cross-sectional designs. Seven of the studies used parent and child participants, eight used parents only, and none used only child participants. None of the selected studies describe child asthma illness representations, and only three describe parental asthma illness representations. Domains of illness representations, including symptoms, timeline, consequences, cause, and controllability were described in the remaining articles. Symptoms and controllability appear to have the most influence on parental asthma management practices. Parents prefer symptomatic or intermittent asthma management and frequently cite concerns regarding daily controller medication use. Parents also primarily rely on their own objective symptom observations rather than the child's report of symptoms. Asthma illness representations are an important area of future study to better understand parent-child shared asthma management.

Are ADHD medications under or over prescribed worldwide?: Protocol for a systematic review and meta-analysis.

PubMed

Moreira-Maia, Carlos Renato; Massuti, Rafael; Tessari, Luca; Campani, Fausto; Akutagava-Martins, Glaucia Chiyoko; Cortese, Samuele; Rohde, Luis Augusto

2018-06-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, characterized by age inappropriate and impairing levels of inattention and/or hyperactivity/impulsivity. Pharmacotherapy is an important part of the ADHD multimodal treatment. The extent to which ADHD is pharmacologically over or under treated worldwide is controversial. We aimed to estimate the pooled worldwide rate of ADHD pharmacological treatment in individuals with and without the disorder. We will include published or unpublished studies reporting the rates of ADHD pharmacological treatment in participants with and without ADHD of any age group. Population-based, cohort, or follow-up studies, as well as data from insurance health system and third-party reimbursements will be eligible. Searches will be performed in a large number of electronic databases, including Medline, Embase, CINAHL, Cochrane, PsycINFO, Web of Science, and Scopus. The primary outcome will be the prevalence of ADHD pharmacological treatment in individuals with ADHD and without ADHD. Two independent reviewers will perform the screening, and data extraction process. Study quality/bias will be assessed with the Newcastle-Ottawa scale by 2 independent reviewers. To test the robustness of the findings, we will perform a series of sensitivity and meta-regression analysis. Analyses will be performed with R and STATA software. No IRB approval will be necessary. The results of this systematic review and meta-analysis will be presented at international conferences and published in peer-reviewed journals. PROSPERO 2018 CRD42018085233.

Resilience of primary healthcare professionals: a systematic review

PubMed Central

Robertson, Helen D; Elliott, Alison M; Burton, Christopher; Iversen, Lisa; Murchie, Peter; Porteous, Terry; Matheson, Catriona

2016-01-01

Background Modern demands and challenges among healthcare professionals can be particularly stressful and resilience is increasingly necessary to maintain an effective, adaptable, and sustainable workforce. However, definitions of, and associations with, resilience have not been examined within the primary care context. Aim To examine definitions and measures of resilience, identify characteristics and components, and synthesise current evidence about resilience in primary healthcare professionals. Design and setting A systematic review was undertaken to identify studies relating to the primary care setting. Method Ovid®, Embase®, CINAHL, PsycINFO, and Scopus databases were searched in December 2014. Text selections and data extraction were conducted by paired reviewers working independently. Data were extracted on health professional resilience definitions and associated factors. Results Thirteen studies met the inclusion criteria: eight were quantitative, four qualitative, and one was an intervention study. Resilience, although multifaceted, was commonly defined as involving positive adaptation to adversity. Interactions were identified between personal growth and accomplishment in resilient physicians. Resilience, high persistence, high self-directedness, and low avoidance of challenges were strongly correlated; resilience had significant associations with traits supporting high function levels associated with demanding health professional roles. Current resilience measures do not allow for these different aspects in the primary care context. Conclusion Health professional resilience is multifaceted, combining discrete personal traits alongside personal, social, and workplace features. A measure for health professional resilience should be developed and validated that may be used in future quantitative research to measure the effect of an intervention to promote it. PMID:27162208

Resilience of primary healthcare professionals: a systematic review.

PubMed

Robertson, Helen D; Elliott, Alison M; Burton, Christopher; Iversen, Lisa; Murchie, Peter; Porteous, Terry; Matheson, Catriona

2016-06-01

Modern demands and challenges among healthcare professionals can be particularly stressful and resilience is increasingly necessary to maintain an effective, adaptable, and sustainable workforce. However, definitions of, and associations with, resilience have not been examined within the primary care context. To examine definitions and measures of resilience, identify characteristics and components, and synthesise current evidence about resilience in primary healthcare professionals. A systematic review was undertaken to identify studies relating to the primary care setting. Ovid(®), Embase(®), CINAHL, PsycINFO, and Scopus databases were searched in December 2014. Text selections and data extraction were conducted by paired reviewers working independently. Data were extracted on health professional resilience definitions and associated factors. Thirteen studies met the inclusion criteria: eight were quantitative, four qualitative, and one was an intervention study. Resilience, although multifaceted, was commonly defined as involving positive adaptation to adversity. Interactions were identified between personal growth and accomplishment in resilient physicians. Resilience, high persistence, high self-directedness, and low avoidance of challenges were strongly correlated; resilience had significant associations with traits supporting high function levels associated with demanding health professional roles. Current resilience measures do not allow for these different aspects in the primary care context. Health professional resilience is multifaceted, combining discrete personal traits alongside personal, social, and workplace features. A measure for health professional resilience should be developed and validated that may be used in future quantitative research to measure the effect of an intervention to promote it. © British Journal of General Practice 2016.

Conflicting relationship between dietary intake and metabolic health in PTSD: A systematic review.

PubMed

Theal, Rebecca; Tay, Valerie Xin Pei; Hickman, Ingrid J

2018-06-01

Posttraumatic stress disorder (PTSD) is a disabling psychological condition associated with significant physical comorbidities. There has been growing evidence to support the relationship between PTSD and cardiometabolic disease. Disordered eating behaviors often seen in people with PTSD symptoms may explain increased cardiometabolic risk. This systematic review aimed to assess the quality of evidence surrounding dietary intake of individuals with symptoms or a diagnosis of PTSD and their associated risk with cardiometabolic health outcomes. Online databases Scopus, ProQuest (Health), Embase, Medline, PsycINFO, and CINAHL with Full Text were searched for peer-reviewed English articles prior to December 2017 that examined dietary intake and cardiometabolic health outcomes in adults with PTSD symptoms or diagnosis. The quality of each study was graded based on the design and methodology using adapted quality assessment tools. Seven studies with five unique participant samples were included in the review. Study methods, design, populations, and outcomes were inconsistent across studies. Dietary intake was considerably varied and limited associations were demonstrated between dietary intake and cardiometabolic risk factors in the PTSD cohorts. Due to the variability of measures and study outcomes, there was insufficient evidence to determine the relationship between dietary intake and PTSD-related cardiometabolic health outcomes. Future studies are needed to examine these associations in individuals with PTSD: specifically higher quality descriptive studies are necessary to confirm a link between diet and cardiometabolic disease in PTSD. Copyright © 2018 Elsevier Inc. All rights reserved.

Biopsychosocial correlates of hope in Asian patients with cancer: a systematic review

PubMed Central

Mahendran, Rathi; Chua, Shi Min; Yee, Isaac J; Tan, Joyce Y S; Kua, Ee Heok; Griva, Konstadina

2016-01-01

Objective To examine the factors associated with hope and hopelessness in patients with cancer in Asian countries, and the instruments used to measure hope and hopelessness. Methords A comprehensive systematic review was conducted with search terms, including cancer, hope, hopelessness and individual Asian country names, on CINAHL, Embase, PsycINFO, PubMed and Scopus databases. Only quantitative studies on adult cancer populations in Asia examining hope or hopelessness were included. Results A total of 2062 unique articles were retrieved from the databases, and 32 studies were selected for inclusion in this review. Hope and hopelessness were most frequently measured with the Herth Hope Index and the Mental Adjustment to Cancer Scale, respectively. The biopsychosocial factors that were most consistently associated with hope and hopelessness included sociodemographic variables (education, employment and economic status); clinical factors (cancer stage, physical condition and symptoms); and psychosocial factors (emotional distress, social support and connections, quality of life, control or self-efficacy, as well as adjustment and resilience). Discussion There is a need for more studies from South and Southeast Asia as most studies hailed from East Asia. This review highlighted the possibility of cultural differences influencing factors related to hope, suggesting that cross-cultural studies specifically would facilitate understanding behind these variations, although future reviews on hope should also include studies on hopelessness for a comprehensive understanding of the concept. Finally, more longitudinal research could be conducted to assess whether the factors associated with hope and hopelessness change over time and disease progression. PMID:27855093

Rest and treatment/rehabilitation following sport-related concussion: a systematic review.

PubMed

Schneider, Kathryn J; Leddy, John J; Guskiewicz, Kevin M; Seifert, Tad; McCrea, Michael; Silverberg, Noah D; Feddermann-Demont, Nina; Iverson, Grant L; Hayden, Alix; Makdissi, Michael

2017-06-01

The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). Systematic review. MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically. Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded. Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care. A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit. PROSPERO 2016:CRD42016039570. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Epidemiology of sport-related spinal cord injuries: A systematic review.

PubMed

Chan, Christie Wl; Eng, Janice J; Tator, Charles H; Krassioukov, Andrei

2016-05-01

Despite the recognition of sports as a significant contributor in the etiology of spinal cord injury (SCI), no studies have systematically explored the epidemiology of SCI caused by sports. This paper aims to give a systematic overview of the epidemiology of sport-related spinal cord injury around the world. A systematic review was conducted to identify published literature reporting the epidemiology of SCI caused by sports. The literature search was conducted in MEDLINE/PubMed, CINAHL, EMBASE, PsycINFO and Sportdiscus with date limits 1980 through to July 2015. Data from 54 studies covering 25 countries was extracted and collated. Important findings include identification of 6 countries in which sports accounts for over 13% of SCI (highest to lowest: Russia, Fiji, New Zealand, Iceland, France and Canada); individual sports with high risk for SCI (diving, skiing, rugby, and horseback riding); and the most common level of injury for various sports (almost entirely cervical for hockey, skiing, diving and American football, while over half of horseback riding and snowboarding injuries are thoracic or lumbosacral). This paper identifies countries and sports with higher rates of sport-related SCIs where implementation of prevention programs and reporting systems to track SCI epidemiology may be helpful, and highlights gaps in our current knowledge for further investigation. The comparison of SCI occurrence for each sport across countries, as well as examination of the specific characteristics of SCI incurred for individual sports will assist in directing efforts for prevention.

Medication and monitoring in palliative sedation therapy: a systematic review and quality assessment of published guidelines.

PubMed

Schildmann, Eva Katharina; Schildmann, Jan; Kiesewetter, Isabel

2015-04-01

Palliative sedation therapy (PST) is increasingly used in patients at the end of life. However, consensus about medications and monitoring is lacking. To assess published PST guidelines with regard to quality and recommendations on drugs and monitoring. We searched CINAHL, the Cochrane Library, Embase, PsycINFO, PubMed, and references of included articles until July 2014. Search terms included "palliative sedation" or "sedation" and "guideline" or "policy" or "framework." Guideline selection was based on English or German publications that included a PST guideline. Two investigators independently assessed the quality of the guidelines according to the Appraisal of Guidelines for Research and Evaluation II instrument (AGREE II) and extracted information on drug selection and monitoring. Nine guidelines were eligible. Eight guidelines received high quality scores for the domain "scope and purpose" (median 69%, range 28-83%), whereas in the other domains the guidelines' quality differed considerably. The majority of guidelines suggest midazolam as drug of first choice. Recommendations on dosage and alternatives vary. The guidelines' recommendations regarding monitoring of PST show wide variation in the number and details of outcome parameters and methods of assessment. The published guidelines on PST vary considerably regarding their quality and content on drugs and monitoring. Given the need for clear guidance regarding PST in patients at the end of life, this comparative analysis may serve as a starting point for further improvement. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Why Do Women Not Use Preconception Care? A Systematic Review On Barriers And Facilitators.

PubMed

Poels, Marjolein; Koster, Maria P H; Boeije, Hennie R; Franx, Arie; van Stel, Henk F

2016-10-01

Preconception care (PCC) has the potential to optimize pregnancy outcomes. However, awareness of PCC among the target population is generally limited, and the use of PCC remains low. The objective of this study was to review the literature on women's perceptions regarding barriers and facilitators for the use of PCC. A systematic search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO for published studies until February 2015. Original qualitative and quantitative peer-reviewed studies from Western countries in English, holding women's perceptions regarding barriers and facilitators for the use of PCC. Data extraction and analysis were performed using NVivo version 10 software. A coding frame was derived from the findings and applied by 2 authors. Thematic analysis was used to identify key topics and themes. Twenty-one good-quality articles were included, of which 10 qualitative and 11 quantitative studies. Seven main themes were identified: preconditions, emotions and beliefs, perceived need, knowledge and experience, social structure, accessibility, and provider characteristics. "Not (fully) planning pregnancy", "perceived absence of risks", "lack of awareness", and "pregnancy experiences" were the most frequently identified barriers and "believing in the benefits" and "availability of PCC" the most frequently identified facilitators for PCC use. Women perceive more barriers than facilitators related to PCC uptake, which explains why the use of PCC remains low. Our results provide a starting point to refocus interventions and strategies, aiming on enlarging the awareness, perceived importance, and accessibility of PCC to improve its uptake.

Interventions for adult family carers of people who have had a stroke: a systematic review.

PubMed

Brereton, Louise; Carroll, Christopher; Barnston, Sue

2007-10-01

A systematic review of the effectiveness of interventions for adult family carers of people with stroke, and an exploratory examination of the relationship between the conceptual basis of these interventions and their effectiveness. Seventeen electronic databases and grey literature sources were searched, including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index and the Science Citation Index, HMIC and the National Research Register. Authors of unpublished material were contacted for data and additional publications. Reference and citation tracking was performed on included publications. randomized controlled trials of interventions aimed primarily at adult family carers of people post stroke; carers were the primary sample; primary outcomes reported were for carers. Two independent reviewers screened titles and abstracts to identify publications and extract data. Quality assessment was performed to weight study findings. Eight papers were found reporting on six complex, generally heterogeneous, interventions: caregiver training; education and counselling; social problem-solving partnerships, delivered principally by telephone; a psycho-educational telephone support group; a nurse-led support and education programme; and a support programme, delivered either to groups in hospital or individuals during home visits. Half of the interventions were based on stress-coping theories; the remainder did not identify a conceptual basis for the intervention. Some benefits were reported for all interventions, although trials were generally of low quality, preventing firm conclusions being drawn. The presence of a conceptual basis for interventions does not appear to influence effectiveness.

Epidemiology of sport-related spinal cord injuries: A systematic review

PubMed Central

Chan, Christie WL; Tator, Charles H.

2016-01-01

Context Despite the recognition of sports as a significant contributor in the etiology of spinal cord injury (SCI), no studies have systematically explored the epidemiology of SCI caused by sports. Objective This paper aims to give a systematic overview of the epidemiology of sport-related spinal cord injury around the world. Methods A systematic review was conducted to identify published literature reporting the epidemiology of SCI caused by sports. The literature search was conducted in MEDLINE/PubMed, CINAHL, EMBASE, PsycINFO and Sportdiscus with date limits 1980 through to July 2015. Data from 54 studies covering 25 countries was extracted and collated. Results Important findings include identification of 6 countries in which sports accounts for over 13% of SCI (highest to lowest: Russia, Fiji, New Zealand, Iceland, France and Canada); individual sports with high risk for SCI (diving, skiing, rugby, and horseback riding); and the most common level of injury for various sports (almost entirely cervical for hockey, skiing, diving and American football, while over half of horseback riding and snowboarding injuries are thoracic or lumbosacral). Conclusion This paper identifies countries and sports with higher rates of sport-related SCIs where implementation of prevention programs and reporting systems to track SCI epidemiology may be helpful, and highlights gaps in our current knowledge for further investigation. The comparison of SCI occurrence for each sport across countries, as well as examination of the specific characteristics of SCI incurred for individual sports will assist in directing efforts for prevention. PMID:26864974

Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.

PubMed

Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini

2017-06-01

Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.

Short- and long-term impact of critical illness on relatives: literature review.

PubMed

Paul, Fiona; Rattray, Janice

2008-05-01

This paper is a report of a literature review undertaken to identify the short- and long-term impact of critical illness on relatives. Patients in intensive care can experience physical and psychological consequences, and their relatives may also experience such effects. Although it is recognized that relatives have specific needs, it is not clear whether these needs are always met and whether further support is required, particularly after intensive care. The following databases were searched for the period 1950-2007: Medline, British Nursing Index and Archive, EMBASE, CINAHL, PsycINFO and EMB Reviews--Cochrane Central Register of Clinical Trials. Search terms focused on adult relatives of critically ill adult patients during and after intensive care. Recurrent topics were categorized to structure the review, i.e. 'relatives needs', 'meeting relatives' needs', 'interventions', 'satisfaction', 'psychological outcomes' and 'coping'. Studies have mainly identified relatives' immediate needs using the Critical Care Family Needs Inventory. There are few studies of interventions to meet relatives' needs and the short- and long-term effects of critical illness on relatives. Despite widespread use of the Critical Care Family Needs Inventory, factors such as local or cultural differences may influence relatives' needs. Relatives may also have unidentified needs, and these needs should be explored. Limited research has been carried out into interventions to meet relatives' needs and the effects of critical illness on their well-being, yet some relatives may experience negative psychological consequences far beyond the acute phase of the illness.

Rule-based deduplication of article records from bibliographic databases.

PubMed

Jiang, Yu; Lin, Can; Meng, Weiyi; Yu, Clement; Cohen, Aaron M; Smalheiser, Neil R

2014-01-01

We recently designed and deployed a metasearch engine, Metta, that sends queries and retrieves search results from five leading biomedical databases: PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Central Register of Controlled Trials. Because many articles are indexed in more than one of these databases, it is desirable to deduplicate the retrieved article records. This is not a trivial problem because data fields contain a lot of missing and erroneous entries, and because certain types of information are recorded differently (and inconsistently) in the different databases. The present report describes our rule-based method for deduplicating article records across databases and includes an open-source script module that can be deployed freely. Metta was designed to satisfy the particular needs of people who are writing systematic reviews in evidence-based medicine. These users want the highest possible recall in retrieval, so it is important to err on the side of not deduplicating any records that refer to distinct articles, and it is important to perform deduplication online in real time. Our deduplication module is designed with these constraints in mind. Articles that share the same publication year are compared sequentially on parameters including PubMed ID number, digital object identifier, journal name, article title and author list, using text approximation techniques. In a review of Metta searches carried out by public users, we found that the deduplication module was more effective at identifying duplicates than EndNote without making any erroneous assignments.

Rule-based deduplication of article records from bibliographic databases

PubMed Central

Jiang, Yu; Lin, Can; Meng, Weiyi; Yu, Clement; Cohen, Aaron M.; Smalheiser, Neil R.

2014-01-01

We recently designed and deployed a metasearch engine, Metta, that sends queries and retrieves search results from five leading biomedical databases: PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Central Register of Controlled Trials. Because many articles are indexed in more than one of these databases, it is desirable to deduplicate the retrieved article records. This is not a trivial problem because data fields contain a lot of missing and erroneous entries, and because certain types of information are recorded differently (and inconsistently) in the different databases. The present report describes our rule-based method for deduplicating article records across databases and includes an open-source script module that can be deployed freely. Metta was designed to satisfy the particular needs of people who are writing systematic reviews in evidence-based medicine. These users want the highest possible recall in retrieval, so it is important to err on the side of not deduplicating any records that refer to distinct articles, and it is important to perform deduplication online in real time. Our deduplication module is designed with these constraints in mind. Articles that share the same publication year are compared sequentially on parameters including PubMed ID number, digital object identifier, journal name, article title and author list, using text approximation techniques. In a review of Metta searches carried out by public users, we found that the deduplication module was more effective at identifying duplicates than EndNote without making any erroneous assignments. PMID:24434031

Physical activity measurement instruments for children with cerebral palsy: a systematic review.

PubMed

Capio, Catherine M; Sit, Cindy H P; Abernethy, Bruce; Rotor, Esmerita R

2010-10-01

this paper is a systematic review of physical activity measurement instruments for field-based studies involving children with cerebral palsy (CP). database searches using PubMed Central, MEDLINE, CINAHL Plus, PsycINFO, EMBASE, Cochrane Library, and PEDro located 12 research papers, identifying seven instruments that met the inclusion criteria of (1) having been developed for children aged 0 to 18 years, (2) having been used to evaluate a physical activity dimension, and (3) having been used in a field-based study involving children with CP. The instruments reviewed were the Activities Scale for Kids - Performance version (ASKp), the Canada Fitness Survey, the Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC), the Compendium of Physical Activities, the Physical Activity Questionnaire - Adolescents (PAQ-A), StepWatch, and the Uptimer. Second-round searches yielded 11 more papers, providing reliability and validity evidence for the instruments. the instruments measure physical activity frequency, mode, domain, and duration. Although most instruments demonstrated adequate reliability and validity, only the ASKp and CAPE/PAC have established reliability and validity for children with physical disabilities; the Uptimer has established concurrent validity. No instrument measuring intensity in free-living has been validated or found reliable for children with CP. the findings suggest that further studies are needed to examine the methodological properties of physical activity measurement in children with CP. Combining subjective and objective instruments is recommended to achieve better understanding of physical activity participation.

Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control.

PubMed

Chrvala, Carole A; Sherr, Dawn; Lipman, Ruth D

2016-06-01

Assess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. We searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants' knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting. This review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours ≥10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C>9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%). This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels. The data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Leadership training in health care action teams: a systematic review.

PubMed

Rosenman, Elizabeth D; Shandro, Jamie R; Ilgen, Jonathan S; Harper, Amy L; Fernandez, Rosemarie

2014-09-01

To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations. The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9). Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.

Muscle Strength and Fitness in Pediatric Obesity: a Systematic Review from the European Childhood Obesity Group.

PubMed

Thivel, David; Ring-Dimitriou, Susanne; Weghuber, Daniel; Frelut, Marie-Laure; O'Malley, Grace

2016-01-01

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A systematic article search was conducted between November 2014 and June 2015 using MEDLINE, EMBASE, CINAHL psycINFO, SPORTDiscus and SocINDEX. Articles published in English and reporting results on muscle strength and muscular fitness in children and adolescents aged 6 to 18 years were eligible. Of 548 identified titles, 36 studies were included for analyses. While laboratory-based studies described higher absolute muscular fitness in youth with obesity compared with their lean peers, these differences are negated when corrected for body weight and lean mass, then supporting field-based investigations. All interventional studies reviewed led to improved muscular fitness in youth with obesity. Children and adolescents with obesity display impaired muscular fitness compared to healthy-weight peers, which seems mainly due to factors such as excessive body weight and increased inertia of the body. Our analysis also points out the lack of information regarding the role of age, maturation or sex in the current literature and reveals that routinely used field tests analysing overall daily muscular fitness in children with obesity provide satisfactory results when compared to laboratory-based data. © 2016 S. Karger GmbH, Freiburg.

Nocebo and the potential harm of 'high risk' labelling: a scoping review.

PubMed

Symon, Andrew; Williams, Brian; Adelasoye, Qadir A; Cheyne, Helen

2015-07-01

A discussion of the existence, prevalence and characteristics of the nocebo effect in health care. There is increasing but inconsistent evidence for nocebo effects (the opposite of placebo). Causal mechanisms are believed to be similar to placebo (negative effects result from suggestions of negative clinical outcomes). Risk screening in health care may produce this unintended effect through labelling some patients as high risk. Given health care's almost universal coverage this potentially affects many people. Discussion paper following a scoping review of the existence and frequency of nocebo. Literature databases (PsycINFO, MEDLINE, CCTR, CINAHL and EMBASE) searched from inception dates to 2013. Significant empirical evidence indicates that negative beliefs may impact on health outcomes (incidence estimates range from 3-27%). The nocebo effect, rooted in the complex interplay between physiological functioning and social factors, appears significantly more common among women and where prior negative knowledge or expectations exist. Pre-existing psychological characteristics (anxiety, neuroses, panic disorder or pessimism) exacerbate it. While the placebo effect is well documented, there has been no systematic attempt to synthesize primary empirical research on the role of nocebo. It is possible that nocebo outcomes may be preventable through careful consideration of information provision and the prior identification of potentially high risk individuals. This paper summarizes the scale and importance of the nocebo effect, its distribution according to a range of social and clinical variables and its known relation to psychological precursors. It identifies important gaps in the research literature. © 2015 John Wiley & Sons Ltd.

Increased mortality among people with schizophrenia and other non-affective psychotic disorders in the community: A systematic review and meta-analysis.

PubMed

Oakley, Padraig; Kisely, Steve; Baxter, Amanda; Harris, Meredith; Desoe, Jocelyne; Dziouba, Alyona; Siskind, Dan

2018-07-01

There is increasing evidence of excess mortality in schizophrenia but less information on other non-affective psychoses. We therefore generated standardised mortality ratios (SMRs) for community-dwelling people with schizophrenia and other non-affective psychoses, relative to the general population, and examined changes to the SMR over time. We conducted a systematic review in which Pubmed, CINAHL, EMBASE, Google Scholar and PsycINFO were searched for publications that reported SMRs for all-cause mortality among community-dwelling people with schizophrenia and psychotic disorders. Meta-analyses of SMRs were conducted, pooled across genders and then separately by gender. Sub-group analyses were conducted for diagnostic group, global region, decade and risk of study bias. We were able to include 34 studies covering 1,724,906 participants. The gender pooled SMR for schizophrenia and psychotic disorders was 3.08 (95%CI 2.88-3.31). Schizophrenia and broader psychotic disorders had similar SMRs. Stratification by decade of observation suggests that the difference in SMR is not declining and may possibly be widening. Analyses showed high levels of heterogeneity. The appearance of a static or widening mortality gap over time between people with schizophrenia and psychotic disorders and the general population is of concern. However, whether it is an increase over time is unclear, as there are insufficient studies to confirm this. Copyright © 2018 Elsevier Ltd. All rights reserved.

The educational effects of mobile learning on students of medical sciences: A systematic review in experimental studies.

PubMed

Koohestani, Hamid Reza; Soltani Arabshahi, Seyed Kamran; Fata, Ladan; Ahmadi, Fazlollah

2018-04-01

The demand for mobile learning in the medical science educational program is increasing. The present review study gathers evidence highlighted by the experimental studies on the educational effects of mobile learning for medical science students. The study was carried out as a systematic literature search published from 2007 to July 2017 in the databases PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge (Thomson Reuters) , Educational Resources and Information Center (ERIC), EMBASE (Elsevier), Cochrane library, PsycINFO and Google Scholar. To examine quality of the articles, a tool validated by the BEME Review was employed. Totally, 21 papers entered the study. Three main themes emerged from the content of papers: (1) improvement in student clinical competency and confidence, (2) acquisition and enhancing of students' theoretical knowledge, and (3) students' positive attitudes to and perception of mobile learning. Level 2B of Kirkpatrick hierarchy had been examined by all the papers and seven of them had reported two or more outcome levels, but level 4 was not reported in the papers. Our review showed that the students of medical sciences had positive response and attitudes to mobile learning. Moreover, implementation of mobile learning in medical sciences program might lead to valuable educational benefits and improve clinical competence and confidence along with theoretical knowledge, attitudes, and perception of mobile learning. The results indicated that mobile learning strategy in medical education can positively affect learning in all three domains of Bloom's Taxonomy.

Development of an evidence-based framework of factors contributing to patient safety incidents in hospital settings: a systematic review

PubMed Central

McEachan, Rosemary R C; Giles, Sally J; Sirriyeh, Reema; Watt, Ian S; Wright, John

2012-01-01

Objective The aim of this systematic review was to develop a ‘contributory factors framework’ from a synthesis of empirical work which summarises factors contributing to patient safety incidents in hospital settings. Design A mixed-methods systematic review of the literature was conducted. Data sources Electronic databases (Medline, PsycInfo, ISI Web of knowledge, CINAHL and EMBASE), article reference lists, patient safety websites, registered study databases and author contacts. Eligibility criteria Studies were included that reported data from primary research in secondary care aiming to identify the contributory factors to error or threats to patient safety. Results 1502 potential articles were identified. 95 papers (representing 83 studies) which met the inclusion criteria were included, and 1676 contributory factors extracted. Initial coding of contributory factors by two independent reviewers resulted in 20 domains (eg, team factors, supervision and leadership). Each contributory factor was then coded by two reviewers to one of these 20 domains. The majority of studies identified active failures (errors and violations) as factors contributing to patient safety incidents. Individual factors, communication, and equipment and supplies were the other most frequently reported factors within the existing evidence base. Conclusions This review has culminated in an empirically based framework of the factors contributing to patient safety incidents. This framework has the potential to be applied across hospital settings to improve the identification and prevention of factors that cause harm to patients. PMID:22421911

A systematic review of peer mentoring interventions for people with traumatic brain injury.

PubMed

Morris, Richard Pg; Fletcher-Smith, Joanna C; Radford, Kathryn A

2017-08-01

This systematic review sought evidence concerning the effectiveness of peer mentoring for people with traumatic brain injury. Fourteen electronic databases were searched, including PsycINFO, MEDLINE, CINAHL, EMBASE and the Cochrane Library, from inception to September 21 2016. Ten grey literature databases, PROSPERO, two trials registers, reference lists and author citations were also searched. Studies which employed a model of one-to-one peer mentoring between traumatic brain injury survivors were included. Two reviewers independently screened all titles and abstracts before screening full texts of shortlisted studies. A third reviewer resolved disagreements. Two reviewers independently extracted data and assessed studies for quality and risk of bias. The search returned 753 records, including one identified through hand searching. 495 records remained after removal of duplicates and 459 were excluded after screening. Full texts were assessed for the remaining 36 studies and six met the inclusion criteria. All were conducted in the United States between 1996 and 2012 and employed a variety of designs including two randomised controlled trials. A total of 288 people with traumatic brain injury participated in the studies. No significant improvements in social activity level or social network size were found, but significant improvements were shown in areas including behavioural control, mood, coping and quality of life. There is limited evidence for the effectiveness of peer mentoring after traumatic brain injury. The available evidence comes from small-scale studies, of variable quality, without detailed information on the content of sessions or the 'active ingredient' of the interventions.

A Systematic Review of Primary Care Safety Climate Survey Instruments: Their Origins, Psychometric Properties, Quality, and Usage.

PubMed

Curran, Ciara; Lydon, Sinéad; Kelly, Maureen; Murphy, Andrew; Walsh, Chloe; OʼConnor, Paul

2018-06-01

Safety climate (SC) measurement is a common and feasible method of proactive safety assessment in primary care. However, there is no consensus on which instrument is "best" to use. The aim of the study was to identify the origins, psychometric properties, quality, and SC domains measured by survey instruments used to assess SC in primary care settings. Systematic searches were conducted using Medline, Embase, CINAHL, and PsycInfo in February 2016. English-language, peer-reviewed studies that reported the development and/or use of a SC survey in a primary care setting were included. Two reviewers independently extracted data (survey characteristics, origins, and psychometric properties) from studies and applied the Quality Assessment Tool for Studies with Diverse Designs to assess methodological rigour. Safety climate domains within surveys were deductively analyzed and categorized into common healthcare SC themes. Seventeen SC surveys were identified, of which 16 had been adapted from 2 main U.S. hospital-based surveys. Only 1 survey was developed de novo for a primary care setting. The quantity and quality of psychometric testing varied considerably across the surveys. Management commitment to safety was the most frequently measured SC theme (87.5%). Workload was infrequently measured (25%). Valid and reliable instruments, which are context specific to the healthcare environment for intentional use, are essential to accurately assess SC. Key recommendations include further establishing the construct and criterion-related validity of existing instruments as opposed to developing additional surveys.

Psychogeriatric inpatient unit design: a literature review.

PubMed

Dobrohotoff, John T; Llewellyn-Jones, Robert H

2011-03-01

In many parts of the world the provision of psychogeriatric inpatient units (PGUs) remains limited. More units will be required over coming decades given rapid population aging. Medline (1950-2010), psycINFO (1806-2009), EMBASE (1980-2009) and CINAHL (1982-2009) were searched for papers about PGU design. Selected non-peer reviewed literature such as government reports and unpublished academic dissertations were also reviewed. Data were also obtained from the literature related to general adult psychiatry inpatient units where there was limited information from studies of units designed for older people. Over 200 papers were reviewed and 130 were included. There are few good quality studies to guide the design of acute PGUs and much of the existing literature is based on opinion and anecdote or, at best, based on observational studies. Randomized controlled studies comparing different designs and assessing outcomes are virtually non-existent. Several studies have identified violence and trauma resulting from hospitalization as significant problems with current acute PGU care. Despite its limitations the available literature provides useful guidance on how PGU design can optimize patient and staff safety and improve clinical outcomes. There are significant problems with current acute PGUs, and patient mix on existing units is an important issue. Future research should examine patient and staff perceptions of different PGU ward environments, the relationship between ward design and clinical outcomes, the effects of segregating patients with challenging behaviors in dementia and the benefits or otherwise of gender segregation.

Economic evaluations of eHealth technologies: A systematic review.

PubMed

Sanyal, Chiranjeev; Stolee, Paul; Juzwishin, Don; Husereau, Don

2018-01-01

Innovations in eHealth technologies have the potential to help older adults live independently, maintain their quality of life, and to reduce their health system dependency and health care expenditure. The objective of this study was to systematically review and appraise the quality of cost-effectiveness or utility studies assessing eHealth technologies in study populations involving older adults. We systematically searched multiple databases (MEDLINE, EMBASE, CINAHL, NHS EED, and PsycINFO) for peer-reviewed studies published in English from 2000 to 2016 that examined cost-effectiveness (or utility) of eHealth technologies. The reporting quality of included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards statement. Eleven full text articles met the inclusion criteria representing public and private health care systems. eHealth technologies evaluated by these studies includes computerized decision support system, a web-based physical activity intervention, internet-delivered cognitive behavioral therapy, telecare, and telehealth. Overall, the reporting quality of the studies included in the review was varied. Most studies demonstrated efficacy and cost-effectiveness of an intervention using a randomized control trial and statistical modeling, respectively. This review found limited information on the feasibility of adopting these technologies based on economic and organizational factors. This review identified few economic evaluations of eHealth technologies that included older adults. The quality of the current evidence is limited and further research is warranted to clearly demonstrate the long-term cost-effectiveness of eHealth technologies from the health care system and societal perspectives.

Celebrities' impact on health-related knowledge, attitudes, behaviors, and status outcomes: protocol for a systematic review, meta-analysis, and meta-regression analysis.

PubMed

Hoffman, Steven J; Mansoor, Yasmeen; Natt, Navneet; Sritharan, Lathika; Belluz, Julia; Caulfield, Timothy; Freedhoff, Yoni; Lavis, John N; Sharma, Arya M

2017-01-21

Celebrities are highly influential people whose actions and decisions are watched and often emulated by wide audiences. Many celebrities have used their prominent social standing to offer medical advice or endorse health products, a trend that is expected to increase. However, the extent of the impact that celebrities have in shaping the public's health-related knowledge, attitudes, behaviors, and status is unclear. This systematic review seeks to answer the following questions: (1) Which health-related outcomes are influenced by celebrities? (2) How large of an impact do celebrities actually have on these health-related outcomes? (3) Under what circumstances do celebrities produce either beneficial or harmful impacts? Ten databases were searched, including MEDLINE, EMBASE, PsycINFO, PubMed, CINAHL, Communication Complete, Sociological Abstracts, Social Sciences Citation Index, Journals @ Scholars Portal, and ProQuest Dissertations & Theses A&I. Two reviewers conducted title and abstract screening and full-text screening to identify primary studies that employed empirical methods (either quantitative or qualitative) to examine celebrities' impact on health-related knowledge, attitudes, behaviors, or status outcomes. The results of this review will contribute to our understanding of celebrity influences and how to design positive evidence-based celebrity health promotion activities. In addition, these findings can help inform the development of media reporting guidelines pertaining to celebrity health news and provide guidance to public health authorities on whether and how to respond to or work with celebrities. PROSPERO CRD42015019268.

Gender differences in the learning and teaching of surgery: a literature review.

PubMed

Burgos, Carmen M; Josephson, Anna

2014-06-15

To explore evidence concerning gender differences in teaching and learning in surgery to guide future initiatives. This systematic review was conducted searching in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and PubMed. All studies related to gender differences in surgical education, teaching or learning of surgery at an undergraduate level were included. Data was extracted and critically appraised. Gender differences in learning, teaching, skills acquisition, perceptions and attitudes, interest on surgery, personality and factors influencing interest in surgical careers were differentiated. There is an underrepresentation of women in surgical academia, due to lack of role models and gender awareness. It is not clear whether or not gender itself is a factor that affects the learning of surgical tasks. Female students pursuing a surgical career had experienced sexual harassment and gender discrimination that can have an effect on the professional identity formation and specialty choice. There are differences in personality among female and male students interested in surgery. Gender is a determining factor to choose surgery, with a consistent lower proportion of women compared interested in pursuing a surgical career. Mentoring and personality fit are important in medical student's specialty selection. Female students are more likely to be discouraged from pursuing a surgical career by a lack of female role models. Bias against women in surgery still exists. There is a lack of studies that investigate the role of women in the teaching of surgery.

Do psychosocial sleep interventions improve infant sleep or maternal mood in the postnatal period? A systematic review and meta-analysis of randomised controlled trials.

PubMed

Kempler, Liora; Sharpe, Louise; Miller, Christopher B; Bartlett, Delwyn J

2016-10-01

Sleep complaints are common amongst mothers of infants and insufficient, inefficient or fragmented sleep is associated with postnatal depression. The aim of this review is to determine whether psychosocial sleep-focused interventions offered in the perinatal period improve infant sleep or maternal mood. We searched PubMed, PsycInfo, EMBASE and CINAHL with no date restriction. We reviewed 1097 articles, resulting in nine papers (n = 1,656) that fit the eligibility criteria for inclusion in the analyses. The primary outcome was infant sleep, defined as maternal reports of infant nocturnal total sleep time and number of night-time wakes. The secondary outcome was maternal mood. The meta-analysis indicated improvements in reported infant nocturnal total sleep time (Hedge's g = 0.204, p < 0.01). However, there was no evidence for reducing infant night wakes (Hedge's g = 0.103, p = 0.134). There was evidence of maternal mood improvements (Hedge's g = 0.152, p = 0.014), however, this could have been influenced by publication bias. Psychosocial sleep interventions appear to impact the amount of sleep that a mother reports her baby to have, although the infants continue to wake as frequently. More research is needed to confirm whether sleep-related improvements can translate into improvements in maternal mood. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Experiences and needs of parents of hospitalised children with disabilities and the health professionals responsible for the child’s health-care – A systematic review].

PubMed

Seliner, Brigitte; Wattinger, Alexandra; Spirig, Rebecca

2015-10-01

Children with disabilities are more often hospitalized than healthy children and burden their parents additionally. Though the parents usually take care of the disabled child in the hospital, systematic knowledge on the experiences of these care-giving parents in hospital is missing in German-speaking countries. What are the experiences and needs described by parents of hospitalized children with disabilities as well as by health professionals responsible for the child’s health-care and what are the implications for parental support? A systematic review according to the PRISMA Statement was performed in the databases Pubmed/Medline, PsycINFO, CINAHL and EMBASE in January 2014. Fourteen publications were analysed thematically using content analysis. The literature identified confirmed the heightened burden of the parents and particularly of the nurses due to emotional and work-related stress. Moreover, the adjustment process, mainly of parents of frequently hospitalized children, was detected. Communication and organisation based on family-centred service can improve the parents’ and the child’s wellbeing. Considering the burden experienced by parents, their support must be of central concern for all health professionals. Nurses can support parents and thus the hospitalized child in the adjustment process by focused preparation and continuous attendance based on family-centred care. The latter must be supported by the management and the multidisciplinary team to tailor the competences and the organization accordingly.

Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature.

PubMed

Brom, Linda; Hopmans, Wendy; Pasman, H Roeline W; Timmermans, Danielle R M; Widdershoven, Guy A M; Onwuteaka-Philipsen, Bregje D

2014-04-03

Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients' preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence. A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples. Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients. This review suggests that a similar approach to all patients is not likely to meet patients' wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients' participation wishes on a regular basis during their illness trajectory.

Congruence between patients’ preferred and perceived participation in medical decision-making: a review of the literature

PubMed Central

2014-01-01

Background Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients’ preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence. Methods A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples. Results Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients. Conclusion This review suggests that a similar approach to all patients is not likely to meet patients’ wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients’ participation wishes on a regular basis during their illness trajectory. PMID:24708833

International approaches to driving under the influence of cannabis: A review of evidence on impact.

PubMed

Watson, Tara Marie; Mann, Robert E

2016-12-01

There are knowledge gaps regarding the effectiveness of different approaches designed to prevent and deter driving under the influence of cannabis (DUIC). Policymakers are increasingly interested in evidence-based responses to DUIC as numerous jurisdictions worldwide have legally regulated cannabis or are debating such regulation. We contribute a comprehensive review of international literature on countermeasures that address DUIC, and identify where and how such measures have been evaluated. The following databases were systematically searched from 1995 to present: Medline, Embase, PsycINFO, CINAHL, Sociological Abstracts, and Criminal Justice Abstracts. Hand searching of relevant documents, internet searches for grey literature, and review of ongoing email alerts were conducted to capture any emerging literature and relevant trends. Numerous international jurisdictions have introduced a variety of measures designed to deter DUIC. Much interest has been generated regarding non-zero per se laws that set fixed legal limits for tetrahydrocannabinol and/or its metabolites detected in drivers. Other approaches include behavioural impairment laws, zero-tolerance per se laws, roadside drug testing, graduated licensing system restrictions, and remedial programs. However, very few evaluations have appeared in the literature. Although some promising results have been reported (e.g., roadside testing), it is premature to draw firm conclusions regarding the broader impacts of general deterrent approaches to DUIC. This review points to the need for a long-term commitment to rigorously evaluate, using multiple methods, the impact of general and specific deterrent DUIC countermeasures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A meta-synthesis of factors influencing nursing home staff decisions to transfer residents to hospital.

PubMed

Laging, Bridget; Ford, Rosemary; Bauer, Michael; Nay, Rhonda

2015-10-01

To report a meta-synthesis of qualitative research studies exploring the role of nursing home staff in decisions to transfer residents to hospital. Nurses and nurse assistants provide the majority of care to residents living in nursing homes and may be the only health workers present when a resident deteriorates. To inform future strategies, it is vital to understand the role of nursing home staff in decisions to transfer to hospital. A systematic review identified 17 studies to be included. The process of meta-synthesis was undertaken using the Joanna Briggs Institute's guidelines. Qualitative research papers published between January 1989-October 2012 were identified in key databases including Cinahl, Embase, Medline and PsycInfo. Nursing home staff members play a key role in decision-making at the time of a resident's deterioration. Multiple factors influence decisions to transfer to hospital including an unclear expectation of the nursing home role; limited staffing capacity; fear of working outside their scope of practice; poor access to multidisciplinary support and difficulties communicating with other decision-makers. There is a lack of consensus regarding the role of the nursing home when a resident's health deteriorates. Nursing home staff would benefit from a clear prescription of their expected minimum clinical skill set; a staffing capacity that allows for the increased requirements to manage residents on-site, greater consistency in access to outside resources and further confidence and skills to optimize their role in resident advocacy. © 2015 John Wiley & Sons Ltd.

Enablement in health care context: a concept analysis.

PubMed

Hudon, Catherine; St-Cyr Tribble, Denise; Bravo, Gina; Poitras, Marie-Eve

2011-02-01

The enablement process is defined as a professional intervention aiming to recognize, support and emphasize the patient's capacity to have control over her or his health and life. The purpose of this article was to study the enablement concept through a concept analysis in the health care context to identify: (1) its attributes and (2) its antecedents and consequents. A concept analysis was performed according to the method of Rodgers. The literature was reviewed from 1980 to June 2008, using search strategies adapted to the databases Cinahl, Medline, Embase, PsycInfo and Social Works Abstract, and hand searching. All articles contributing to a deeper understanding of the concept were included. The analysis was carried out according to a thematic analysis procedure, as described by Miles & Huberman. The search identified 1305 citations. After in-depth assessment of 148 potentially eligible citations, 61 articles were included in the review. Five articles were added with hand searching. Sixty-seven per cent of these articles were related to nursing. The attributes of the enablement concept included: contribution to the therapeutic relationship; consideration of the person as a whole; facilitation of learning; valorization of the person's strengths; implication and support to decision making; and broadening of the possibilities. These attributes could be used as a basis for other studies on enablement. Conceptual and empirical work is still needed to better position this concept among others such as patient-centred care, shared decision making and patient's participation. © 2010 Blackwell Publishing Ltd.

Predictors of quality of life for chronic stroke survivors in relation to cultural differences: a literature review.

PubMed

Wang, Rongrong; Langhammer, Birgitta

2017-09-26

Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self-perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. © 2017 Nordic College of Caring Science.

Technologies for an aging society: a systematic review of "smart home" applications.

PubMed

Demiris, G; Hensel, B K

2008-01-01

A "smart home" is a residence wired with technology features that monitor the well-being and activities of their residents to improve overall quality of life, increase independence and prevent emergencies. This type of informatics applications targeting older adults, people with disabilities or the general population is increasingly becoming the focus of research worldwide. The aim of this study was to provide a comprehensive review of health related smart home projects and discuss human factors and other challenges. To cover not only the medical but also the social sciences and electronics literature, we conducted extensive searches across disciplines (e.g., Medline, Embase, CINAHL, PsycINFO, Electronics and Communications Abstracts, Web of Science etc.). In order to be inclusive of all new initiatives and efforts in this area given the innovativeness of the concept, we manually searched for relevant references in the retrieved articles as well as published books on smart homes and gerontechnology. A total of 114 publications (including papers, abstracts and web pages) were identified and reviewed to identify the overarching projects. Twenty one smart home projects were identified (71% of the projects include technologies for functional monitoring, 67% for safety monitoring, 47% for physiological monitoring, 43% for cognitive support or sensory aids, 19% for monitoring security and 19% to increase social interaction). Evidence for their impact on clinical outcomes is lacking. The field of smart homes is a growing informatics domain. Several challenges including not only technical but also ethical ones need to be addressed.

The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis.

PubMed

Marx, Wolfgang; Kelly, Jaimon; Marshall, Skye; Nakos, Stacey; Campbell, Katrina; Itsiopoulos, Catherine

2017-12-11

End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/), MEDLINE (https://health.ebsco.com/products/medline-with-full-text), Embase (https://www.elsevier.com/solutions/embase-biomedical-research), and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete). Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD) -5.62 mmHg (95% Confidence Interval (CI) -8.47, -2.78); I ² = 2%; p = 0.0001), triglyceride levels (MD -26.52 mg/dL (95% CI -47.22, -5.83); I ² = 57%; p = 0.01), and myeloperoxidase (MD -90.10 (95% CI -135.84, -44.36); I ² = 0%; p = 0.0001). Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.

Effect of Preventive Interventions in Mentally Ill Parents on the Mental Health of the Offspring: Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Siegenthaler, Eliane; Munder, Thomas; Egger, Matthias

2012-01-01

Objective: Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed. Method: The Cochrane, MEDLINE, EMBASE, and PsycINFO databases were searched for randomized controlled…

Systematic review of suicide in economic recession

PubMed Central

Oyesanya, Mayowa; Lopez-Morinigo, Javier; Dutta, Rina

2015-01-01

AIM: To provide a systematic update of the evidence concerning the relationship between economic recession and suicide. METHODS: A keyword search of Ovid Medline, Embase, Embase Classic, PsycINFO and PsycARTICLES was performed to identify studies that had investigated the association between economic recession and suicide. RESULTS: Thirty-eight studies met predetermined selection criteria and 31 of them found a positive association between economic recession and increased suicide rates. Two studies reported a negative association, two articles failed to find such an association, and three studies were inconclusive. CONCLUSION: Economic recession periods appear to increase overall suicide rates, although further research is warranted in this area, particularly in low income countries. PMID:26110126

EMS Systems in Lower-Middle Income Countries: A Literature Review.

PubMed

Suryanto; Plummer, Virginia; Boyle, Malcolm

2017-02-01

Introduction Prehospital care is one of the many issues that require addressing by lower-middle income countries (LMICs) where approximately 90% of global injuries occur. This may arise from more traffic in LMICs, poor road conditions, lack of public awareness of the importance of road safety, and the lack of ability to provide first aid to the victims. However, prehospital care in LMICs remains underdeveloped. Problem There is insufficient evidence regarding the development of prehospital care among LMICs. Thus, the objective of this study was to investigate the status of Emergency Medical Services (EMS) systems in these countries. A review of medical-related electronic databases was designed to identify the development of EMS systems in LMICs. A search of the literature was undertaken using three electronic databases, CINAHL, Ovid Medline, and EMBASE via Ovid, from their commencement date until the end of July 2015. The grey literature was searched using Google Scholar. Articles were included if they reported on the establishment and current status of an EMS system and were excluded if they were letters to the editor, articles focusing on disaster management, a combination of more than one country if the other country was not a LMIC, written in a language other than English or Bahasa Indonesia, and/or focusing only on in-hospital care. There were 337 articles identified in CINAHL, 731 in Ovid Medline, 891 in EMBASE via Ovid, and 41 in Google Scholar. Based on the title and abstract, 31 articles from CINAHL, 40 from Ovid Medline, 43 from EMBASE, and 11 from Google Scholar were retrieved for further review. There were 92 articles that met the inclusion criteria with 35 articles removed, as they were duplicated, leaving 57 articles to be reviewed. From those 48 countries categorized as LMICs, there were 16 (33.3%) countries that had information about an EMS system, including injury types, patient demographic, prehospital transport, and the obstacles in implementing the prehospital care system. The implementation and development of an EMS system is varied among LMICs. Many LMICs lack an organized EMS system with most ambulances used purely for transport and not as an emergency care vehicle. Financial issues are the most common problems faced by LMICs with support from developed countries a necessity. Suryanto , Plummer V , Boyle M . EMS systems in lower-middle income countries: a literature review. Prehosp Disaster Med. 2017;32(1):64-70.

Effect of drug reminder packaging on medication adherence: a systematic review revealing research gaps

PubMed Central

2014-01-01

Background This was a systematic review of the literature in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Evidence mapping was used to reveal the effect of drug reminder packaging on medication adherence, to identify research gaps and to make suggestions for future research. Methods PubMed, Embase, CINAHL and PsycINFO were searched with an end date of September 2013 using the Medical Subject Headings (MeSH) term ‘medication adherence’ and 20 different search terms for ‘drug reminder packaging’, limited to the English and German languages. Additional references were identified through cross-referencing. All prospective controlled trials with an intervention using drug reminder packaging for patients taking at least one medication without the assistance of a health-care professional were included in the evidence mapping of the effect of drug reminder packaging on adherence and outcomes according to the Economic, Clinical and Humanistic Outcomes (ECHO) model. Results A total of 30 studies met the inclusion criteria: 10 randomized controlled trials, 19 controlled clinical trials and 1 cohort study. Drug reminder packaging had a significant effect on at least one adherence parameter in 17 studies (57%). The methodological quality was strong in five studies. Two studies provided complete information. Clear research gaps emerged. Conclusions Overall, the studies showed a positive effect of drug reminder packaging on adherence and clinical outcomes. However, poor reporting and important gaps like missing humanistic and economic outcomes and neglected safety issues limit the drawing of firm conclusions. Suggestions are made for future research. PMID:24661495

A systematic review of evidence for older adults' sedentary behavior and physical activity after hip fracture.

PubMed

Zusman, Enav Z; Dawes, Martin G; Edwards, Nicola; Ashe, Maureen C

2018-05-01

To synthesize evidence on older adults' sedentary behavior and physical activity during rehabilitation and recovery for hip fracture (1) across the care continuum and (2) from clinical interventions. We conducted a systematic review of peer-reviewed publications using CINAHL, Embase, Ovid MEDLINE, PsycINFO, and SportDiscus (last search: 17 October 2017). We included studies that measured sedentary behavior and physical activity of older adults with hip fracture using activity monitors (e.g. accelerometers). We identified literature at Level 1 (title and abstract) and Level 2 (full text), and conducted forward and backward searches. We assessed observational studies' adherence to reporting guidelines and intervention studies' risk of bias. We included 14 studies (882 participants). Four studies reported sedentary behavior data, while all studies reported information on physical activity. Settings included hospital, rehabilitation centers, and the community. Nine studies were observational; five were experimental design. Older adults had excessive sedentary time (>10 hours/day) and low physical activity. Participants' average upright time differed across settings. During hospital stay, it ranged 16-52 minutes/day, while in the community, it ranged 51-261 minutes/day. Data from five interventions reported on physical activity change: two studies increased between 14 and 27 minutes/day. Another study reported participants accumulated 6994 steps/day at the end of the intervention, but for two other interventions, activity was below 5000 steps/day. Based on available evidence, older adults with hip fracture engage in prolonged sedentary behavior and have low levels of physical activity during rehabilitation and recovery.

Human Papillomavirus Vaccination and Sexual Disinhibition in Females: A Systematic Review.

PubMed

Madhivanan, Purnima; Pierre-Victor, Dudith; Mukherjee, Soumyadeep; Bhoite, Prasad; Powell, Brionna; Jean-Baptiste, Naomie; Clarke, Rachel; Avent, Tenesha; Krupp, Karl

2016-09-01

Some parents believe human papillomavirus (HPV) vaccination increases the chance of risky sexual behaviors among adolescents. This review summarizes the evidence available on adolescent girls and women engaging in risky sexual activity following HPV vaccination. Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in 2014 and updated in 2015. Literature was searched for articles published between 2004 and 2015 in MEDLINE, PsycInfo, CINAHL, Cochrane Database, Web of Science, and EMBASE without language limits. Studies were screened according to predefined inclusion and exclusion criteria. Methodologic quality of the included articles was assessed. The search resulted in 21 articles to be included in the review, with 527,475 participants. Included studies were conducted in 12 different countries using experimental and observational study designs. The review included data on girls aged as young as 11 years to women aged 40 years. Studies measured changes in sexual behaviors using a variety of outcomes, including age at sexual debut; risky sexual behaviors; use of condoms and contraception; and clinical indicators such as rates of sexually transmitted infections, HIV, and pregnancy terminations. Available data showed either no association between vaccination status and the outcomes of interest or a positive association between safer sexual behaviors, such as condom use and receipt of HPV vaccination. Methodologic quality of all but one study was moderate or weak. This review did not find sufficient evidence to support compensatory sexual risk behaviors following HPV vaccination among adolescent girls or women. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The effects of aquatic therapy on mobility of individuals with neurological diseases: a systematic review.

PubMed

Marinho-Buzelli, Andresa R; Bonnyman, Alison M; Verrier, Mary C

2015-08-01

To summarize evidence on the effects of aquatic therapy on mobility in individuals with neurological diseases. MEDLINE, EMBASE, PsycInfo, CENTRAL, CINAHL, SPORTDiscus, PEDro, PsycBITE and OT Seeker were searched from inception to 15 September 2014. Hand-searching of reference lists was performed in the selected studies. The search included randomized controlled trials and quasi-experimental studies that investigated the use of aquatic therapy and its effect on mobility of adults with neurological diseases. One reviewer screened titles and abstracts of retrieved studies from the search strategy. Two reviewers independently examined the full texts and conducted the study selection, data extraction and quality assessment. A narrative synthesis of data was applied to summarize information from included studies. The Downs and Black Scale was used to assess methodological quality. A total of 116 articles were obtained for full text eligibility. Twenty studies met the specified inclusion criteria: four Randomized Controlled Trials (RCTs), four non-randomized studies and 12 before-and-after tests. Two RCTs (30 patients with stroke in the aquatic therapy groups), three non-randomized studies and three before-and-after studies showed "fair" evidence that aquatic therapy increases dynamic balance in participants with some neurological disorders. One RCT (seven patients with stroke in the aquatic therapy group) and two before-and-after tests (20 patients with multiple sclerosis) demonstrated "fair" evidence on improvement of gait speed after aquatic therapy. Our synthesis showed "fair" evidence supporting the use of aquatic therapy to improve dynamic balance and gait speed in adults with certain neurological conditions. © The Author(s) 2014.

Incentivizing Blood Donation: Systematic Review and Meta-Analysis to Test Titmuss’ Hypotheses

PubMed Central

2013-01-01

Objectives: Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Method: Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. Results: The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91–1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). Conclusion: The limited evidence suggests that Titmuss’ hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PMID:24001244

Effectiveness of dietary supplements in spinal cord injury subjects.

PubMed

Navarrete-Opazo, Angela; Cuitiño, Pilar; Salas, Inés

2017-04-01

Individuals with spinal cord injury (SCI) consume more dietary supplements than the general population. However, there is limited information regarding the clinical effectiveness of dietary supplements in SCI population. To systematically review the effectiveness of dietary supplements for the prevention or treatment of health-related conditions associated with SCI. Randomized or non-randomized controlled clinical trials were selected, comparing the effect of any dose and form of a dietary supplement (defined by the Dietary Supplement Health and Education Act), with either no treatment, placebo, or other medication. Data Sources included the Cochrane Database, DARE, LILACS, CINAHL, EMBASE, MEDLINE, OTSeeker, PEDro, PsycINFO, SpeechBITE, ScienceDirect, Scopus, clinicaltrials.gov, Google Scholar, and OpenGrey. Two reviewers independently classified articles from January 1970 through October 2015, and 18 articles were selected. Due to the heterogeneity of outcome measures across studies, a meta-analysis was not conducted. However, high-quality evidence showed that cranberry supplementation is not effective for prevention of urinary tract infections (UTIs) in SCI. Moderate-quality evidence supported a beneficial effect of vitamin D, alpha-lipoic acid, and omega-3 supplementation, although replication of results is needed. There were conflicting results for the effect of creatine supplementation on improvement of motor outcomes. Low-quality evidence does not permit assessment of the effectiveness of melatonin, whey protein, vitamin C, and Chinese herb in SCI. There is sufficient data suggesting that cranberry supplementation is ineffective for prevention of UTIs in individuals with SCI. There is insufficient data to support or refute the use of any other dietary supplement in individuals with SCI. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of whole body vibration on pulmonary function, functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease: a systematic review.

PubMed

Yang, Xiaotian; Zhou, Yujing; Wang, Pu; He, Chengqi; He, Hongchen

2016-05-01

To examine the effect of whole-body vibration in enhancing pulmonary function, functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease and examine its safety. Randomized controlled trials examining the effects of whole body vibration among people with chronic obstructive pulmonary disease were identified by two independent researchers. Articles were excluded if they were studies on people with other primary diagnosis, abstracts published in the conferences or books. PEDro scale was used to assess the methodological quality of the selected studies. We evaluated the level of evidence by using the GRADE approach. The results were extracted by two researchers and confirmed by the third researcher if disagreement existed. Sources included Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE, PEDro, AMED, PsycINFO, ClinicalTrials.gov, Current Controlled Trials and reference lists of all relevant articles. Four studies involving 206 participants were included in this systematic review. Methodological quality was rated as good for two studies. No great benefits on pulmonary function were found in whole body vibration treatment group. Two studies showed that quality of life was improved in people with chronic obstructive pulmonary disease. Whole body vibration led to significant improvements in functional exercise capacity measured with six minutes walking test. Nearly no adverse events were observed. Whole body vibration may improve functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease. There was insufficient evidence to prove the effects of whole body vibration on pulmonary function. © The Author(s) 2015.

The effectiveness of interventions to reduce the household economic burden of illness and injury: a systematic review

PubMed Central

Kimman, Merel; Svenstrup, Nina; Lindevig Kjoege, Katharina; Lea Laba, Tracey; Hackett, Maree L; Jan, Stephen

2015-01-01

Abstract Objective To determine the nature, scope and effectiveness of interventions to reduce the household economic burden of illness or injury. Methods We systematically reviewed reports published on or before 31 January 2014 that we found in the CENTRAL, CINAHL, Econlit, Embase, MEDLINE, PreMEDLINE and PsycINFO databases. We extracted data from prospective controlled trials and assessed the risk of bias. We narratively synthesized evidence. Findings Nine of the 4330 studies checked met our inclusion criteria – seven had evaluated changes to existing health-insurance programmes and two had evaluated different modes of delivering information. The only interventions found to reduce out-of-pocket expenditure significantly were those that eliminated or substantially reduced co-payments for a given patient population. However, the reductions only represented marginal changes in the total expenditures of patients. We found no studies that had been effective in addressing broader household economic impacts – such as catastrophic health expenditure – in the disease populations investigated. Conclusion In general, interventions designed to reduce the complex household economic burden of illness and injury appear to have had little impact on household economies. We only found a few relevant studies using rigorous study designs that were conducted in defined patient populations. The studies were limited in the range of interventions tested and they evaluated only a narrow range of household economic outcomes. There is a need for method development to advance the measurement of the household economic consequences of illness and injury and facilitate the development of innovative interventions to supplement the strategies based on health insurance. PMID:25883403

Mastery learning for health professionals using technology-enhanced simulation: a systematic review and meta-analysis.

PubMed

Cook, David A; Brydges, Ryan; Zendejas, Benjamin; Hamstra, Stanley J; Hatala, Rose

2013-08-01

Competency-based education requires individualization of instruction. Mastery learning, an instructional approach requiring learners to achieve a defined proficiency before proceeding to the next instructional objective, offers one approach to individualization. The authors sought to summarize the quantitative outcomes of mastery learning simulation-based medical education (SBME) in comparison with no intervention and nonmastery instruction, and to determine what features of mastery SBME make it effective. The authors searched MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, key journals, and previous review bibliographies through May 2011. They included original research in any language evaluating mastery SBME, in comparison with any intervention or no intervention, for practicing and student physicians, nurses, and other health professionals. Working in duplicate, they abstracted information on trainees, instructional design (interactivity, feedback, repetitions, and learning time), study design, and outcomes. They identified 82 studies evaluating mastery SBME. In comparison with no intervention, mastery SBME was associated with large effects on skills (41 studies; effect size [ES] 1.29 [95% confidence interval, 1.08-1.50]) and moderate effects on patient outcomes (11 studies; ES 0.73 [95% CI, 0.36-1.10]). In comparison with nonmastery SBME instruction, mastery learning was associated with large benefit in skills (3 studies; effect size 1.17 [95% CI, 0.29-2.05]) but required more time. Pretraining and additional practice improved outcomes but, again, took longer. Studies exploring enhanced feedback and self-regulated learning in the mastery model showed mixed results. Limited evidence suggests that mastery learning SBME is superior to nonmastery instruction but takes more time.

Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review

PubMed Central

Whitehead, Phillip J; Worthington, Esme J; Parry, Ruth H; Walker, Marion F; Drummond, Avril ER

2015-01-01

Objectives: To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. Data sources: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. Review methods: We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Results: Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed ‘re-ablement’ or ‘restorative homecare’ (n=5/13); and those involving separate components which were not described using this terminology (n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. Conclusion: There is limited evidence that interventions targeted at personal ADL can reduce homecare service users’ dependency with activities, the content of evaluated interventions varies greatly. PMID:25587088

The association between child exposure to intimate partner violence (IPV) and perpetration of IPV in adulthood-A systematic review.

PubMed

Kimber, Melissa; Adham, Sami; Gill, Sana; McTavish, Jill; MacMillan, Harriet L

2018-02-01

Increasingly recognized as a distinct form of childhood maltreatment, children's exposure to intimate partner violence (IPV) has been shown to be associated with an array of negative psychosocial outcomes, including elevated risk for additional violence over the life course. Although studies have identified child exposure to IPV as a predictor of IPV perpetration in adulthood, no review has critically evaluated the methodology of this quantitative work. The present study examines the association between childhood exposure to IPV and the perpetration of IPV in adulthood based on a systematic review of the literature from inception to January 4, 2016. Databases searched included Medline, Embase, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, Sociological Abstracts and ERIC. Database searches were complemented with backward and forward citation chaining. Studies were critically appraised using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Of 5601 articles identified by the search, 19 studies were included for data extraction. Sixteen of these studies found that child exposure to IPV was significantly and positively associated with adult IPV perpetration; three studies reported null findings. The methodological quality of the studies was low. Work thus far has tended to focus on child exposure to physical IPV and the perpetration of physical IPV within heterosexual contexts. In addition, measures of child exposure to IPV vary in their classification of what exposure entails. We critically discuss the strengths and limitations of the existing evidence and the theoretical frameworks informing this work. Copyright © 2017 Elsevier Ltd. All rights reserved.

Light therapy for non-seasonal depression: systematic review and meta-analysis.

PubMed

Perera, Stefan; Eisen, Rebecca; Bhatt, Meha; Bhatnagar, Neera; de Souza, Russell; Thabane, Lehana; Samaan, Zainab

2016-03-01

Light therapy is a known treatment for patients with seasonal affective disorder. However, the efficacy of light therapy in treating patients with non-seasonal depression remains inconclusive. To provide the current state of evidence for efficacy of light therapy in non-seasonal depressive disorders. Systematic review of randomised controlled trials (RCTs) was conducted by searching MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from their inception to September 2015. Study selection, data abstraction and risk of bias assessment were independently conducted in duplicate. Meta-analyses were performed to provide a summary statistic for the included RCTs. The reporting of this systematic review follows the PRISMA guidelines. A meta-analysis including 881 participants from 20 RCTs demonstrated a beneficial effect of light therapy in non-seasonal depression (standardised mean difference in depression score -0.41 (95% CI -0.64 to -0.18)). This estimate was associated with significant heterogeneity ( I 2 =60%, P =0.0003) that was not sufficiently explained by subgroup analyses. There was also high risk of bias in the included trials limiting the study interpretation. The overall quality of evidence is poor due to high risk of bias and inconsistency. However, considering that light therapy has minimal side-effects and our meta-analysis demonstrated that a significant proportion of patients achieved a clinically significant response, light therapy may be effective for patients with non-seasonal depression and can be a helpful additional therapeutic intervention for depression. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Knowledge translation and implementation in spinal cord injury: a systematic review

PubMed Central

Noonan, VK; Wolfe, DL; Thorogood, NP; Park, SE; Hsieh, JT; Eng, JJ

2015-01-01

Objective To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. Methods MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. Results A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. Conclusion The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions. PMID:24796445

Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review.

PubMed

Wei, Yifeng; McGrath, Patrick J; Hayden, Jill; Kutcher, Stan

2015-11-17

Mental health literacy has received increasing attention as a useful strategy to promote early identification of mental disorders, reduce stigma and enhance help-seeking behaviors. However, despite the abundance of research on mental health literacy interventions, there is the absence of evaluations of current available mental health literacy measures and related psychometrics. We conducted a scoping review to bridge the gap. We searched PubMed, PsycINFO, Embase, CINAHL, Cochrane Library, and ERIC for relevant studies. We only focused on quantitative studies and English publications, however, we didn't limit study participants, locations, or publication dates. We excluded non-English studies, and did not check the grey literature (non peer-reviewed publications or documents of any type) and therefore may have missed some eligible measures. We located 401 studies that include 69 knowledge measures (14 validated), 111 stigma measures (65 validated), and 35 help-seeking related measures (10 validated). Knowledge measures mainly investigated the ability of illness identification, and factual knowledge of mental disorders such as terminology, etiology, diagnosis, prognosis, and consequences. Stigma measures include those focused on stigma against mental illness or the mentally ill; self-stigma ; experienced stigma; and stigma against mental health treatment and help-seeking. Help-seeking measures included those of help-seeking attitudes, intentions to seek help, and actual help-seeking behaviors. Our review provides a compendium of available mental health literacy measures to facilitate applying existing measures or developing new measures. It also provides a solid database for future research on systematically assessing the quality of the included measures.

Web-Based Patient Education in Orthopedics: Systematic Review

PubMed Central

Melles, Marijke; Groeneveld, Bob Sander; de Ridder, Huib

2018-01-01

Background Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. Objective The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. Methods CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. Results A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients’ knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. Conclusions Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients’ knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only. PMID:29685869

Effect of exercise on cognitive function in chronic disease patients: a meta-analysis and systematic review of randomized controlled trials

PubMed Central

Cai, Hong; Li, Guichen; Hua, Shanshan; Liu, Yufei; Chen, Li

2017-01-01

Background The purpose of this study was to conduct a meta-analysis and systematic review to assess the effect of exercise on cognitive function in people with chronic diseases. Methods PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, PsycINFO, and three Chinese databases were electronically searched for papers that were published until September 2016. This meta-analysis and systematic review included randomized controlled trials that evaluated the effect of exercise on cognitive function compared with control group for people with chronic diseases. Results Totally, 35 studies met the inclusion criteria, with 3,113 participants. The main analysis revealed a positive overall random effect of exercise intervention on cognitive function in patients with chronic diseases. The secondary analysis revealed that aerobic exercise interventions and aerobic included exercise interventions had a positive effect on cognition in patients with chronic diseases. The intervention offering low frequency had a positive effect on cognitive function in patients with chronic diseases. Finally, we found that interventions offered at both low exercise intensity and moderate exercise intensity had a positive effect on cognitive function in patients with chronic diseases. The secondary analysis also revealed that exercise interventions were beneficial in Alzheimer’s disease patients when grouped by disease type. Conclusion This meta-analysis and systematic review suggests that exercise interventions positively influence cognitive function in patients with chronic diseases. Beneficial effect was independent of the type of disease, type of exercise, frequency, and the intensity of the exercise intervention. PMID:28546744

Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review.

PubMed

Lin, Kuan-Yin; Granger, Catherine L; Denehy, Linda; Frawley, Helena C

2015-11-01

To identify, evaluate and synthesize the evidence examining the effectiveness of pelvic floor muscle training (PFMT) on bowel dysfunction in patients who have undergone colorectal cancer surgery. Eight electronic databases (MEDLINE 1950-2014; CINAHL 1982-2014; EMBASE 1980-2014; Scopus 1823-2014; PsycINFO 1806-2014; Web of Science 1970-2014; Cochrane Library 2014; PEDro 1999-2014) were systematically searched in March 2014. Reference lists of identified articles were cross referenced and hand searched. Randomized controlled trials, cohort studies and case series were included if they investigated the effects of conservative treatments, including PFMT on bowel function in patients with colorectal cancer following surgery. Two reviewers independently assessed the risk of bias of studies using the Newcastle-Ottawa Scale (NOS). Six prospective non-randomized studies and two retrospective studies were included. The mean (SD) NOS risk of bias score was 4.9 (1.2) out of 9; studies were limited by a lack of non-exposed cohort, lack of independent blinded assessment, heterogeneous treatment protocols, and lack of long-term follow-up. The majority of studies reported significant improvements in stool frequency, incontinence episodes, severity of fecal incontinence, and health-related quality of life (HRQoL) after PFMT. Meta-analysis was not possible due to lack of randomized controlled trials. Pelvic floor muscle training for patients following surgery for colorectal cancer appears to be associated with improvements in bowel function and HRQoL. Results from non-randomized studies are promising but randomized controlled trials with sufficient power are needed to confirm the effectiveness of PFMT in this population. © 2014 Wiley Periodicals, Inc.

A systematic review of mHealth-based heart failure interventions

PubMed Central

Cajita, Maan Isabella; Gleason, Kelly T.; Han, Hae-Ra

2015-01-01

Background The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. Purpose This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to: (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. Methods PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Conclusions Ten articles, representing nine studies, were included in this review. Majority of the studies utilized mobile health technology as part of a HF monitoring system, which typically included a blood pressure measuring device, weighing scale, and an ECG recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, NYHA functional class, LVEF, quality of life, and self-care were inconsistent at best. Implications Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (e.g. inadequate sample size, quasi-experimental design, use of older mobile phone models, etc.) should be taken into account when designing future studies. PMID:26544175

A Systematic Review of mHealth-Based Heart Failure Interventions.

PubMed

Cajita, Maan Isabella; Gleason, Kelly T; Han, Hae-Ra

2016-01-01

The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. PubMed, CINAHL Plus, EMBASE, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Ten articles, representing 9 studies, were included in this review. The majority of the studies utilized mobile health technology as part of an HF monitoring system, which typically included a blood pressure-measuring device, weighing scale, and an electrocardiogram recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, New York Heart Association functional class, left ventricular ejection fraction, quality of life, and self-care were inconsistent at best. Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (eg, inadequate sample size, quasi-experimental design, use of older mobile phone models, etc) should be taken into account when designing future studies.

Effects of Screening for Psychological Distress on Patient Outcomes in Cancer: a Systematic Review

PubMed Central

Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

2013-01-01

Objective Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes. Methods CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT. Results There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement. Conclusion Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening. PMID:23751231

Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: systematic review and meta-analysis.

PubMed

Blakemore, Amy; Dickens, Chris; Guthrie, Else; Bower, Peter; Kontopantelis, Evangelos; Afzal, Cara; Coventry, Peter A

2014-01-01

The causal association between depression, anxiety, and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD) is unclear. We therefore conducted a systematic review of prospective cohort studies that measured depression, anxiety, and HRQoL in COPD. Electronic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature [CINAHL], British Nursing Index and Archive, PsycINFO and Cochrane database) were searched from inception to June 18, 2013. Studies were eligible for inclusion if they: used a nonexperimental prospective cohort design; included patients with a diagnosis of COPD confirmed by spirometry; and used validated measures of depression, anxiety, and HRQoL. Data were extracted and pooled using random effects models. Six studies were included in the systematic review; of these, three were included in the meta-analysis for depression and two were included for the meta-analysis for anxiety. Depression was significantly correlated with HRQoL at 1-year follow-up (pooled r=0.48, 95% confidence interval 0.37-0.57, P<0.001). Anxiety was also significantly correlated with HRQoL at 1-year follow-up (pooled r=0.36, 95% confidence interval 0.23-0.48, P<0.001). Anxiety and depression predict HRQoL in COPD. However, this longitudinal analysis does not show cause and effect relationships between depression and anxiety and future HRQoL. Future studies should identify psychological predictors of poor HRQoL in well designed prospective cohorts with a view to isolating the mediating role played by anxiety disorder and depression.

Predictors of clinical recovery from concussion: a systematic review

PubMed Central

Iverson, Grant L; Gardner, Andrew J; Terry, Douglas P; Ponsford, Jennie L; Sills, Allen K; Broshek, Donna K; Solomon, Gary S

2017-01-01

Objective A systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion. Clinical recovery was defined functionally as a return to normal activities, including school and sports, following injury. Design Systematic review. Data sources PubMed, PsycINFO, MEDLINE, CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus and Web of Science. Eligibility criteria for selecting studies Studies published by June of 2016 that addressed clinical recovery from concussion. Results A total of 7617 articles were identified using the search strategy, and 101 articles were included. There are major methodological differences across the studies. Many different clinical outcomes were measured, such as symptoms, cognition, balance, return to school and return to sports, although symptom outcomes were the most frequently measured. The most consistent predictor of slower recovery from concussion is the severity of a person’s acute and subacute symptoms. The development of subacute problems with headaches or depression is likely a risk factor for persistent symptoms lasting greater than a month. Those with a preinjury history of mental health problems appear to be at greater risk for having persistent symptoms. Those with attention deficit hyperactivity disorder (ADHD) or learning disabilities do not appear to be at substantially greater risk. There is some evidence that the teenage years, particularly high school, might be the most vulnerable time period for having persistent symptoms—with greater risk for girls than boys. Conclusion The literature on clinical recovery from sport-related concussion has grown dramatically, is mostly mixed, but some factors have emerged as being related to outcome. PMID:28566342

A mixed-methods systematic review of the effects of mindfulness on nurses.

PubMed

Guillaumie, Laurence; Boiral, Olivier; Champagne, Julie

2017-05-01

To review the effects of mindfulness-based interventions on Registered Nurses and nursing students. Work-related stress among nurses is estimated to be the biggest occupational health problem after musculoskeletal disorders. A mixed-method systematic review incorporating quantitative and qualitative data was conducted. Studies on the effects of mindfulness-based interventions for nurses and nursing students published between 1980 and 2014 were identified through a systematic search in electronic databases: Medline, Embase, PsycINFO, Cochrane Library and Cinahl. Data analysis was conducted based on the framework of Thomas and Harden (2004). A total of 32 studies, including 17 controlled designs, 11 pre-post designs and four qualitative designs were reviewed. Meta-analysis suggests that mindfulness-based interventions may be effective in significantly reducing state anxiety and depression at posttreatment and state anxiety and trait anxiety at follow-up. Qualitative studies and uncontrolled studies shed light on benefits overlooked in RCTs, including improvements in the well-being of individuals (e.g. inner state of calmness, awareness and enthusiasm) and improved performance at work (better communication with colleagues and patients, higher sensitivity to patients' experiences, clearer analysis of complex situations and emotional regulation in stressful contexts). Mindfulness appeared to improve nurses' mental health significantly. It could be used in worksite health promotion programmes. Only a few studies have explored the impact of mindfulness on nurses' professional behaviours and their relationships with patients and colleagues. Future research should further explore the long-term impacts of mindfulness on performance and well-being at work using sound methodological designs. © 2016 John Wiley & Sons Ltd.

A Systematic Review of Tools Used to Assess Team Leadership in Health Care Action Teams.

PubMed

Rosenman, Elizabeth D; Ilgen, Jonathan S; Shandro, Jamie R; Harper, Amy L; Fernandez, Rosemarie

2015-10-01

To summarize the characteristics of tools used to assess leadership in health care action (HCA) teams. HCA teams are interdisciplinary teams performing complex, critical tasks under high-pressure conditions. The authors conducted a systematic review of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012 for English-language articles that applied leadership assessment tools to HCA teams in all specialties. Pairs of reviewers assessed identified articles for inclusion and exclusion criteria and abstracted data on study characteristics, tool characteristics, and validity evidence. Of the 9,913 abstracts screened, 83 studies were included. They described 61 team leadership assessment tools. Forty-nine tools (80%) provided behaviors, skills, or characteristics to define leadership. Forty-four tools (72%) assessed leadership as one component of a larger assessment, 13 tools (21%) identified leadership as the primary focus of the assessment, and 4 (7%) assessed leadership style. Fifty-three studies (64%) assessed leadership at the team level; 29 (35%) did so at the individual level. Assessments of simulated (n = 55) and live (n = 30) patient care events were performed. Validity evidence included content validity (n = 75), internal structure (n = 61), relationship to other variables (n = 44), and response process (n = 15). Leadership assessment tools applied to HCA teams are heterogeneous in content and application. Comparisons between tools are limited by study variability. A systematic approach to team leadership tool development, evaluation, and implementation will strengthen understanding of this important competency.

Organ and tissue donation in clinical settings: a systematic review of the impact of interventions aimed at health professionals

PubMed Central

2014-01-01

In countries where presumed consent for organ donation does not apply, health professionals (HP) are key players for identifying donors and obtaining their consent. This systematic review was designed to verify the efficacy of interventions aimed at HPs to promote organ and tissue donation in clinical settings. CINAHL (1982 to 2012), COCHRANE LIBRARY, EMBASE (1974 to 2012), MEDLINE (1966 to 2012), PsycINFO (1960 to 2012), and ProQuest Dissertations and Theses were searched for papers published in French or English until September 2012. Studies were considered if they met the following criteria: aimed at improving HPs’ practices regarding the donation process or at increasing donation rates; HPs working in clinical settings; and interventions with a control group or pre-post assessments. Intervention behavioral change techniques were analyzed using a validated taxonomy. A risk ratio was computed for each study having a control group. A total of 15 studies were identified, of which only 5 had a control group. Interventions were either educational, organizational or a combination of both, and had a weak theoretical basis. The most common behavior change technique was providing instruction. Two sets of interventions showed a significant risk ratio. However, most studies did not report the information needed to compute their efficacy. Therefore, interventions aimed at improving the donation process or at increasing donation rates should be based on sound theoretical frameworks. They would benefit from more rigorous evaluation methods to ensure good knowledge translation and appropriate organizational decisions to improve professional practices. PMID:24628967

Patient beliefs and attitudes to taking statins: systematic review of qualitative studies.

PubMed

Ju, Angela; Hanson, Camilla S; Banks, Emily; Korda, Rosemary; Craig, Jonathan C; Usherwood, Tim; MacDonald, Peter; Tong, Allison

2018-06-01

Statins are effective in preventing cardiovascular disease (CVD) events and are recommended for at-risk individuals but estimated adherence rates are low. To describe patients' perspectives, experiences, and attitudes towards taking statins. Systematic review of qualitative studies reporting perspectives of patients on statins. PsycINFO, CINAHL, Embase, MEDLINE, and PhD dissertations from inception to 6 October 2016 were searched for qualitative studies on adult patients' perspectives on statins. All text and participant quotations were extracted from each article and analysed by thematic synthesis. Thirty-two studies involving 888 participants aged 22-93 years across eight countries were included. Seven themes were identified: confidence in prevention (trust in efficacy, minimising long-term catastrophic CVD, taking control, easing anxiety about high cholesterol); routinising into daily life; questioning utility (imperceptible benefits, uncertainties about pharmacological mechanisms); medical distrust (scepticism about overprescribing, pressure to start therapy); threatening health (competing priorities and risks, debilitating side effects, toxicity to body); signifying sickness (fear of perpetual dependence, losing the battle); and financial strain. An expectation that statins could prevent CVD and being able to integrate the statin regimen in daily life facilitated acceptance of statins among patients. However, avoiding the 'sick' identity and prolonged dependence on medications, uncertainties about the pharmacological mechanisms, risks to health, side effects, costs, and scepticism about clinicians' motives for prescribing statins were barriers to uptake. Shared decision making that addresses the risks, reasons for prescribing, patient priorities, and implementing strategies to minimise lifestyle intrusion and manage side effects may improve patient satisfaction and continuation of statins. © British Journal of General Practice 2018.

Addressing the crisis of GP recruitment and retention: a systematic review.

PubMed

Marchand, Catherine; Peckham, Stephen

2017-04-01

The numbers of GPs and training places in general practice are declining, and retaining GPs in their practices is an increasing problem. To identify evidence on different approaches to retention and recruitment of GPs, such as intrinsic versus extrinsic motivational determinants. Synthesis of qualitative and quantitative research using seven electronic databases from 1990 onwards (Medline, Embase, Cochrane Library, Health Management Information Consortium [HMIC], Cumulative Index to Nursing and Allied Health Literature (Cinahl), PsycINFO, and the Turning Research Into Practice [TRIP] database). A qualitative approach to reviewing the literature on recruitment and retention of GPs was used. The studies included were English-language studies from Organisation for Economic Cooperation and Development countries. The titles and abstracts of 138 articles were reviewed and analysed by the research team. Some of the most important determinants to increase recruitment in primary care were early exposure to primary care practice, the fit between skills and attributes, and a significant experience in a primary care setting. Factors that seemed to influence retention were subspecialisation and portfolio careers, and job satisfaction. The most important determinants of recruitment and retention were intrinsic and idiosyncratic factors, such as recognition, rather than extrinsic factors, such as income. Although the published evidence relating to GP recruitment and retention is limited, and most focused on attracting GPs to rural areas, the authors found that there are clear overlaps between strategies to increase recruitment and retention. Indeed, the most influential factors are idiosyncratic and intrinsic to the individuals. © British Journal of General Practice 2017.

Addressing the crisis of GP recruitment and retention: a systematic review

PubMed Central

Marchand, Catherine; Peckham, Stephen

2017-01-01

Background The numbers of GPs and training places in general practice are declining, and retaining GPs in their practices is an increasing problem. Aim To identify evidence on different approaches to retention and recruitment of GPs, such as intrinsic versus extrinsic motivational determinants. Design and setting Synthesis of qualitative and quantitative research using seven electronic databases from 1990 onwards (Medline, Embase, Cochrane Library, Health Management Information Consortium [HMIC], Cumulative Index to Nursing and Allied Health Literature (Cinahl), PsycINFO, and the Turning Research Into Practice [TRIP] database). Method A qualitative approach to reviewing the literature on recruitment and retention of GPs was used. The studies included were English-language studies from Organisation for Economic Cooperation and Development countries. The titles and abstracts of 138 articles were reviewed and analysed by the research team. Results Some of the most important determinants to increase recruitment in primary care were early exposure to primary care practice, the fit between skills and attributes, and a significant experience in a primary care setting. Factors that seemed to influence retention were subspecialisation and portfolio careers, and job satisfaction. The most important determinants of recruitment and retention were intrinsic and idiosyncratic factors, such as recognition, rather than extrinsic factors, such as income. Conclusion Although the published evidence relating to GP recruitment and retention is limited, and most focused on attracting GPs to rural areas, the authors found that there are clear overlaps between strategies to increase recruitment and retention. Indeed, the most influential factors are idiosyncratic and intrinsic to the individuals. PMID:28289014

A systematic review of decision aids that facilitate elements of shared decision-making in chronic illnesses: a review protocol.

PubMed

Wieringa, Thomas H; Kunneman, Marleen; Rodriguez-Gutierrez, Rene; Montori, Victor M; de Wit, Maartje; Smets, Ellen M A; Schoonmade, Linda J; Spencer-Bonilla, Gabriela; Snoek, Frank J

2017-08-07

Shared decision-making (SDM) is a patient-centred approach in which clinicians and patients work side-by-side to decide together on the best course of action for each patient's particular situation. Six key elements of SDM can be distinguished: situation diagnosis, choice awareness, option clarification, discussion of harms and benefits, deliberation of patient preferences and making the decision. Decision aids (DAs) are tools that facilitate SDM. The impact of DAs for chronic illnesses on SDM, clinical and patient reported outcomes remains uncertain. We will perform a systematic review aiming to describe (a) which SDM elements are incorporated in DAs for adult patients with chronic conditions and (b) the effects of DA use on SDM, clinical and patient reported outcomes. This manuscript reports on the protocol for this systematic review. The following databases will be searched for relevant articles: PubMed, Embase, Web of Science, CINAHL and PsycINFO, from their inception to October 2016. We will ascertain ongoing research by querying experts and searching trial registries. To enhance feasibility, we will limit the review to randomized controlled trials (RCTs) including patients with chronic cardiovascular and/or respiratory diseases and/or diabetes. SDM elements incorporated in DAs, DA effects and DA itself will be described. This study will characterize DAs for chronic illness and will provide an overview of their effects on SDM, clinical and patient reported outcomes. We anticipate this review will bring to light knowledge gaps and inform further research into the design and use of DAs for patients with chronic conditions. PROSPERO registration number: CRD42016050320 .

Early childhood neurodevelopment after intrauterine growth restriction: a systematic review.

PubMed

Levine, Terri A; Grunau, Ruth E; McAuliffe, Fionnuala M; Pinnamaneni, RagaMallika; Foran, Adrienne; Alderdice, Fiona A

2015-01-01

Children who experienced intrauterine growth restriction (IUGR) may be at increased risk for adverse developmental outcomes in early childhood. The objective of this study was to carry out a systematic review of neurodevelopmental outcomes from 6 months to 3 years after IUGR. PubMed, Embase, PsycINFO, Maternity and Infant Care, and CINAHL databases were searched by using the search terms intrauterine, fetal, growth restriction, child development, neurodevelopment, early childhood, cognitive, motor, speech, language. Studies were eligible for inclusion if participants met specified criteria for growth restriction, follow-up was conducted within 6 months to 3 years, methods were adequately described, non-IUGR comparison groups were included, and full English text of the article was available. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-documented quality-appraisal guidelines. Of 731 studies reviewed, 16 were included. Poorer neurodevelopmental outcomes after IUGR were described in 11. Ten found motor, 8 cognitive, and 7 language delays. Other delays included social development, attention, and adaptive behavior. Only 8 included abnormal Doppler parameters in their definitions of IUGR. Evidence suggests that children are at risk for poorer neurodevelopmental outcomes following IUGR from 6 months to 3 years of age. The heterogeneity of primary outcomes, assessment measures, adjustment for confounding variables, and definitions of IUGR limits synthesis and interpretation. Sample sizes in most studies were small, and some examined preterm IUGR children without including term IUGR or AGA comparison groups, limiting the value of extant studies. Copyright © 2015 by the American Academy of Pediatrics.

Exercise Effects on Depressive Symptoms in Cancer Survivors: A Systematic Review and Meta-Analysis

PubMed Central

Craft, Lynette L.; VanIterson, Erik H.; Helenowski, Irene B.; Rademaker, Alfred W.; Courneya, Kerry S.

2011-01-01

Background Depression is a distressing side effect of cancer and its treatment. In the general population, exercise is an effective antidepressant. Objective We conducted a systematic review and meta-analysis to determine the antidepressant effect of exercise in cancer survivors. Data Sources In May, 2011, we searched MEDLINE, PsycInfo, EMBASE, CINAHL, CDSR, CENTRAL, AMED, Biosis Previews, and Sport Discus, and citations from relevant papers and reviews. Study Eligibility Criteria We included randomized controlled trials (RCTs) comparing exercise interventions to usual care in cancer survivors, utilizing a self-report inventory or clinician rating to assess depressive symptoms, and reporting symptoms pre- and post-intervention. Study Appraisal 7,042 study titles were identified and screened, with 15 RCTs included. Synthesis Methods Effect sizes (ES) were reported as mean change scores. The Q test was conducted to evaluate heterogeneity of ES. Potential moderator variables were evaluated with examination of scatter plots and Wilcoxon rank-sum or Kruskal-Wallis tests. Results The overall ES, under a random effects model, was −0.22 (CI −0.43, −0.09, p = 0.04). Significant moderating variables (ps < .05) were exercise location, exercise supervision, and exercise duration. Limitations Only one study identified depression as the primary endpoint. Conclusions Exercise has modest positive effects on depressive symptoms with larger effects for programs that were supervised or partially supervised, not performed at home, and at least 30 minutes in duration. Impact Our results complement other studies showing that exercise is associated with reduced pain and fatigue and with improvements in quality of life among cancer survivors. PMID:22068286

Quality end-of-life care for dementia: What have family carers told us so far? A narrative synthesis

PubMed Central

Maio, Laura; Rait, Greta; Iliffe, Steve

2014-01-01

Background: People with dementia do not always receive good quality end-of-life care, with undertreated pain, aggressive medical interventions and limited access to hospice care being common. Family carers often provide the majority of informal care for people with dementia, therefore may be best placed to comment on quality of care. Aim: We explored what quality end-of-life care for dementia is from the perspective of family carers. Design: A review of qualitative evidence taking a systematic approach using a narrative synthesis with tabulation, textual description of studies and thematic analysis as tools, following the guidelines from the Economic and Social Research Council. Data sources: Keywords and subject headings were searched in MEDLINE, EMBASE, CINAHL, SCIE and PsycINFO for studies from 1990 in April 2012 and updated in May 2013. Reference lists were checked and citation searches undertaken. Results: Eight studies were included. There was an overarching theme of ‘A family’s belief of death and their choice of treatment’. Three further themes were then identified to explain family carers’ beliefs: the relationship with professionals as a core component of care quality; emotional and commitment pressures of caring and finally, family carers’ ability to think about death and dying. Conclusion: It is difficult to define what constitutes high-quality end-of-life care for people with dementia from the perspective of family carers. Their views expressed in the literature appear to demonstrate more variation of preference of care and treatment and their uncertainty of this. PMID:24625567

The educational effects of mobile learning on students of medical sciences: A systematic review in experimental studies

PubMed Central

KOOHESTANI, HAMID REZA; SOLTANI ARABSHAHI, SEYED KAMRAN; FATA, LADAN; AHMADI, FAZLOLLAH

2018-01-01

Introduction: The demand for mobile learning in the medical science educational program is increasing. The present review study gathers evidence highlighted by the experimental studies on the educational effects of mobile learning for medical science students. Methods: The study was carried out as a systematic literature search published from 2007 to July 2017 in the databases PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge (Thomson Reuters) , Educational Resources and Information Center (ERIC), EMBASE (Elsevier), Cochrane library, PsycINFO and Google Scholar. To examine quality of the articles, a tool validated by the BEME Review was employed. Results: Totally, 21 papers entered the study. Three main themes emerged from the content of papers: (1) improvement in student clinical competency and confidence, (2) acquisition and enhancing of students' theoretical knowledge, and (3) students' positive attitudes to and perception of mobile learning. Level 2B of Kirkpatrick hierarchy had been examined by all the papers and seven of them had reported two or more outcome levels, but level 4 was not reported in the papers. Conclusion: Our review showed that the students of medical sciences had positive response and attitudes to mobile learning. Moreover, implementation of mobile learning in medical sciences program might lead to valuable educational benefits and improve clinical competence and confidence along with theoretical knowledge, attitudes, and perception of mobile learning. The results indicated that mobile learning strategy in medical education can positively affect learning in all three domains of Bloom’s Taxonomy. PMID:29607333

Medication taking in coronary artery disease: a systematic review and qualitative synthesis.

PubMed

Rashid, Mohammed A; Edwards, Duncan; Walter, Fiona M; Mant, Jonathan

2014-01-01

Despite the compelling evidence supporting cardiovascular medications in the secondary prevention of coronary artery disease, many patients discontinue treatment. In this synthesis, we sought to understand from a patient perspective the factors that promote medication persistence. We systematically searched 7 databases (MEDLINE, Embase, PsycINFO, SCOPUS, CINAHL, ASSIA, and SSCI) for published qualitative research about the medication-taking experiences of patients with coronary artery disease and their partners. Articles were assessed for quality using a modified CASP (Critical Appraisal Skills Programme) checklist. Synthesis was undertaken using well-established meta-ethnographic approaches. We included 17 articles in the final synthesis from the United Kingdom (6), Europe (5), United States (4), China (1), and Australia (1), with a total sample size of 391 patients. Analyses suggested that some patients hold fatalistic beliefs about their disease, whereas others believe they have been cured by interventions; both can lead to failure to take medication. Patients who adapt to being a "heart patient" are positive about medication taking. Some individuals dislike taking tablets generally and are wary of long-term effects. Relationships with prescribing clinicians are of critical importance for patients, with inaccessibility and insensitive terminology negatively affecting patients' perceptions about treatments. Strategies to promote higher persistence of secondary prevention medications in patients with coronary artery disease need to recognize the key role of the prescribing clinician. Providing medication-specific information at the time of initiating therapy, improving the transition between secondary and primary care, and explaining the risk of disease recurrence may all help to modify patient attitudes toward drugs to prevent further cardiovascular disease.

Identifying determinants of quality of life of children with cancer and childhood cancer survivors: a systematic review.

PubMed

Klassen, Anne F; Anthony, Samantha J; Khan, Aalia; Sung, Lillian; Klaassen, Robert

2011-09-01

This paper describes a systematic review conducted to identify factors that have been investigated as explanations of variability in the quality of life of children with cancer and childhood cancer survivors. Our purpose was to build an evidence base that could be used to guide and direct future research. MEDLINE, CINAHL, EMBASE, PsycINFO, Cancerlit, and Sociological Abstracts were searched from the inception of each database to June 15, 2009 using the following search terms: "quality of life," "health-related quality of life," "quality adjusted life years," "health status," "functional status," "well-being," or "patient-reported outcome." Sample characteristics and information about the relationship between a quality of life domain or total scale score and at least one factor (e.g., child gender or age, coping skills, family income) were extracted from eligible studies. Nine cancer-specific and nine generic QOL questionnaires were used in 58 publications described 239 factors (50 unique factors). The large number of cancer, treatment, child, and family variables considered indicates that extensive research activity has occurred. However, most of the variables identified were examined in only a few studies and most represent medical and treatment variables with less research attention paid to child and family variables. Our study has compiled evidence about determinants of QOL for children with cancer and childhood cancer survivors from the existing literature. Future research can build on this evidence base to expand the range of factors studied as most research to date has focused on medical and treatment factors.

Effectiveness of health education programs on exercise behavior among patients with heart disease: a systematic review and meta-analysis.

PubMed

Zhu, Li-Xia; Ho, Shuk-Ching; Wong, Thomas K S

2013-11-01

Regular exercise has been shown to be beneficial to patients with heart disease. Previous studies have indicated that health education can effectively increase participants' physical activity. However, no systematic review was conducted to evaluate the effectiveness of health education programs on changing exercise behavior among patients with heart disease. The aim of this study was to examine the effectiveness of health education programs on exercise behavior among heart disease patients. Potential studies were retrieved in the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMbase, PsycINFO, the British Nursing Index and Archive, Science Direct, and ERIC via EBSCOhost. Meta-analysis was done using the random-effect model. Thirty-seven studies were identified. Only 12 studies delivered health education based on various theories/models. Twenty-eight studies were included in the meta-analyses. The results showed that health education had significantly positive effects on exercise adherence (risk ratio = 1.35 to 1.48), exercise duration (SMD = 0.25 to 0.69), exercise frequency (MD = 0.54 to 1.46 session/week), and exercise level (SMD = 0.25), while no significant effects were found on exercise energy expenditure and cognitive exercise behavior. Health education has overall positive effects on changing exercise behavior among heart disease patients. Few theoretical underpinning studies were conducted for changing exercise behavior among heart disease patients. The findings suggest that health education improves exercise behavior for heart disease patients. Health professionals should reinforce health education programs for them. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Relationship of Psychosocial Resources with Allostatic Load: A Systematic Review

PubMed Central

Wiley, Joshua F.; Bei, Bei; Bower, Julienne E.; Stanton, Annette L.

2016-01-01

Objective Allostatic load (AL) represents cumulative wear-and-tear on the body, and is operationalized as a multi-system index of biomarkers. AL is associated with morbidities and mortality, leading to a growing body of literature that uses AL as an outcome on its own right. Psychosocial resources (PSRs), such as mastery and social support, may influence health outcomes in part via AL, and the current review seeks to characterize the relations between PSRs and AL. Methods A systematic review was conducted by searching PubMed, CINAHL Plus, PsycINFO, Scopus, and Embase for studies examining the relation between PSR(s) and AL in humans. From 1,417 abstracts screened, 60 full-text articles were reviewed, and 24 studies met inclusion criteria. Results Mixed evidence exists for a relationship between PSRs and AL. Most (14/24) studies used a cross-sectional design and only one study investigated whether a PSR predicted change in AL. Compared to cross-sectional studies, longitudinal studies were more likely to report a significant relationship (8/14 versus 8/10, respectively). Studies with statistically significant main or moderated effects had larger sample sizes than those reporting null effects. Whether a study reported a significant main or moderated relationship did not differ by whether psychological (8/11) or social (10/16) resources were assessed. Conclusions Evidence for a relationship between PSRs and AL is equivocal, and obtained significant relationships are generally small in magnitude. Gaps in the current literature and directions for future research are discussed. Longitudinal studies are needed that repeatedly assess PSRs and AL. PMID:27768647

Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review.

PubMed

Bennett, Sophie; Shafran, Roz; Coughtrey, Anna; Walker, Susan; Heyman, Isobel

2015-04-01

Children with chronic physical illness are significantly more likely to develop common psychiatric symptoms than otherwise healthy children. These children therefore warrant effective integrated healthcare yet it is not established whether the known, effective, psychological treatments for symptoms of common childhood mental health disorders work in children with chronic physical illness. EMBASE, MEDLINE, PsycINFO and CINAHL databases were searched with predefined terms relating to evidence-based psychological interventions for psychiatric symptoms in children with chronic physical illness. We included all studies (randomised and non-randomised designs) investigating interventions aimed primarily at treating common psychiatric symptoms in children with a chronic physical illness in the review. Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality analysis. Ten studies (209 children, including 70 in control groups) met the criteria for inclusion in the review. All studies demonstrated some positive outcomes of cognitive behavioural therapy for the treatment of psychiatric symptoms in children with chronic physical illness. Only two randomised controlled trials, both investigating interventions for symptoms of depression, were found. There is preliminary evidence that cognitive behavioural therapy has positive effects in the treatment of symptoms of depression and anxiety in children with chronic physical illness. However, the current evidence base is weak and fully powered randomised controlled trials are needed to establish the efficacy of psychological treatments in this vulnerable population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Transition to adult services for young people with mental health needs: A systematic review.

PubMed

Paul, Moli; Street, Cathy; Wheeler, Nicola; Singh, Swaran P

2015-07-01

Young people's transition from child and adolescent (CAMHS) to adult mental health services (AMHS). To systematically review evidence on the effectiveness of different models of CAMHS-AMHS transitional care, service user and staff perspectives, and facilitators of/barriers to effective CAMHS-AMHS transition. A systematic search in May 2012 of Medline, PsycINFO, CINAHL, EMBASE, AMED, Health Business Elite, HMIC, Cochrane Database, Web of Science and ASSIA; ancestral searches; and consultation with experts in the field. Qualitative, quantitative and mixed-methods primary research on the CAMHS-AMHS health-care transition of young people (aged 16-21 years) with mental health problems. Two reviewers independently completed a standardised data extraction form and critically evaluated identified documents using a validated appraisal tool for empirical studies with varied methodologies. A total of 19 studies of variable quality were identified. None were randomised or case-controlled trials. Studies incorporating service user/carer perspectives highlighted the need to tackle stigma and provide accessible, age-appropriate services. Parents/carers wanted more involvement with AMHS. Transitional care provision was considered patchy and often not prioritised within mental health services. There was no clear evidence of superior effectiveness of any particular model. High-quality evidence of transitional care models is lacking. Data broadly support the development of programmes that address the broader transitional care needs of 'emerging adults' and their mental health needs but further evaluation is necessary. Developing robust transitional mental health care will require the policy-practice gap to be addressed and development of accessible, acceptable, responsive, age-appropriate provision. © The Author(s) 2014.

Diabetes in people with an intellectual disability: a systematic review of prevalence, incidence and impact.

PubMed

McVilly, K; McGillivray, J; Curtis, A; Lehmann, J; Morrish, L; Speight, J

2014-08-01

To establish the prevalence and incidence of type 1 and type 2 diabetes in people with an intellectual and developmental disability and determine their impact on health and well-being and to appraise the evidence available to inform good practice in diabetes management for people with intellectual and developmental disabilities. We conducted separate searches of multiple databases (EMBASE, CINAHL, MEDLINE, PsycINFO, SCOPUS, Web of Science, PUBMED and Cochrane Library) to find relevant articles. A total of 13 studies were identified: 13 addressed the prevalence of diabetes in people with intellectual and developmental disability, three addressed the impact of diabetes on their health and well-being and three addressed the management of diabetes. The prevalence of diabetes in people with intellectual and developmental disability remains uncertain, and the incidence of diabetes in this group of people is unknown. There is some evidence to support the assertion that people with intellectual and developmental disability might be at greater risk of diabetes than the general population. Overall, the quality of the evidence on which to base prevention and management strategies is variable. There is a paucity of research focusing on the prevalence, incidence and impact of diabetes among people with intellectual and developmental disability. Further research is needed to inform policy and practice in this area and, in particular, work is needed to develop methodologies, evaluation tools, educational resources and diabetes care support services appropriate to the needs of people with intellectual and developmental disability. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Effectiveness of Training Clinicians' Communication Skills on Patients' Clinical Outcomes: A Systematic Review.

PubMed

Oliveira, Vinicius C; Ferreira, Manuela L; Pinto, Rafael Z; Filho, Ruben F; Refshauge, Kathryn; Ferreira, Paulo H

2015-10-01

The aim of this systematic review was to investigate the literature on the effectiveness of communication skills training for clinicians on patients' clinical outcomes in primary care and rehabilitation settings. We systematically reviewed the literature for randomized controlled trials investigating the effectiveness of communication skills training for clinicians on patients' satisfaction with care and on pain and disability in primary care and rehabilitation settings. The search strategy was conducted using AMED, PsycINFO, MEDLINE, CINAHL, EMBASE, PEDro, and Cochrane Central Register of Controlled Trials through June 2015. Methodological quality of included trials was assessed by 2 independent investigators using the PEDro scale, and consensus was used to resolve disagreements. Data were extracted, and meta-analyses were performed. Nineteen randomized controlled trials were included. Of these, 16 investigated communication training for clinicians that emphasized patient participation (eg, shared decision-making approaches). Communication training had small effects on patients' satisfaction with care when compared to control (4.1 points on a 100-point scale, 95% confidence interval [CI], 1.1-7.0). Communication training also had small effects on pain and disability with pooled results showing weighted mean differences of -3.8 points (95% CI, -6.5 to -1.1) and -3.6 (95% CI, -5.4 to -1.7), respectively. Studies show that communication training for clinicians produces small effects in improving patients' satisfaction with care or reducing pain and disability in primary care and rehabilitation settings. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Effectiveness of workplace social distancing measures in reducing influenza transmission: a systematic review.

PubMed

Ahmed, Faruque; Zviedrite, Nicole; Uzicanin, Amra

2018-04-18

Social distancing is one of the community mitigation measures that may be recommended during influenza pandemics. Social distancing can reduce virus transmission by increasing physical distance or reducing frequency of congregation in socially dense community settings, such as schools or workplaces. We conducted a systematic review to assess the evidence that social distancing in non-healthcare workplaces reduces or slows influenza transmission. Electronic searches were conducted using MEDLINE, Embase, Scopus, Cochrane Library, PsycINFO, CINAHL, NIOSHTIC-2, and EconLit to identify studies published in English from January 1, 2000, through May 3, 2017. Data extraction was done by two reviewers independently. A narrative synthesis was performed. Fifteen studies, representing 12 modeling and three epidemiological, met the eligibility criteria. The epidemiological studies showed that social distancing was associated with a reduction in influenza-like illness and seroconversion to 2009 influenza A (H1N1). However, the overall risk of bias in the epidemiological studies was serious. The modeling studies estimated that workplace social distancing measures alone produced a median reduction of 23% in the cumulative influenza attack rate in the general population. It also delayed and reduced the peak influenza attack rate. The reduction in the cumulative attack rate was more pronounced when workplace social distancing was combined with other nonpharmaceutical or pharmaceutical interventions. However, the effectiveness was estimated to decline with higher basic reproduction number values, delayed triggering of workplace social distancing, or lower compliance. Modeling studies support social distancing in non-healthcare workplaces, but there is a paucity of well-designed epidemiological studies. PROSPERO registration # CRD42017065310.

Child-Report Measures of Occupational Performance: A Systematic Review

PubMed Central

Totino, Rebekah; Doma, Kenji; Leicht, Anthony; Brown, Nicole; Cuomo, Belinda

2016-01-01

Introduction Improving occupational performance is a key service of occupational therapists and client-centred approach to care is central to clinical practice. As such it is important to comprehensively evaluate the quality of psychometric properties reported across measures of occupational performance; in order to guide assessment and treatment planning. Objective To systematically review the literature on the psychometric properties of child-report measures of occupational performance for children ages 2–18 years. Methods A systematic search of the following six electronic databases was conducted: CINAHL; PsycINFO; EMBASE; PubMed; the Health and Psychosocial Instruments (HAPI) database; and Google Scholar. The quality of the studies was evaluated against the COSMIN taxonomy of measurement properties and the overall quality of psychometric properties was evaluated using pre-set psychometric criteria. Results Fifteen articles and one manual were reviewed to assess the psychometric properties of the six measures–the PEGS, MMD, CAPE, PAC, COSA, and OSA- which met the inclusion criteria. Most of the measures had conducted good quality studies to evaluate the psychometric properties of measures (PEGS, CAPE, PAC, OSA); however, the quality of the studies for two of these measures was relatively weak (MMD, COSA). When integrating the quality of the psychometric properties of the measures with the quality of the studies, the PAC stood out as having superior psychometric qualities. Conclusions The overall quality of the psychometric properties of most measures was limited. There is a need for continuing research into the psychometric properties of child-report measures of occupational performance, and to revise and improve the psychometric properties of existing measures. PMID:26808674

Masculinity, Racism, Social Support, and Colorectal Cancer Screening Uptake Among African American Men: A Systematic Review.

PubMed

Rogers, Charles R; Mitchell, Jamie A; Franta, Gabriel J; Foster, Margaret J; Shires, Deirdre

2017-09-01

Colorectal cancer (CRC) is highly preventable when CRC screening is utilized, yet CRC screening completion among African American men is relatively low and their mortality rates remain 50% higher juxtaposed to their White counterparts. Since a growing body of literature indicates masculinity, racism, and social support each have strong influences on CRC screening uptake, this systematic review examined the connections between these three sociocultural factors and CRC screening uptake among African American men. Potential studies were retrieved from MEDLINE, CINAHL, EMBASE, and PsycINFO. Cited reference searching for the final sample was employed to identify and assess additional studies for inclusion using Scopus. The methodological quality of the reviewed evidence was also evaluated. Nineteen studies met inclusion/exclusion criteria. Thirteen studies employed nonexperimental research designs; a quasi-experimental design was present in four, and two utilized experimental designs. Studies were published between 2000 and 2014; the majority between 2009 and 2013. Social support was most frequently addressed (84%) while masculinity and racism were equally studied with paucity (11%) for their influence on CRC screening. After evaluating conceptual and methodological characteristics of the studies, 42% fell below average in quality and rigor. The need for increased attention to the sociocultural correlates of CRC screening for African American men are highlighted in this systematic review, and important recommendations for research and practice are provided. Alongside a call for more rigorous research, further research examining the influence of masculinity and racism on CRC screening completion among African American men is warranted.

Content Validity of Patient-Reported Outcome Instruments used with Pediatric Patients with Facial Differences: A Systematic Review.

PubMed

Wickert, Natasha M; Wong Riff, Karen W Y; Mansour, Mark; Forrest, Christopher R; Goodacre, Timothy E E; Pusic, Andrea L; Klassen, Anne F

2018-01-01

Objective The aim of this systematic review was to identify patient-reported outcome (PRO) instruments used in research with children/youth with conditions associated with facial differences to identify the health concepts measured. Design MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from 2004 to 2016 to identify PRO instruments used in acne vulgaris, birthmarks, burns, ear anomalies, facial asymmetries, and facial paralysis patients. We performed a content analysis whereby the items were coded to identify concepts and categorized as positive or negative content or phrasing. Results A total of 7,835 articles were screened; 6 generic and 11 condition-specific PRO instruments were used in 96 publications. Condition-specific instruments were for acne (four), oral health (two), dermatology (one), facial asymmetries (two), microtia (one), and burns (one). The PRO instruments provided 554 items (295 generic; 259 condition specific) that were sorted into 4 domains, 11 subdomains, and 91 health concepts. The most common domain was psychological (n = 224 items). Of the identified items, 76% had negative content or phrasing (e.g., "Because of the way my face looks I wish I had never been born"). Given the small number of items measuring facial appearance (n = 19) and function (n = 22), the PRO instruments reviewed lacked content validity for patients whose condition impacted facial function and/or appearance. Conclusions Treatments can change facial appearance and function. This review draws attention to a problem with content validity in existing PRO instruments. Our team is now developing a new PRO instrument called FACE-Q Kids to address this problem.

Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review.

PubMed

Andronis, Lazaros; Kinghorn, Philip; Qiao, Suyin; Whitehurst, David G T; Durrell, Susie; McLeod, Hugh

2017-04-01

Low back pain (LBP) is a major health problem, having a substantial effect on peoples' quality of life and placing a significant economic burden on healthcare systems and, more broadly, societies. Many interventions to alleviate LBP are available but their cost effectiveness is unclear. To identify, document and appraise studies reporting on the cost effectiveness of non-invasive and non-pharmacological treatment options for LBP. Relevant studies were identified through systematic searches in bibliographic databases (EMBASE, MEDLINE, PsycINFO, Cochrane Library, CINAHL and the National Health Service Economic Evaluation Database), 'similar article' searches and reference list scanning. Study selection was carried out by three assessors, independently. Study quality was assessed using the Consensus on Health Economic Criteria checklist. Data were extracted using customized extraction forms. Thirty-three studies were identified. Study interventions were categorised as: (1) combined physical exercise and psychological therapy, (2) physical exercise therapy only, (3) information and education, and (4) manual therapy. Interventions assessed within each category varied in terms of their components and delivery. In general, combined physical and psychological treatments, information and education interventions, and manual therapies appeared to be cost effective when compared with the study-specific comparators. There is inconsistent evidence around the cost effectiveness of physical exercise programmes as a whole, with yoga, but not group exercise, being cost effective. The identified evidence suggests that combined physical and psychological treatments, medical yoga, information and education programmes, spinal manipulation and acupuncture are likely to be cost-effective options for LBP.

How dietary evidence for the prevention and treatment of CVD is translated into practice in those with or at high risk of CVD: a systematic review.

PubMed

Schumacher, Tracy L; Burrows, Tracy L; Neubeck, Lis; Redfern, Julie; Callister, Robin; Collins, Clare E

2017-01-01

CVD is a leading cause of mortality and morbidity, and nutrition is an important lifestyle factor. The aim of the present systematic review was to synthesise the literature relating to knowledge translation (KT) of dietary evidence for the prevention and treatment of CVD into practice in populations with or at high risk of CVD. A systematic search of six electronic databases (CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO and Scopus) was performed. Studies were included if a nutrition or dietary KT was demonstrated to occur with a relevant separate measureable outcome. Quality was assessed using a tool adapted from two quality checklists. Population with or at high risk of CVD or clinicians likely to treat this population. A total of 4420 titles and abstracts were screened for inclusion, with 354 full texts retrieved to assess inclusion. Forty-three articles were included in the review, relating to thirty-five separate studies. No studies specifically stated their aim to be KT. Thirty-one studies were in patient or high-risk populations and four targeted health professionals. Few studies stated a theory on which the intervention was based (n 10) and provision of instruction was the most common behaviour change strategy used (n 26). KT in nutrition and dietary studies has been inferred, not stated, with few details provided regarding how dietary knowledge is translated to the end user. This presents challenges for implementation by clinicians and policy and decision makers. Consequently a need exists to improve the quality of publications in this area.

Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence.

PubMed

Spanos, Dimitrios; Melville, Craig Andrew; Hankey, Catherine Ruth

2013-09-23

To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on (1) intervention components, (2) methodology, (3) attrition rate (4) reported weight loss and (5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225-300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified.

Workplace interventions to improve work ability: A systematic review and meta-analysis of their effectiveness.

PubMed

Oakman, Jodi; Neupane, Subas; Proper, Karin I; Kinsman, Natasha; Nygård, Clas-Håkan

2018-03-01

Objective Extended working lives due to an ageing population will necessitate the maintenance of work ability across the life course. This systematic review aimed to analyze whether workplace interventions positively impact work ability. Methods We searched Medline, PsycINFO, CINAHL and Embase databases using relevant terms. Work-based interventions were those focused on individuals, the workplace, or multilevel (combination). Work ability - measured using the work ability index (WAI) or the single-item work ability score (WAS) - was the outcome measure. Grading of Recommendations Assessment, Development & Evaluation (GRADE) criteria was used to assess evidence quality, and impact statements were developed to synthesize the results. Meta-analysis was undertaken where appropriate. Results We reviewed 17 randomized control trials (comprising 22 articles). Multilevel interventions (N=5) included changes to work arrangements and liaisons with supervisors, whilst individual-focused interventions (N=12) involved behavior change or exercise programs. We identified only evidence of a moderate quality for either individual or multilevel interventions aiming to improve work ability. The meta-analysis of 13 studies found a small positive significant effect for interventions on work ability [overall pooled mean 0.12, 95% confidence interval (CI) 0.03-0.21] with no heterogeneity for the effect size (Chi 2 =11.28, P=0.51; I 2 =0%). Conclusions The meta-analysis showed a small positive effect, suggesting that workplace interventions might improve work ability. However, the quality of the evidence base was only moderate, precluding any firm conclusion. Further high quality studies are require to establish the role of interventions on work ability.

Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials.

PubMed

Guo, Ping

2015-01-01

To update evidence of the effectiveness of preoperative education among cardiac surgery patients. Patients awaiting cardiac surgery may experience high levels of anxiety and depression, which can adversely affect their existing disease and surgery and result in prolonged recovery. There is evidence that preoperative education interventions can lead to improved patient experiences and positive postoperative outcomes among a mix of general surgical patients. However, a previous review suggested limited evidence to support the positive impact of preoperative education on patients' recovery from cardiac surgery. Comprehensive review of the literature. The Cochrane Central Register of Controlled Trials from the Cochrane Library, MEDLINE, CINAHL, PsycINFO, EMBASE and Web of Science were searched for English-language articles published between 2000-2011. Original articles were included reporting randomised controlled trials of cardiac preoperative education interventions. Six trials were identified and have produced conflicting findings. Some trials have demonstrated the effects of preoperative education on improving physical and psychosocial recovery of cardiac patients, while others found no evidence that patients' anxiety is reduced or of any effect on pain or hospital stay. Evidence of the effectiveness of preoperative education interventions among cardiac surgery patients remains inconclusive. Further research is needed to evaluate cardiac preoperative education interventions for sustained effect and in non-Western countries. A nurse-coordinated multidisciplinary preoperative education approach may offer a way forward to provide a more effective and efficient service. Staff training in developing and delivering such interventions is a priority. © 2014 John Wiley & Sons Ltd.

Association between Prenatal and Postnatal Psychological Distress and Toddler Cognitive Development: A Systematic Review

PubMed Central

2015-01-01

Purpose Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development. Methods Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form. Results Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes. Conclusion Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development. PMID:25996151

Association between Prenatal and Postnatal Psychological Distress and Toddler Cognitive Development: A Systematic Review.

PubMed

Kingston, Dawn; McDonald, Sheila; Austin, Marie-Paule; Tough, Suzanne

2015-01-01

Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development. Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form. Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes. Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development.

Transition to injecting drug use in Iran: a systematic review of qualitative and quantitative evidence

PubMed Central

Rahimi-Movaghar, Afarin; Amin-Esmaeili, Masoumeh; Shadloo, Behrang; Malekinejad, Mohsen

2015-01-01

Background Injection drug use has been increasing over the past decade in Iran. This study aims to review the epidemiological and qualitative evidence on factors that facilitate or protect against transition to injection in Iran. Methods Five international (Medline, Web of Science, EMBASE, CINAHL, PsycINFO), one regional (IMEMR) and three Iranian (Iranmedex, Iranpsych, IranDoc) databases were searched and key experts were contacted. Two trained researchers screened documents to identify relevant studies and independently extracted data using a pre-specified protocol. A thematic analysis was applied to the qualitative data and a random effect meta-analysis model was used to determine age of first injection. Results A total of 39 documents from 31 studies met the eligibility criteria; more than 50% were conducted between 2006 and 2008. The weighted mean age of first injection was 25.8 years (95% Confidence Interval: 25.3–26.2). Overall, drug users had used drugs for 6 to 7 years before starting to inject. Heroin was the first drug of injection in the majority of cases. Factors influencing transition to injection included 1) individual (pleasure-seeking behavior and development of drug dependency), 2) social network (role of peer drug users in first injection use), and 3) environmental (the economic efficiency associated with injection and the wide availability of injectable form of drugs in the market). Conclusion Harm reduction policies in Iran have almost exclusively focused on drug injectors. However, given the extent of non-injection drug use, evidence from this study can provide insight on points of interventions for preventing transition to injection use. PMID:26210009

Dual-Task Assessment Protocols in Concussion Assessment: A Systematic Literature Review.

PubMed

Kleiner, Michelle; Wong, Lynne; Dubé, Alexandra; Wnuk, Katie; Hunter, Susan W; Graham, Laura J

2018-02-01

Study Design Systematic review. Background When assessed in isolation, balance and neurocognitive testing may not be sufficiently responsive to capture changes that occur with concussion. Normal daily activities require simultaneous cognitive and physical demands. Therefore, a dual-task assessment paradigm should be considered to identify performance deficits. Objectives To evaluate the literature and to identify dual-task testing protocols associated with changes in gait after concussion. Methods A systematic review of articles of individuals with concussion who underwent dual-task testing with a combination of motor and cognitive tasks was conducted. The AMED, CINAHL, Embase, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science databases and gray literature were searched from inception to January 29, 2017. Title and abstract, full-text, and quality review and data abstraction were performed by 2 independent reviewers. Results Twenty-four articles met the inclusion criteria. Eleven articles reported decreased gait velocity and increased medial-lateral displacement for individuals with concussion during dual-task conditions. Overall, included articles were of poor to moderate methodological quality. Fifteen articles used the same participants and data sets, creating a threat to validity and limiting the ability to make conclusions. Conclusion A deterioration in gait performance during dual-task testing is present among people with concussion. Specific recommendations for the use of a dual-task protocol to assess individuals with suspected concussion injury in a clinical setting have yet to be determined. J Orthop Sports Phys Ther 2018;48(2):87-103. Epub 7 Nov 2017. doi:10.2519/jospt.2018.7432.

Drug and alcohol treatment providers' views about the disease model of addiction and its impact on clinical practice: A systematic review.

PubMed

Barnett, Anthony I; Hall, Wayne; Fry, Craig L; Dilkes-Frayne, Ella; Carter, Adrian

2017-12-14

Addiction treatment providers' views about the disease model of addiction (DMA), and their contemporary views about the brain disease model of addiction (BDMA), remain an understudied area. We systematically reviewed treatment providers' attitudes about the DMA/BDMA, examined factors associated with positive or negative attitudes and assessed their views on the potential clinical impact of both models. Pubmed, EMBASE, PsycINFO, CINAHL Plus and Sociological Abstracts were systematically searched. Original papers on treatment providers' views about the DMA/BDMA and its clinical impact were included. Studies focussing on tobacco, behavioural addictions or non-Western populations were excluded. The 34 included studies were predominantly quantitative and conducted in the USA. Among mixed findings of treatment providers' support for the DMA, strong validity studies indicated treatment providers supported the disease concept and moral, free-will or social models simultaneously. Support for the DMA was positively associated with treatment providers' age, year of qualification, certification status, religious beliefs, being in recovery and Alcoholics Anonymous attendance. Greater education was negatively associated with DMA support. Treatment providers identified potential positive (e.g. reduced stigma) and negative (e.g. increased sense of helplessness) impacts of the DMA on client behaviour. The review suggests treatment providers may endorse disease and other models while strategically deploying the DMA for presumed therapeutic benefits. Varying DMA support across workforces indicated service users may experience multiple and potentially contradictory explanations of addiction. Future policy development will benefit by considering how treatment providers adopt disease concepts in practice. © 2017 Australasian Professional Society on Alcohol and other Drugs.

End-of-life decision-making for children with severe developmental disabilities: The parental perspective.

PubMed

Zaal-Schuller, I H; de Vos, M A; Ewals, F V P M; van Goudoever, J B; Willems, D L

2016-01-01

The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and PsycINFO. The search was limited to articles in English or Dutch published between January 2004 and August 2014. We included qualitative and quantitative original studies that directly investigated the experiences of parents of children aged 0-18 years with severe developmental disorders for whom an end-of-life decision had been considered or made. We identified nine studies that met all inclusion criteria. Reportedly, parental involvement in end-of-life decision-making varied widely, ranging from having no involvement to being the sole decision-maker. Most parents preferred to actively share in the decision-making process regardless of their child's specific diagnosis or comorbidity. The main factors that influenced parents in their decision-making were: their strong urge to advocate for their child's best interests and to make the best (possible) decision. In addition, parents felt influenced by their child's visible suffering, remaining quality of life and the will they perceived in their child to survive. Most parents of children with severe developmental disorders wish to actively share in the end-of-life decision-making process. An important emerging factor in this process is the parents' feeling that they have to stand up for their child's interests in conversations with the medical team. Copyright © 2015 Elsevier Ltd. All rights reserved.

Selective Serotonin Reuptake Inhibitors for Premenstrual Syndrome and Premenstrual Dysphoric Disorder

PubMed Central

Shah, Nirav R.; Jones, J. B.; Aperi, Jaclyn; Shemtov, Rachel; Karne, Anita; Borenstein, Jeff

2009-01-01

OBJECTIVE To systematically review evidence of the treatment benefits of selective serotonin reuptake inhibitors (SSRIs) for symptoms related to severe premenstrual syndrome (PMS) and premenstrual dysphoric disorder. DATA SOURCES We conducted electronic database searches of MEDLINE, Web of Science, Cochrane Library, Embase, PsycINFO, and Cinahl through March 2007, and hand-searched reference lists and pertinent journals. METHODS OF STUDY SELECTION Studies included in the review were double-blind, randomized, controlled trials comparing an SSRI with placebo that reported a change in a validated score of premenstrual symptomatology. Studies had to report follow-up for any duration longer than one menstrual cycle among premenopausal women who met clinical diagnostic criteria for PMS or premenstrual dysphoric disorder. From 2,132 citations identified, we pooled results from 29 studies (in 19 citations) using random-effects meta-analyses and present results as odds ratios (ORs). TABULATION, INTEGRATION, AND RESULTS Our metaanalysis, which included 2,964 women, demonstrates that SSRIs are effective for treating PMS and premenstrual dysphoric disorder (OR 0.40, 95% confidence interval [CI] 0.31-0.51). Intermittent dosing regimens were found to be less effective (OR 0.55, 95% CI 0.45-0.68) than continuous dosing regimens (OR 0.28, 95% CI 0.18-0.42). No SSRI was demonstrably better than another. The choice of outcome measurement instrument was associated with effect size estimates. The overall effect size is smaller than reported previously. CONCLUSION Selective serotonin reuptake inhibitors were found to be effective in treating premenstrual symptoms, with continuous dosing regimens favored for effectiveness. PMID:18448752

The relationship between empathy and burnout - lessons for paramedics: a scoping review.

PubMed

Williams, Brett; Lau, Rosalind; Thornton, Emma; Olney, Lauren S

2017-01-01

The concepts of empathy and burnout are critical for practicing paramedics and the profession. While there has been an increasing body of research on the relationship between empathy and burnout with physicians and nurses, surprisingly, no research has been undertaken with paramedics. The aim of this scoping review was to explore the relationship between empathy and burnout. A scoping review was performed based on Arskey and O'Malley's framework. Five databases were searched: CINAHL plus, EMBASE, MEDLINE, PsycINFO, and Scopus. Google Scholar was searched for gray literature. Two reviewers independently assessed eligibility and extracted the data. The initial search produced a yield of 1270 articles after removal of duplicates. All abstracts were screened for relevance, and 30 articles were selected for further screening. Twenty six articles were deemed relevant, of which there were 23 cross-sectional studies, two editorials, and one description article on the multidimensional aspect of burnout and empathy. The studies were conducted in Europe, USA, North America, and Asia. In most studies, there was an inverse correlation between empathy and emotional exhaustion and depersonalization but a positive correlation with personal accomplishment. Although there seems to be a real relationship between empathy and burnout in physicians and nurses, the strength of the relationship differs to some extent depending on the samples and settings. Due to similarities between health professions, the relationship between empathy and burnout may also be relevant to the paramedic profession. Future paramedic research should focus on longitudinal studies to determine the factors that might influence empathy and burnout levels to provide a better understanding of these two key factors.

Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

PubMed Central

Sun, Zhen; Kong, Xin-Juan; Jing, Xue; Deng, Run-Jun; Tian, Zi-Bin

2015-01-01

Background The nutritional risk screening (NRS 2002) has been applied increasingly in patients who underwent abdominal surgery for nutritional risk assessment. However, the usefulness of the NRS 2002 for predicting is controversial. This meta-analysis was to examine whether a preoperative evaluation of nutritional risk by NRS 2002 provided prediction of postoperative outcomes in patients undergoing abdominal surgery. Methods A systematic literature search for published papers was conducted using the following online databases: MEDLINE, EMBASE, the Cochrane library, EBSCO, CRD databases, Cinahl, PsycInfo and BIOSIS previews. The pooled odds ratio (OR) or weight mean difference (WMD) was calculated using a random-effect model or a fix-effect model. Results Eleven studies with a total of 3527 patients included in this study. Postoperative overall complications were more frequent in nutritional risk patients versus patients without nutritional risk (the pooled OR 3.13 [2.51, 3.90] p<0.00001). The pooled OR of mortality for the nutritional risk group and non-nutritional risk group was 3.61 [1.38, 9.47] (p = 0.009). Furthermore, the postoperative hospital stay was significant longer in the preoperative nutritional risk group than in the nutritional normal group (WMD 5.58 [4.21, 6.95] p<0.00001). Conclusions The present study has demonstrated that patients at preoperative nutritional risk have increased complication rates, high mortality and prolonged hospital stay after surgery. However, NRS 2002 needs to be validated in larger samples of patients undergoing abdominal surgery by better reference method. PMID:26172830

The impact of childbirth-related post-traumatic stress on a couple's relationship: a systematic review and meta-synthesis.

PubMed

Delicate, A; Ayers, S; Easter, A; McMullen, S

2018-02-01

This review aimed to identify the impact of childbirth-related post-traumatic stress disorder (PTSD) or symptoms (PTSS) on a couple's relationship. Childbirth can be psychologically traumatic and can lead to PTSD. There is emerging evidence that experiencing a traumatic birth can affect the quality of the couple's relationship. This is an important issue because poor-quality relationships can impact on the well-being of partners, their parenting and the welfare of the infant. A systematic search was conducted of Amed, CENTRAL, Cinahl, Embase, Maternity and Infant Care, Medline, MITCognet, POPLINE, PsycARTICLES, PsycBITE, PsycINFO, Pubmed and Science Direct. Additionally, grey literature, citation and reference searches were conducted. Papers were eligible for inclusion if they reported qualitative data about parents who had experienced childbirth and measures of PTSD or PTSS and the relationship were taken. Analysis was conducted using meta-ethnography. Seven studies were included in the meta-synthesis. Results showed that childbirth-related PTSD or PTSS can have a perceived impact on the couple's relationship and five themes were identified: negative emotions; lack of understanding and support; loss of intimacy; strain on the relationship; and strengthened relationships. A model of proposed interaction between these themes is presented. The impact of childbirth-related PTSD or PTSS on the couple's relationships is complex. As the quality of the couple relationship is important to family well-being, it is important that healthcare professionals are aware of the impact of experiencing psychologically traumatic childbirth as impetus for prevention and support.

A systematic review and meta-analysis of educational interventions for children and adolescents with acquired brain injury.

PubMed

Linden, Mark A; Glang, Ann E; McKinlay, Audrey

2018-01-01

Children with brain injuries face significant challenges in their recovery. One of the greatest is transitioning from hospital/home to school where they face issues such as reintegration, lack of understanding and catching up with missed work. Many children struggle with their altered circumstances and require additional supports to meet the academic demands of systems which are ill equipped to teach them. To summarise the best available evidence for the use of educational interventions to improve academic attainment in childhood survivors of acquired brain injury (ABI). Six electronic databases (Cinahl, Embase, Medline, PsycINFO, Pubmed, & Web of Science) were systematically searched for randomised controlled trials published between 1980 and 2017. Two authors independently reviewed these studies and extracted data on type of intervention, characteristics of participants, outcome measures, findings and recommendations. The Cochrane Collaboration's Risk of Bias tool was used to assess systematic error in the included studies. Four studies met the inclusion criteria (n = 296 children and adolescents). Three studies (n = 287) were included in meta-analysis for the primary outcome which showed no statistically significant difference between the intervention and control conditions on academic attainment (SMD 1.31, 95% CI -0.06 to 2.68, p = 0.06). No statistically significant differences were found which favoured the intervention for the secondary outcomes of attention, internalising or externalising behavior. All effect sizes were considered as small. This review suggests that no currently effective educational interventions exist for children with ABI. Greater efforts are required to produce effective and rigorously tested interventions to improve outcomes for these children.

Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Uchendu, C; Blake, H

2017-03-01

Diabetes is a chronic progressive condition presenting physical, social and psychological challenges that increase the risk of comorbid mental health problems. Cognitive-behavioural therapy (CBT) is effective in treating a variety of psychological disorders, and may potentially improve glycaemic control and psychological outcomes in diabetes. This systematic review and meta-analysis aims to establish the effectiveness of CBT on glycaemic control and comorbid diabetes-related distress, depression, anxiety and quality of life in the short, medium and longer term among adults with diabetes. An electronic search was conducted in PubMed, Embase, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, Cochrane Central Register of Controlled Trials and references in reviews. Twelve randomized controlled trials (RCTs) were identified that evaluated the effectiveness of CBT on at least one of: glycaemic control, diabetes-related distress, anxiety, depression or quality of life in adults with Type 1 or Type 2 diabetes. The Cochrane Risk of Bias Tool and Review Manager version 5.3 were used for risk of bias assessment and meta-analysis, respectively. CBT is effective in reducing short-term and medium-term glycaemic control, although no significant effect was found for long-term glycaemic control. CBT improved short- and medium-term anxiety and depression, and long-term depression. Mixed results were found for diabetes-related distress and quality of life. CBT is beneficial in improving depression for adults with diabetes. It may have benefits for improving glycaemic control and other aspects of psychological health, although the findings are inconclusive. © 2016 Diabetes UK.

Meta-Review of CSF Core Biomarkers in Alzheimer’s Disease: The State-of-the-Art after the New Revised Diagnostic Criteria

PubMed Central

Ferreira, Daniel; Perestelo-Pérez, Lilisbeth; Westman, Eric; Wahlund, Lars-Olof; Sarría, Antonio; Serrano-Aguilar, Pedro

2014-01-01

Background: Current research criteria for Alzheimer’s disease (AD) include cerebrospinal fluid (CSF) biomarkers into the diagnostic algorithm. However, spreading their use to the clinical routine is still questionable. Objective: To provide an updated, systematic and critical review on the diagnostic utility of the CSF core biomarkers for AD. Data sources: MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane Library, and CRD. Eligibility criteria: (1a) Systematic reviews with meta-analysis; (1b) Primary studies published after the new revised diagnostic criteria; (2) Evaluation of the diagnostic performance of at least one CSF core biomarker. Results: The diagnostic performance of CSF biomarkers is generally satisfactory. They are optimal for discriminating AD patients from healthy controls. Their combination may also be suitable for mild cognitive impairment (MCI) prognosis. However, CSF biomarkers fail to distinguish AD from other forms of dementia. Limitations: (1) Use of clinical diagnosis as standard instead of pathological postmortem confirmation; (2) variability of methodological aspects; (3) insufficiently long follow-up periods in MCI studies; and (4) lower diagnostic accuracy in primary care compared with memory clinics. Conclusion: Additional work needs to be done to validate the application of CSF core biomarkers as they are proposed in the new revised diagnostic criteria. The use of CSF core biomarkers in clinical routine is more likely if these limitations are overcome. Early diagnosis is going to be of utmost importance when effective pharmacological treatment will be available and the CSF core biomarkers can also be implemented in clinical trials for drug development. PMID:24715863

Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.

PubMed

Veinot, Tiffany C; Senteio, Charles R; Hanauer, David; Lowery, Julie C

2018-06-01

To describe a new, comprehensive process model of clinical information interaction in primary care (Clinical Information Interaction Model, or CIIM) based on a systematic synthesis of published research. We used the "best fit" framework synthesis approach. Searches were performed in PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Library and Information Science Abstracts, Library, Information Science and Technology Abstracts, and Engineering Village. Two authors reviewed articles according to inclusion and exclusion criteria. Data abstraction and content analysis of 443 published papers were used to create a model in which every element was supported by empirical research. The CIIM documents how primary care clinicians interact with information as they make point-of-care clinical decisions. The model highlights 3 major process components: (1) context, (2) activity (usual and contingent), and (3) influence. Usual activities include information processing, source-user interaction, information evaluation, selection of information, information use, clinical reasoning, and clinical decisions. Clinician characteristics, patient behaviors, and other professionals influence the process. The CIIM depicts the complete process of information interaction, enabling a grasp of relationships previously difficult to discern. The CIIM suggests potentially helpful functionality for clinical decision support systems (CDSSs) to support primary care, including a greater focus on information processing and use. The CIIM also documents the role of influence in clinical information interaction; influencers may affect the success of CDSS implementations. The CIIM offers a new framework for achieving CDSS workflow integration and new directions for CDSS design that can support the work of diverse primary care clinicians.

Effects of prenatal childbirth education for partners of pregnant women on paternal postnatal mental health and couple relationship: A systematic review.

PubMed

Suto, Maiko; Takehara, Kenji; Yamane, Yumina; Ota, Erika

2017-03-01

Partner education during pregnancy may be able to prevent postnatal mental health problems, and support expectant fathers in their transition to parenthood. The aim of this systematic review is to investigate the effects of prenatal childbirth education among partners of pregnant women, particularly regarding paternal postnatal mental health and couple relationship. We searched Medline, CINAHL, EMBASE, PsycINFO, ERIC, and CENTRAL using terms such as "partners of pregnant women," "education," and "prenatal support." Searches were limited to randomized trials. We included 11 trials out of 13 reports that addressed the following topics: childbirth preparation, couple relationship, infants and parenting, postpartum psychosocial issues, and housework sharing. Overall risk of bias was low or unclear. Study outcomes, including parents' mental health (e.g., anxiety, depression, distress), couple relationship, parents' transition adjustment and parenting stress, and parents' satisfaction with their experience of childbirth and prenatal childbirth education programs were reported. The studies included in this review were very diverse regarding intervention intensity and content, outcome types, measurement tools, and outcome timing. This impeded evaluation of the interventions' effectiveness. No sufficient evidence was identified that prenatal childbirth education for partners of pregnant women protects against paternal postnatal depression and couple relationship; however, paternal postnatal mental health is important to maternal and perinatal healthcare. The results of this review suggest that further research and intervention are required to provide partners of pregnant women with evidence-based information and support whole families during the perinatal period. Copyright © 2016 Elsevier B.V. All rights reserved.

Research priority setting in childhood chronic disease: a systematic review.

PubMed

Odgers, Harrison Lindsay; Tong, Allison; Lopez-Vargas, Pamela; Davidson, Andrew; Jaffe, Adam; McKenzie, Anne; Pinkerton, Ross; Wake, Melissa; Richmond, Peter; Crowe, Sally; Caldwell, Patrina Ha Yuen; Hill, Sophie; Couper, Jennifer; Haddad, Suzy; Kassai, Behrouz; Craig, Jonathan C

2018-04-11

To evaluate research priority setting approaches in childhood chronic diseases and to describe the priorities of stakeholders including patients, caregivers/families and health professionals. We conducted a systematic review of MEDLINE, Embase, PsycINFO and CINAHL from inception to 16 October 2016. Studies that elicited stakeholder priorities for paediatric chronic disease research were eligible for inclusion. Data on the prioritisation process were extracted using an appraisal checklist. Generated priorities were collated into common topic areas. We identified 83 studies (n=15 722). Twenty (24%) studies involved parents/caregivers and four (5%) children. The top three health areas were cancer (11%), neurology (8%) and endocrine/metabolism (8%). Priority topic areas were treatment (78%), disease trajectory (48%), quality of life/psychosocial impact (48%), disease onset/prevention (43%), knowledge/self-management (33%), prevalence (30%), diagnostic methods (28%), access to healthcare (25%) and transition to adulthood (12%). The methods included workshops, Delphi techniques, surveys and focus groups/interviews. Specific methods for collecting and prioritising research topics were described in only 60% of studies. Most reviewed studies were conducted in high-income nations. Research priority setting activities in paediatric chronic disease cover many discipline areas and have elicited a broad range of topics. However, child/caregiver involvement is uncommon, and the methods often lack clarity. A systematic and explicit process that involves patients and families in partnership may help to inform a more patient and family-relevant research agenda in paediatric chronic disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Experiences and perspectives of older people regarding advance care planning: A meta-synthesis of qualitative studies.

PubMed

Ke, Li-Shan; Huang, Xiaoyan; Hu, Wen-Yu; O'Connor, Margaret; Lee, Susan

2017-05-01

Studies have indicated that family members or health professionals may not know or predict their older relatives' or patients' health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. To understand the experiences and perspectives of older people regarding advance care planning. A systematic review of qualitative studies and meta-synthesis was conducted. CINAHL, MEDLINE, EMBASE, and PsycINFO databases were searched. A total of 50 articles were critically appraised and a thematic synthesis was undertaken. Four themes were identified: life versus death, internal versus external, benefits versus burdens, and controlling versus being controlled. The view of life and death influenced older people's willingness to discuss their future. The characteristics, experiences, health status, family relationship, and available resources also affected their plans of advance care planning. Older people needed to balance the benefits and burdens of advance care planning, and then judge their own ability to make decisions about end-of-life care. Older people's perspectives and experiences of advance care planning were varied and often conflicted; cultural differences amplified variances among older people. Truthful information, available resources, and family support are needed to enable older people to maintain dignity at the end of life. The views of life and death for older people from different cultures should be compared to assist health professionals to understand older people's attitudes toward advance care planning, and thus to develop appropriate strategies to promote advance care planning in different cultures.

A systematic review of patient perspectives on surveillance after colorectal cancer treatment.

PubMed

Berian, Julia R; Cuddy, Amanda; Francescatti, Amanda B; O'Dwyer, Linda; Nancy You, Y; Volk, Robert J; Chang, George J

2017-10-01

Surveillance after colorectal cancer (CRC) treatment is routine, but intensive follow-up may offer little-to-no overall survival benefit. Given the growing population of CRC survivors, we aimed to systematically evaluate the literature for the patient perspective on two questions: (1) How do CRC patients perceive routine surveillance following curative treatment and what do they expect to gain from their surveillance testing or visits? (2) Which providers (specialists, nursing, primary care) are preferred by CRC survivors to guide post-treatment surveillance? Systematic searches of PubMed MEDLINE, Embase, the CENTRAL Register of Controlled Trials, CINAHL, and PsycINFO were conducted. Studies were screened for inclusion by two reviewers, with discrepancies adjudicated by a third reviewer. Data were abstracted and evaluated utilizing validated reporting tools (CONSORT, STROBE, CASP) appropriate to study design. Citations (3691) were screened, 91 full-text articles reviewed, and 23 studies included in the final review: 15 quantitative and 8 qualitative. Overall, 12 studies indicated CRC patients perceive routine surveillance positively, expecting to gain reassurance of continued disease suppression. Negative perceptions described in six studies included anxiety and dissatisfaction related to quality of life or psychosocial issues during follow-up. Although 5 studies supported specialist-led care, 9 studies indicated patient willingness to have follow-up with non-specialist providers (primary care or nursing). Patients' perceptions of follow-up after CRC are predominantly positive, although unmet needs included psychosocial support and quality of life. Survivors perceived follow-up as reassuring, however, surveillance care should be more informative and focused on survivor-specific needs.

Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research

PubMed Central

Robertshaw, Luke; Dhesi, Surindar

2017-01-01

Objectives To thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries. Design Systematic review and qualitative thematic synthesis. Methods Searches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs. Results Twenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes. Conclusions A range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group. PMID:28780549

The Association between Obstructive Sleep Apnoea and Metabolic Abnormalities in Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis.

PubMed

Kahal, Hassan; Kyrou, Ioannis; Uthman, Olalekan; Brown, Anna; Johnson, Samantha; Wall, Peter; Metcalfe, Andrew; Tahrani, Abd A; Randeva, Harpal S

2018-05-02

In this systematic review and meta-analysis, we aimed to examine the relationship between obstructive sleep apnoea (OSA) and metabolic abnormalities in women with polycystic ovary syndrome (PCOS). Electronic databases (Medline, Embase, Cinahl, PsycInfo, Scopus, Web of Science, Opengrey, CENTRAL), conference abstracts, and reference lists of relevant articles were searched. No restriction was applied for language or publication status. Six studies involving 252 participants were included. Women with PCOS and OSA had significantly higher body mass index (mean difference [MD]: 6.01 kg/m 2, 95% Confidence Intervals [CI]: 4.69-7.33), waist circumference (MD: 10.93 cm, 95% CI: 8.03-13.83), insulin resistance, systolic and diastolic blood pressure, as well as worse lipids' profile and impaired glucose regulation compared to women with PCOS without OSA. Most studies did not adjust for weight in their between groups analysis. Total and free testosterone levels were not significantly different between the two groups. The majority of studies were found to be at high risk of selection bias; did not account for important confounders; were conducted in one country (USA); and used different methodologies to assess testosterone levels (preventing a meta-analysis for this specific outcome). OSA is associated with obesity and worse metabolic profiles in women with PCOS. However, whether the effects of OSA are independent of obesity remain unclear. As OSA is a treatable condition, research focused on the independent effects of OSA on key clinical outcomes in women with PCOS, including fertility, psychological health, type 2 diabetes and cardiovascular risk is lacking and needed.

Monitoring gender equity in health using gender-sensitive indicators: a cross-national study.

PubMed

Diaz-Granados, Natalia; Pitzul, Kristen Blythe; Dorado, Linda M; Wang, Feng; McDermott, Sarah; Rondon, Marta B; Posada-Villa, Jose; Saavedra, Javier; Torres, Yolanda; Des Meules, Marie; Stewart, Donna E

2011-01-01

As gender is known to be a major determinant of health, monitoring gender equity in health systems remains a vital public health priority. Focusing on a low-income (Peru), middle-income (Colombia), and high-income (Canada) country in the Americas, this study aimed to (1) identify and select gender-sensitive health indicators and (2) assess the feasibility of measuring and comparing gender-sensitive health indicators among countries. Gender-sensitive health indicators were selected by a multidisciplinary group of experts from each country. The most recent gender-sensitive health measures corresponding to selected indicators were identified through electronic databases (CINAHL, PsycINFO, MEDLINE, Embase, LILACS, LIPECS, Latindex, and BIREME) and expert consultation. Data from population-based studies were analyzed when indicator information was unavailable from reports. Twelve of the 17 selected gender-sensitive health indicators were feasible to measure in at least two countries, and 9 of these were comparable among all countries. Indicators that were available were not stratified or adjusted by age, education, marital status, or wealth. The largest between-country difference was maternal mortality, and the largest gender inequity was mortality from homicides. This study shows that gender inequities in health exist in all countries, regardless of income level. Economic development seemed to confer advantages in the availability of such indicators; however, this finding was not consistent and needs to be further explored. Future initiatives should include identifying health system factors and risk factors associated with disparities as well as assessing the cost-effectiveness of including the routine monitoring of gender inequities in health.

The relationship between doctors' and nurses' own weight status and their weight management practices: a systematic review.

PubMed

Zhu, D Q; Norman, I J; While, A E

2011-06-01

It has been established that health professionals' smoking and physical activity influence their related health-promoting behaviours, but it is unclear whether health professionals' weight status also influences their related professional practices. A systematic review was conducted to understand the relationship between personal weight status and weight management practices. Nine eligible studies were identified from a search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases. All included studies were cross-sectional surveys employing self-reported questionnaires. Weight management practice variables studied were classified under six practice indicators, developed from weight management guidelines. Syntheses of the findings from the selected studies suggest that: normal weight doctors and nurses were more likely than those who were overweight to use strategies to prevent obesity in-patients, and, also, provide overweight or obese patients with general advice to achieve weight loss. Doctors' and nurses' own weight status was not found to be significantly related to their referral and assessment of overweight or obese patients, and associations with their relevant knowledge/skills and specific treatment behaviours were inconsistent. Additionally, in female, primary care providers, relevant knowledge and training, self-efficacy and a clear professional identity emerged as positive predictors of weight management practices. This review's findings will need to be confirmed by prospective theoretically driven studies, which employ objective measures of weight status and weight management practices and involve multivariate analyses to identify the relative contribution of weight status to weight management. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Measurement properties of tools measuring mental health knowledge: a systematic review.

PubMed

Wei, Yifeng; McGrath, Patrick J; Hayden, Jill; Kutcher, Stan

2016-08-23

Mental health literacy has received great attention recently to improve mental health knowledge, decrease stigma and enhance help-seeking behaviors. We conducted a systematic review to critically appraise the qualities of studies evaluating the measurement properties of mental health knowledge tools and the quality of included measurement properties. We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library, and ERIC for studies addressing psychometrics of mental health knowledge tools and published in English. We applied the COSMIN checklist to assess the methodological quality of each study as "excellent", "good", "fair", or "indeterminate". We ranked the level of evidence of the overall quality of each measurement property across studies as "strong", "moderate", "limited", "conflicting", or "unknown". We identified 16 mental health knowledge tools in 17 studies, addressing reliability, validity, responsiveness or measurement errors. The methodological quality of included studies ranged from "poor" to "excellent" including 6 studies addressing the content validity, internal consistency or structural validity demonstrating "excellent" quality. We found strong evidence of the content validity or internal consistency of 6 tools; moderate evidence of the internal consistency, the content validity or the reliability of 8 tools; and limited evidence of the reliability, the structural validity, the criterion validity, or the construct validity of 12 tools. Both the methodological qualities of included studies and the overall evidence of measurement properties are mixed. Based on the current evidence, we recommend that researchers consider using tools with measurement properties of strong or moderate evidence that also reached the threshold for positive ratings according to COSMIN checklist.

Quality-of-life measures for use within care homes: a systematic review of their measurement properties.

PubMed

Aspden, Trefor; Bradshaw, Siobhan A; Playford, E Diane; Riazi, Afsane

2014-09-01

the aims of this review were (i) to identify quality-of-life (QoL) measures which have had their measurement properties validated in people residing in care homes or nursing homes, and to critically compare and summarise these instruments and (ii) to make recommendations for measurement instruments. bibliographic databases PsycINFO, PubMed, Cochrane, CINAHL and Embase were searched for articles evaluating measurement properties of QoL instruments in people residing in care homes. Methodological quality of studies was assessed using the consensus-based standards for the selection of health measurement instruments checklist. Measurement properties of instruments were appraised using a systematic checklist. the search strategy resulted in 3252 unique citations, of which 15 articles were included in this review. These articles assessed 13 instruments, 8 of which were dementia or Alzheimer specific instruments. The QUALIDEM, a dementia-specific observational instrument, had the widest array of information available on its measurement properties, which were mostly satisfactory. Most measurement instruments lacked information on hypotheses testing and content validity. Information on responsiveness and measurement error was not available for any instrument. for people with dementia living in care homes, the QUALIDEM is recommended for measuring QoL. For residents without dementia, we recommend Kane et al.'s Psychosocial Quality of Life Domains questionnaire. Studies of higher methodological quality, assessing a wider range of measurement properties are needed to allow a more fully informed choice of QoL instrument. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Systematic review of measurement properties of self-reported instruments for evaluating self-care in adults.

PubMed

Matarese, Maria; Lommi, Marzia; De Marinis, Maria Grazia

2017-06-01

The aims of this study were as follows: to identify instruments developed to assess self-care in healthy adults; to determine the theory on which they were based; their validity and reliability properties and to synthesize the evidence on their measurement properties. Many instruments have been developed to assess self-care in many different populations and conditions. Clinicians and researchers should select the most appropriate self-care instrument based on the knowledge of their measurement properties. Systematic review of measurement instruments according to the protocol recommended by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel. PubMed, Embase, PsycINFO, Scopus and CINAHL databases were searched from inception to December 2015. Studies testing measurement properties of self-report instruments assessing self-care in healthy adults, published in the English language and in peer review journals were selected. Two reviewers independently appraised the methodological quality of the studies with the COSMIN checklist and the quality of results using specific quality criteria. Twenty-six articles were included in the review testing the measurement properties of nine instruments. Seven instruments were based on Orem's Self-care theory. Not all the measurement properties were evaluated for the identified instruments. No self-care instrument showed strong evidence supporting the evaluated measurement properties. Despite the development of several instruments to assess self-care in the adult population, no instrument can be fully recommended to clinical nurses and researchers. Further studies of high methodological quality are needed to confirm the measurement properties of these instruments. © 2016 John Wiley & Sons Ltd.

Neurobiological Basis of Insight in Schizophrenia: A Systematic Review.

PubMed

Xavier, Rose Mary; Vorderstrasse, Allison

2016-01-01

Insight in schizophrenia is defined as awareness into illness, symptoms, and need for treatment and has long been associated with cognition, other psychopathological symptoms, and several adverse clinical and functional outcomes. However, the biological basis of insight is not clearly understood. The aim of this systematic review was to critically evaluate and summarize advances in the study of the biological basis of insight in schizophrenia and to identify gaps in this knowledge. A literature search of PubMed, CINAHL, PsycINFO, and EMBASE databases was conducted using search terms to identify articles relevant to the biology of insight in schizophrenia published in the last 6 years. Articles that focused on etiology of insight in schizophrenia and those that examined the neurobiology of insight in schizophrenia or psychoses were chosen for analysis. Articles on insight in conditions other than schizophrenia or psychoses and which did not investigate the neurobiological underpinnings of insight were excluded from the review. Twenty-six articles met the inclusion criteria for this review. Of the 26 articles, 3 focused on cellular abnormalities and 23 were neuroimaging studies. Preliminary data identify the prefrontal cortex, cingulate cortex, and regions of the temporal and parietal lobe (precuneus, inferior parietal lobule) and hippocampus as the neural correlates of insight. A growing body of literature attests to the neurobiological basis of insight in schizophrenia. Current evidence supports the neurobiological basis of insight in schizophrenia and identifies specific neural correlates for insight types and its dimensions. Further studies that examine the precise biological mechanisms of insight are needed to apply this knowledge to effective clinical intervention development.

Survivors of Child Maltreatment and Postpartum Depression: An Integrative Review.

PubMed

Hutchens, Bridget F; Kearney, Joan; Kennedy, Holly Powell

2017-11-01

An integrative review was performed to explore the relationship between a maternal history of child maltreatment and subsequent postpartum depression (PPD) symptoms. Six electronic databases were used to explore the literature, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, and Scopus. Studies were included that used victims of child maltreatment as one of the independent variables and PPD symptoms as one of the dependent variables. Studies were excluded if they focused only on women with adult intimate partner violence or women with PPD who were perpetrators of child abuse rather than survivors. The studies were required to be original research, and there was no limit to years or language. The search yielded 589 studies, 16 of which were included in the final sample. These studies were assessed for quality, and a data display matrix was developed to extract the sample, design, methods, operational definitions for independent and dependent variables of interest, major findings with effect sizes, and limitations. Using the data display matrix, the studies' methods and findings were synthesized for divergent and convergent patterns. Studies were varied in their designs, samples, and operational definitions of child maltreatment and PPD, and were low to moderate in quality. Results were inconsistent, but a majority suggest a positive association between a maternal history of child maltreatment and subsequent symptoms of PPD. Child maltreatment and PPD are complex issues that require careful screening by women's health care providers and clearly defined operational definitions in future research. Implications for clinical practice and research are discussed. © 2017 by the American College of Nurse-Midwives.

Methods for Alleviating Stress and Increasing Resilience in the Midwifery Community: A Scoping Review of the Literature.

PubMed

Wright, Erin M; Matthai, Maude Theo; Warren, Nicole

2017-11-01

Work-related stress and exposure to traumatic birth have deleterious impacts on midwifery practice, the midwife's physiologic well-being, and the midwifery workforce. This is a global phenomenon, and the specific sources of this stress vary dependent on practice setting. This scoping review aims to determine which, if any, modalities help to reduce stress and increase resilience among a population of midwives. A scoping review of the literature published between January 2011 and September 2016 using PubMed, CINAHL, Embase, PsycINFO, and Cochrane databases was performed. Of the initial 796 reviewed records, 6 met inclusion criteria. Three of the 6 included studies were quantitative in nature, 2 were qualitative, and one used mixed methods. Countries where studies were conducted include Uganda, Iran, the United Kingdom, Israel, and Australia. Three of the studies used interventions for stress reduction and increased coping. Two of these 3 used a mindfulness-based stress reduction program resulting in improved stress levels and coping skills. In each study, midwives express a desire for work-based programs and support from colleagues and employers for increasing coping abilities. These studies focused on stress reduction and/or increasing resilience. While modalities such as mindfulness-based stress reduction show promise, further studies with a cohort of midwives should be conducted. These studies should include interventions aimed at addressing the needs of midwives to improve psychological outcomes related to employment-related stress on a global scale and specific to each health care context. © 2017 by the American College of Nurse-Midwives.

HIV care and treatment experiences among female sex workers living with HIV in sub-Saharan Africa: A systematic review.

PubMed

Lancaster, Kathryn E; Cernigliaro, Dana; Zulliger, Rose; Fleming, Paul F

2016-12-01

Female sex workers (FSW) living with HIV in sub-Saharan Africa have poor engagement to HIV care and treatment. Understanding the HIV care and treatment engagement experiences of FSW has important implications for interventions to enhance care and treatment outcomes. We conducted a systematic review to examine the HIV care experiences and determinants of linkage and retention in care, antiretroviral therapy (ART) initiation, and ART adherence and viral suppression among FSW living with HIV in sub-Saharan Africa. The databases PubMed, Embase, Web of Science, SCOPUS, CINAHL, Global Health, Psycinfo, Sociological Abstracts, and Popline were searched for variations of search terms related to sex work and HIV care and treatment among sub-Saharan African populations. Ten peer-reviewed articles published between January 2000 and August 2015 met inclusion criteria and were included in this review. Despite expanded ART access, FSW in sub-Saharan Africa have sub-optimal HIV care and treatment engagement outcomes. Stigma, discrimination, poor nutrition, food insecurity, and substance use were commonly reported and associated with poor linkage to care, retention in care, and ART initiation. Included studies suggest that interventions with FSW should focus on multilevel barriers to engagement in HIV care and treatment and explore the involvement of social support from intimate male partners. Our results emphasise several critical points of intervention for FSW living with HIV, which are urgently needed to enhance linkage to HIV care, retention in care, and treatment initiation, particularly where the HIV prevalence among FSW is greatest.

Health-related quality of life questionnaires in individuals with haemophilia: a systematic review of their measurement properties.

PubMed

Limperg, P F; Terwee, C B; Young, N L; Price, V E; Gouw, S C; Peters, M; Grootenhuis, M A; Blanchette, V; Haverman, L

2017-07-01

The evaluation of health related quality of life (HRQOL) is essential for a full assessment of the influence of an illness on patients' lives. The aim of this paper is to critically appraise and compare the measurement properties of HRQOL questionnaires studied in haemophilia. Bibliographic databases (Embase, Medline, Cinahl and PsycInfo) were searched for articles evaluating measurement properties of HRQOL questionnaires in haemophilia. Articles were excluded that did not report HRQOL measurement properties, or when <50% of the study population had haemophilia. The methodological quality of the selected studies was evaluated using the COSMIN checklist. The measurement properties of the HRQL questionnaires were rated as 'positive', 'indeterminate' or 'negative', accompanied by levels of evidence. The search resulted in 1597 unique hits, of which 22 studies were included. These articles evaluated three questionnaires for children (CHO-KLAT, Haemo-QoL and one unnamed measure) and five for adults (Hemofilia-QoL, Haemophilia Well-Being Index, HAEMO-QoL-A, Haem-A-QoL, and SF-36). The CHO-KLAT was the paediatric measure that showed the strongest measurement properties in high-quality studies. The Haemophilia Well-Being Index and HAEMO-QoL-A performed best among the adult measures. None of the studies reported measurement error and responsiveness. Our findings suggest that there is no need for new disease-specific HRQOL questionnaires for haemophilia, but rather that additional research is necessary to document the measurement properties of the currently available questionnaires, specifically focusing on the structural validity, measurement error and responsiveness of these questionnaires. © 2017 John Wiley & Sons Ltd.

The use of psychiatry-focused simulation in undergraduate nursing education: A systematic search and review.

PubMed

Vandyk, Amanda D; Lalonde, Michelle; Merali, Sabrina; Wright, Erica; Bajnok, Irmajean; Davies, Barbara

2018-04-01

Evidence on the use of simulation to teach psychiatry and mental health (including addiction) content is emerging, yet no summary of the implementation processes or associated outcomes exists. The aim of this study was to systematically search and review empirical literature on the use of psychiatry-focused simulation in undergraduate nursing education. Objectives were to (i) assess the methodological quality of existing evidence on the use of simulation to teach mental health content to undergraduate nursing students, (ii) describe the operationalization of the simulations, and (iii) summarize the associated quantitative and qualitative outcomes. We conducted online database (MEDLINE, Embase, ERIC, CINAHL, PsycINFO from January 2004 to October 2015) and grey literature searches. Thirty-two simulation studies were identified describing and evaluating six types of simulations (standardized patients, audio simulations, high-fidelity simulators, virtual world, multimodal, and tabletop). Overall, 2724 participants were included in the studies. Studies reflected a limited number of intervention designs, and outcomes were evaluated with qualitative and quantitative methods incorporating a variety of tools. Results indicated that simulation was effective in reducing student anxiety and improving their knowledge, empathy, communication, and confidence. The summarized qualitative findings all supported the benefit of simulation; however, more research is needed to assess the comparative effectiveness of the types of simulations. Recommendations from the findings include the development of guidelines for educators to deliver each simulation component (briefing, active simulation, debriefing). Finally, consensus around appropriate training of facilitators is needed, as is consistent and agreed upon simulation terminology. © 2017 Australian College of Mental Health Nurses Inc.

Systematic review: interventions for abdominal pain management in inflammatory bowel disease.

PubMed

Norton, C; Czuber-Dochan, W; Artom, M; Sweeney, L; Hart, A

2017-07-01

Abdominal pain is frequently reported by people with inflammatory bowel disease (IBD), including in remission. Pain is an under-treated symptom. To systematically review evidence on interventions (excluding disease-modifying interventions) for abdominal pain management in IBD. Databases (MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Cochrane Library) were searched (February 2016). Two researchers independently screened references and extracted data. Fifteen papers were included: 13 intervention studies and two cross-sectional surveys. A variety of psychological, dietary and pharmacological interventions were reported. Four of six studies reported pain reduction with psychological intervention including individualised and group-based relaxation, disease anxiety-related Cognitive Behavioural Therapy and stress management. Both psychologist-led and self-directed stress management in inactive Crohn's disease reduced pain compared with controls (symptom frequency reduction index=-26.7, -11.3 and 17.2 at 6-month follow-up, respectively). Two dietary interventions (alcoholic drinks with high sugar content and fermentable carbohydrate with prebiotic properties) had an effect on abdominal pain. Antibiotics (for patients with bacterial overgrowth) and transdermal nicotine patches reduced abdominal pain. Current and past cannabis users report it relieves pain. One controlled trial of cannabis reduced SF-36 and EQ-5D pain scores (1.84 and 0.7, respectively). These results must be treated with caution: data were derived from predominantly small uncontrolled studies of moderate to low quality. Few interventions have been tested for IBD abdominal pain. The limited evidence suggests that relaxation and changing cognitions are promising, possibly with individualised dietary changes. There is a need to develop interventions for abdominal pain management in IBD. © 2017 John Wiley & Sons Ltd.

Experiences and perspectives of adults living with systemic lupus erythematosus: thematic synthesis of qualitative studies.

PubMed

Sutanto, Bernadet; Singh-Grewal, Davinder; McNeil, H Patrick; O'Neill, Sean; Craig, Jonathan C; Jones, Julie; Tong, Allison

2013-11-01

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that significantly impairs patients’ quality of life and can be life threatening. This study aimed to describe the experiences and perspectives of adults living with SLE. We conducted a systematic review and thematic synthesis of qualitative studies that explored the experiences of adults living with SLE. We searched MEDLINE, Embase, PsycINFO, CINAHL (to November week 1, 2012), Google Scholar, a thesis database, and reference lists of relevant articles. Forty-six studies involving 1,385 participants were included. Five themes were identified: restricted lifestyle(including subthemes of pervasive pain, debilitating fatigue, mental deterioration, disruptive episodic symptoms, and postponing parenthood), disrupted identity (gaining diagnostic closure, prognostic uncertainty, being a burden, hopelessness, heightened self-consciousness, fearing rejection, and guilt and punishment), societal stigma and indifference(illness trivialization, socially ostracized, and averse to differential treatment), gaining resilience (optimism, control and empowerment, being informed and involved, and valuing mutual understanding), and treatment adherence (preserving health, rapport with clinicians, negotiating medication regimens, and financial burden). SLE has a severe and pervasive impact on patients’ self-esteem and independence. Their physical and social functioning is limited and they feel anxious about their future. Patients perceive that SLE is trivialized, misunderstood,and stigmatized by their family, friends, and physicians, which intensifies their sense of isolation. Educational, psychosocial, and self-care interventions are needed to promote mental resilience, positive coping strategies, self-advocacy, and capacities for social participation, and thereby to achieve better treatment and health outcomes in patients with SLE.

Therapeutic Alliances in Stroke Rehabilitation: A Meta-Ethnography.

PubMed

Lawton, Michelle; Haddock, Gillian; Conroy, Paul; Sage, Karen

2016-11-01

To synthesize qualitative studies exploring patients' and professionals' perspectives and experiences of developing and maintaining therapeutic alliances in stroke rehabilitation. A systematic literature search was conducted using the following electronic databases: PsycINFO, CINAHL, Embase, MEDLINE, Allied and Complementary Medicine Database, Applied Social Sciences Index and Abstracts, and ComDisDome from inception to May 2014. This was supplemented by hand searching, reference tracking, generic web searching, and e-mail contact with experts. Qualitative peer reviewed articles reporting experiences or perceptions of the patient or professional in relation to therapeutic alliance construction and maintenance in stroke rehabilitation were selected for inclusion. After a process of exclusion, 17 publications were included in the synthesis. All text identified in the results and discussion sections of the selected studies were extracted verbatim for analysis in a qualitative software program. Studies were critically appraised independently by 2 reviewers. Articles were synthesized using a technique of meta-ethnography. Four overarching themes emerged from the process of reciprocal translation: (1) the professional-patient relationship: degree of connectedness; (2) asymmetrical contributions; (3) the process of collaboration: finding the middle ground; and (4) system drivers. The findings from the meta-ethnography suggest that the balance of power between the patient and professional is asymmetrically distributed in the construction of the alliance. However, given that none of the studies included in the review addressed therapeutic alliance as a primary research area, further research is required to develop a conceptual framework relevant to stroke rehabilitation, in order to determine how this construct contributes to treatment efficacy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design.

PubMed

Kelly, Sarah; Olanrewaju, Olawale; Cowan, Andy; Brayne, Carol; Lafortune, Louise

2018-01-01

Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed. Systematic review of qualitative studies in older populations (55+ years) to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature) were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA. Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful. To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.

Effectiveness of resistance training on muscle strength and physical function in people with Parkinson's disease: a systematic review and meta-analysis.

PubMed

Chung, Chloe Lau Ha; Thilarajah, Shamala; Tan, Dawn

2016-01-01

To systematically review the evidence investigating the effectiveness of resistance training on strength and physical function in people with Parkinson's disease. Seven electronic databases (COCHRANE, CINAHL, Medline ISI, Psycinfo, Scopus, Web of Science ISI and Embase) were systematically searched for full-text articles published in English between 1946 and November 2014 using relevant search terms. Only randomized controlled trials investigating the effects of resistance training on muscle strength and physical function in people with Parkinson's disease were considered. The PEDro scale was used to assess study quality. Studies with similar outcomes were pooled by calculating standardized mean differences (SMD) using fixed or random effects model, depending on study heterogeneity. Seven studies, comprising of 401 participants with early to advanced disease (Hoehn & Yahr stage 1 to 4), were included. The median quality score was 6/10. The meta-analyses demonstrated significant SMD in favour of resistance training compared to non-resistance training or no intervention controls for muscle strength (0.61; 95% CI, 0.35 to 0.87; P <0.001), balance (0.36; 95% CI, 0.08 to 0.64; P = 0.01) and parkinsonian motor symptoms (0.48; 95% CI, 0.21 to 0.75; P < 0.001) but not for gait, balance confidence and quality of life. This review demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease. © The Author(s) 2015.

Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review.

PubMed

Salman Popattia, Amber; Winch, Sarah; La Caze, Adam

2018-04-01

The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines. International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists' practices or perceptions, consumers' expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists' responsibilities in selling complementary medicines were included in the review. Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist's business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict. There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines. © 2018 Royal Pharmaceutical Society.

Physiotherapy Secretion Removal Techniques in People With Spinal Cord Injury: A Systematic Review

PubMed Central

Reid, W. Darlene; Brown, Jennifer A; Konnyu, Kristin J; Rurak, Jennifer M.E; Sakakibara, Brodie M

2010-01-01

Objective: To address whether secretion removal techniques increase airway clearance in people with chronic spinal cord injury (SCI). Data Sources and Study Selection: MEDLINE/PubMed, CINAHL, EMBASE, and PsycINFO were searched from inception to May 2009 for population keywords (spinal cord injury, paraplegia, tetraplegia, quadriplegia) paired with secretion removal–related interventions and outcomes. Inclusion criteria for articles were a research study, irrespective of design, that examined secretion removal in people with chronic SCI published in English. Review Methods: Two reviewers determined whether articles met the inclusion criteria, abstracted information, and performed a quality assessment using PEDro or Downs and Black criteria. Studies were then given a level of evidence based on a modified Sackett scale. Results: Of 2,416 abstracts and titles retrieved, 24 met the inclusion criteria. Subjects were young (mean, 31 years) and 84% were male. Most evidence was level 4 or 5 and only 2 studies were randomized controlled trials. Three reports described outcomes for secretion removal techniques in addition to cough, whereas most articles examined the immediate effects of various components of cough. Studies examining insufflation combined with manual assisted cough provided the most consistent, high-level evidence. Compelling recent evidence supports the use of respiratory muscle training or electrical stimulation of the expiratory muscles to facilitate airway clearance in people with SCI. Conclusion: Evidence supporting the use of secretion removal techniques in SCI, while positive, is limited and mostly of low level. Treatments that increase respiratory muscle force show promise as effective airway clearance techniques. PMID:21061895

Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis.

PubMed

Stubbs, Brendon; Aluko, Yetty; Myint, Phyo Kyaw; Smith, Toby O

2016-03-01

osteoarthritis is a leading cause of disability. This systematic review aimed to establish the prevalence of depressive symptoms and anxiety among people with osteoarthritis in comparison to those without osteoarthritis. we systematically reviewed databases including AMED, EMBASE, MEDLINE, PsycINFO, BNI, CINAHL and the Cochrane database library from their inception to January 2015. Studies presenting data on depressive symptoms and anxiety in people with osteoarthritis were included. A random- and fixed-effect meta-analysis was conducted on all eligible data. a total of 49 studies were included, representing 15,855 individuals (59% women; mean age 65.2 years). The evidence base was moderate in quality. The pooled prevalence of depressive symptoms in osteoarthritis was 19.9% (95% confidence intervals (CI): 15.9-24.5%, n = 10,811). The corresponding pooled prevalence was 21.3% (95% CI: 15.5-28.5%; n = 1,226) for anxiety symptoms. The relative risk of depression among people with osteoarthritis was 1.17 (95% CI 0.69-2.00, three studies, n = 941) compared with people without osteoarthritis. The relative risk of anxiety was 1.35 (95% CI: 0.51-3.59; three studies, n = 733) compared with those without osteoarthritis. one-fifth of people with osteoarthritis experience symptoms of depression and anxiety. However, it is uncertain whether this is increased compared with those without osteoarthritis, with no direct evidence to support an increase in anxiety and depression in osteoarthritis. CRD42013006733. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reasons why patients referred to diabetes education programmes choose not to attend: a systematic review.

PubMed

Horigan, G; Davies, M; Findlay-White, F; Chaney, D; Coates, V

2017-01-01

To identify the reasons why those offered a place on diabetes education programmes declined the opportunity. It is well established that diabetes education is critical to optimum diabetes care; it improves metabolic control, prevents complications, improves quality of life and empowers people to make informed choices to manage their condition. Despite the significant clinical and personal rewards offered by diabetes education, programmes are underused, with a significant proportion of patients choosing not to attend. A systematic search of the following databases was conducted for the period from 2005-2015: Medline; EMBASE; Scopus; CINAHL; and PsycINFO. Studies that met the inclusion criteria focusing on patient-reported reasons for non-attendance at structured diabetes education were selected. A total of 12 studies spanning quantitative and qualitative methodologies were included. The selected studies were published in Europe, USA, Pakistan, Canada and India, with a total sample size of 2260 people. Two broad categories of non-attender were identified: 1) those who could not attend for logistical, medical or financial reasons (e.g. timing, costs or existing comorbidities) and 2) those who would not attend because they perceived no benefit from doing so, felt they had sufficient knowledge already or had emotional and cultural reasons (e.g. no perceived problem, denial or negative feelings towards education). Diabetes education was declined for many reasons, and the range of expressed reasons was more diverse and complex than anticipated. New and innovative methods of delivering diabetes education are required which address the needs of people with diabetes whilst maintaining quality and efficiency. © 2016 Diabetes UK.

Simulation-based bronchoscopy training: systematic review and meta-analysis.

PubMed

Kennedy, Cassie C; Maldonado, Fabien; Cook, David A

2013-07-01

Simulation-based bronchoscopy training is increasingly used, but effectiveness remains uncertain. We sought to perform a comprehensive synthesis of published work on simulation-based bronchoscopy training. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, and Scopus for eligible articles through May 11, 2011. We included all original studies involving health professionals that evaluated, in comparison with no intervention or an alternative instructional approach, simulation-based training for flexible or rigid bronchoscopy. Study selection and data abstraction were performed independently and in duplicate. We pooled results using random effects meta-analysis. From an initial pool of 10,903 articles, we identified 17 studies evaluating simulation-based bronchoscopy training. In comparison with no intervention, simulation training was associated with large benefits on skills and behaviors (pooled effect size, 1.21 [95% CI, 0.82-1.60]; n=8 studies) and moderate benefits on time (0.62 [95% CI, 0.12-1.13]; n=7). In comparison with clinical instruction, behaviors with real patients showed nonsignificant effects favoring simulation for time (0.61 [95% CI, -1.47 to 2.69]) and process (0.33 [95% CI, -1.46 to 2.11]) outcomes (n=2 studies each), although variation in training time might account for these differences. Four studies compared alternate simulation-based training approaches. Inductive analysis to inform instructional design suggested that longer or more structured training is more effective, authentic clinical context adds value, and animal models and plastic part-task models may be superior to more costly virtual-reality simulators. Simulation-based bronchoscopy training is effective in comparison with no intervention. Comparative effectiveness studies are few.

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

PubMed Central

Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Vincent, Charles; van Gurp, Petra J; de Vet, Henrica C W; Wollersheim, Hub

2016-01-01

Objectives Record review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review. Design A systematic review of the literature. Methods We searched PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library and from their inception through February 2015. We included all studies that aimed to describe the reliability and/or validity of record review. Two reviewers conducted data extraction. We pooled κ values (κ) and analysed the differences in subgroups according to number of reviewers, reviewer experience and training level, adjusted for the prevalence of adverse events. Results In 25 studies, the psychometric data of the Global Trigger Tool (GTT) and the Harvard Medical Practice Study (HMPS) were reported and 24 studies were included for statistical pooling. The inter-rater reliability of the GTT and HMPS showed a pooled κ of 0.65 and 0.55, respectively. The inter-rater agreement was statistically significantly higher when the group of reviewers within a study consisted of a maximum five reviewers. We found no studies reporting on the validity of the GTT and HMPS. Conclusions The reliability of record review is moderate to substantial and improved when a small group of reviewers carried out record review. The validity of the record review method has never been evaluated, while clinical data registries, autopsy or direct observations of patient care are potential reference methods that can be used to test concurrent validity. PMID:27550650

Personal assistance for children and adolescents (0-18) with physical impairments.

PubMed

Montgomery, Paul; Mayo-Wilson, Evan; Dennis, Jane A

2008-07-16

There is a high and increasing prevalence of impairments among children and adolescents in the West. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. To assess the effectiveness of personal assistance for children and adolescents with physical impairments, and the impacts of personal assistance on others, compared to other interventions. Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Children and adolescents with physical impairments (0-18 years) living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities due to permanent impairments. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Titles and abstracts were examined by two reviewers. 130 full papers were examined. None met the inclusion criteria. No eligible studies were found. Research in this field is limited. When implementing new programmes, recipients could be randomly assigned to different forms of assistance. While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of personal assistance are most effective and efficient for particular people.

Patients' and carers' perspectives of palliative care in general practice: A systematic review with narrative synthesis.

PubMed

Green, Emilie; Knight, Selena; Gott, Merryn; Barclay, Stephen; White, Patrick

2018-04-01

General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner's role. To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner's capacity to fulfil this perceived role. Systematic literature review and narrative synthesis. Seven electronic databases (MEDLINE, Embase, PsycINFO, BNI, CINAHL, Cochrane and HMIC) were searched from inception to May 2017. Two reviewers independently screened papers at title, abstract and full-text stages. Grey literature, guideline, hand searches of five journals and reference list/citation searches of included papers were undertaken. Data were extracted, tabulated and synthesised using narrative, thematic analysis. A total of 25 studies were included: 14 employed qualitative methods, 8 quantitative survey methods and 3 mixed-methods. Five key themes were identified: continuity of care, communication between primary and secondary care, contact and accessibility, communication between general practitioner and patient, and knowledge and competence. Although the terminology and context of general practice vary internationally, themes relating to the perceived role of general practitioners were consistent. General practitioners are considered well placed to provide palliative care due to their breadth of clinical responsibility, ongoing relationships with patients and families, and duty to visit patients at home and coordinate healthcare resources. These factors, valued by service users, should influence future practice and policy development.

Comparative efficacy, acceptability, and safety of medicinal, cognitive-behavioral therapy, and placebo treatments for acute major depressive disorder in children and adolescents: a multiple-treatments meta-analysis.

PubMed

Ma, Dongfeng; Zhang, Zhijun; Zhang, Xiangrong; Li, Lingjiang

2014-06-01

New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) were introduced in the late 1980s; however, few comprehensive studies compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in pediatric patients. Multiple-treatments meta-analysis (MTM) was conducted to assess efficacy, acceptability, and safety of contemporary interventions in children and adolescents with MDD. Cochrane Library, AMED, CINAHL, EMBASE, LiLACS, MEDLINE, PSYCINFO, PSYNDEX, and Journal of Medicine and Pharmacy databases were searched for randomized controlled trials (RCTs) comparing medicinal interventions (citalopram, escitalopram, fluoxetine, mirtazapine, paroxetine, sertraline, venlafaxine), cognitive behavioral therapy (CBT), combined fluoxetine with CBT, and placebo treatment for acute MDD from January 1988 to March 2013. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Bayesian methods were used to conduct a MTM including age and funding subgroups. A total of 21 RCTs (4969 participants) were identified. Combined fluoxetine/CBT exhibited the highest efficacy, with fluoxetine alone superior to CBT, paroxetine, sertraline, citalopram, escitalopram, and placebo treatment. Sertraline, paroxetine, escitalopram, and venlafaxine showed superior acceptability to fluoxetine and combined fluoxetine/CBT. Combined fluoxetine/CBT combination was less safe, though CBT was safer than fluoxetine alone. Combined fluoxetine/CBT, fluoxetine, and mirtazapine exhibited the highest efficacy; sertraline, escitalopram, venlafaxine, and paroxetine were the best tolerated; and mirtazapine and venlafaxine were the safest. Sertraline and mirtazapine exhibited optimally balanced efficacy, acceptability, and safety for first-line acute treatment of child and adolescent MDD.

Using the 'Social Marketing Mix Framework' to explore recruitment barriers and facilitators in palliative care randomised controlled trials? A narrative synthesis review.

PubMed

Dunleavy, Lesley; Walshe, Catherine; Oriani, Anna; Preston, Nancy

2018-05-01

Effective recruitment to randomised controlled trials is critically important for a robust, trustworthy evidence base in palliative care. Many trials fail to achieve recruitment targets, but the reasons for this are poorly understood. Understanding barriers and facilitators is a critical step in designing optimal recruitment strategies. To identify, explore and synthesise knowledge about recruitment barriers and facilitators in palliative care trials using the '6 Ps' of the 'Social Marketing Mix Framework'. A systematic review with narrative synthesis. Medline, CINAHL, PsycINFO and Embase databases (from January 1990 to early October 2016) were searched. Papers included the following: interventional and qualitative studies addressing recruitment, palliative care randomised controlled trial papers or reports containing narrative observations about the barriers, facilitators or strategies to increase recruitment. A total of 48 papers met the inclusion criteria. Uninterested participants (Product), burden of illness (Price) and 'identifying eligible participants' were barriers. Careful messaging and the use of scripts/role play (Promotion) were recommended. The need for intensive resources and gatekeeping by professionals were barriers while having research staff on-site and lead clinician support (Working with Partners) was advocated. Most evidence is based on researchers' own reports of experiences of recruiting to trials rather than independent evaluation. The 'Social Marketing Mix Framework' can help guide researchers when planning and implementing their recruitment strategy but suggested strategies need to be tested within embedded clinical trials. The findings of this review are applicable to all palliative care research and not just randomised controlled trials.

Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development.

PubMed

Latimer-Cheung, Amy E; Pilutti, Lara A; Hicks, Audrey L; Martin Ginis, Kathleen A; Fenuta, Alyssa M; MacKibbon, K Ann; Motl, Robert W

2013-09-01

To conduct a systematic review of evidence surrounding the effects of exercise training on physical fitness, mobility, fatigue, and health-related quality of life in adults with multiple sclerosis (MS). The databases included EMBASE, 1980 to 2011 (wk 12); Ovid MEDLINE and Ovid OLDMEDLINE, 1947 to March (wk 3) 2011; PsycINFO, 1967 to March (wk 4) 2011; CINAHL all-inclusive; SPORTDiscus all-inclusive; Cochrane Library all-inclusive; and Physiotherapy Evidence Database all-inclusive. The review was limited to English-language studies (published before December 2011) of people with MS that evaluated the effects of exercise training on outcomes of physical fitness, mobility, fatigue, and/or health-related quality of life. One research assistant extracted data and rated study quality. A second research assistant verified the extraction and quality assessment. From the 4362 studies identified, 54 studies were included in the review. The extracted data were analyzed using a descriptive approach. There was strong evidence that exercise performed 2 times per week at a moderate intensity increases aerobic capacity and muscular strength. The evidence was not consistent regarding the effects of exercise training on other outcomes. Among those with mild to moderate disability from MS, there is sufficient evidence that exercise training is effective for improving both aerobic capacity and muscular strength. Exercise may improve mobility, fatigue, and health-related quality of life. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review.

PubMed

Lee, Jung-Ah; Choi, Mona; Lee, Sang A; Jiang, Natalie

2018-02-20

Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management. Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion. Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system. Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

PubMed

Cordier, Reinie; Speyer, Renée; Chen, Yu-Wei; Wilkes-Gillan, Sarah; Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

2015-01-01

Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

Therapies for Cognitive Deficits Associated With Chemotherapy for Breast Cancer: A Systematic Review of Objective Outcomes.

PubMed

Morean, Diane F; O'Dwyer, Linda; Cherney, Leora R

2015-10-01

To systematically review evidence of treatments for cognitive impairments experienced by at least 20% of all women who undergo chemotherapy for breast cancer. Searches of 5 databases (PubMed, Embase, Cochrane CENTRAL, PsycINFO, CINAHL), with no date or language restrictions, identified 1701 unique results. Search terms included breast cancer, chemotherapy, chemobrain, chemofog, and terms on cognition and language deficits. Included only peer-reviewed journal articles that described therapies for cognitive dysfunction in women undergoing (or who had undergone) chemotherapy for breast cancer and provided objective measurements of cognition or language. Data were extracted according to Cochrane recommendations, including characteristics of participants, interventions, outcomes, and studies. Quality assessment of all 12 eligible studies was performed using the Physiotherapy Evidence Database scale and treatment fidelity criteria. Screening, data extraction, and quality assessment reliability were performed. Six articles described interventions for cognition that took place during cancer treatment; 6, afterward. Five interventions were medical (including a strength-training program), 2 were restorative, and 5 were cognitive. Medicinal treatments were ineffective; restorative and exercise treatments had mixed results; cognitive therapy had success in varying cognitive domains. The domains most tested and most successfully treated were verbal memory, attention, and processing speed. Cognitive therapy protocols delivered after chemotherapy and aimed at improving verbal memory, attention, and processing speed hold the most promise. Future research is needed to clarify whether computerized cognitive training can be effective in treating this population, and to identify objective assessment tools that are sensitive to this disorder. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Let's talk about sleep: a systematic review of psychological interventions to improve sleep in college students.

PubMed

Friedrich, Anja; Schlarb, Angelika A

2018-02-01

Sleep problems are a common occurrence in college students. Insomnia, nightmares and impaired sleep quality lead to several mental health issues, as well as impaired academic performance. Although different sleep programmes exist, a systematic overview comparing their effectiveness is still missing. This systematic review aims to provide an overview of psychological interventions to improve sleep in college students. Seven databases were searched from November to December 2016 (MEDLINE, EMBASE, PsycINFO, Cinahl, Cochrane Library, PubMed, OpenSigle). The search string included search terms from three different topics: sleep, intervention and college students. Outcome measures included subjective as well as objective measures and focused on sleep, sleep-related and mental health variables. Twenty-seven studies met the inclusion criteria. They were assigned to four intervention categories: (1) sleep hygiene, (2) cognitive-behavioural therapy (CBT), (3) relaxation, mindfulness and hypnotherapy and (4) other psychotherapeutic interventions. Fifteen studies were randomized controlled trials. While sleep hygiene interventions provided small to medium effects, the CBTs showed large effects. The variability of the effect sizes was especially large in the relaxation category, ranging from very small to very large effect sizes. Other psychotherapeutic interventions showed medium effects. CBT approaches provided the best effects for the improvement of different sleep variables in college students. Five studies included insomnia patients. The other three intervention categories also showed promising results with overall medium effects. In the future, CBT should be combined with relaxation techniques, mindfulness and hypnotherapy. Furthermore, the interventions should broaden their target group and include more sleep disorders. © 2017 European Sleep Research Society.

Global systematic review of Indigenous community-led legal interventions to control alcohol

PubMed Central

Muhunthan, Janani; Angell, Blake; Hackett, Maree L; Wilson, Andrew; Latimer, Jane; Eades, Anne-Marie; Jan, Stephen

2017-01-01

Objectives The national and subnational governments of most developed nations have adopted cost-effective regulatory and legislative controls over alcohol supply and consumption with great success. However, there has been a lack of scrutiny of the effectiveness and appropriateness of these laws in shaping the health-related behaviours of Indigenous communities, who disproportionately experience alcohol-related harm. Further, such controls imposed unilaterally without Indigenous consultation have often been discriminatory and harmful in practice. Setting, participants and outcome measures In this systematic review of quantitative evaluations of Indigenous-led alcohol controls, we aim to investigate how regulatory responses have been developed and implemented by Indigenous communities worldwide, and evaluate their effectiveness in improving health and social outcomes. We included articles from electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science from inception to December 2015. Results Our search yielded 1489 articles from which 18 met the inclusion criteria. Controls were implemented in rural and remote populations of high-income nations. Communities employed a range of regulatory options including alcohol rationing, prohibition of sale, importation or possession, restrictions on liquor sold, times of sale or mode of sale, Indigenous-controlled liquor licensing, sin tax and traditional forms of control. 11 studies reported interventions that were effective in reducing crime, injury deaths, injury, hospitalisations or lowering per capita consumption. In six studies interventions were found to be ineffective or harmful. The results were inconclusive in one. Conclusions Indigenous-led policies that are developed or implemented by communities can be effective in improving health and social outcomes. PMID:28348189

A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder.

PubMed

Ágh, Tamás; Kovács, Gábor; Supina, Dylan; Pawaskar, Manjiri; Herman, Barry K; Vokó, Zoltán; Sheehan, David V

2016-09-01

To perform a systematic review of the health-related quality of life (HRQoL) and economic burdens of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). A systematic literature search of English-language studies was performed in Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier, and Cochrane Library. Cost data were converted to 2014 Euro. Sixty-nine studies were included. Data on HRQoL were reported in 41 studies (18 for AN, 17 for BN, and 18 for BED), on healthcare utilization in 20 studies (14 for AN, 12 for BN, and 8 for BED), and on healthcare costs in 17 studies (9 for AN, 11 for BN, and only 2 for BED). Patients' HRQoL was significantly worse with AN, BN, and BED compared with healthy populations. AN, BN, and BED were associated with a high rate of hospitalization, outpatient care, and emergency department visits. However, patients rarely received specific treatment for their eating disorder. The annual healthcare costs for AN, BN, and BED were €2993 to €55,270, €888 to €18,823, and €1762 to €2902, respectively. AN, BN, and BED have a serious impact on patient's HRQoL and are also associated with increased healthcare utilization and healthcare costs. The burden of BED should be examined separately from that of BN. The limited evidence suggests that further research is warranted to better understand the differences in long-term HRQoL and economic burdens of AN, BN, and BED.

Social media use in medical education: a systematic review.

PubMed

Cheston, Christine C; Flickinger, Tabor E; Chisolm, Margaret S

2013-06-01

The authors conducted a systematic review of the published literature on social media use in medical education to answer two questions: (1) How have interventions using social media tools affected outcomes of satisfaction, knowledge, attitudes, and skills for physicians and physicians-in-training? and (2) What challenges and opportunities specific to social media have educators encountered in implementing these interventions? The authors searched the MEDLINE, CINAHL, ERIC, Embase, PsycINFO, ProQuest, Cochrane Library, Web of Science, and Scopus databases (from the start of each through September 12, 2011) using keywords related to social media and medical education. Two authors independently reviewed the search results to select peer-reviewed, English-language articles discussing social media use in educational interventions at any level of physician training. They assessed study quality using the Medical Education Research Study Quality Instrument. Fourteen studies met inclusion criteria. Interventions using social media tools were associated with improved knowledge (e.g., exam scores), attitudes (e.g., empathy), and skills (e.g., reflective writing). The most commonly reported opportunities related to incorporating social media tools were promoting learner engagement (71% of studies), feedback (57%), and collaboration and professional development (both 36%). The most commonly cited challenges were technical issues (43%), variable learner participation (43%), and privacy/security concerns (29%). Studies were generally of low to moderate quality; there was only one randomized controlled trial. Social media use in medical education is an emerging field of scholarship that merits further investigation. Educators face challenges in adapting new technologies, but they also have opportunities for innovation.

Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review.

PubMed

Williams, Nefyn H; Hendry, Maggie; France, Barbara; Lewis, Ruth; Wilkinson, Clare

2007-12-01

Despite the health benefits of physical activity, most adults do not take the recommended amount of exercise. To assess whether exercise-referral schemes are effective in improving exercise participation in sedentary adults. Systematic review. Studies were identified by searching MEDLINE, CINAHL, EMBASE, AMED, PsycINFO, SPORTDiscus, The Cochrane Library and SIGLE until March 2007. Randomised controlled trials (RCTs), observational studies, process evaluations and qualitative studies of exercise-referral schemes, defined as referral by a primary care clinician to a programme that encouraged physical activity or exercise were included. RCT results were combined in a meta-analysis where there was sufficient homogeneity. Eighteen studies were included in the review. These comprised six RCTs, one non-randomised controlled study, four observational studies, six process evaluations and one qualitative study. In addition, two of the RCTs and two of the process evaluations incorporated a qualitative component. Results from five RCTs were combined in a meta-analysis. There was a statistically significant increase in the numbers of participants doing moderate exercise with a combined relative risk of 1.20 (95% confidence intervals = 1.06 to 1.35). This means that 17 sedentary adults would need to be referred for one to become moderately active. This small effect may be at least partly due to poor rates of uptake and adherence to the exercise schemes. Exercise-referral schemes have a small effect on increasing physical activity in sedentary people. The key challenge, if future exercise-referral schemes are to be commissioned by the NHS, is to increase uptake and improve adherence by addressing the barriers described in these studies.

Instruments used to assess functional limitations in workers applying for disability benefit: a systematic review.

PubMed

Spanjer, Jerry; Groothoff, Johan W; Brouwer, Sandra

2011-01-01

To systematically review the quality of the psychometric properties of instruments for assessing functional limitations in workers applying for disability benefit. Electronic searches of Medline, Embase, CINAHL and PsycINFO were performed to identify studies focusing on the psychometric properties of instruments used to assess functional limitations in workers' compensation claimants. Two independent reviewers applied the inclusion criteria to select relevant articles and then evaluated the psychometric qualities of the instruments found. Of the 712 articles that were identified, 10 studies met the inclusion criteria, reporting on four instruments: the Roland-Morris Disability Questionnaire (RMDQ), the Patient-Specific Functional Scale (PSFS), the Isernhagen Work System (IWS) and the Multiperspective Multidimensional Pain Assessment Protocol (MMPAP). The questionnaires (RMDQ and PSFS) did not focus specifically on the work situation and measured three to eight functional limitations. The psychometric qualities of the IWS were poor to moderate. For the MMPAP, only predictive validity was measured. The instruments assessed a range varying between 3 and 34 physical functional limitations. No instruments were found for assessing mental limitations in workers' compensation claimants. Studies on four instruments specifically focusing on assessing physical functional limitations in workers applying for disability benefit were found. All four instruments have limitations regarding their psychometric qualities or contents. Since the RMDQ has the best demonstrated psychometric qualities and takes little time to complete it, we recommend the RMDQ for clinicians in rehabilitation. For the assessment of functional limitations in workers applying for disability benefit a combination of questionnaires, performance tests or interviews together with the judgment by physicians looks the most promising.

The use of behavioural theories in end-of-life care research: A systematic review.

PubMed

Scherrens, Anne-Lore; Beernaert, Kim; Robijn, Lenzo; Deliens, Luc; Pauwels, Nele S; Cohen, Joachim; Deforche, Benedicte

2018-06-01

It is necessary to understand behaviours that contribute to improvement in the quality of end-of-life care; use of behavioural theories allows identification of factors underlying end-of-life care behaviour, but little is known about the extent to which, and in what manner, these theories are used in an end-of-life care research context. To assess the number of end-of-life care studies that have used behavioural theories, which theories were used, to what extent main constructs were explored/measured and which behavioural outcomes were examined. We conducted a systematic review. The protocol was registered on PROSPERO (CRD42016036009). The MEDLINE (PubMed), PsycINFO, EMBASE, Web of Science and CINAHL databases were searched from inception to June 2017. We included studies aimed at understanding or changing end-of-life care behaviours and that explicitly referred to individual behavioural theories. We screened 2231 records by title and abstract, retrieved 43 full-text articles and included 31 studies - 27 quantitative (of which four (quasi-)randomised controlled trials) and four qualitative - for data extraction. More than half used the Theory of Planned Behaviour (9), the Theory of Reasoned Action (4) or the Transtheoretical Model (8). In 9 of 31 studies, the theory was fully used, and 16 of the 31 studies focussed on behaviours in advance care planning. In end-of-life care research, the use of behavioural theories is limited. As many behaviours can determine the quality of care, their more extensive use may be warranted if we want to better understand and influence behaviours and improve end-of-life care.

The clinical aspects of mirror therapy in rehabilitation: a systematic review of the literature.

PubMed

Rothgangel, Andreas Stefan; Braun, Susy M; Beurskens, Anna J; Seitz, Rüdiger J; Wade, Derick T

2011-03-01

The objective of this study was to evaluate the clinical aspects of mirror therapy (MT) interventions after stroke, phantom limb pain and complex regional pain syndrome. A systematic literature search of the Cochrane Database of controlled trials, PubMed/MEDLINE, CINAHL, EMBASE, PsycINFO, PEDro, RehabTrials and Rehadat, was made by two investigators independently (A.S.R. and M.J.). No restrictions were made regarding study design and type or localization of stroke, complex regional pain syndrome and amputation. Only studies that had MT given as a long-term treatment were included. Two authors (A.S.R. and S.M.B.) independently assessed studies for eligibility and risk of bias by using the Amsterdam-Maastricht Consensus List. Ten randomized trials, seven patient series and four single-case studies were included. The studies were heterogeneous regarding design, size, conditions studied and outcome measures. Methodological quality varied; only a few studies were of high quality. Important clinical aspects, such as assessment of possible side effects, were only insufficiently addressed. For stroke there is a moderate quality of evidence that MT as an additional intervention improves recovery of arm function, and a low quality of evidence regarding lower limb function and pain after stroke. The quality of evidence in patients with complex regional pain syndrome and phantom limb pain is also low. Firm conclusions could not be drawn. Little is known about which patients are likely to benefit most from MT, and how MT should preferably be applied. Future studies with clear descriptions of intervention protocols should focus on standardized outcome measures and systematically register adverse effects.

Classroom Standing Desks and Sedentary Behavior: A Systematic Review.

PubMed

Minges, Karl E; Chao, Ariana M; Irwin, Melinda L; Owen, Neville; Park, Chorong; Whittemore, Robin; Salmon, Jo

2016-02-01

Reducing sedentary behaviors, or time spent sitting, is an important target for health promotion in children. Standing desks in schools may be a feasible, modifiable, and acceptable environmental strategy to this end. To examine the impact of school-based standing desk interventions on sedentary behavior and physical activity, health-related outcomes, and academic and behavioral outcomes in school-aged children. Ovid Embase, Medline, PsycINFO, Web of Science, Global Health, and CINAHL. Full-text peer-reviewed journal publications written in English; samples of school-aged youth (5-18 years of age); study designs including the same participants at baseline and follow-up; and use of a standing desk as a component of the intervention. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight studies satisfied selection criteria and used quasi-experimental (n = 4), randomized controlled trial (n = 3), and pre-post, no control (n = 1) designs. When examined, time spent standing increased in all studies (effect sizes: 0.38-0.71), while sitting time decreased from a range of 59 to 64 minutes (effect sizes: 0.27-0.49). Some studies reported increased physical activity and energy expenditure and improved classroom behavior. One-half of the studies had nonrandomized designs, and most were pilot or feasibility studies. This initial evidence supports integrating standing desks into the classroom environment; this strategy has the potential to reduce sitting time and increase standing time among elementary schoolchildren. Additional research is needed to determine the impact of standing desks on academic performance and precursors of chronic disease risk. Copyright © 2016 by the American Academy of Pediatrics.

The impact of negative childbirth experience on future reproductive decisions: A quantitative systematic review.

PubMed

Shorey, Shefaly; Yang, Yen Yen; Ang, Emily

2018-06-01

The aim of this study was to systematically retrieve, critique and synthesize available evidence regarding the association between negative childbirth experiences and future reproductive decisions. A child's birth is often a joyous event; however, there is a proportion of women who undergo negative childbirth experiences that have long-term implications on their reproductive decisions. A systematic review of quantitative studies was undertaken using Joanna Briggs Institute's methods. A search was carried out in CINAHL Plus with Full Text, Embase, PsycINFO, PubMed, Scopus and Web of Science from January 1996 - July 2016. Studies that fulfilled the inclusion criteria were assessed by two independent reviewers using the Joanna Briggs Institute's Critical Appraisal Tools. Data were extracted under subheadings adapted from the institute's data extraction forms. Twelve studies, which examined either one or more influences of negative childbirth experiences, were identified. The included studies were either cohort or cross-sectional designs. Five studies observed positive associations between prior negative childbirth experiences and decisions to not have another child, three studies found positive associations between negative childbirth experiences and decisions to delay a subsequent birth and six studies concluded positive associations between negative childbirth experiences and maternal requests for caesarean section in subsequent pregnancies. To receive a holistic understanding on negative childbirth experiences, a suitable definition and validated measuring tools should be used to understand this phenomenon. Future studies or reviews should include a qualitative component and/or the exploration of specific factors such as cultural and regional differences that influence childbirth experiences. © 2018 John Wiley & Sons Ltd.

Interventions to improve child-parent-medical provider communication: A systematic review.

PubMed

Kodjebacheva, Gergana Damianova; Sabo, Tina; Xiong, Janet

2016-10-01

Research related to effective communication between children/parents and medical providers is limited. To review interventions seeking to improve communication between children/parents and medical providers. The inclusion criteria were interventions in peer-reviewed articles and dissertations in English. Because of the limited availability of pediatric communication research, no restrictions were placed on the year, design, and length of follow-up of the interventions. Out of 4163 articles in the CINAHL, Cochrane, EMBASE, ERIC, MEDLINE, and PsycINFO databases, 34 met the inclusion criteria. The design, strategies, measurement tools, results, and conflicts of interest of the interventions were reviewed. Most interventions were conducted in the United States, had a small sample size, and used a pre-posttest design. Fifteen were randomized controlled trials (RCTs). The most frequent intervention strategies were role-playing sessions and seminars for medical providers. Standardized children (i.e., fictitious child patients) were frequently used to help train physicians. Most interventions improved providers' interpersonal, patient-centered interviewing skills. Interventions that targeted parents involved booklets and role-playing to encourage questions. They improved parents' satisfaction and communication. An intervention that targeted youth used a video portraying how children can communicate better with physicians. Once the children aged 5-15 years watched the video, they wrote questions for their physicians prior to the medical visit. The experimental group of children had better rapport with physicians and could recall recommendations about medications more often than the control group. More RCTs involving children as active participants are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Non-modifiable worker and workplace risk factors contributing to workplace absence: A stakeholder-centred synthesis of systematic reviews.

PubMed

White, Marc I; Wagner, Shannon L; Schultz, Izabela Z; Murray, Eleanor; Bradley, Susan M; Hsu, Vernita; McGuire, Lisa; Schulz, Werner

2015-01-01

Workplace stakeholders report the identification and translation of relevant high quality research to inform workplace disability policy and practice is a challenge. The present study engaged academic and community stakeholders in conducting a best evidence-synthesis to identify non-modifiable risk and protective worker and workplace factors impacting work-related absence across a variety of health conditions. To identify non-modifiable worker and workplace disability risk and protective factors impacting work-related absence across common health conditions. The research team searched Medline, Embase, CINAHL, The Cochrane Library, PsycINFO, BusinessSource-Complete, and ABI/Inform from 2000 to 2011. Quantitative, qualitative, or mixed methods systematic reviews of work-focused population were considered for inclusion. Two or more reviewers independently reviewed articles for inclusion and methodological screening. The search strategy, including expert input and grey literature, led to the identification of 2,467 unique records. From this initial search, 2325 were eliminated by title or abstract review, 142 articles underwent comprehensive review to assess for inclusion, 26 systematic reviews met eligibility criteria for this synthesis. For non-modifiable worker and workplace factors we found consistent evidence across two or more health conditions for increased risk of disability in situations where workers experience lower education, older age, emotional distress, poor personal functioning, decreased physical functioning, psychological symptoms, overweight status, and greater sick leave history. Heterogeneity of existing literature due to differences in outcome measures, definitions and research designs limited ability to assess effect size and results reflect findings limited to English-language papers.

Self-management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies.

PubMed

Dwarswaard, Jolanda; Bakker, Ellen J M; van Staa, AnneLoes; Boeije, Hennie R

2016-04-01

Receiving adequate support seems to be crucial to the success of self-management. Although different empirical studies separately examined patients' preferences for self-management support (SMS), an overview is lacking. The aim of this qualitative review was to identify patients' needs with respect to SMS and to explore by whom this support is preferably provided. Qualitative studies were identified from Embase, MEDLINE OvidSP, Web of science, PubMed publisher, Cochrane central, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. Articles needed to meet all of the following criteria: (i) focuses on self-management, (ii) concerns adult patients with rheumatic diseases (rheumatoid arthritis and fibromyalgia), a variant of cancer or chronic kidney disease, (iii) explores support needs from the patients' perspective, (iv) uses qualitative methods and (v) published in English. A thematic synthesis, developed by Thomas and Harden, was conducted of the 37 included studies. Chronic patients need instrumental support, psychosocial support and relational support from health-care professionals, family/friends and fellow patients to manage the chronic condition. Relational support is at the centre of the support needs and fuels all other types of support. Patients do not self-manage on their own. Patients expect health-care professionals to fulfil a comprehensive role. Support needs can be knitted together only when patients and professionals work together on the basis of collaborative partnership. Dynamics in support needs make it important to regularly assess patient needs. © 2015 John Wiley & Sons Ltd.

Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence

PubMed Central

2013-01-01

To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on 1) intervention components, 2) methodology, 3) attrition rate 4) reported weight loss and 5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225–300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified. PMID:24060348

Becoming a nurse: a meta-study of early professional socialization and career choice in nursing.

PubMed

Price, Sheri L

2009-01-01

This paper is a report of a meta-study of early professional socialization and career choice in nursing. The current and growing shortage of nurses is a global issue, and nursing recruitment and retention are recognized priorities internationally. The future of nursing will lie in the ability to recruit and retain the next generation to the profession. Studies were identified through a search of the CINAHL, PsycInfo, Sociological Abstracts, PubMed; Medline and Embase databases from 1990 to 2007. Studies were included if they gave insight into the experience of choosing nursing as a career, used qualitative methodology and methods, and were published in English. Analysis was undertaken using Paterson et al.'s framework for qualitative meta-synthesis. Ten primary studies were included in the review. Their methodologies included: ethnography (4); descriptive qualitative (3); grounded theory (2); and phenomenology (1). The location of the research was Canada (3), United Kingdom (2), United States of America (2), Australia (1), Japan (1) and Sweden (1). Three main themes were identified: influence of ideals; paradox of caring and role of others. Career choice and early professional socialization are influenced by multiple factors. In future recruitment and retention strategies to address the critical nursing shortage, it is important to consider the role of mentors, peers and role models in the formulation of career expectations, and career choice decisions. It is also necessary to consider the role of mentors, peers and role models in the formulation of career expectations, and career choice decisions.

Enhanced education and physiotherapy before knee replacement; is it worth it? A systematic review.

PubMed

Jordan, R W; Smith, N A; Chahal, G S; Casson, C; Reed, M R; Sprowson, A P

2014-12-01

Around 20% of knee replacement have an unsatisfactory outcome. Pre-operative physiotherapy and education have been proposed to improve post-operative outcomes. This systematic review evaluated whether these factors improved length of stay and patient reported outcomes after knee replacement surgery. Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO and PEDro were searched on the 1st January 2013. Randomised or quasi-randomised studies assessing either pre-operative education or physiotherapy on patients undergoing a planned total or partial knee replacement were included in the review. Only studies with a control group receiving a defined standard of pre-operative care were included. Eleven studies met the inclusion criteria set. Two studies analysed the effect of pre-operative education, seven pre-operative treatment by a physiotherapist and two studies used both factors. No study found significant differences in validated joint specific patient reported outcome measures. The education studies found a decrease in pre-operative expectation and an improvement in knowledge, flexion and regularity of exercise. Two studies found an improvement in muscle strength in the group treated by a physiotherapist at three months. The combination of education and physiotherapy was shown to reduce patient length of stay and cost in one study. The evidence reviewed is insufficient to support the implementation of either pre-operative education or physiotherapy programmes. The combination of pre-operative education and treatment by a physiotherapist may reduce the medical costs associated with surgery. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance: A systematic review.

PubMed

Saab, Mohamad M; McCarthy, Bridie; Andrews, Tom; Savage, Eileen; Drummond, Frances J; Walshe, Nuala; Forde, Mary; Breen, Dorothy; Henn, Patrick; Drennan, Jonathan; Hegarty, Josephine

2017-11-01

This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognize and manage deteriorating patients. Little is known as to the effectiveness of these programmes. Systematic review. Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October and November 2015. This is a quantitative systematic review using Cochrane methods. Studies published between January 2011 - November 2015 in English were sought. The risk of bias, level of evidence and the quality of evidence per outcome were assessed. Eleven articles with 10 studies were included. Nine studies addressed clinical performance, four addressed knowledge and two addressed confidence. Knowledge, vital signs recording and Early Warning Score calculation were improved in the short term. Two interventions had no effect on nurses' response to clinical deterioration and use of communication tools. This review highlights the importance of measuring outcomes using standardized tools and valid and reliable instruments. Using longitudinal designs, researchers are encouraged to investigate the effect of Early Warning Systems educational programmes. These can include interactive e-learning, on-site interdisciplinary Early Warning Scoring systems training sessions and simulated scenarios. © 2017 John Wiley & Sons Ltd.

Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review

PubMed Central

Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

2016-01-01

Background Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. Aim To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians’ and nurses’ perceived influences on care. Design and setting Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Method Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians’ or nurses’ perceived influences on treatment goals for type 2 diabetes. Results A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Conclusion Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than ‘one size fits all’ approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians’ skills and emotions around treatment intensification and facilitation of patient behaviour change. PMID:26823263

Maternal health research outputs and gaps in Latin America: reflections from the mapping study.

PubMed

Vargas-Riaño, Emily; Becerril-Montekio, Víctor; Becerra-Posada, Francisco; Tristán, Mario

2017-09-18

As part of the MASCOT/WOTRO multinational team conducting the maternal health literature mapping, four Latin American researchers were particularly interested in analysing information specific to their region. The mapping started with 45,959 papers uploaded from MEDLINE, CINAHL, Embase, LILACAS, PopLINE, PsycINFO and Web of Knowledge. From these, 4175 full texts were reviewed and 2295 papers were subsequently included. Latin America experienced an average maternal mortality decline of 40% between 1990 and 2013. Nevertheless, the region's performance was below the global average and short of the 75% reduction set in Millennium Development Goal 5 for 2015. The main outcomes show that research on maternal health in the countries where the most impoverished populations of the world are living is not always aligned with their compelling needs. From another perspective, the review made it possible to recognize that research funding as well as the amount of scientific literature produced concentrate on issues that are not necessarily among the main causes of maternal deaths. Even though research on maternal health in Latin America has grown from an average of 92.5 publications per year in 2000-2003 to 236.7 between 2008 and 2012, it's not satisfactorily keeping pace with other regions. In conclusion, it is critical to effectively orient research funding and production to respond to the health needs of the population. At the same time, there is a need for innovative mechanisms to strengthen the production and uptake of scientific evidence that can properly inform public health decision making.

Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis.

PubMed

Traeger, Adrian C; Reed, Benjamin J; O'Connor, Denise A; Hoffmann, Tammy C; Machado, Gustavo C; Bonner, Carissa; Maher, Chris G; Buchbinder, Rachelle

2018-02-10

Little is known about how to reduce unnecessary imaging for low back pain. Understanding clinician, patient and general public beliefs about imaging is critical to developing strategies to reduce overuse. To synthesise qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain. We will perform a qualitative evidence synthesis of relevant qualitative research exploring clinician, patient and general public beliefs about diagnostic imaging for low back pain. Exclusions will be studies not using qualitative methods and studies not published in English. Studies will be identified using sensitive search strategies in MEDLINE, EMBASE, CINAHL, AMED and PsycINFO. Two reviewers will independently apply inclusion and exclusion criteria, extract data, and use the Critical Appraisal Skills Programme quality assessment tool to assess the quality of included studies. To synthesise the data we will use a narrative synthesis approach that involves developing a theoretical model, conducting a preliminary synthesis, exploring relations in the data, and providing a structured summary. We will code the data using NVivo. At least two reviewers will independently apply the thematic framework to extracted data. Confidence in synthesis findings will be evaluated using the GRADE Confidence in the Evidence from Reviews of Qualitative Research tool. Ethical approval is not required to conduct this review. We will publish the results in a peer-reviewed journal. CRD42017076047. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ambient Temperature and Stroke Occurrence: A Systematic Review and Meta-Analysis.

PubMed

Wang, Xia; Cao, Yongjun; Hong, Daqing; Zheng, Danni; Richtering, Sarah; Sandset, Else Charlotte; Leong, Tzen Hugh; Arima, Hisatomi; Islam, Shariful; Salam, Abdul; Anderson, Craig; Robinson, Thompson; Hackett, Maree L

2016-07-12

Biologically plausible associations exist between climatic conditions and stroke risk, but study results are inconsistent. We aimed to summarize current evidence on ambient temperature and overall stroke occurrence, and by age, sex, and variation of temperature. We performed a systematic literature search across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 16 October 2015 to identify all population-based observational studies. Where possible, data were pooled for meta-analysis with Odds ratios (OR) and corresponding 95% confidence intervals (CI) by means of the random effects meta-analysis. We included 21 studies with a total of 476,511 patients. The data were varied as indicated by significant heterogeneity across studies for both ischemic stroke (IS) and intracerebral hemorrhage (ICH). Pooled OR (95% CI) in every 1 degree Celsius increase in ambient temperature was significant for ICH 0.97 (0.94-1.00), but not for IS 1.00 (0.99-1.01) and subarachnoid hemorrhage (SAH) 1.00 (0.98-1.01). Meta-analysis was not possible for the pre-specified subgroup analyses by age, sex, and variation of temperature. Change in temperature over the previous 24 h appeared to be more important than absolute temperature in relation to the risk of stroke, especially in relation to the risk of ICH. Older age appeared to increase vulnerability to low temperature for both IS and ICH. To conclude, this review shows that lower mean ambient temperature is significantly associated with the risk of ICH, but not with IS and SAH. Larger temperature changes were associated with higher stroke rates in the elderly.

Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.

PubMed

Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

2016-02-01

Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians' and nurses' perceived influences on care. Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians' or nurses' perceived influences on treatment goals for type 2 diabetes. A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than 'one size fits all' approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians' skills and emotions around treatment intensification and facilitation of patient behaviour change. © British Journal of General Practice 2016.

Community-based interventions to optimize early childhood development in low resource settings.

PubMed

Maulik, P K; Darmstadt, G L

2009-08-01

Interventions targeting the early childhood period (0 to 3 years) help to improve neuro-cognitive functioning throughout life. Some of the more low cost, low resource-intensive community practices for this age-group are play, reading, music and tactile stimulation. This research was conducted to summarize the evidence regarding the effectiveness of such strategies on child development, with particular focus on techniques that may be transferable to developing countries and to children at risk of developing secondary impairments. PubMed, PsycInfo, Embase, ERIC, CINAHL and Cochrane were searched for studies involving the above strategies for early intervention. Reference lists of these studies were scanned and other studies were incorporated based on snow-balling. Overall, 76 articles corresponding to 53 studies, 24 of which were randomized controlled trials, were identified. Sixteen of those studies were from low- and middle-income countries. Play and reading were the two commonest interventions and showed positive impact on intellectual development of the child. Music was evaluated primarily in intensive care settings. Kangaroo Mother Care, and to a lesser extent massage, also showed beneficial effects. Improvement in parent-child interaction was common to all the interventions. Play and reading were effective interventions for early childhood interventions in low- and middle-income countries. More research is needed to judge the effectiveness of music. Kangaroo Mother Care is effective for low birth weight babies in resource poor settings, but further research is needed in community settings. Massage is useful, but needs more rigorous research prior to being advocated for community-level interventions.

The effectiveness of toolkits as knowledge translation strategies for integrating evidence into clinical care: a systematic review

PubMed Central

Yamada, Janet; Shorkey, Allyson; Barwick, Melanie; Widger, Kimberley; Stevens, Bonnie J

2015-01-01

Objectives The aim of this systematic review was to evaluate the effectiveness of toolkits as a knowledge translation (KT) strategy for facilitating the implementation of evidence into clinical care. Toolkits include multiple resources for educating and/or facilitating behaviour change. Design Systematic review of the literature on toolkits. Methods A search was conducted on MEDLINE, EMBASE, PsycINFO and CINAHL. Studies were included if they evaluated the effectiveness of a toolkit to support the integration of evidence into clinical care, and if the KT goal(s) of the study were to inform, share knowledge, build awareness, change practice, change behaviour, and/or clinical outcomes in healthcare settings, inform policy, or to commercialise an innovation. Screening of studies, assessment of methodological quality and data extraction for the included studies were conducted by at least two reviewers. Results 39 relevant studies were included for full review; 8 were rated as moderate to strong methodologically with clinical outcomes that could be somewhat attributed to the toolkit. Three of the eight studies evaluated the toolkit as a single KT intervention, while five embedded the toolkit into a multistrategy intervention. Six of the eight toolkits were partially or mostly effective in changing clinical outcomes and six studies reported on implementation outcomes. The types of resources embedded within toolkits varied but included predominantly educational materials. Conclusions Future toolkits should be informed by high-quality evidence and theory, and should be evaluated using rigorous study designs to explain the factors underlying their effectiveness and successful implementation. PMID:25869686

What do we know about different models of providing palliative care? Findings from a systematic review of reviews.

PubMed

Brereton, Louise; Clark, Joseph; Ingleton, Christine; Gardiner, Clare; Preston, Louise; Ryan, Tony; Goyder, Elizabeth

2017-10-01

A wide range of organisational models of palliative care exist. However, decision makers need more information about which models are likely to be most effective in different settings and for different patient groups. To identify the existing range of models of palliative care that have been evaluated, what is already known and what further information is essential if the most effective and cost-effective models are to be identified and replicated more widely. A review of systematic and narrative reviews according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the AMSTAR (A MeaSurement Tool to Assess Reviews) tool. MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, Web of Science and ASSIA were searched for reviews about models of service provision from 2000 to 2014 and supplemented with Google searches of the grey literature. Much of the evidence relates to home-based palliative care, although some models are delivered across care settings. Reviews report several potential advantages and few disadvantages of models of palliative care delivery. However, under-reporting of the components of intervention and comparator models are major barriers to the evaluation and implementation of models of palliative care. Irrespective of setting or patient characteristics, models of palliative care appear to show benefits and some models of palliative care may reduce total healthcare costs. However, much more detailed and systematic reporting of components and agreement about outcome measures is essential in order to understand the key components and successfully replicate effective organisational models.

Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites.

PubMed

Lim, Megan S C; Wright, Cassandra J C; Carrotte, Elise R; Pedrana, Alisa E

2016-02-01

Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

Prophylactic antipsychotic use for postoperative delirium: a systematic review and meta-analysis.

PubMed

Hirota, Tomoya; Kishi, Taro

2013-12-01

Although antipsychotics have been used empirically to prevent the development of postoperative delirium, there has been no confirming evidence to support their use. Thus, we conducted a systematic review and a meta-analysis to elucidate their efficacy and tolerability in surgical patients. MEDLINE, EMBASE, the Cochrane Library databases, CINAHL, and PsycINFO were searched up to February 2013 without language restrictions, using the following keywords: (antipsychotics OR [nonproprietary name of each antipsychotic medication, separated by OR]) AND delirium AND (randomized OR random OR randomly). Randomized controlled trials comparing prophylactic use of antipsychotics with placebo in surgical patients were included. Two authors extracted and scrutinized the data. The risk ratio (RR), 95% confidence interval (CI), number needed to treat (NNT), and standardized mean difference were used. Six studies (3 haloperidol, 1 olanzapine, and 2 risperidone) including 1,689 surgical patients were identified. The results showed significant efficacy in reducing the occurrence of delirium (RR = 0.50, 95% CI = 0.34 to 0.73, P = .0003; NNT = 7, P = .001, 6 studies). Sensitivity analysis showed that second-generation antipsychotics were superior to placebo (RR = 0.36, P < .00001; NNT = 4, P < .00001), whereas haloperidol failed to show superiority to placebo. There were no statistically significant differences between groups in severity of delirium, discontinuation rate, or rates of several adverse events. Our results suggest that second-generation antipsychotics are more beneficial than placebo for preventing the incidence of delirium. Among patients who do develop delirium, the severity of delirium is not reduced in those who received prophylactic antipsychotics. © Copyright 2013 Physicians Postgraduate Press, Inc.

The allure of the waterpipe: a narrative review of factors affecting the epidemic rise in waterpipe smoking among young persons globally

PubMed Central

Akl, E A; Ward, K D; Bteddini, D; Khaliel, R; Alexander, A C; Lotfi, T; Alaouie, H; Afifi, R A

2015-01-01

Objective The objective of this narrative review is to highlight the determinants of the epidemic rise in waterpipe tobacco smoking (WTS) among youth globally. The Ecological Model of Health Promotion (EMHP) was the guiding framework for the review. Data sources The following electronic databases were searched: Cochrane library, MEDLINE, EMBASE, PsycINFO, Web of Science and CINAHL Plus with Full Text. Search terms included waterpipe and its many variant terms. Study selection Articles were included if they were published between 1990 and 2014, were in English, were available in full text and included the age group 10–29 years. Data extraction Articles which analysed determinants of WTS at any of the levels of the EMHP were retained regardless of methodological rigour: 131 articles are included. Articles were coded in a standard template that abstracted methods as well as results. Data synthesis The review found that methodologies used to assess determinants of WTS among youth were often conventional and lacked rigor: 3/4 of the studies were cross-sectional surveys and most enrolled non-representative samples. Within the framework, the review identified determinants of WTS at the intrapersonal, interpersonal, organisational, community and policy levels. Conclusions The review suggests potential interventions to control WTS among youth, with emphasis on creative utilisation of social media, and tobacco control policies that include the specificities of WTS. The review further suggests the need for rigorous qualitative work to better contextualise determinants, and prospective observational and experimental studies that track and manipulate them to assess their viability as intervention targets. PMID:25618895

The challenges of the family physician policy in Iran: a systematic review and meta-synthesis of qualitative researches.

PubMed

Behzadifar, Masoud; Behzadifar, Meysam; Heidarvand, Sanaz; Gorji, Hasan Abolghasem; Aryankhesal, Aidin; Taheri Moghadam, Sharare; Mohammadibakhsh, Roghayeh; Bragazzi, Nicola Luigi

2018-05-07

A good level of health requires the establishment of primary health care. Family physician policy (FPP) is probably one of such initiatives, which enables societies attaining the universal health coverage. The present study is the first systematic review and meta-synthesis that seeks to provide a more comprehensive understanding of the challenges for FPP in Iran. Several international scholarly databases (namely, ISI/Web of Sciences, PubMed/MEDLINE via Ovid, Embase, PsycINFO, Scopus and CINAHL via EBSCO), as well as three Iranian databases [MagIran, Irandoc and Scientific Information Database (SID) databases], were mined from January 2006 to December 2017. The Noblit & Hare approach was used to analyse the selected studies. Based on the study inclusion criteria, seven studies were retained. Initially, 133 codes were identified. In the second step, two of the authors examined the codes and merged themes based on their similarities and shared meaning. New codes were created through discussion. In the next and final step, eight themes emerged, namely, (i) financing; (ii) motivational factors; (iii) education; (iv) referral system; (v) performance evaluation; (vi) problems with health policy; (vii) health information system; and (viii) culture-building for proper policy implementation. Although more than 10 years have passed since the implementation of FPP in Iran, and despite its positive effects on health, there are still challenges in implementing this policy, which makes it difficult to achieve its objectives. Health decision- and policy-makers in Iran should address these challenges and use all available capacities to face them.

Prevalence and severity of behavioural symptoms in patients with Korsakoff syndrome and other alcohol-related cognitive disorders: a systematic review.

PubMed

Gerridzen, Ineke J; Moerman-van den Brink, Wiltine G; Depla, Marja F; Verschuur, Els M L; Veenhuizen, Ruth B; van der Wouden, Johannes C; Hertogh, Cees M P M; Joling, Karlijn J

2017-03-01

Experiences from clinical practice suggest that behavioural symptoms in patients with Korsakoff syndrome (KS) are a frequent problem. Knowledge about behavioural symptoms is important in understanding and managing these symptoms. The aim of this study is to review the prevalence and severity of behavioural symptoms in KS. Relevant articles were identified by searching Medline (PubMed), PsycINFO, Embase and CINAHL up to 4 June 2014. Two reviewers independently selected the studies, extracted their baseline data and assessed methodological quality using a standardized checklist. Fifteen studies fulfilled the inclusion criteria. A diversity of diagnoses was used indicating that KS and other alcohol-related cognitive disorders and terms were used interchangeably. None of the studies were primarily designed to estimate the prevalence or severity of behavioural symptoms in patients with KS. Most studies had serious methodological limitations. The reported prevalence estimates of behavioural symptoms in the included studies varied strongly. Most prevalent were depressive symptoms and disorders (2-50%, median 27%) and agitation and aggression (10-54%, median 27%). None of the reported, mean severity estimates met pathological thresholds. The highest severity estimates were found for apathy. Good quality studies on behavioural symptoms in patients with KS are lacking. Observational research designed to provide reliable estimates of the prevalence and severity of behavioural symptoms in patients with KS is needed. This could improve understanding and managing these symptoms and help care staff to better support the needs of this specific patient group. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Early psychological interventions for posttraumatic stress, depression and anxiety after traumatic injury: A systematic review and meta-analysis.

PubMed

Giummarra, Melita J; Lennox, Alyse; Dali, Gezelle; Costa, Beth; Gabbe, Belinda J

2018-06-01

The psychological impacts of injury have significant long-term implications on injury recovery. This review examined the effectiveness of interventions delivered within three months of injury on reducing the severity of posttraumatic stress disorder (PTSD), anxiety and depression symptoms. A systematic search of seven databases (PsycINFO, Medline, Web of Science, CINAHL, Embase, Scopus and Cochrane Library) identified 15,224 records. 212 full-text articles were retrieved, 26 studies were included in narrative synthesis, and 12 studies with lower risk of bias were included in meta-analyses. Prolonged exposure, and cognitive and behavioural interventions elicited improvements in PTSD, anxiety and depression symptoms; multidisciplinary interventions improved PTSD and depression symptoms; and education-based interventions had little impact on any psychological symptoms. Studies comprising risk stratified or stepped care methods showed markedly greater population impact through better reach, implementation and adoption. Meta-analyses revealed small-medium reductions in PTSD symptoms over the first 12 months postinjury (SMD = 0.32 to 0.49) with clinically meaningful effects in 64% of studies; reduced depression symptoms at 0-3 (small effect; SMD = 0.34) and 6-12 months postinjury (medium effect; SMD = 0.60), with clinically meaningful effects in 40% of studies; but no pooled effects on anxiety symptoms at any time. Altogether, exposure- and CBT-based psychological interventions had the greatest impact on PTSD and depression symptoms postinjury when delivered within three months of injury, with risk-stratified, stepped care having the greatest population impact potential. Copyright © 2018 Elsevier Ltd. All rights reserved.

Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis.

PubMed

Golding, Sarah E; Horsfield, Claire; Davies, Annette; Egan, Bernadette; Jones, Martyn; Raleigh, Mary; Schofield, Patricia; Squires, Allison; Start, Kath; Quinn, Tom; Cropley, Mark

2017-01-01

The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: 'Organisational and Operational Factors' and 'Interactions with Others'. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. CRD42014010806.

Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review.

PubMed

Theadom, Alice; Cropley, Mark

2006-10-01

To establish the effect of preoperative smoking cessation on the risk of postoperative complications, and to identify the effect of the timing of preoperative cessation. The Cochrane Library Database, PsycINFO, EMBASE, Medline, and CINAHL databases were searched, using the terms: "smoking", "smoking-cessation", "tobacco-use", "tobacco-abstinence", "cigarett$", "complication$", "postoperative-complication$", "preoperative", "perioperative" and "surg$". Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to November 2005. Prospective cohort designs exploring the effects of preoperative smoking cessation on postoperative complications were included. Two reviewers independently scanned abstracts of relevant articles to determine eligibility. Lack of agreement was resolved through discussion and consensus. Twelve studies met the inclusion criteria. Methodological quality was assessed by both reviewers, exploring validation of smoking status, clear definition of the period of smoking cessation, control for confounding variables and length of follow-up. Only four of the studies specified the exact period of smoking cessation, with six studies specifying the length of the follow-up period. Five studies revealed a lower risk or incidence of postoperative complications in past smokers than current smokers or reported that there was no significant difference between past smokers and non-smokers. Longer periods of smoking cessation appear to be more effective in reducing the incidence/risk of postoperative complications; there was no increased risk in postoperative complications from short term cessation. An optimal period of preoperative smoking cessation could not be identified from the available evidence.

The effectiveness of smoking cessation interventions prior to surgery: a systematic review.

PubMed

Cropley, Mark; Theadom, Alice; Pravettoni, Gabriella; Webb, Gemma

2008-03-01

The objective of this review was to evaluate the effectiveness of smoking cessation interventions prior to surgery and examine smoking cessation rates at 6 months follow-up. The Cochrane Library Database, PsycINFO, EMBASE, Medline, and Cinahl databases were searched using the terms: smok$, smoking cessation, tobacco, cigar$, preop$, operati$, surg$, randomi*ed control$ trial, intervention, program$, cessation, abstinen$, quit. Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to December 2006. Only randomized control trials (RCTs) that incorporated smoking cessation interventions to patients awaiting elective surgery were included. Seven studies met the inclusion criteria. Methodological quality was assessed by all the authors. The findings revealed that short-term quit rates (or a reduction by more than half of normal daily rate) ranged from 18% to 93% in patients receiving a smoking intervention (mean 55%), compared with a range of 2%-65% of controls (mean = 27.7%). Two studies examined smoking status at 6 months but these revealed no significant difference in abstinence rates between patients who had received an intervention and those that had not. Studies that incorporated counseling in addition to nicotine replacement therapy appeared to show greater benefits. It is concluded that smoking cessation interventions prior to surgery are effective in helping patients to quit smoking. However, such effects appear to be short-lived. Future research needs to examine intervention and patient factors to see whether tailoring the smoking cessation intervention specifically to the patient improves overall abstinence rates.

Beyond solicitousness: a comprehensive review on informal pain-related social support.

PubMed

Bernardes, Sónia F; Forgeron, Paula; Fournier, Karine; Reszel, Jessica

2017-11-01

Adults with chronic pain cite social support (SS) as an important resource. Research has mostly focused on general SS or pain-specific solicitousness, resulting in a limited understanding of the role of SS in pain experiences. Drawing on SS theoretical models, this review aimed to understand how pain-related SS has been conceptualized and measured and how its relationship with pain experiences has been investigated. Arksey and O'Malley scoping review framework guided the study. A database search (2000-2015) was conducted in PsycINFO, CINAHL, MEDLINE, and EMBASE using a combination of subject headings/keywords on pain and SS; 3864 citations were screened; 101 full texts were assessed for eligibility; references of 52 papers were hand searched. Fifty-three studies were included. Most studies were either a-theoretical or drew upon the operant conditioning model. There are several self-report measures and observational systems to operationalize pain-related SS. However, the Multidimensional Pain Inventory remains the most often used, accounting for the centrality of the concept of solicitousness in the literature. Most studies focused on individuals with chronic pain self-report of spousal pain-related SS and investigated its main effects on pain outcomes. Only a minority investigated the role of pain SS within the stress and coping process (as a buffer or mediator). Little is known about mediating pathways, contextual modulation of the effectiveness of SS exchanges, and there are practically no SS-based intervention studies. Drawing on general SS models, the main gaps in pain-related SS research are discussed and research directions for moving this literature beyond solicitousness are proposed.

Effect of exercise on depressive symptoms in adults with neurologic disorders: a systematic review and meta-analysis.

PubMed

Adamson, Brynn C; Ensari, Ipek; Motl, Robert W

2015-07-01

To review and quantify the effect of exercise on depression in adults with neurologic disorders. CINAHL, Cochrane Register of Controlled Clinical Trials, EMBASE, ERIC, MEDLINE, PsycINFO, PubMed, and SPORTDiscus were searched, with the last search performed in May 2014. Included were randomized controlled trials conducted in adults with a diagnosed neurologic disorder that compared an exercise intervention group with a control group and used depression as an outcome measure. Depression data were extracted independently by 2 authors. Methodological quality was assessed independently by 2 authors. Forty-three full-length articles were reviewed, and 26 trials met our inclusion criteria. These trials represented 1324 participants with 7 different neurologic disorders: Alzheimer disease (n=4 trials), migraine (n=1), multiple sclerosis (n=13), Parkinson disease (n=2), spinal cord injury (n=1), stroke (n=2), and traumatic brain injury (n=3). Data measuring depression were extracted and effect sizes were computed for 23 trials. Results from a meta-analysis yielded an overall effect size of .28 (SE=.07; 95% confidence interval, .15-.41; P=.00) favoring a reduction in depression outcomes after an exercise intervention compared with the control condition. Of note, interventions that met physical activity guidelines yielded an overall effect of .38 compared with .19 for studies that did not meet physical activity guidelines. This review provides evidence that exercise, particularly when meeting physical activity guidelines, can improve depressive symptoms in adults with neurologic disorders. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Does the use of specialist palliative care services modify the effect of socioeconomic status on place of death? A systematic review.

PubMed

Chen, Hong; Nicolson, Donald J; Macleod, Una; Allgar, Victoria; Dalgliesh, Christopher; Johnson, Miriam

2016-05-01

Cancer patients in lower socioeconomic groups are significantly less likely to die at home and experience more barriers to access to palliative care. It is unclear whether receiving palliative care may mediate the effect of socioeconomic status on place of death. This review examines whether and how use of specialist palliative care may modify the effect of socioeconomic status on place of death. A systematic review was conducted. Eligible papers were selected and the quality appraised by two independent reviewers. Data were synthesised using a narrative approach. MEDLINE, Embase, CINAHL, PsycINFO and Web of Knowledge were searched (1997-2013). Bibliographies were scanned and experts contacted. Papers were included if they reported the effect of both socioeconomic status and use of specialist palliative care on place of death for adult cancer patients. Nine studies were included. All study subjects had received specialist palliative care. With regard to place of death, socioeconomic status was found to have (1) no effect in seven studies and (2) an effect in one study. Furthermore, one study found that the effect of socioeconomic status on place of death was only significant when patients received standard specialist palliative care. When patients received more intense care adapted to their needs, the effect of socioeconomic status on place of death was no longer seen. There is some evidence to suggest that use of specialist palliative care may modify the effect of socioeconomic status on place of death. © The Author(s) 2015.

The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals

PubMed Central

Murtagh, Fliss EM

2014-01-01

Background: Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. Aim: To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gaps in the evidence. Design: Standard systematic review and narrative synthesis. Data sources: MEDLINE, Embase, CINAHL, PsycINFO, Applied Social Science Abstract and the Cochrane library were searched in 2012. Reference searching, hand searching, expert consultations and grey literature searches complemented these. Papers with the views of patients/carers or professionals on primary palliative care provision to non-cancer patients in the community were included. The amended Hawker’s criteria were used for quality assessment of included studies. Results: A total of 30 studies were included and represent the views of 719 patients, 605 carers and over 400 professionals. In all, 27 studies are from the United Kingdom. Patients and carers expect primary care physicians to provide compassionate care, have appropriate knowledge and play central roles in providing care. The roles of professionals are unclear to patients, carers and professionals themselves. Uncertainty of illness trajectory and lack of collaboration between health-care professionals were identified as barriers to effective care. Conclusions: Effective interprofessional work to deal with uncertainty and maintain coordinated care is needed for better palliative care provision to non-cancer patients in the community. Research into and development of a best model for effective interdisciplinary work are needed. PMID:24821710

Chest compressions in newborn animal models: A review.

PubMed

Solevåg, Anne Lee; Cheung, Po-Yin; Lie, Helene; O'Reilly, Megan; Aziz, Khalid; Nakstad, Britt; Schmölzer, Georg Marcus

2015-11-01

Much of the knowledge about the optimal way to perform chest compressions (CC) in newborn infants is derived from animal studies. The objective of this review was to identify studies of CC in newborn term animal models and review the evidence. We also provide an overview of the different models. MEDLINE, EMBASE and CINAHL, until September 29th 2014. Study eligibility criteria and interventions: term newborn animal models where CC was performed. Based on 419 retrieved studies from MEDLINE and 502 from EMBASE, 28 studies were included. No additional studies were identified in CINAHL. Most of the studies were performed in pigs after perinatal transition without long-term follow-up. The models differed widely in methodological aspects, which limits the possibility to compare and synthesize findings. Studies uncommonly reported the method for randomization and allocation concealment, and a limited number were blinded. Only the evidence in favour of the two-thumb encircling hands technique for performing CC, a CC to ventilation ratio of 3:1; and that air can be used for ventilation during CC; was supported by more than one study. Animal studies should be performed and reported with the same rigor as in human randomized trials. Good transitional and survival models are needed to further increase the strength of the evidence derived from animal studies of newborn chest compressions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Mapping the literature of home health nursing.

PubMed

Friedman, Yelena

2006-04-01

The purpose of this study was to identify core journals in home health nursing and to determine how well these journals were covered by indexing and abstracting services. The study was part of the project for mapping the nursing literature of the Medical Library Association's Nursing and Allied Health Resource Section. A citation analysis of two core journals was done to determine distribution of references by format types and age of citations and dispersion of the literature, according to Bradford's Law of Scattering. The analysis of indexing coverage for Zone 1 and 2 was also provided. The study showed that 64.2% of citations came from journals, versus 22.9% from books and 12.9% from other publications. PubMed/ MEDLINE rated highest in average indexing coverage of Zone 1 and 2 journals, followed by CINAHL. PsycINFO, SocioAbstracts, and EBSCO Health Business FullTEXT showed practically no coverage for the home health nursing literature. As expected, journal articles were found to be the primary source for referencing and books, the secondary source. In regard to bibliographic control, no databases provided full coverage of the journals in the field of home health nursing. PubMed/MEDLINE and CINAHL gave better results in combination, because CINAHL tended to cover more nursing journals, while PubMed/MEDLINE did better with medical titles.

Beyond relevance and recall: testing new user-centred measures of database performance.

PubMed

Stokes, Peter; Foster, Allen; Urquhart, Christine

2009-09-01

Measures of the effectiveness of databases have traditionally focused on recall, precision, with some debate on how relevance can be assessed, and by whom. New measures of database performance are required when users are familiar with search engines, and expect full text availability. This research ascertained which of four bibliographic databases (BNI, CINAHL, MEDLINE and EMBASE) could be considered most useful to nursing and midwifery students searching for information for an undergraduate dissertation. Searches on title were performed for dissertation topics supplied by nursing students (n = 9), who made the relevance judgements. Measures of recall and precision were combined with additional factors to provide measures of effectiveness, while efficiency combined measures of novelty and originality and accessibility combined measures for availability and retrievability, based on obtainability. There were significant differences among the databases in precision, originality and availability, but other differences were not significant (Friedman test). Odds ratio tests indicated that BNI, followed by CINAHL were the most effective, CINAHL the most efficient, and BNI the most accessible. The methodology could help library services in purchase decisions as the measure for accessibility, and odds ratio testing helped to differentiate database performance.

Diabetes-related information-seeking behaviour: a systematic review.

PubMed

Kuske, Silke; Schiereck, Tim; Grobosch, Sandra; Paduch, Andrea; Droste, Sigrid; Halbach, Sarah; Icks, Andrea

2017-10-24

Information-seeking behaviour is necessary to improve knowledge on diabetes therapy and complications. Combined with other self-management skills and autonomous handling of the disease, it is essential for achieving treatment targets. However, a systematic review addressing this topic is lacking. The aims of this systematic review were to identify and analyse existing knowledge of information-seeking behaviour: (1) types information-seeking behaviour, (2) information sources, (3) the content of searched information, and (4) associated variables that may affect information-seeking behaviour. The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements. MEDLINE, CINAHL, EMBASE, ScienceDirect, PsycInfo, Cochrane Library, Web of Science, CCMed, ERIC, Journals@OVID, Deutsches Ärzteblatt and Karlsruher virtueller Katalog (KvK) databases were searched. Publications dealing with information-seeking behaviour of people with diabetes mellitus published up to June 2015 were included. A forward citation tracking was performed in September 2016 and June 2017. Additionally, an update of the two main databases (MEDLINE, CINAHL) was conducted, considering studies published up to July 2017. Studies published in languages other than English or German were excluded, as well as letters, short reports, editorials, comments and discussion papers. A study selection and the critical appraisal of the selected studies were performed independently by two reviewers. A third reviewer was consulted if any disagreement was found. Data extraction and content analysis were performed using selected dimensions of Wilson's 'model of information behaviour'. Twenty-six studies were included. Five 'types of information-seeking behaviour' were identified, e.g. passive and active search. The 'Internet' and 'healthcare professionals' were the most frequently reported sources. 'Diet', 'complications', 'exercise' and 'medications and pharmacological interactions' were the most frequently identified content of information. Seven main categories including associated variables were identified, e.g. 'socioeconomic', 'duration of DM', and 'lifestyle'. The systematic review provides a valuable overview of available knowledge on the information-seeking behaviour of people with diabetes mellitus, although there are only a few studies. There was a high heterogeneity regarding the research question, design, methods and participants. Although the Internet is often used to seek information, health professionals still play an important role in supporting their patients' information-seeking behaviour. Specific needs of people with diabetes must be taken into consideration. PROSPERO CRD42016037312.

Knowledge produced on the health of low-income older women: an integrative review.

PubMed

Tavares, Renata Evangelista; Jesus, Maria Cristina Pinto de; Cordeiro, Samara Macedo; Machado, Daniel Rodrigues; Braga, Vanessa Augusta; Merighi, Miriam Aparecida Barbosa

2017-01-01

to identify the knowledge produced on the health of low-income older women. an integrative review was conducted in February 2016 on the SCOPUS, CINAHL, MEDLINE, LILACS, EMBASE, WEB OF SCIENCE databases, and in the SciELO journals directory. After the application of inclusion and exclusion criteria, 24 articles were selected. the knowledge produced comprises two main themes: "health in face of economic adversities" and "reciprocity in social support between low-income older women and their social network". health professionals, especially nurses, should be attentive to aspects related to social determinants and the health of low-income older women, highlighting the fact that they are not always the recipients of care. identificar o conhecimento produzido sobre a saúde das mulheres idosas de baixa renda. revisão integrativa realizada em fevereiro de 2016, nas bases de dados SCOPUS, CINAHL, MEDLINE, LILACS, EMBASE, WEB OF SCIENCE e no diretório de revistas SciELO. Após aplicação dos critérios de inclusão e exclusão, foram selecionados 24 artigos. o conhecimento produzido congrega dois temas principais: "a saúde diante das adversidades econômicas" e "reciprocidade no apoio social entre as mulheres idosas de baixa renda e sua rede social". os profissionais de saúde, em especial o enfermeiro, devem atentar para aspectos relacionados aos determinantes sociais e de saúde de mulheres idosas de baixa renda, destacando-se que elas, nem sempre, são apenas receptoras de cuidado.

Incentive spirometry following thoracic surgery: what should we be doing?

PubMed

Agostini, Paula; Singh, Sally

2009-06-01

Thoracic surgery may cause reduced respiratory function and pulmonary complications, with associated increased risk of mortality. Postoperative physiotherapy aims to reverse atelectasis and secretion retention, and may include incentive spirometry. To review the evidence for incentive spirometry, examining the physiological basis, equipment and its use following thoracic surgery. MEDLINE was searched from 1950 to January 2008, EMBASE was searched from 1980 to January 2008, and CINAHL was searched from 1982 to January 2008, all using the OVID interface. The search term was: '[incentive spirometry.mp]'. The Cochrane Library was searched using the terms 'incentive spirometry' and 'postoperative physiotherapy'. The Chartered Society of Physiotherapy Resource Centre was also searched, and a hand search was performed to follow-up references from the retrieved studies. Non-scientific papers were excluded, as were papers that did not relate to thoracic surgery or the postoperative treatment of patients with incentive spirometry. Initially, 106 studies were found in MEDLINE, 99 in EMBASE and 42 in CINAHL. Eight references were found in the Cochrane Library and one paper in the Chartered Society of Physiotherapy Resource Centre. Four studies and one systematic review investigating the effects of postoperative physiotherapy and incentive spirometry in thoracic surgery patients were selected and reviewed. Physiological evidence suggests that incentive spirometry may be appropriate for lung re-expansion following major thoracic surgery. Based on sparse literature, postoperative physiotherapy regimes with, or without, the use of incentive spirometry appear to be effective following thoracic surgery compared with no physiotherapy input.

Transgender Phonosurgery: A Systematic Review and Meta-analysis.

PubMed

Song, Tara Elena; Jiang, Nancy

2017-05-01

Objectives Different surgical techniques have been described in the literature to increase vocal pitch. The purpose of this study is to systematically review these surgeries and perform a meta-analysis to determine which technique increases pitch the most. Data Sources CINAHL, Cochrane, Embase, Medline, PubMed, and Science Direct. Review Methods A systematic review and meta-analysis of the literature was performed using the CINAHL, Cochrane, Embase, Medline, PubMed, and Science Direct databases. Studies were eligible for inclusion if they evaluated pitch-elevating phonosurgical techniques in live humans and performed pre- and postoperative acoustic analysis. Data were gathered regarding surgical technique, pre- and postoperative fundamental frequencies, perioperative care measures, and complications. Results Twenty-nine studies were identified. After applying inclusion and exclusion criteria, a total of 13 studies were included in the meta-analysis. Mechanisms of pitch elevation included increasing vocal cord tension (cricothyroid approximation), shortening the vocal cord length (cold knife glottoplasty, laser-shortening glottoplasty), and decreasing mass (laser reduction glottoplasty). The most common interventions were shortening techniques and cricothyroid approximation (6 studies each). The largest increase in fundamental frequency was seen with techniques that shortened the vocal cords. Preoperative speech therapy, postoperative voice rest, and reporting of patient satisfaction were inconsistent. Many of the studies were limited by low power and short length of follow-up. Conclusions Multiple techniques for elevation of vocal pitch exist, but vocal cord shortening procedures appear to result in the largest increase in fundamental frequency.

Optimizing literature search in systematic reviews - are MEDLINE, EMBASE and CENTRAL enough for identifying effect studies within the area of musculoskeletal disorders?

PubMed

Aagaard, Thomas; Lund, Hans; Juhl, Carsten

2016-11-22

When conducting systematic reviews, it is essential to perform a comprehensive literature search to identify all published studies relevant to the specific research question. The Cochrane Collaborations Methodological Expectations of Cochrane Intervention Reviews (MECIR) guidelines state that searching MEDLINE, EMBASE and CENTRAL should be considered mandatory. The aim of this study was to evaluate the MECIR recommendations to use MEDLINE, EMBASE and CENTRAL combined, and examine the yield of using these to find randomized controlled trials (RCTs) within the area of musculoskeletal disorders. Data sources were systematic reviews published by the Cochrane Musculoskeletal Review Group, including at least five RCTs, reporting a search history, searching MEDLINE, EMBASE, CENTRAL, and adding reference- and hand-searching. Additional databases were deemed eligible if they indexed RCTs, were in English and used in more than three of the systematic reviews. Relative recall was calculated as the number of studies identified by the literature search divided by the number of eligible studies i.e. included studies in the individual systematic reviews. Finally, cumulative median recall was calculated for MEDLINE, EMBASE and CENTRAL combined followed by the databases yielding additional studies. Deemed eligible was twenty-three systematic reviews and the databases included other than MEDLINE, EMBASE and CENTRAL was AMED, CINAHL, HealthSTAR, MANTIS, OT-Seeker, PEDro, PsychINFO, SCOPUS, SportDISCUS and Web of Science. Cumulative median recall for combined searching in MEDLINE, EMBASE and CENTRAL was 88.9% and increased to 90.9% when adding 10 additional databases. Searching MEDLINE, EMBASE and CENTRAL was not sufficient for identifying all effect studies on musculoskeletal disorders, but additional ten databases did only increase the median recall by 2%. It is possible that searching databases is not sufficient to identify all relevant references, and that reviewers must rely upon additional sources in their literature search. However further research is needed.

Smoke-free homes: what are the barriers, motivators and enablers? A qualitative systematic review and thematic synthesis

PubMed Central

Robinson, Jude; Wiggers, John

2016-01-01

Objective To thematically synthesise primary qualitative studies of the barriers, motivators and enablers of smoke-free homes (SFHs). Design Systematic review and thematic synthesis. Data sources Searches of MEDLINE, EBM Reviews (Cochrane Database of Systematic Reviews), PsycINFO, Global Health, CINAHL, Web of Science, Informit and EMBASE, combining terms for families, households and vulnerable populations; SFH and secondhand smoke; and qualitative research, were supplemented by searches of PhD theses, key authors, specialist journals and reference lists. Study selection We included 22 articles, reporting on 18 studies, involving 646 participants. Inclusion criteria: peer-reviewed; English language; published from 1990 onwards (to week 3 of April 2014); used qualitative data collection methods; explored participants’ perspectives of home smoking behaviours; and the barriers, motivators and enablers to initiating and/or maintaining a SFH. Data extraction 1 of 3 authors extracted data with checking by a second. Data synthesis A thematic synthesis was performed to develop 7 core analytic themes: (1) knowledge, awareness and risk perception; (2) agency and personal skills/attributes; (3) wider community norms and personal moral responsibilities; (4) social relationships and influence of others; (5) perceived benefits, preferences and priorities; (6) addiction and habit; (7) practicalities. Conclusions This synthesis highlights the complexity faced by many households in having a SFH, the practical, social, cultural and personal issues that need to be addressed and balanced by households, and that while some of these are common across study settings, specific social and cultural factors play a critical role in shaping household smoking behaviours. The findings can inform policy and practice and the development of interventions aimed at increasing SFHs. Trial registration number CRD42014014115. PMID:26988351

Diet Behavior Change Techniques in Type 2 Diabetes: A Systematic Review and Meta-analysis.

PubMed

Cradock, Kevin A; ÓLaighin, Gearóid; Finucane, Francis M; McKay, Rhyann; Quinlan, Leo R; Martin Ginis, Kathleen A; Gainforth, Heather L

2017-12-01

Dietary behavior is closely connected to type 2 diabetes. The purpose of this meta-analysis was to identify behavior change techniques (BCTs) and specific components of dietary interventions for patients with type 2 diabetes associated with changes in HbA 1c and body weight. The Cochrane Library, CINAHL, Embase, PubMed, PsycINFO, and Scopus databases were searched. Reports of randomized controlled trials published during 1975-2017 that focused on changing dietary behavior were selected, and methodological rigor, use of BCTs, and fidelity and intervention features were evaluated. In total, 54 studies were included, with 42 different BCTs applied and an average of 7 BCTs used per study. Four BCTs-"problem solving," "feedback on behavior," "adding objects to the environment," and "social comparison"-and the intervention feature "use of theory" were associated with >0.3% (3.3 mmol/mol) reduction in HbA 1c . Meta-analysis revealed that studies that aimed to control or change the environment showed a greater reduction in HbA 1c of 0.5% (5.5 mmol/mol) (95% CI -0.65, -0.34), compared with 0.32% (3.5 mmol/mol) (95% CI -0.40, -0.23) for studies that aimed to change behavior. Limitations of our study were the heterogeneity of dietary interventions and poor quality of reporting of BCTs. This study provides evidence that changing the dietary environment may have more of an effect on HbA 1c in adults with type 2 diabetes than changing dietary behavior. Diet interventions achieved clinically significant reductions in HbA 1c , although initial reductions in body weight diminished over time. If appropriate BCTs and theory are applied, dietary interventions may result in better glucose control. © 2017 by the American Diabetes Association.

Psychosocial correlates of oral hygiene behaviour in people aged 9 to 19 - a systematic review with meta-analysis.

PubMed

Scheerman, Janneke F M; van Loveren, Cor; van Meijel, Berno; Dusseldorp, Elise; Wartewig, Eva; Verrips, Gijsbert H W; Ket, Johannes C F; van Empelen, Pepijn

2016-08-01

This systematic and meta-analytic review aimed to quantify the association of psychosocial correlates with oral hygiene behaviour among 9- to 19-year olds. A systematic search up to August 2015 was carried out using the following databases: PubMed, PsycInfo, Embase, CINAHL and Web of Science. If necessary, authors of studies were contacted to obtain unpublished statistical information. A study was eligible for inclusion when it evaluated the association between the psychosocial correlates and oral hygiene behaviour varying from self-reports to clinical measurements, including plaque and bleeding scores. A modified New Castle Ottawa Scale was applied to examine the quality of the included studies. Twenty-seven data sets (k) presented in 22 publications, addressing nine psychosocial correlates, were found to be eligible for the meta-analysis. For both tooth brushing and oral hygiene behaviour, random effect models revealed significant weighted average correlation (r+ ) for the psychosocial factors: 'intention', 'self-efficacy', 'attitude' (not significant for tooth brushing), 'social influence', 'coping planning' and 'action planning' (r+ ranging from 0.18 to 0.57). Little or no associations were found for 'locus of control', 'self-esteem' and 'sense of coherence' (r+ ranges from 0.01 to 0.08). The data at present indicates that 'self-efficacy', 'intention', 'social influences', 'coping planning' and 'action planning' are potential psychosocial determinants of oral health behaviour. Future studies should consider a range of psychological factors that have not been studied, but have shown to be important psychosocial determinants of health behaviours, such as 'self-determination', 'anticipated regret', 'action control' and 'self-identity'. Effectiveness of addressing these potential determinants to induce behaviour change should be further examined by intervention trials. © 2016 The Authors. Community Dentistry and Oral Epidemiology Published by John Wiley & Sons Ltd.

Association between organisational and workplace cultures, and patient outcomes: systematic review protocol.

PubMed

Braithwaite, J; Herkes, J; Ludlow, K; Lamprell, G; Testa, L

2016-12-01

Despite widespread interest in the topic, no current synthesis of research is available analysing the linkages between organisational or workplace cultures on the one hand, and patient outcomes on the other. This protocol proposes a systematic review to analyse and synthesise the literature to date on this topic. The resulting review will discuss characteristics of included studies in terms of the type of healthcare settings researched, the measurements of organisational and workplace culture, patient outcomes measured and the influence of these cultures on patient outcomes. A systematic review will be conducted aiming to examine the associations between organisational and workplace cultures, and patient outcomes, guided by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. An English language search of abstracts will be executed using the following academic databases: CINAHL, EMBASE, Ovid MEDLINE, Web of Science and PsycINFO. The review will include relevant peer-reviewed articles from randomised controlled trials (RCTs), non-RCTs, controlled before and after studies, interrupted time series studies, cross-sectional analyses, qualitative studies and mixed-method studies. Multiple researchers will be involved in assessing the quality of articles for inclusion in the review. This protocol documents a detailed search strategy, including terms and inclusion criteria, which will form the basis of the subsequent systematic review. Ethics approval is not required as no primary data will be collected. Results will be disseminated through a peer-reviewed publication and conference presentations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Combinations of physical activity, sedentary behaviour and sleep: relationships with health indicators in school-aged children and youth.

PubMed

Saunders, Travis John; Gray, Casey Ellen; Poitras, Veronica Joan; Chaput, Jean-Philippe; Janssen, Ian; Katzmarzyk, Peter T; Olds, Timothy; Connor Gorber, Sarah; Kho, Michelle E; Sampson, Margaret; Tremblay, Mark S; Carson, Valerie

2016-06-01

The purpose of this systematic review was to determine how combinations of physical activity (PA), sedentary behaviour (SB), and sleep were associated with important health indicators in children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE, SPORTdiscus, CINAHL, and PsycINFO) were searched for relevant studies examining the relationship between time spent engaging in different combinations of PA, SB, and sleep with the following health indicators: adiposity, cardiometabolic biomarkers, physical fitness, emotional regulation/psychological distress, behavioural conduct/pro-social behaviour, cognition, quality of life/well-being, injuries, bone density, motor skill development, and self-esteem. PA had to be objectively measured, while sleep and SB could be objectively or subjectively measured. The quality of research evidence and risk of bias for each health indicator and for each individual study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. A total of 13 cross-sectional studies and a single prospective cohort study reporting data from 36 560 individual participants met the inclusion criteria. Children and youth with a combination of high PA/high sleep/low SB had more desirable measures of adiposity and cardiometabolic health compared with those with a combination of low PA/low sleep/high SB. Health benefits were also observed for those with a combination of high PA/high sleep (cardiometabolic health and adiposity) or high PA/low SB (cardiometabolic health, adiposity and fitness), compared with low PA/low sleep or low PA/high SB. Of the 3 movement behaviours, PA (especially moderate- to vigorous-intensity PA) was most consistently associated with desirable health indicators. Given the lack of randomized trials, the overall quality of the available evidence was low.

The effect of whole body vibration on balance, gait performance and mobility in people with stroke: a systematic review and meta-analysis.

PubMed

Yang, Xiaotian; Wang, Pu; Liu, Chuan; He, Chengqi; Reinhardt, Jan D

2015-07-01

To examine the effect of whole body vibration on balance, gait performance and mobility among people with stroke. A systematic review was conducted by two independent reviewers who completed the article search and selection. We included randomized controlled trials published in English examining effects of whole body vibration on balance, gait, mobility, muscle strength and muscle tone in adults with a clinical diagnosis of stroke. Articles were excluded if they were research studies on people with other primary diagnosis, abstracts published in the conferences or books. The Cochrane risk of bias tool was used to assess the methodological quality of the selected studies. Sources included Cochrane Central Register of Controlled Trials, Pubmed, MEDLINE, CINAHL, EMBASE, PEDro, PsycINFO, Science Citation Index, ClinicalTrials.gov, Current Controlled Trials, Stroke Trials Registry, and reference lists of all relevant articles. Eight randomized controlled trials (nine articles) involving 271 participants were included in this meta-analysis. No significant improvement was found regarding Berg balance scale (SMD=-0.08, 95%CI=-1.35 to 1.19, P=0.91), mobility (SMD=0.45, 95%CI=-0.46 to 1.37, P=0.33), maximal isometric contracion of knee extension strength (SMD=0.23, 95%CI=-0.27 to 0.74, P=0.36), and maximal isometric contracion of knee extension strength (SMD=0.09, 95%CI=-0.38 to 0.56, P=0.71). There was no evidence for effects of whole body vibration on balance in people with stroke. Effects of whole body vibration on mobility and gait performance remain inconclusive. More large and high-quality trials are required. © The Author(s) 2014.

Exploring and explaining low participation in physical activity among children and young people with asthma: a review.

PubMed

Williams, Brian; Powell, Alison; Hoskins, Gaylor; Neville, Ron

2008-06-30

Asthma is the most common chronic illness among children and accounts for 1 in 5 of all child GP consultations. This paper reviews and discusses recent literature outlining the growing problem of physical inactivity among young people with asthma and explores the psychosocial dimensions that may explain inactivity levels and potentially relevant interventions and strategies, and the principles that should underpin them. A narrative review based on an extensive and documented search of search of CinAHL, Embase, Medline, PsycINFO and the Cochrane Library. Children and young people with asthma are generally less active than their non-asthmatic peers. Reduced participation may be influenced by organisational policies, family illness beliefs and behaviours, health care advice, and inaccurate symptom perception and attribution. Schools can be reluctant to encourage children to take part in physical education or normal play activity due to misunderstanding and a lack of clear corporate guidance. Families may accept a child's low level of activity if it is perceived that breathlessness or the need to take extra inhalers is harmful. Many young people themselves appear to accept sub-optimal control of symptoms and frequently misinterpret healthy shortness of breath on exercising with the symptoms of an impending asthma attack. A multi-faceted approach is needed to translate the rhetoric of increasing activity levels in young people to the reality of improved fitness. Physical activity leading to improved fitness should become part of a goal orientated management strategy by schools, families, health care professionals and individuals. Exercise induced asthma should be regarded as a marker of poor control and a need to increase fitness rather as an excuse for inactivity. Individuals' perceptual accuracy deserves further research attention.

Are brief interventions to increase physical activity cost-effective? A systematic review

PubMed Central

GC, Vijay; Suhrcke, Marc; Hardeman, Wendy; Sutton, Stephen

2016-01-01

Objective To determine whether brief interventions promoting physical activity are cost-effective in primary care or community settings. Design Systematic review of economic evaluations. Methods and data sources We searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit, SPORTDiscus, PEDro, the Cochrane library, National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry up to 20 August 2014. Web of Knowledge was used for cross-reference search. We included studies investigating the cost-effectiveness of brief interventions, as defined by National Institute for Health and Care Excellence, promoting physical activity in primary care or the community. Methodological quality was assessed using Drummond's checklist for economic evaluations. Data were extracted from individual studies fulfilling selection criteria using a standardised pro forma. Comparisons of cost-effectiveness and cost-utility ratios were made between studies. Results Of 1840 identified publications, 13 studies fulfilled the inclusion criteria describing 14 brief interventions. Studies varied widely in the methods used, such as the perspective of economic analysis, intervention effects and outcome measures. The incremental cost of moving an inactive person to an active state, estimated for eight studies, ranged from £96 to £986. The cost-utility was estimated in nine studies compared with usual care and varied from £57 to £14 002 per quality-adjusted life year; dominant to £6500 per disability-adjusted life year; and £15 873 per life years gained. Conclusions Brief interventions promoting physical activity in primary care and the community are likely to be inexpensive compared with usual care. Given the commonly accepted thresholds, they appear to be cost-effective on the whole, although there is notable variation between studies. PMID:26438429

Experiences of Physical Therapists Working in the Acute Hospital Setting: Systematic Review.

PubMed

Lau, Bonnie; Skinner, Elizabeth H; Lo, Kristin; Bearman, Margaret

2016-09-01

Physical therapists working in acute care hospitals require unique skills to adapt to the challenging environment and short patient length of stay. Previous literature has reported burnout of clinicians and difficulty with staff retention; however, no systematic reviews have investigated qualitative literature in the area. The purpose of this study was to investigate the experiences of physical therapists working in acute hospitals. Six databases (MEDLINE, CINAHL Plus, EMBASE, AMED, PsycINFO, and Sociological Abstracts) were searched up to and including September 30, 2015, using relevant terms. Studies in English were selected if they included physical therapists working in an acute hospital setting, used qualitative methods, and contained themes or descriptive data relating to physical therapists' experiences. Data extraction included the study authors and year, settings, participant characteristics, aims, and methods. Key themes, explanatory models/theories, and implications for policy and practice were extracted, and quality assessment was conducted. Thematic analysis was used to conduct qualitative synthesis. Eight articles were included. Overall, study quality was high. Four main themes were identified describing factors that influence physical therapists' experience and clinical decision making: environmental/contextual factors, communication/relationships, the physical therapist as a person, and professional identity/role. Qualitative synthesis may be difficult to replicate. The majority of articles were from North America and Australia, limiting transferability of the findings. The identified factors, which interact to influence the experiences of acute care physical therapists, should be considered by therapists and their managers to optimize the physical therapy role in acute care. Potential strategies include promotion of interprofessional and collegial relationships, clear delineation of the physical therapy role, multidisciplinary team member education, additional support staff, and innovative models of care to address funding and staff shortages. © 2016 American Physical Therapy Association.

Interventions to enhance work participation of workers with a chronic disease: a systematic review of reviews.

PubMed

Vooijs, Marloes; Leensen, Monique C J; Hoving, Jan L; Wind, Haije; Frings-Dresen, Monique H W

2015-11-01

The aim of this systematic review was to provide an overview of the available effective interventions that enhance work participation of people with a chronic disease, irrespective of their diagnosis. A search was conducted in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library, searching for systematic reviews published between 2004 and February 2015. Systematic reviews were eligible for inclusion if they described an intervention aimed at enhancing work participation and included participants of working age (18-65 years) with a chronic disease. Reviews had to include populations having different chronic diseases. The quality of the included reviews was evaluated using the quality instrument AMSTAR. Results of reviews of medium and high quality were described in this review. The search resulted in 9 reviews, 5 of which were of medium quality. No high quality reviews were retrieved. 1 review reported inconclusive evidence for policy-based return to work initiatives. The 4 other reviews described interventions focused on changes at work, such as changes in work organisation, working conditions and work environment. Of these 4 reviews, 3 reported beneficial effects of the intervention on work participation. Interventions examined in populations having different chronic diseases were mainly focused on changes at work. The majority of the included interventions were reported to be effective in enhancing work participation of people with a chronic disease, indicating that interventions directed at work could be considered for a generic approach in order to enhance work participation in various chronic diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis.

PubMed

Cook, David A; Hamstra, Stanley J; Brydges, Ryan; Zendejas, Benjamin; Szostek, Jason H; Wang, Amy T; Erwin, Patricia J; Hatala, Rose

2013-01-01

Although technology-enhanced simulation is increasingly used in health professions education, features of effective simulation-based instructional design remain uncertain. Evaluate the effectiveness of instructional design features through a systematic review of studies comparing different simulation-based interventions. We systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, key journals, and previous review bibliographies through May 2011. We included original research studies that compared one simulation intervention with another and involved health professions learners. Working in duplicate, we evaluated study quality and abstracted information on learners, outcomes, and instructional design features. We pooled results using random effects meta-analysis. From a pool of 10,903 articles we identified 289 eligible studies enrolling 18,971 trainees, including 208 randomized trials. Inconsistency was usually large (I2 > 50%). For skills outcomes, pooled effect sizes (positive numbers favoring the instructional design feature) were 0.68 for range of difficulty (20 studies; p < 0.001), 0.68 for repetitive practice (7 studies; p = 0.06), 0.66 for distributed practice (6 studies; p = 0.03), 0.65 for interactivity (89 studies; p < 0.001), 0.62 for multiple learning strategies (70 studies; p < 0.001), 0.52 for individualized learning (59 studies; p < 0.001), 0.45 for mastery learning (3 studies; p = 0.57), 0.44 for feedback (80 studies; p < 0.001), 0.34 for longer time (23 studies; p = 0.005), 0.20 for clinical variation (16 studies; p = 0.24), and -0.22 for group training (8 studies; p = 0.09). These results confirm quantitatively the effectiveness of several instructional design features in simulation-based education.

Factors contributing to registered nurse medication administration error: a narrative review.

PubMed

Parry, Angela M; Barriball, K Louise; While, Alison E

2015-01-01

To explore the factors contributing to Registered Nurse medication administration error behaviour. A narrative review. Electronic databases (Cochrane, CINAHL, MEDLINE, BNI, EmBase, and PsycINFO) were searched from 1 January 1999 to 31 December 2012 in the English language. 1127 papers were identified and 26 papers were included in the review. Data were extracted by one reviewer and checked by a second reviewer. A thematic analysis and narrative synthesis of the factors contributing to Registered Nurses' medication administration behaviour. Bandura's (1986) theory of reciprocal determinism was used as an organising framework. This theory proposes that there is a reciprocal interplay between the environment, the person and their behaviour. Medication administration error is an outcome of RN behaviour. The 26 papers reported studies conducted in 4 continents across 11 countries predominantly in North America and Europe, with one multi-national study incorporating 27 countries. Within both the environment and person domain of the reciprocal determinism framework, a number of factors emerged as influencing Registered Nurse medication administration error behaviour. Within the environment domain, two key themes of clinical workload and work setting emerged, and within the person domain the Registered Nurses' characteristics and their lived experience of work emerged as themes. Overall, greater attention has been given to the contribution of the environment domain rather than the person domain as contributing to error, with the literature viewing an error as an event rather than the outcome of behaviour. The interplay between factors that influence behaviour were poorly accounted for within the selected studies. It is proposed that a shift away from error as an event to a focus on the relationships between the person, the environment and Registered Nurse medication administration behaviour is needed to better understand medication administration error. Copyright © 2014 Elsevier Ltd. All rights reserved.

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

PubMed

Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

2017-09-07

While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

Rehabilitation service models for people with physical and/or mental disability living in low- and middle-income countries: A systematic review.

PubMed

Furlan, Andréa D; Irvin, Emma; Munhall, Claire; Giraldo-Prieto, Mario; Fullerton, Laura; McMaster, Robert; Danak, Shivang; Costante, Alicia; Pitzul, Kristen B; Bhide, Rohit P; Marchenko, Stanislav; Mahood, Quenby; David, Judy A; Flannery, John F; Bayley, Mark

2018-04-03

To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries. CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed. Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language. Date extraction: Standardized forms were used. Methodological quality was assessed using AMSTAR and quality of evidence was assessed using GRADE. Twenty-four systematic reviews which included 578 studies and 202,307 participants were selected. In addition, four primary studies were included to complement the gaps in the systematic reviews. The studies were all done at various countries. Moderate- to high-quality evidence supports the following models of rehabilitation services: psychological intervention in primary care settings for people with major depression, admission into an inpatient, multidisciplinary, specialized rehabilitation unit for those with recent onset of a severe disabling condition; outpatient rehabilitation with multidisciplinary care in the community, hospital or home is recommended for less severe conditions; However, a model of rehabilitation service that includes early discharge is not recommended for elderly patients with severe stroke, chronic obstructive pulmonary disease, hip fracture and total joints. Models of rehabilitation care in inpatient, multidisciplinary and specialized rehabilitation units are recommended for the treatment of severe conditions with recent onset, as they reduce mortality and the need for institutionalized care, especially among elderly patients, stroke patients, or those with chronic back pain. Results are expected to be generalizable for brain/spinal cord injury and complex fractures.

Interventions That Restore Awareness of Hypoglycemia in Adults With Type 1 Diabetes: A Systematic Review and Meta-analysis.

PubMed

Yeoh, Ester; Choudhary, Pratik; Nwokolo, Munachiso; Ayis, Salma; Amiel, Stephanie A

2015-08-01

Impaired awareness of hypoglycemia (IAH) increases the risk of severe hypoglycemia (SH) sixfold and affects 30% of adults with type 1 diabetes (T1D). This systematic review and meta-analysis looks at the educational, technological, and pharmacological interventions aimed at restoring hypoglycemia awareness (HA) in adults with T1D. We searched The Cochrane Library, MEDLINE, Embase, Science Citation Index Expanded, Social Sciences Citation Index, PsycINFO, and CINAHL from inception until 1 October 2014. Included studies described HA status at baseline. Outcome measures were SH rates, change in HA, counterregulatory hormone responses, and glycemic control. Forty-three studies (18 randomized controlled trials, 25 before-and-after studies) met the inclusion criteria, comprising 27 educational, 11 technological, and 5 pharmacological interventions. Educational interventions included structured diabetes education on flexible insulin therapy, including psychotherapeutic and behavioral techniques. These were able to reduce SH and improve glycemic control, with greater benefit from the latter two techniques in improving IAH. Technological interventions (insulin pump therapy, continuous glucose monitoring, and sensor-augmented pump) reduced SH, improved glycemic control, and restored awareness when used in combination with structured education and frequent contact. Pharmacological studies included four insulin studies and one noninsulin study, but with low background SH prevalence rates. This review provides evidence for the effectiveness of a stepped-care approach in the management of patients with IAH, initially with structured diabetes education in flexible insulin therapy, which may incorporate psychotherapeutic and behavioral therapies, progressing to diabetes technology, incorporating sensors and insulin pumps, in those with persisting need. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Effects of Postgraduate Medical Education “Boot Camps” on Clinical Skills, Knowledge, and Confidence: A Meta-Analysis

PubMed Central

Blackmore, Christopher; Austin, Janice; Lopushinsky, Steven R; Donnon, Tyrone

2014-01-01

Background Throughout their medical education, learners face multiple transition periods associated with increased demands, producing stress and concern about the adequacy of their skills for their new role. Objective We evaluated the effectiveness of boot camps in improving clinical skills, knowledge, and confidence during transitions into postgraduate or discipline-specific residency programs. Methods Boot camps are in-training courses combining simulation-based practice with other educational methods to enhance learning and preparation for individuals entering new clinical roles. We performed a search of MEDLINE, CINAHL, PsycINFO, EMBASE, and ERIC using boot camp and comparable search terms. Inclusion criteria included studies that reported on medical education boot camps, involved learners entering new clinical roles in North American programs, and reported empirical data on the effectiveness of boot camps to improve clinical skills, knowledge, and/or confidence. A random effects model meta-analysis was performed to combined mean effect size differences (Cohen's d) across studies based on pretest/posttest or comparison group analyses. Results The search returned 1096 articles, 15 of which met all inclusion criteria. Combined effect size estimates showed learners who completed boot camp courses had significantly “large” improvements in clinical skills (d  =  1.78; 95% CI 1.33–2.22; P < .001), knowledge (d  =  2.08; 95% CI 1.20–2.96; P < .001), and confidence (d  =  1.89; 95% CI 1.63–2.15; P < .001). Conclusions Boot camps were shown as an effective educational strategy to improve learners' clinical skills, knowledge, and confidence. Focus on pretest/posttest research designs limits the strength of these findings. PMID:26140112

Conditions-Based Learning Theory as a Framework for Comparative-Effectiveness Reviews: A Worked Example.

PubMed

Rourke, Liam; Leong, Jessica; Chatterly, Patricia

2018-02-16

Phenomenon: An evidence-informed era of medical education encourages the generation and use of comparative-effectiveness reviews, yet the reviews often conclude, curiously, that all instructional approaches are equally effective. We used a conditions-based learning theory to structure a review of the comparative-effectiveness literature on electrocardiogram instruction. We searched MEDLINE, EMBASE (Ovid), ERIC (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO) from inception to June 2016. We selected prospective studies that examined the effect of instructional interventions on participants' knowledge and skill with electrocardiogram interpretation. Two reviewers extracted information on the quality of the studies, the effect of instruction on the acquisition of knowledge and skill, and instructional quality. Instructional quality is an index of the extent to which instruction incorporates 4 practices of Gagne's conditions-based learning theory: presenting information, eliciting performance, providing feedback, and assessing learning. Twenty-five studies (3,286 participants) evaluating 47 instructional interventions were synthesized. The methodological quality of most studies was moderate. Instructional quality varied: All interventions presented information and assessed learning, but fewer than half elicited performances or provided feedback. Instructional interventions that incorporated all 4 components improved trainees' abilities considerably more than those that incorporated 3 or fewer; respectively, standardized mean difference (SMD) = 2.80, 95% confidence interval (CI) [2.05, 3.55], versus SMD = 1.44, 95% CI [1.18, 1.69]. Studies that compared "innovative" to "traditional" types of instruction did not yield a significant pooled effect: SMD = 0.18, 95% CI [-0.09, 0.45]. Insights: The use of a conditions-based learning theory to organize the comparative-effectiveness literature reveals differences in the instructional impact of different instructional approaches. It overturns the unlikely, but common, conclusion that all approaches are equally effective.

Safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings: A systematic review.

PubMed

Hignett, Sue; Edmunds Otter, Mary; Keen, Christine

2016-07-01

To explore the safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings. Seven-stage framework from the PRISMA statement for research question, eligibility (definition), search, identification of relevant papers from title and abstract, selection and retrieval of papers, appraisal and synthesis. British Nursing Index (BNI), Allied and Complementary Medicine Database (AMED), Applied Social Sciences Index and Abstracts (ASSIA), Cinahl, Cochrane Library, Embase, Ergonomics Abstracts, Health Business Elite, Health Management Information Consortium (HMIC), Medline, PsycInfo, Scopus, Social Care online, Social Science Citation Index. The included references (n=42) were critically appraised using a modified version of Downs and Black checklist and the Mixed Methods Appraisal Tool. The risk factors are reported using the modified model of human factors of health care in the home to represent the roles of both patients and caregivers in the system. The results are grouped as environment (health policy, physical and social), artefacts (equipment and technology), tasks (procedures and work schedules) and care recipient/provider. These include permanent and temporary building design and access, communication and lone working, provision of equipment and consumables, and clinical tasks. The topics with strong evidence from at least 2 papers relate to risks associated with awkward working positions, social environment issues (additional tasks and distractions), abuse and violence, inadequate team (peer) support, problems with workload planning, needle stick injuries and physical workload (moving and handling patients). As home care increases, there is a need to ensure the safety of both patients and caregivers with an understanding of the physical interactions and tasks to manage safety risks and plan safer care delivery systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

How Do We Value Postoperative Recovery?: A Systematic Review of the Measurement Properties of Patient-reported Outcomes After Abdominal Surgery.

PubMed

Fiore, Julio F; Figueiredo, Sabrina; Balvardi, Saba; Lee, Lawrence; Nauche, Bénédicte; Landry, Tara; Mayo, Nancy E; Feldman, Liane S

2018-04-01

To appraise the level of evidence supporting the measurement properties of patient-reported outcome measures (PROMs) in the context of postoperative recovery after abdominal surgery. There is growing interest in using PROMs to support value-based care in abdominal surgery; however, to draw valid conclusions regarding patient-reported outcomes data, PROMs with robust measurement properties are required. Eight databases (MEDLINE, EMBASE, Biosis, PsycINFO, The Cochrane Library, CINAHL, Scopus, Web of Science) were searched for studies focused on the measurement properties of PROMs in the context of recovery after abdominal surgery. The methodological quality of individual studies was evaluated using the consensus-based COSMIN checklist. Evidence supporting the measurement properties of each PROM was synthetized according to standardized criteria and compared against the International Society of Quality of Life Research minimum standards for the selection of PROMs for outcomes research. We identified 35 studies evaluating 22 PROMs [12 focused on nonspecific surgical populations (55%), 4 focused on abdominal surgery (18%), and 6 generic PROMs (27%)]. The great majority of the studies (74%) received only poor or fair quality ratings. Measurement properties of PROMs were predominantly supported by limited or unknown evidence. None of the PROMs fulfilled International Society of Quality of Life Research's minimum standards, hindering specific recommendations. There is very limited evidence supporting the measurement properties of existing PROMs used in the context of recovery after abdominal surgery. This precludes the use of these PROMs to support value-based surgical care. Further research is required to bridge this major knowledge gap. International Prospective Register of Systematic Reviews (PROSPERO): CRD42014014349.

Psychological and Physical Interventions for 
the Management of Cancer-Related Pain in Pediatric and Young Adult Patients: An Integrative Review.

PubMed

Jibb, Lindsay A; Nathan, Paul C; Stevens, Bonnie J; Seto, Emily; Cafazzo, Joseph A; Stephens, Nisha; Yohannes, Liza; Stinson, Jennifer N

2015-11-01

To identify and appraise current evidence related to the effectiveness of psychological and physical (nonpharmacologic) pain management modalities for children and young adults with cancer
. Electronic searches in MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science (from database inception to June 2013) for clinical trials. A total of 32 unique studies were identified. Substantial heterogeneity existed across identified studies, precluding meta-analysis. Therefore, a narrative review of included studies is presented. Studies featured psychological and/or physical pain interventions for children and young adults (N = 1,171) aged 1-21 years with a variety of cancer diagnoses. Interventions included aromatherapy, art therapy, distraction, hypnosis, physical activity, physical positioning, touch therapy, and multimodal cognitive-behavior therapy. Twenty-two studies (69%) reported success in preventing or reducing pain intensity. The level of evidence and methodologic quality of studies were generally low
. Current nonpharmacologic pain interventions for pediatric and young adult patients with cancer are diverse. Several modalities significantly decreased pain intensity, suggesting that these strategies may be effective methods of pain treatment, particularly in the case of painful medical procedures. Future well-designed, multicenter, randomized, controlled trials are needed to further discern treatment effects on pain and other health outcomes in this population and to compare the relative effectiveness of different modalities. Nurses play a key role in pain assessment and management in pediatric and young adult patients with cancer. The studies included in this review constitute the beginnings of an evidence base that supports the need to implement psychological and physical interventions to improve pain outcomes in pediatric and young adult patients with cancer.

Social capital interventions targeting older people and their impact on health: a systematic review.

PubMed

Coll-Planas, Laura; Nyqvist, Fredrica; Puig, Teresa; Urrútia, Gerard; Solà, Ivan; Monteserín, Rosa

2017-07-01

Observational studies show that social capital is a protective health factor. Therefore, we aim to assess the currently unclear health impact of social capital interventions targeting older adults. We conducted a systematic review based on a logic model. Studies published between January 1980 and July 2015 were retrieved from MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. We included randomised controlled trials targeting participants over 60 years old and focused on social capital or its components (eg, social support and social participation). The comparison group should not promote social capital. We assessed risk of bias and impact on health outcomes and use of health-related resources applying a procedure from the Canadian Agency for Drugs and Technologies in Health (CADTH) based on vote-counting and standardised decision rules. The review protocol was registered in PROSPERO (reference number CRD42014015362). We examined 17 341 abstracts and included 73 papers reporting 36 trials. Trials were clinically and methodologically diverse and reported positive effects in different contexts, populations and interventions across multiple subjective and objective measures. According to sufficiently reported outcomes, social capital interventions showed mixed effects on quality of life, well-being and self-perceived health and were generally ineffective on loneliness, mood and mortality. Eight trials with high quality showed favourable impacts on overall, mental and physical health, mortality and use of health-related resources. Our review highlights the lack of evidence and the diversity among trials, while supporting the potential of social capital interventions to reach comprehensive health effects in older adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis

PubMed Central

Nosè, Michela; Ballette, Francesca; Bighelli, Irene; Turrini, Giulia; Purgato, Marianna; Tol, Wietse; Priebe, Stefan; Barbui, Corrado

2017-01-01

Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future. PMID:28151992

Clinical and economic impact of non-adherence to antidepressants in major depressive disorder: A systematic review.

PubMed

Ho, Siew Ching; Chong, Huey Yi; Chaiyakunapruk, Nathorn; Tangiisuran, Balamurugan; Jacob, Sabrina Anne

2016-03-15

Medication non-adherence is one of the major challenges in treating patients with depression. This systematic review aims to determine the clinical and economic outcomes of non-adherence in depression. A systematic search was performed across the following databases: PubMed, EMBASE, DARE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews; from database inception to March 31, 2015. Studies must report on the association between adherence and outcomes, and English full texts needed to be available. The quality of each study was assessed using the Newcastle-Ottawa scale. A total of 11 articles were included, with eight reporting on clinical outcomes, two reporting on economic outcomes, and one reporting on both. The majority of studies were retrospective cohort studies. The mean quality of all included studies was 7, with a range from 3 to 9. Results clearly indicate that patients who were non-adherent were more likely to experience increased risks of relapse and/or recurrence, emergency department visits, and hospitalization rates; increased severity of depression, and a decrease in response and remission rates. The worsening of clinical outcomes in patients who were non-adherent subsequently translated to an increase in healthcare utilization and charges. No standardized adherence measurement tools were used, and few studies looked at the economic impact of non-adherence in depression. There is a strong association between non-adherence to antidepressants and a worsening of patients' clinical and economic outcomes. Cost-effective interventions should be directed to this group of patients to improve medication adherence. Copyright © 2015 Elsevier B.V. All rights reserved.

Maths anxiety and medication dosage calculation errors: A scoping review.

PubMed

Williams, Brett; Davis, Samantha

2016-09-01

A student's accuracy on drug calculation tests may be influenced by maths anxiety, which can impede one's ability to understand and complete mathematic problems. It is important for healthcare students to overcome this barrier when calculating drug dosages in order to avoid administering the incorrect dose to a patient when in the clinical setting. The aim of this study was to examine the effects of maths anxiety on healthcare students' ability to accurately calculate drug dosages by performing a scoping review of the existing literature. This review utilised a six-stage methodology using the following databases; CINAHL, Embase, Medline, Scopus, PsycINFO, Google Scholar, Trip database (http://www.tripdatabase.com/) and Grey Literature report (http://www.greylit.org/). After an initial title/abstract review of relevant papers, and then full text review of the remaining papers, six articles were selected for inclusion in this study. Of the six articles included, there were three experimental studies, two quantitative studies and one mixed method study. All studies addressed nursing students and the presence of maths anxiety. No relevant studies from other disciplines were identified in the existing literature. Three studies took place in the U.S, the remainder in Canada, Australia and United Kingdom. Upon analysis of these studies, four factors including maths anxiety were identified as having an influence on a student's drug dosage calculation abilities. Ultimately, the results from this review suggest more research is required in nursing and other relevant healthcare disciplines regarding the effects of maths anxiety on drug dosage calculations. This additional knowledge will be important to further inform development of strategies to decrease the potentially serious effects of errors in drug dosage calculation to patient safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

A systematic review of interventions for children with cerebral palsy: state of the evidence.

PubMed

Novak, Iona; McIntyre, Sarah; Morgan, Catherine; Campbell, Lanie; Dark, Leigha; Morton, Natalie; Stumbles, Elise; Wilson, Salli-Ann; Goldsmith, Shona

2013-10-01

The aim of this study was to describe systematically the best available intervention evidence for children with cerebral palsy (CP). This study was a systematic review of systematic reviews. The following databases were searched: CINAHL, Cochrane Library, DARE, EMBASE, Google Scholar MEDLINE, OTSeeker, PEDro, PsycBITE, PsycINFO, and speechBITE. Two independent reviewers determined whether studies met the inclusion criteria. These were that (1) the study was a systematic review or the next best available; (2) it was a medical/allied health intervention; and (3) that more than 25% of participants were children with CP. Interventions were coded using the Oxford Levels of Evidence; GRADE; Evidence Alert Traffic Light; and the International Classification of Function, Disability and Health. Overall, 166 articles met the inclusion criteria (74% systematic reviews) across 64 discrete interventions seeking 131 outcomes. Of the outcomes assessed, 16% (21 out of 131) were graded 'do it' (green go); 58% (76 out of 131) 'probably do it' (yellow measure); 20% (26 out of 131) 'probably do not do it' (yellow measure); and 6% (8 out of 131) 'do not do it' (red stop). Green interventions included anticonvulsants, bimanual training, botulinum toxin, bisphosphonates, casting, constraint-induced movement therapy, context-focused therapy, diazepam, fitness training, goal-directed training, hip surveillance, home programmes, occupational therapy after botulinum toxin, pressure care, and selective dorsal rhizotomy. Most (70%) evidence for intervention was lower level (yellow) while 6% was ineffective (red). Evidence supports 15 green light interventions. All yellow light interventions should be accompanied by a sensitive outcome measure to monitor progress and red light interventions should be discontinued since alternatives exist. © 2013 Mac Keith Press.

Exploring the relationship between cognitive illness representations and poor emotional health and their combined association with diabetes self-care. A systematic review with meta-analysis.

PubMed

Hudson, Joanna L; Bundy, Chris; Coventry, Peter A; Dickens, Chris

2014-04-01

Depression and anxiety are common in diabetes and are associated with lower diabetes self-care adherence. How this occurs is unclear. Our systematic review explored the relationship between cognitive illness representations and poor emotional health and their combined association with diabetes self-care. Medline, Psycinfo, EMBASE, and CINAHL were searched from inception to June 2013. Data on associations between cognitive illness representations, poor emotional health, and diabetes self-care were extracted. Random effects meta-analysis was used to test the relationship between cognitive illness representations and poor emotional health. Their combined effect on diabetes self-care was narratively evaluated. Nine cross-sectional studies were included. Increased timeline cyclical, consequences, and seriousness beliefs were associated with poorer emotional health symptoms. Lower perceived personal control was associated with increased depression and anxiety, but not mixed anxiety and depressive symptoms. Remaining cognitive illness representation domains had mixed statistically significant and non-significant relationships across emotional states or were measured only once. Effect sizes ranged from small to large (r=±0.20 to 0.51). Two studies explored the combined effects of cognitions and emotions on diabetes self-care. Both showed that cognitive illness representations have an independent effect on diabetes self-care, but only one study found that depression has an independent effect also. Associations between cognitive illness representations and poor emotional health were in the expected direction - negative diabetes perceptions were associated with poorer emotional health. Few studies examined the relative effects of cognitions and emotions on diabetes self-care. Longitudinal studies are needed to clarify directional pathways. Copyright © 2014 Elsevier Inc. All rights reserved.

Primary prevention of cannabis use: a systematic review of randomized controlled trials.

PubMed

Norberg, Melissa M; Kezelman, Sarah; Lim-Howe, Nicholas

2013-01-01

A systematic review of primary prevention was conducted for cannabis use outcomes in youth and young adults. The aim of the review was to develop a comprehensive understanding of prevention programming by assessing universal, targeted, uni-modal, and multi-modal approaches as well as individual program characteristics. Twenty-eight articles, representing 25 unique studies, identified from eight electronic databases (EMBASE, MEDLINE, CINAHL, ERIC, PsycINFO, DRUG, EBM Reviews, and Project CORK), were eligible for inclusion. Results indicated that primary prevention programs can be effective in reducing cannabis use in youth populations, with statistically significant effect sizes ranging from trivial (0.07) to extremely large (5.26), with the majority of significant effect sizes being trivial to small. Given that the preponderance of significant effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent across program type and individual components, the effectiveness of primary prevention for cannabis use should be interpreted with caution. Universal multi-modal programs appeared to outperform other program types (i.e, universal uni-modal, targeted multi-modal, targeted unimodal). Specifically, universal multi-modal programs that targeted early adolescents (10-13 year olds), utilised non-teacher or multiple facilitators, were short in duration (10 sessions or less), and implemented boosters sessions were associated with large median effect sizes. While there were studies in these areas that contradicted these results, the results highlight the importance of assessing the interdependent relationship of program components and program types. Finally, results indicated that the overall quality of included studies was poor, with an average quality rating of 4.64 out of 9. Thus, further quality research and reporting and the development of new innovative programs are required.

Primary Prevention of Cannabis Use: A Systematic Review of Randomized Controlled Trials

PubMed Central

Norberg, Melissa M.; Kezelman, Sarah; Lim-Howe, Nicholas

2013-01-01

A systematic review of primary prevention was conducted for cannabis use outcomes in youth and young adults. The aim of the review was to develop a comprehensive understanding of prevention programming by assessing universal, targeted, uni-modal, and multi-modal approaches as well as individual program characteristics. Twenty-eight articles, representing 25 unique studies, identified from eight electronic databases (EMBASE, MEDLINE, CINAHL, ERIC, PsycINFO, DRUG, EBM Reviews, and Project CORK), were eligible for inclusion. Results indicated that primary prevention programs can be effective in reducing cannabis use in youth populations, with statistically significant effect sizes ranging from trivial (0.07) to extremely large (5.26), with the majority of significant effect sizes being trivial to small. Given that the preponderance of significant effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent across program type and individual components, the effectiveness of primary prevention for cannabis use should be interpreted with caution. Universal multi-modal programs appeared to outperform other program types (i.e, universal uni-modal, targeted multi-modal, targeted unimodal). Specifically, universal multi-modal programs that targeted early adolescents (10–13 year olds), utilised non-teacher or multiple facilitators, were short in duration (10 sessions or less), and implemented boosters sessions were associated with large median effect sizes. While there were studies in these areas that contradicted these results, the results highlight the importance of assessing the interdependent relationship of program components and program types. Finally, results indicated that the overall quality of included studies was poor, with an average quality rating of 4.64 out of 9. Thus, further quality research and reporting and the development of new innovative programs are required. PMID:23326396

Measurement tools of resource use and quality of life in clinical trials for dementia or cognitive impairment interventions: protocol for a scoping review.

PubMed

Yang, Fan; Dawes, Piers; Leroi, Iracema; Gannon, Brenda

2017-01-26

Dementia and cognitive impairment could severely impact patients' life and bring heavy burden to patients, caregivers and societies. Some interventions are suggested for the older patients with these conditions to help them live well, but economic evaluation is needed to assess the cost-effectiveness of these interventions. Trial-based economic evaluation is an ideal method; however, little is known about the tools used to collect data of resource use and quality of life alongside the trials. Therefore, the aim of this review is to identify and describe the resource use and quality of life instruments in clinical trials of interventions for older patients with dementia or cognitive impairment. We will perform a search in main electronic databases (Ovid MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Databases of Systematic Reviews, Web of Science and Scopus) using the key terms or their synonyms: older, dementia, cognitive impairment, cost, quality of life, intervention and tools. After removing duplicates, two independent reviewers will screen each entry for eligibility, initially by title and abstract, then by full-text. A hand search of the references of included articles and general search, e.g. Google Scholar, will also be conducted to identify potential relevant studies. All disagreements will be resolved by discussion or consultation with a third reviewer if necessary. Data analysis will be completed and reported in a narrative review. This review will identify the instruments used in clinical trials to collect resource use and quality of life data for dementia or cognitive impairment interventions. This will help to guide the study design of future trial-based economic evaluation of these interventions. PROSPERO CRD42016038495.

The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

PubMed

Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

2018-03-01

Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

The relationship between empathy and burnout – lessons for paramedics: a scoping review

PubMed Central

Williams, Brett; Lau, Rosalind; Thornton, Emma; Olney, Lauren S

2017-01-01

Background The concepts of empathy and burnout are critical for practicing paramedics and the profession. While there has been an increasing body of research on the relationship between empathy and burnout with physicians and nurses, surprisingly, no research has been undertaken with paramedics. The aim of this scoping review was to explore the relationship between empathy and burnout. Method A scoping review was performed based on Arskey and O’Malley’s framework. Five databases were searched: CINAHL plus, EMBASE, MEDLINE, PsycINFO, and Scopus. Google Scholar was searched for gray literature. Two reviewers independently assessed eligibility and extracted the data. Results The initial search produced a yield of 1270 articles after removal of duplicates. All abstracts were screened for relevance, and 30 articles were selected for further screening. Twenty six articles were deemed relevant, of which there were 23 cross-sectional studies, two editorials, and one description article on the multidimensional aspect of burnout and empathy. The studies were conducted in Europe, USA, North America, and Asia. In most studies, there was an inverse correlation between empathy and emotional exhaustion and depersonalization but a positive correlation with personal accomplishment. Conclusion Although there seems to be a real relationship between empathy and burnout in physicians and nurses, the strength of the relationship differs to some extent depending on the samples and settings. Due to similarities between health professions, the relationship between empathy and burnout may also be relevant to the paramedic profession. Future paramedic research should focus on longitudinal studies to determine the factors that might influence empathy and burnout levels to provide a better understanding of these two key factors. PMID:29225482

Interventions to reduce sedentary behaviour in 0–5-year-olds: a systematic review and meta-analysis of randomised controlled trials

PubMed Central

Downing, Katherine L; Hnatiuk, Jill A; Hinkley, Trina; Salmon, Jo; Hesketh, Kylie D

2018-01-01

Aim or objective To evaluate the effectiveness of behavioural interventions that report sedentary behaviour outcomes during early childhood. Design Systematic review and meta-analysis. Data sources Academic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with Full Text and EMBASE electronic databases were searched in March 2016. Eligibility criteria for selecting studies Inclusion criteria were: (1) published in a peer-reviewed English language journal; (2) sedentary behaviour outcomes reported; (3) randomised controlled trial (RCT) study design; and (4) participants were children with a mean age of ≤5.9 years and not yet attending primary/elementary school at postintervention. Results 31 studies were included in the systematic review and 17 studies in the meta-analysis. The overall mean difference in screen time outcomes between groups was −17.12 (95% CI −28.82 to −5.42) min/day with a significant overall intervention effect (Z=2.87, p=0.004). The overall mean difference in sedentary time between groups was −18.91 (95% CI −33.31 to −4.51) min/day with a significant overall intervention effect (Z=2.57, p=0.01). Subgroup analyses suggest that for screen time, interventions of ≥6 months duration and those conducted in a community-based setting are most effective. For sedentary time, interventions targeting physical activity (and reporting changes in sedentary time) are more effective than those directly targeting sedentary time. Summary/conclusions Despite heterogeneity in study methods and results, overall interventions to reduce sedentary behaviour in early childhood show significant reductions, suggesting that this may be an opportune time to intervene. Trial registration number CRD42015017090. PMID:29449219

Patient Information Needs and Breast Reconstruction After Mastectomy: A Qualitative Meta-Synthesis.

PubMed

Carr, Tracey L; Groot, Gary; Cochran, David; Holtslander, Lorraine

2018-04-27

Although many women benefit from breast reconstruction after mastectomy, several studies report women's dissatisfaction with the level of information they were provided with before reconstruction. The present meta-synthesis examines the qualitative literature that explores women's experiences of breast reconstruction after mastectomy and highlights women's healthcare information needs. After a comprehensive search of 6 electronic databases (CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Scopus), we followed the methodology for synthesizing qualitative research. The search produced 423 studies, which were assessed against 5 inclusion criteria. A meta-synthesis methodology was used to analyze the data through taxonomic classification and constant targeted comparison. Some 17 studies met the inclusion criteria, and findings from 16 studies were synthesized. The role of the healthcare practitioner is noted as a major influence on women's expectations, and in some instances, women did not feel adequately informed about the outcomes of surgery and the recovery process. In general, women's desire for normality and effective emotional coping shapes their information needs. The information needs of women are better understood after considering women's actual experiences with breast reconstruction. It is important to inform women of the immediate outcomes of reconstruction surgery and the recovery process. In an attempt to better address women's information needs, healthcare practitioners should discover women's initial expectations of reconstruction as a starting point in the consultation. In addition, the research revealed the importance of the nurse navigator in terms of assisting women through the recovery process.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Advance care planning, palliative care, and end-of-life care interventions for homeless people: A systematic review.

PubMed

Sumalinog, Rafael; Harrington, Katy; Dosani, Naheed; Hwang, Stephen W

2017-02-01

Homeless individuals have a high prevalence of multiple chronic comorbidities and early mortality compared to the general population. They also experience significant barriers to access and stigmatization in the healthcare system. Providing advance care planning, palliative care, and end-of-life care for this underserved population is an important health issue. To summarize and evaluate the evidence surrounding advance care planning, palliative care, and end-of-life care interventions for homeless persons. A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles from MEDLINE, EMBASE, CINAHL, PsycINFO, Social Work Abstracts, Cochrane Library, Web of Science, and PubMed databases were searched through 13 June 2015. Peer-reviewed studies that implemented advance care planning, palliative care, and end-of-life care interventions for homeless populations were included. Data from studies were independently extracted by two investigators using pre-specified criteria, and quality was assessed using modified Cochrane and Critical Appraisal Skills Programme tools. Six articles met inclusion criteria. Two studies were randomized controlled trials involving advance directive completion. Two cohort studies investigated the costs of a shelter-based palliative care intervention and predictors for completing advance directives. These studies were rated low to fair quality. Two qualitative studies explored the interface between harm-reduction services and end-of-life care and the conditions for providing palliative care for homeless persons in a support home. The effectiveness of advance care planning, palliative care, and end-of-life care interventions for homeless individuals is uncertain. High-quality studies of interventions that reflect the unique and complex circumstances of homeless populations and investigate patient-related outcomes, caregiver burden, and cost-effectiveness are needed.

Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review.

PubMed

Benyon, Kay; Hill, Susan; Zadurian, Natalie; Mallen, Christian

2010-12-01

 Systematically to review the literature, investigating the prognostic value of self-efficacy and coping strategies used by adults with osteoarthritis (OA) recruited within the community or primary care.  An online electronic search was performed from inception to August 2009, using EMBASE, CINAHL, PsycINFO and MEDLINE databases. A search of keywords and key authors was performed to find related articles, and experts in the field were contacted to identify additional literature. Three reviewers blindly assessed the quality of the included studies, using pre-determined criteria. Data on coping strategies and self-efficacy were extracted and tabulated.  Eight studies were identified and included in this review. Six of the papers were rated as being of acceptable methodological quality. Strong evidence was identified for the role of self-efficacy in predicting disability, but no evidence was found for the relationship between self-efficacy and pain. Although problem-solving coping had no effect on pain, there was weak evidence that active coping strategies predict increased pain and worsened mood. There was also weak evidence demonstrating that problem avoidance, wishful thinking, social withdrawal, self-criticism and turning to religion are predictors of depressed mood. This review also presents evidence for catastrophizing, self-efficacy and passive coping strategies as predictors of mood.  Coping strategies and self-efficacy are important prognostic factors for people with OA. This review highlights the need for further research to ascertain the predictive values of coping strategies that, to date, have been less well investigated. This may, in turn, result in a better understanding of the role of coping in OA and enable clinicians and patients to manage the condition more effectively. Copyright © 2010 John Wiley & Sons, Ltd.

Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis.

PubMed

Nosè, Michela; Ballette, Francesca; Bighelli, Irene; Turrini, Giulia; Purgato, Marianna; Tol, Wietse; Priebe, Stefan; Barbui, Corrado

2017-01-01

Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future.

A systematic review of midwife-led interventions to address post partum post-traumatic stress.

PubMed

Borg Cunen, Nicole; McNeill, Jenny; Murray, Karen

2014-02-01

to systematically identify interventions that midwives could introduce to address post-traumatic stress in women following childbirth. a search strategy was developed and relevant papers were identified from databases including Cinahl, Cochrane Library, EMBASE, Maternity and Infant Care, MEDLINE, PsycINFO, and Web of Science. Key search terms used were post-traumatic stress, post partum, intervention, controlled trial and review. Papers eligible for inclusion were primary studies and reviews of research published from 2002-2012, focusing on interventions which could be implemented by midwives for the prevention and/or management of PTSD. For primary studies, RCTs, controlled clinical trials, and cohort studies with a control group were eligible. Eligible reviews were those with a specified search strategy and inclusion/exclusion criteria. Methodological quality was assessed using recognised frameworks. six primary studies and eight reviews were eligible for inclusion. The majority of included studies or reviews focused on debriefing and/or counselling interventions; however the results were not consistent due to significant variation in methodological quality and use of dissimilar interventions. Two of the reviews considered the general management of post partum PTSD and one broadly covered anxiety during pregnancy and the post partum, incorporating a section on PTSD. The majority of women reported that the opportunity to discuss their childbirth experience was subjectively beneficial. no evidence-based midwifery interventions were identified from this systematic review that can be recommended for introduction into practice to address PTSD. It is recommended that future research in this area should incorporate standardised interventions with similar outcome measures to facilitate synthesis of results. Further research on interventions used in non-maternity populations is needed in order to confirm their usefulness in addressing post partum PTSD. © 2013 Elsevier Ltd. All rights reserved.

Interventions to prevent post-traumatic stress disorder: a systematic review.

PubMed

Forneris, Catherine A; Gartlehner, Gerald; Brownley, Kimberly A; Gaynes, Bradley N; Sonis, Jeffrey; Coker-Schwimmer, Emmanuel; Jonas, Daniel E; Greenblatt, Amy; Wilkins, Tania M; Woodell, Carol L; Lohr, Kathleen N

2013-06-01

Traumatic events are prevalent worldwide; trauma victims seek help in numerous clinical and emergency settings. Using effective interventions to prevent post-traumatic stress disorder (PTSD) is increasingly important. This review assessed the efficacy, comparative effectiveness, and harms of psychological, pharmacologic, and emerging interventions to prevent PTSD. The following sources were searched for research on interventions to be included in the review: MEDLINE; Cochrane Library; CINAHL; EMBASE; PILOTS (Published International Literature on Traumatic Stress); International Pharmaceutical Abstracts; PsycINFO; Web of Science; reference lists of published literature; and unpublished literature (January 1, 1980 to July 30, 2012). Two reviewers independently selected studies, extracted data or checked accuracy, assessed study risk of bias, and graded strength of evidence. All data synthesis occurred between January and September 2012. Nineteen studies covered various populations, traumas, and interventions. In meta-analyses of three trials (from the same team) for people with acute stress disorder, brief trauma-focused cognitive behavioral therapy was more effective than supportive counseling in reducing the severity of PTSD symptoms (moderate-strength); these two interventions had similar results for incidence of PTSD (low-strength); depression severity (low-strength); and anxiety severity (moderate-strength). PTSD symptom severity after injury decreased more with collaborative care than usual care (single study; low-strength). Debriefing did not reduce incidence or severity of PTSD or psychological symptoms in civilian traumas (low-strength). Evidence about relevant outcomes was unavailable for many interventions or was insufficient owing to methodologic shortcomings. Evidence is very limited regarding best practices to treat trauma-exposed individuals. Brief cognitive behavioral therapy may reduce PTSD symptom severity in people with acute stress disorder; collaborative care may help decrease symptom severity post-injury. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Medication adherence in the management of nocturia: challenges and solutions

PubMed Central

Jayadevappa, Ravishankar; Newman, Diane K; Chhatre, Sumedha; Wein, Alan J

2015-01-01

Objective Nocturia affects millions of men and women. No prior reviews or meta-analyses have explored the issue of adherence in nocturia patients. The objective of our study was to examine the attributes and their interaction that might impact pharmacological adherence in nocturia care using a conceptual model of adherence. Materials and methods A literature search of the Medline, PubMed, Embase, PsycInfo, and CINAHL databases for studies published between January 1990 and June 2014 was conducted. We developed a conceptual model in order to facilitate our review. Results Currently, multiple treatment options for nocturia exist, depending on the underlying cause. Adherence to nocturia treatment and outcomes are complex and intertwined, and nonadherence to nocturia treatment is common. In 15 studies meeting eligibility criteria, behavioral and pharmacologic interventions for nocturia were associated with reduced nocturia symptoms. Urinary symptoms that are associated with nocturia need individualized management depending on renal and hepatic function, medical comorbidities, and ongoing medication use in a patient. Another important factor related to adherence is the bother. Although nocturia is defined as nighttime-voiding frequency of one or more, not all persons may find this bothersome. The degree of bother is subjective, and may change from person to person. However, there is no information related to the association between bother and adherence to medication or behavioral treatments for nocturia. Medication dosing convenience, preference, and cost play important roles in adherence. We present a patient-centered conceptual model that brings together the various dimensions of medication adherence for nocturia. Conclusion Few studies have explored adherence to medication and related factors in the care of nocturia. Our conceptual model can aid development of interventions to improve adherence to nocturia medications. PMID:25609929

Mindfulness for palliative care patients. Systematic review.

PubMed

Latorraca, Carolina de Oliveira Cruz; Martimbianco, Ana Luiza Cabrera; Pachito, Daniela Vianna; Pacheco, Rafael Leite; Riera, Rachel

2017-12-01

Nineteen million adults worldwide are in need of palliative care. Of those who have access to it, 80% fail to receive an efficient management of symptoms. To assess the effectiveness and safety of mindfulness meditation for palliative care patients. We searched CENTRAL, MEDLINE, Embase, LILACS, PEDro, CINAHL, PsycINFO, Opengrey, ClinicalTrials.gov and WHO-ICTRP. No restriction of language, status or date of publication was applied. We considered randomised clinical trials (RCTs) comparing any mindfulness meditation scheme vs any comparator for palliative care. Cochrane Risk of Bias (Rob) Table was used for assessing methodological quality of RCTs. Screening, data extraction and methodological assessments were performed by two reviewers. Mean differences (MD) (confidence intervals of 95% (CI 95%)) were considered for estimating effect size. Quality of evidence was appraised by GRADE. Four RCTs, 234 participants, were included. All studies presented high risk of bias in at least one RoB table criteria. We assessed 4 comparisons, but only 2 studies showed statistically significant difference for at least one outcome. 1. Mindfulness meditation (eight weeks, one session/week, daily individual practice) vs control: statistically significant difference in favour of control for quality of life - physical aspects. 2. Mindfulness meditation (single 5-minute session) vs control: benefit in favour of mindfulness for stress outcome in both time-points. None of the included studies analysed safety and harms outcomes. Although two studies have showed statistically significant difference, only one showed effectiveness of mindfulness meditation in improving perceived stress. This study focused on one single session of mindfulness of 5 minutes for adult cancer patients in palliative care, but it was considered as possessing high risk of bias. Other schemes of mindfulness meditation did not show benefit in any outcome evaluated (low and very low quality evidence). © 2017 John Wiley & Sons Ltd.

Incentivizing health care behaviors in emerging adults: a systematic review

PubMed Central

Yu, Catherine H; Guarna, Giuliana; Tsao, Pamela; Jesuthasan, Jude R; Lau, Adrian NC; Siddiqi, Ferhan S; Gilmour, Julie Anne; Ladha, Danyal; Halapy, Henry; Advani, Andrew

2016-01-01

Purpose For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases. Methods The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years) with chronic medical conditions including addictions, were included. Results A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated. Conclusion While the majority of studies reported positive outcomes, these studies focused on promoting the cessation of adverse behaviors rather than promoting positive behaviors. In addition, conclusions were limited by the high risk of bias present in the majority of studies, as well as lack of follow-up after the incentive period. Whether behavioral incentives facilitate the adoption of positive health choices in this population remains to be determined. PMID:27069356

Adherence and Persistence Among Statin Users Aged 65 Years and Over: A Systematic Review and Meta-analysis.

PubMed

Ofori-Asenso, Richard; Jakhu, Avtar; Zomer, Ella; Curtis, Andrea J; Korhonen, Maarit Jaana; Nelson, Mark; Gambhir, Manoj; Tonkin, Andrew; Liew, Danny; Zoungas, Sophia

2018-05-09

Older people (aged ≥ 65 years) have distinctive challenges with medication adherence. However, adherence and persistence patterns among older statin users have not been comprehensively reviewed. As part of a broader systematic review, we searched Medline, Embase, PsycINFO, CINAHL, Database of Abstracts of Reviews of Effects, CENTRAL, and the National Health Service Economic Evaluation Database through December 2016 for English articles reporting adherence and/or persistence among older statin users. Data were analyzed via descriptive methods and meta-analysis using random-effect modeling. Data from more than 3 million older statin users in 82 studies conducted in over 40 countries were analyzed. At 1-year follow-up, 59.7% (primary prevention 47.9%; secondary prevention 62.3%) of users were adherent (medication possession ratio [MPR] or proportion of days covered [PDC] ≥ 80%). For both primary and secondary prevention subjects, 1-year adherence was worse among individuals aged more than 75 years than those aged 65-75 years. At 3 and ≥10 years, 55.3% and 28.4% of users were adherent, respectively. The proportion of users persistent at 1-year was 76.7% (primary prevention 76.0%; secondary prevention 82.6%). Additionally, 68.1% and 61.2% of users were persistent at 2 and 4 years, respectively. Among new statin users, 48.2% were nonadherent and 23.9% discontinued within the first year. The proportion of statin users who were adherent based on self-report was 85.5%. There is poor short and long term adherence and persistence among older statin users. Strategies to improve adherence and reduce discontinuation are needed if the intended cardiovascular benefits of statin treatment are to be realized.

Psychosocial stimulation interventions for children with severe acute malnutrition: a systematic review

PubMed Central

Daniel, Allison I; Bandsma, Robert H; Lytvyn, Lyubov; Voskuijl, Wieger P; Potani, Isabel; van den Heuvel, Meta

2017-01-01

Background The WHO Guidelines for the inpatient treatment of severely malnourished children include a recommendation to provide sensory stimulation or play therapy for children with severe acute malnutrition (SAM). This systematic review was performed to synthesize evidence around this recommendation. Specifically, the objective was to answer the question: “In children with severe acute malnutrition, does psychosocial stimulation improve child developmental, nutritional, or other outcomes?” Methods A review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO 2016: CRD42016036403). MEDLINE, Embase, CINAHL, and PsycINFO were searched with terms related to SAM and psychosocial stimulation. Studies were selected if they applied a stimulation intervention in children with SAM and child developmental and nutritional outcomes were assessed. Findings were presented within a narrative synthesis and a summary of findings table. Quality of the evidence was evaluated using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Findings Only two studies, both non–randomized controlled trials, met the selection criteria for this review. One was conducted in Jamaica (1975) with a follow–up period of 14 years; the other was done in Bangladesh (2002) with a six–month follow–up. At the individual study level, each of the included studies demonstrated significant differences in child development outcomes between intervention and control groups. Only the study conducted in Bangladesh demonstrated a clinically significant increase in weight–for–age z–scores in the intervention group compared to the control group. Conclusions The evidence supporting the recommendation of psychosocial stimulation for children with SAM is not only sparse, but also of very low quality across important outcomes. High–quality trials are needed to determine the effects of psychosocial stimulation interventions on outcomes in children with SAM. PMID:28567278

Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series.

PubMed

Abraha, Iosief; Rimland, Joseph M; Trotta, Fabiana Mirella; Dell'Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Petrovic, Mirko; Gudmundsson, Adalsteinn; Soiza, Roy; O'Mahony, Denis; Guaita, Antonio; Cherubini, Antonio

2017-03-16

To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Systematic overview of reviews. PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015). Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs. Extracted data were synthesised using a narrative approach. 38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Virtual Reality Therapy for Adults Post-Stroke: A Systematic Review and Meta-Analysis Exploring Virtual Environments and Commercial Games in Therapy

PubMed Central

Lohse, Keith R.; Hilderman, Courtney G. E.; Cheung, Katharine L.; Tatla, Sandy; Van der Loos, H. F. Machiel

2014-01-01

Background The objective of this analysis was to systematically review the evidence for virtual reality (VR) therapy in an adult post-stroke population in both custom built virtual environments (VE) and commercially available gaming systems (CG). Methods MEDLINE, CINAHL, EMBASE, ERIC, PSYCInfo, DARE, PEDro, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews were systematically searched from the earliest available date until April 4, 2013. Controlled trials that compared VR to conventional therapy were included. Population criteria included adults (>18) post-stroke, excluding children, cerebral palsy, and other neurological disorders. Included studies were reported in English. Quality of studies was assessed with the Physiotherapy Evidence Database Scale (PEDro). Results Twenty-six studies met the inclusion criteria. For body function outcomes, there was a significant benefit of VR therapy compared to conventional therapy controls, G = 0.48, 95% CI = [0.27, 0.70], and no significant difference between VE and CG interventions (P = 0.38). For activity outcomes, there was a significant benefit of VR therapy, G = 0.58, 95% CI = [0.32, 0.85], and no significant difference between VE and CG interventions (P = 0.66). For participation outcomes, the overall effect size was G = 0.56, 95% CI = [0.02, 1.10]. All participation outcomes came from VE studies. Discussion VR rehabilitation moderately improves outcomes compared to conventional therapy in adults post-stroke. Current CG interventions have been too few and too small to assess potential benefits of CG. Future research in this area should aim to clearly define conventional therapy, report on participation measures, consider motivational components of therapy, and investigate commercially available systems in larger RCTs. Trial Registration Prospero CRD42013004338 PMID:24681826

Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models.

PubMed

Lotfi, Tamara; Bou-Karroum, Lama; Darzi, Andrea; Hajjar, Rayan; El Rahyel, Ahmed; El Eid, Jamale; Itani, Mira; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; El-Jardali, Fadi; Akl, Elie

2016-08-03

Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the "Cluster Approach" (with 16 case studies), the 4Ws "Who is Where, When, doing What" mapping tool (with four case studies), the "Sphere Project" (with two case studies), the "5x5" model (with one case study), and the "model of information coordination" (with one case study). The 4Ws and the 5x5 focus on coordination of services for mental health, the remaining models do not focus on a specific health topic. The Cluster approach appears to be the most widely used. One case study was a mixed implementation of the Cluster approach and the Sphere model. We identified no model of coordination for funding of health service. This systematic review identified five proposed coordination models that have been implemented by entities funding or delivering health service in humanitarian crises. There is a need to compare the effect of these different models on outcomes such as availability of and access to health services.

Bringing antiretroviral therapy (ART) closer to the end-user through mobile clinics and home-based ART: systematic review shows more evidence on the effectiveness and cost effectiveness is needed.

PubMed

Mdege, Noreen Dadirai; Chindove, Stanley

2014-01-01

Home-based antiretroviral therapy (ART) and ART through mobile clinics can potentially increase access to ART for large numbers of people, including hard-to-reach populations. We reviewed literature on the effectiveness and cost implications of the home-based ART and mobile clinic ART models. We searched Medline, Embase, PsycInfo, CINAHL, Cochrane Library, Web of Knowledge and Current Controlled Trials Register for articles published up to March 2012. We included non-randomised and randomised controlled clinical trials that recruited HIV/AIDS positive adults with or without prior exposure to ART. Six studies were included in the review, with only four effectiveness studies (all evaluating home-based ART and none for mobile clinic ART) and four studies reporting on the cost implications. The evidence suggests home-based ART is as effective as health facility-based ART, including on clinical outcomes, viral load and CD4+ count. However, three of these studies were very small. Studies suggest health facility-based ART is the most cost-effective, followed by mobile-clinic ART, with home-based ART being the least cost-effective. Evidence on the effectiveness and cost implications of mobile clinic and home-based ART is currently limited. Although the few available studies suggest home-based ART can potentially be as effective as health facility-based ART, there is need for more research before robust conclusions can be made. Results from the few available studies also suggest that health facility-based ART is the most cost-effective. Copyright © 2013 John Wiley & Sons, Ltd.

Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review.

PubMed

Boerleider, Agatha W; Wiegers, Therese A; Manniën, Judith; Francke, Anneke L; Devillé, Walter L J M

2013-03-27

Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a systematic review of factors affecting non-western women's use of prenatal care (both medical care and prenatal classes) in industrialized western countries. Eleven databases (PubMed, Embase, PsycINFO, Cochrane, Sociological Abstracts, Web of Science, Women's Studies International, MIDIRS, CINAHL, Scopus and the NIVEL catalogue) were searched for relevant peer-reviewed articles from between 1995 and July 2012. Qualitative as well as quantitative studies were included. Quality was assessed using the Mixed Methods Appraisal Tool. Factors identified were classified as impeding or facilitating, and categorized according to a conceptual framework, an elaborated version of Andersen's healthcare utilization model. Sixteen articles provided relevant factors that were all categorized. A number of factors (migration, culture, position in host country, social network, expertise of the care provider and personal treatment and communication) were found to include both facilitating and impeding factors for non-western women's utilization of prenatal care. The category demographic, genetic and pregnancy characteristics and the category accessibility of care only included impeding factors.Lack of knowledge of the western healthcare system and poor language proficiency were the most frequently reported impeding factors. Provision of information and care in women's native languages was the most frequently reported facilitating factor. The factors found in this review provide specific indications for identifying non-western women who are at risk of not using prenatal care adequately and for developing interventions and appropriate policy aimed at improving their prenatal care utilization.

Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review

PubMed Central

2014-01-01

Background The purpose of this systematic review is to assess the effectiveness of brief interventions (BIs) as part of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances. Methods Bibliographic databases (including MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO to April 2012) and gray literature sources were searched. We included randomized controlled trials that opportunistically screened adolescents or adults and then provided a one-to-one, verbal BI to those at risk of substance-use harm. Of interest was the nonmedical use of psychoactive substances (for example, drugs prohibited by international law), excluding alcohol, nicotine, and caffeine. Interventions comprised four or fewer sessions and were compared with no/delayed intervention or provision of information only. Studies were assessed for bias using the Cochrane risk of bias tool. Results were synthesized narratively. Evidence was interpreted according to the GRADE framework. Results We identified 8,836 records. Of these, five studies met our inclusion criteria. Two studies compared BI with no BI, and three studies compared BI with information only. Studies varied in characteristics such as substances targeted, screening procedures, and BI administered. Outcomes were mostly reported by a single study, leading to limited or uncertain confidence in effect estimates. Conclusions Insufficient evidence exists as to whether BIs, as part of SBIRT, are effective or ineffective for reducing the use of, or harms associated with nonmedical use of, psychoactive substances when these interventions are administered to nontreatment-seeking, screen-detected populations. Updating this review with emerging evidence will be important. Trial registration CRD42012002414 PMID:24887418

Phthalate exposure and childrens neurodevelopment: A systematic review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ejaredar, Maede, E-mail: mejareda@ucalgary.ca; Nyanza, Elias C.; Ten Eycke, Kayla

Background: Emerging evidence from observational studies suggests that prenatal exposure to phthalates affects neurodevelopment in children. Objective: To conduct a systematic review of the existing literature on the association between urinary phthalate concentrations and children's neurodevelopment. Methods: We searched electronic bibliographic databases (MEDLINE, PubMed, EMBASE, PsycINFO, CINAHL, Global Health, CAB abstracts, and ERIC) (1910 to February 21st, 2014); reference lists of included articles, and conference abstracts (American Psychiatric Association, American Academy of Neurology, and Pediatric Academic Societies). Two independent reviewers screened abstracts and extracted data. We included original studies reporting on the association between prenatal or childhood urinary phthalate metabolites,more » and cognitive and behavioral outcomes (e.g., IQ scores, BASC-2 scores or equivalent) in children 0–12 years of age. Results: Of 2804 abstracts screened, 11 original articles met our criteria for inclusion. Conclusions: A systematic review of the literature supports the contention that prenatal exposure phthalates is associated with adverse cognitive and behavioral outcomes in children, including lower IQ, and problems with attention, hyperactivity, and poorer social communication. Further research characterizing the associations between specific phthalate metabolites and children's neurodevelopmental outcomes is needed to support the development of mitigation strategies and enhance the development of appropriate health policy. - Highlights: • Prenatal maternal urinary concentrations of phthalate metabolites appear to be associated with adverse cognitive and behavioral outcomes in children. • Both low molecular weight (e.g., monobutyl phthalate, MBP) and high molecular weight (e.g., di(2-ethylhexyl) phthalate, DEHP) phthalate metabolites are associated with adverse cognitive and behavioral outcomes. • Sex-specific effects from phthalate exposure were noted between low (e.g., mono-n-butyl phthalate, MnBP) and high (e.g., DEHP) molecular weight phthalate metabolites, and cognitive and behavioral outcomes.« less

Successful ageing in lesbian, gay and bisexual older people: a concept analysis.

PubMed

Caceres, Billy A; Frank, Mayu O

2016-09-01

The aim of this study was to report on an analysis of the concept of successful ageing in lesbian, gay and bisexual older people. Research indicates that lesbian, gay and bisexual older people experience significant health disparities. Yet there is a lack of understanding on what factors contribute to successful ageing in this population. Nursing has lagged behind other disciplines in investigating the health of lesbian, gay and bisexual older people. A concept analysis using Rodgers' evolutionary method. Twenty studies were retrieved by searching PubMed, CINAHL, PsycInfo, EMBASE, Cochrane Library and Scopus for English-language peer-reviewed studies published from January 2004 to March 2014. The antecedents, attributes and consequences of the concept were identified through the Rodgers' method of concept analysis. Attributes included support from families of origin and/or families of choice, access to lesbian, gay, and bisexual-friendly services and crisis competence. Self-realisation of lesbian, gay and bisexual identity (coming out to oneself) and age >50 were identified as antecedents. Three consequences of successful ageing in lesbian, gay and bisexual older people were social engagement, optimism and resilience. Successful ageing in lesbian, gay and bisexual older people is defined as a subjective and multifactorial concept that is characterised by support from families of origin/families of choice, access to lesbian, gay, and bisexual-friendly services and the development of crisis competence skills which impact the ageing experience of LGB individuals. Successful ageing models can provide a roadmap for developing culturally competent interventions to address key healthcare issues present in this population. The nursing profession's multidisciplinary knowledge and competence in providing health promotion makes nurses well positioned to take a leading role in reducing disparities of lesbian, gay and bisexual older people. © 2016 John Wiley & Sons Ltd.

Exercise-based treatments for substance use disorders: evidence, theory, and practicality

PubMed Central

Linke, Sarah E.; Ussher, Michael

2016-01-01

Background Epidemiological studies reveal that individuals who report risky substance use are generally less likely to meet physical activity guidelines (with the exception of certain population segments, such as adolescents and athletes). A growing body of evidence suggests that individuals with substance use disorders (SUDs) are interested in exercising and that they may derive benefits from regular exercise, in terms of both general health/fitness and SUD recovery. Objectives The aims of this paper were to: (i) summarize the research examining the effects of exercise-based treatments for SUDs; (ii) discuss the theoretical mechanisms and practical reasons for investigating this topic; (iii) identify the outstanding relevant research questions that warrant further inquiry; and (iv) describe potential implications for practice. Methods The following databases were searched for peer-reviewed original and review papers on the topic of substance use and exercise: PubMed Central, MEDLINE, EMBASE, PsycINFO, and CINAHL Plus. Reference lists of these publications were subsequently searched for any missed but relevant manuscripts. Identified papers were reviewed and summarized by both authors. Results The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs. In contrast to the scarce intervention trials to date, a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published. Conclusions Definitive conclusions are difficult to draw due to diverse study protocols and low adherence to exercise programs, among other problems. Despite the currently limited and inconsistent evidence, numerous theoretical and practical reasons support exercise-based treatments for SUDs, including psychological, behavioral, neurobiological, nearly universal safety profile, and overall positive health effects. PMID:25397661

A review of the evidence for the effectiveness of primary prevention interventions for Hepatitis C among injecting drug users

PubMed Central

Wright, Nat MJ; Tompkins, Charlotte NE

2006-01-01

Background Hepatitis C (HCV) prevalence is most common amongst injecting drug users where up to 98% of the population can be infected despite a low prevalence of HIV. This review considers the evidence for the effectiveness of primary prevention interventions to reduce incidence or prevalence of hepatitis C. Methods Systematic review of the major electronic medical databases: Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library (Evidence Based Health). Either intervention or observational studies were included if they described an intervention targeting injecting drug using populations with the outcome to reduce either the prevalence or incidence of hepatitis C infection. Results 18 papers were included in the final review from 1007 abstracts. Needle exchange programmes reduce the prevalence of HCV though prevalence remains high. Similarly the effectiveness of methadone maintenance treatment is only marginally effective at reducing HCV incidence. There is limited evidence evaluating either the effectiveness of behavioural interventions, bleach disinfectants, or drug consumption rooms. Conclusion Primary prevention interventions have led to a reduction in HIV incidence, have been less effective at reducing HCV incidence. Global prevalence of HCV remains disturbingly high in injecting drug users. A robust response to the global health problem of HCV will require provision of new interventions. Behavioural interventions; distribution of bleach disinfectant; other injecting paraphernalia alongside sterile needle distribution; and evaluation of drug consumption rooms merit further expansion internationally and research activity to contribute to the emerging evidence base. Whilst the prevalence of HCV remains high, nevertheless many current interventions aimed at primary HCV prevention have been shown to be cost-effective due to their significant positive impact upon prevalence of HIV. PMID:16956393

Psychological interventions for the treatment of depression, anxiety, alcohol misuse or anger in armed forces veterans and their families: systematic review and meta-analysis protocol.

PubMed

O'Shea, Luke; Watkins, Ed; Farrand, Paul

2017-06-15

Evidence highlights a high prevalence of common mental health disorders in armed forces veterans and their families, with depression, anxiety, alcohol misuse and anger being more common than PTSD. This paper presents a protocol for a systematic review and meta-analysis to identify existing randomised controlled trial (RCT) research testing the effectiveness of psychological interventions for these difficulties in armed forces veterans and their family members. Electronic databases (CENTRAL, PsycInfo, MEDLINE, CINAHL, The Cochrane Register of Clinical Trials, EMBASE and ASSIA) will be searched to identify suitable studies for inclusion in the review supplemented by forward and backward reference checking, grey literature searches and contact with subject authors. Research including armed forces veterans and their family members will be included in the review with research including serving personnel or individuals under the age of 18 being excluded. Few RCTs examining the treatment of depression, anxiety, alcohol misuse or anger exist in armed forces veterans to date. The primary outcome will be symptomatic change following intervention for these difficulties. The secondary outcomes will include methodological aspects of interest such as discharge type and recruitment setting if data permits. In the event that the number of studies identified is too low to undertake a meta-analysis, a narrative review will be conducted. Quality assessment will be undertaken using the Cochrane Collaboration Tool and Cochran's Q statistic calculated to test for heterogeneity as suggested by the Cochrane handbook. The review will examine the findings of existing intervention research for depression, anxiety, alcohol misuse or anger in armed forces veterans and their families, along with any effect sizes that may exist. PROSPERO CRD42016036676.

Exit interviews to reduce turnover amongst healthcare professionals.

PubMed

Flint, Anndrea; Webster, Joan

2013-03-28

Exit interviews are widely used in healthcare organisations to identify reasons for staff attrition, yet their usefulness in limiting turnover is unclear. To determine the effectiveness of various exit interview strategies in decreasing turnover rates amongst healthcare professionals. We searched the Cochrane EPOC Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL), Issue 11, 2012; MEDLINE, Ovid (1950- ); EMBASE, Ovid (1947- ); CINAHL, EbscoHost (1980- ), and PsycINFO, OVID (1806-) between October 31 and November 6, 2012. We also screened the reference lists of included studies and relevant reviews; and searched trial registries for planned and on-going trials. We did not restrict searches by language or publication date. Randomised controlled trials, controlled clinical trials, controlled before-after studies and interrupted time series studies comparing turnover rates between healthcare professionals who had undergone one form of exit interview with another form of exit interview or with no interview. Two review authors independently assessed trial quality and extracted data. The original search identified 1560 citations, of which we considered 19 potentially relevant. The two authors independently reviewed the abstracts of these studies and retrieved the full texts of eight studies. We excluded all eight following independent assessment; they were either interviews, commentaries on how to do an exit interview or descriptive studies about reasons for leaving. We found no trials that matched our inclusion criteria. For this first update, we screened 2220 citations and identified no new trials. Evidence about the effectiveness of exit interviews to reduce turnover is currently not available. However, exit interviews may provide useful information about the work environment which, in turn, may be useful in the development of interventions to reduce turnover.

Exit interviews to reduce turnover amongst healthcare professionals.

PubMed

Webster, Joan; Flint, Anndrea

2014-03-15

Exit interviews are widely used in healthcare organisations to identify reasons for staff attrition, yet their usefulness in limiting turnover is unclear. To determine the effectiveness of various exit interview strategies in decreasing turnover rates amongst healthcare professionals. We searched the Cochrane EPOC Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL), Issue 11, 2012; MEDLINE, Ovid (1950- ); EMBASE, Ovid (1947- ); CINAHL, EbscoHost (1980- ), and PsycINFO, OVID (1806-) between October 31 and November 6, 2012. We also screened the reference lists of included studies and relevant reviews; and searched trial registries for planned and on-going trials. We did not restrict searches by language or publication date. Randomised controlled trials, controlled clinical trials, controlled before-after studies and interrupted time series studies comparing turnover rates between healthcare professionals who had undergone one form of exit interview with another form of exit interview or with no interview. Two review authors independently assessed trial quality and extracted data. The original search identified 1560 citations, of which we considered 19 potentially relevant. The two authors independently reviewed the abstracts of these studies and retrieved the full texts of eight studies. We excluded all eight following independent assessment; they were either interviews, commentaries on how to do an exit interview or descriptive studies about reasons for leaving. We found no trials that matched our inclusion criteria. For this first update, we screened 2220 citations and identified no new trials. Evidence about the effectiveness of exit interviews to reduce turnover is currently not available. However, exit interviews may provide useful information about the work environment which, in turn, may be useful in the development of interventions to reduce turnover.

Exit interviews to reduce turnover amongst healthcare professionals.

PubMed

Webster, Joan; Flint, Anndrea

2014-08-19

Exit interviews are widely used in healthcare organisations to identify reasons for staff attrition, yet their usefulness in limiting turnover is unclear. To determine the effectiveness of various exit interview strategies in decreasing turnover rates amongst healthcare professionals. We searched the Cochrane EPOC Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL), Issue 11, 2012; MEDLINE, Ovid (1950- ); EMBASE, Ovid (1947- ); CINAHL, EbscoHost (1980- ), and PsycINFO, OVID (1806-) between October 31 and November 6, 2012. We also screened the reference lists of included studies and relevant reviews; and searched trial registries for planned and on-going studies. We did not restrict searches by language or publication date. Randomised controlled trials, controlled clinical trials, controlled before-after studies and interrupted time series studies comparing turnover rates between healthcare professionals who had undergone one form of exit interview with another form of exit interview or with no interview. Two review authors independently assessed trial quality and extracted data. The original search identified 1560 citations, of which we considered 19 potentially relevant. The two authors independently reviewed the abstracts of these studies and retrieved the full texts of eight studies. We excluded all eight following independent assessment; they were either interviews, commentaries on how to do an exit interview or descriptive studies about reasons for leaving. We found no studies that matched our inclusion criteria. For this first update, we screened 2220 citations and identified no new studies. Evidence about the effectiveness of exit interviews to reduce turnover is currently not available. However, exit interviews may provide useful information about the work environment which, in turn, may be useful in the development of interventions to reduce turnover.

A systematic review of the effectiveness of simulation-based education on satisfaction and learning outcomes in nurse practitioner programs.

PubMed

Warren, Jessie N; Luctkar-Flude, Marian; Godfrey, Christina; Lukewich, Julia

2016-11-01

High-fidelity simulation (HFS) is becoming an integral component in healthcare education programs. There is considerable evidence demonstrating the effectiveness of HFS on satisfaction and learning outcomes within undergraduate nursing programs; however, there are few studies that have investigated its use and effectiveness within nurse practitioner (NP) programs. To synthesize the best available evidence about the effectiveness of HFS within NP education programs worldwide. The specific review question was: what is the effect of HFS on learner satisfaction, knowledge, attitudes, and skill performance in NP education? Joanna Briggs Institute systematic review methodology was utilized. The following databases were searched: MEDLINE, CINAHL, EMBASE, Epistemonikos, PROSPERO, HealthSTAR, AMED, Cochrane, Global Health and PsycINFO. Studies were included if they were quantitative in nature and reported on any aspect HFS within a NP program. Ten studies were included in the review. All studies were conducted in the United States and published between 2007 and 2014. Outcomes explored included: knowledge, attitudes, skills and satisfaction. The majority of studies compared HFS to online learning or traditional classroom lecture. Most study scenarios featured high acuity, low frequency events within acute care settings; only two studies utilized scenarios simulated within primary care. There is limited evidence supporting the use of HFS within NP programs. In general, HFS increases students' knowledge and confidence, and students are more satisfied with simulation-based teaching in comparison to other methods. Future studies should explore the effectiveness of simulation training within NP programs in reducing the theory to practice gap, and evaluate knowledge retention, transferability to real patient situations, and impact of simulation on patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effectiveness of patient-family carer (couple) intervention for the management of symptoms and other health-related problems in people affected by cancer: a systematic literature search and narrative review.

PubMed

Hopkinson, Jane B; Brown, Joanne C; Okamoto, Ikumi; Addington-Hall, Julia M

2012-01-01

Cancer is widely acknowledged to impact on the whole family. Yet, we do not know if there is benefit (or harm) from patient-family carer interventions in the context of cancer care. To report a systematic search for and narrative review of patient-family carer interventions tested in the context of cancer care for effect on symptoms and other health-related problems in patients and/or their family members. A systematic literature search was carried out using Cochrane principles. Searches were of MEDLINE, EMBASE, PsycINFO, and CINAHL databases for reported trials of patient-family carer focused interventions. Outcomes of interest were health indicators; measures of physical, psychological, social, and quality-of-life status of the patient and/or family member(s). Limits were English language; 1998 to March 2010; and adults. Relevant information was extracted, quality assessed using the Cochrane Collaboration's tool for assessing risk of bias, and presented as a narrative synthesis (meta-analysis was not appropriate). The review found no empirically tested interventions for family groups (patient and two or more family members), but 22 interventions for patient-family carer partnerships (couple interventions) tested in 23 studies and reported in 27 publications. Recruitment and attrition were problematic in these studies, limiting the reliability and generalizability of their results. In the trials of cancer couple interventions included in the review, a pattern emerged of improvement in the emotional health of cancer patients and their carers when the intervention included support for the patient-family carer relationship. Further investigation is warranted. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Factors associated with family satisfaction with end-of-life care in the ICU: a systematic review.

PubMed

Hinkle, Laura J; Bosslet, Gabriel T; Torke, Alexia M

2015-01-01

Family satisfaction with end-of-life care in the ICU has not previously been systematically reviewed. Our objective was to perform a review, synthesizing published data identifying factors associated with family satisfaction with end-of-life care in critically ill adult populations. The following electronic databases were searched: MEDLINE (Medical Literature Analysis and Retrieval System Online), MEDLINE Updated, EMBASE (Excerpta Medical Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycInfo, and PubMed. Two authors reviewed retrieved titles and abstracts. Studies describing nonadult and non-ICU populations or not addressing end-of-life care, family satisfaction, or factors affecting satisfaction were excluded. The remaining articles underwent full review and data extraction by two authors. Quality was assessed using a checklist based on the recommendations of the Consolidated Standards for Reporting Trials group. The search yielded 1,072 articles, with 23 articles describing 14 studies meeting inclusion criteria. All studies obtained satisfaction data from family members via surveys and structured interviews. Specific communication strategies increasing satisfaction included: expressions of empathy, nonabandonment, and assurances of comfort and provision of written information. Additionally, support for shared decision-making, family presence at time of death, and specific patient-care measures such as extubation before death were associated with increased satisfaction. Good-quality communication, support for shared decision-making, and specific patient-care measures were associated with increased satisfaction with end-of-life care. Assessing the family's desire to participate in shared decision-making may also be an important factor. Few interventions increased satisfaction. Future research is needed to further define optimal communication strategies, understand effective integration of palliative care into the ICU, and define significant score changes in survey instruments.

Clinical Benefits of Joint Mobilization on Ankle Sprains: A Systematic Review and Meta-Analysis.

PubMed

Weerasekara, Ishanka; Osmotherly, Peter; Snodgrass, Suzanne; Marquez, Jodie; de Zoete, Rutger; Rivett, Darren A

2018-07-01

To assess the clinical benefits of joint mobilization for ankle sprains. MEDLINE, MEDLINE In-Process, Embase, AMED, PsycINFO, CINAHL, Cochrane Library, PEDro, Scopus, SPORTDiscus, and Dissertations and Theses were searched from inception to June 2017. Studies investigating humans with grade I or II lateral or medial sprains of the ankle in any pathologic state from acute to chronic, who had been treated with joint mobilization were considered for inclusion. Any conservative intervention was considered as a comparator. Commonly reported clinical outcomes were considered such as ankle range of movement, pain, and function. After screening of 1530 abstracts, 56 studies were selected for full-text screening, and 23 were eligible for inclusion. Eleven studies on chronic sprains reported sufficient data for meta-analysis. Data were extracted using the participants, interventions, comparison, outcomes, and study design approach. Clinically relevant outcomes (dorsiflexion range, proprioception, balance, function, pain threshold, pain intensity) were assessed at immediate, short-term, and long-term follow-up points. Methodological quality was assessed independently by 2 reviewers, and most studies were found to be of moderate quality, with no studies rated as poor. Meta-analysis revealed significant immediate benefits of joint mobilization compared with comparators on improving posteromedial dynamic balance (P=.0004), but not for improving dorsiflexion range (P=.16), static balance (P=.96), or pain intensity (P=.45). Joint mobilization was beneficial in the short-term for improving weight-bearing dorsiflexion range (P=.003) compared with a control. Joint mobilization appears to be beneficial for improving dynamic balance immediately after application, and dorsiflexion range in the short-term. Long-term benefits have not been adequately investigated. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Nurse staffing impact on quality of care in nursing homes: a systematic review of longitudinal studies.

PubMed

Backhaus, Ramona; Verbeek, Hilde; van Rossum, Erik; Capezuti, Elizabeth; Hamers, Jan P H

2014-06-01

The relationship between nurse staffing and quality of care (QoC) in nursing homes continues to receive major attention. The evidence supporting this relationship, however, is weak because most studies employ a cross-sectional design. This review summarizes the findings from recent longitudinal studies. In April 2013, the databases PubMed, CINAHL, EMBASE, and PsycINFO were systematically searched. Studies were eligible if they (1) examined the relationship between nurse staffing and QoC outcomes, (2) included only nursing home data, (3) were original research articles describing quantitative, longitudinal studies, and (4) were written in English, Dutch, or German. The methodological quality of 20 studies was assessed using the Newcastle-Ottawa scale, excluding 2 low-quality articles for the analysis. No consistent relationship was found between nurse staffing and QoC. Higher staffing levels were associated with better as well as lower QoC indicators. For example, for restraint use both positive (ie, less restraint use) and negative outcomes (ie, more restraint use) were found. With regard to pressure ulcers, we found that more staff led to fewer pressure ulcers and, therefore, better results, no matter who (registered nurse, licensed practical nurse/ licensed vocational nurse, or nurse assistant) delivered care. No consistent evidence was found for a positive relationship between staffing and QoC. Although some positive indications were suggested, major methodological and theoretical weaknesses (eg, timing of data collection, assumed linear relationship between staffing and QoC) limit interpretation of results. Our findings demonstrate the necessity for well-designed longitudinal studies to gain a better insight into the relationship between nurse staffing and QoC in nursing homes. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Palliative Sedation for Existential Suffering: A Systematic Review of Argument-Based Ethics Literature.

PubMed

Rodrigues, Paulo; Crokaert, Jasper; Gastmans, Chris

2018-06-01

Although unanimity exists on using palliative sedation (PS) for controlling refractory physical suffering in end-of-life situations, using it for controlling refractory existential suffering (PS-ES) is controversial. Complicating the debate is that definitions and terminology for existential suffering are unclear, ambiguous, and imprecise, leading to a lack of consensus for clinical practice. To systematically identify, describe, analyze, and discuss ethical arguments and concepts underpinning the argument-based bioethics literature on PS-ES. We conducted a systematic search of the argument-based bioethics literature in PubMed, CINAHL, Embase ® , The Philosopher's Index, PsycINFO ® , PsycARTICLES ® , Scopus, ScienceDirect, Web of Science, Pascal-Francis, and Cairn. We included articles published in peer-reviewed journals till December 31, 2016, written in English or French, which focused on ethical arguments related to PS-ES. We used Peer Review of Electronic Search Strategies protocol, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and The Qualitative Analysis Guide of Leuven for data extraction and synthesis of themes. We identified 18 articles that met the inclusion criteria. Our analysis revealed mind-body dualism, existential suffering, refractoriness, terminal condition, and imminent death as relevant concepts in the ethical debate on PS-ES. The ethical principles of double effect, proportionality, and the four principles of biomedical ethics were used in argumentations in the PS-ES debate. There is a clear need to better define the terminology used in discussions of PS-ES and to ground ethical arguments in a more effective way. Anthropological presuppositions such as mind-body dualism underpin the debate and need to be more clearly elucidated using an interdisciplinary approach. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Teenage pregnancy and mental health beyond the postpartum period: a systematic review.

PubMed

Xavier, Chloé; Benoit, Anita; Brown, Hilary K

2018-06-01

Teenage mothers are at increased risk for adverse social outcomes and short-term health problems, but long-term impacts on mental health are poorly understood. The aims of our systematic review were to determine the association between teenage pregnancy and mental health beyond the postpartum period, critically appraise the literature's quality and guide future research. We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus and Web of Science from inception to June 2017 for peer-reviewed articles written in English or French. Data were collected using a modified Cochrane Data Extraction Form. Study quality was assessed using the Effective Public Health Practice Project critical appraisal tool. Heterogeneity of studies permitted only a qualitative synthesis. Nine quantitative studies comprising the results from analyses of 11 cohorts met our criteria and were rated as strong (n=5), moderate (n=2) or weak (n=2). Three cohorts found a statistically significant association between teenage pregnancy and poor long-term mental health after adjustment, three found a statistically significant association before but not after adjustment and five did not find a statistically significant association. Studies observed varying degrees of attenuation after considering social context. Studies with statistically significant findings tended to comprise earlier cohorts, with outcomes measured at older ages. The association between teenage pregnancy and mental health beyond the postpartum period remains unclear. Future studies should employ age-period-cohort frameworks to disentangle effects of normative patterns and stress accumulation. Social factors are important in determining long-term mental health of teenage mothers and should be prioritised in prevention and intervention strategies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smoke-free homes: what are the barriers, motivators and enablers? A qualitative systematic review and thematic synthesis.

PubMed

Passey, Megan E; Longman, Jo M; Robinson, Jude; Wiggers, John; Jones, Laura L

2016-03-17

To thematically synthesise primary qualitative studies of the barriers, motivators and enablers of smoke-free homes (SFHs). Systematic review and thematic synthesis. Searches of MEDLINE, EBM Reviews (Cochrane Database of Systematic Reviews), PsycINFO, Global Health, CINAHL, Web of Science, Informit and EMBASE, combining terms for families, households and vulnerable populations; SFH and secondhand smoke; and qualitative research, were supplemented by searches of PhD theses, key authors, specialist journals and reference lists. We included 22 articles, reporting on 18 studies, involving 646 participants. peer-reviewed; English language; published from 1990 onwards (to week 3 of April 2014); used qualitative data collection methods; explored participants' perspectives of home smoking behaviours; and the barriers, motivators and enablers to initiating and/or maintaining a SFH. 1 of 3 authors extracted data with checking by a second. A thematic synthesis was performed to develop 7 core analytic themes: (1) knowledge, awareness and risk perception; (2) agency and personal skills/attributes; (3) wider community norms and personal moral responsibilities; (4) social relationships and influence of others; (5) perceived benefits, preferences and priorities; (6) addiction and habit; (7) practicalities. This synthesis highlights the complexity faced by many households in having a SFH, the practical, social, cultural and personal issues that need to be addressed and balanced by households, and that while some of these are common across study settings, specific social and cultural factors play a critical role in shaping household smoking behaviours. The findings can inform policy and practice and the development of interventions aimed at increasing SFHs. CRD42014014115. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis

PubMed Central

Maher, Chris G; Ferreira, Manuela L; Ferreira, Paulo H; Hancock, Mark; Oliveira, Vinicius C; McLachlan, Andrew J; Koes, Bart

2012-01-01

Objective To investigate the efficacy and tolerability of analgesic and adjuvant pain drugs typically administered in primary care for the management of patients with sciatica. Design Systematic review. Data source International Pharmaceutical Abstracts, PsycINFO, Medline, Embase, Cochrane Central Register of Clinical Trials (CENTRAL), CINAHL, and LILACS. Study selection Randomised controlled trials assessing the efficacy and tolerability of drugs versus placebo or other treatment for sciatica. Data extraction Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability outcomes were converted to a common 0 to 100 scale. Data were pooled with a random effects model, and the GRADE approach was used in summary conclusions. Results Twenty three published reports met the inclusion criteria. The evidence to judge the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antidepressants, anticonvulsants, muscle relaxants, and opioid analgesics ranged from moderate to low quality. Most of the pooled estimates did not favour the active treatment over placebo. The pooled results of two trials of corticosteroids (mean difference in overall and leg pain −12.2, 95% confidence interval −20.9 to −3.4) and a single trial of the anticonvulsant gabapentin for chronic sciatica (mean difference in overall pain relief −26.6, −38.3 to −14.9) showed some benefits but only in the short term. The median rate of adverse events was 17% (interquartile range 10-30%) for the active drugs and 11% (3-23%) for placebo. Trial limitations included failure to use validated outcome measures, lack of long term follow-up, and small sample size. Conclusions As the existing evidence from clinical trials is of low quality, the efficacy and tolerability of drugs commonly prescribed for the management of sciatica in primary care is unclear. PMID:22331277

Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review.

PubMed

Young, Matthew M; Stevens, Adrienne; Galipeau, James; Pirie, Tyler; Garritty, Chantelle; Singh, Kavita; Yazdi, Fatemeh; Golfam, Mohammed; Pratt, Misty; Turner, Lucy; Porath-Waller, Amy; Arratoon, Cheryl; Haley, Nancy; Leslie, Karen; Reardon, Rhoda; Sproule, Beth; Grimshaw, Jeremy; Moher, David

2014-05-24

The purpose of this systematic review is to assess the effectiveness of brief interventions (BIs) as part of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances. Bibliographic databases (including MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO to April 2012) and gray literature sources were searched. We included randomized controlled trials that opportunistically screened adolescents or adults and then provided a one-to-one, verbal BI to those at risk of substance-use harm. Of interest was the nonmedical use of psychoactive substances (for example, drugs prohibited by international law), excluding alcohol, nicotine, and caffeine. Interventions comprised four or fewer sessions and were compared with no/delayed intervention or provision of information only. Studies were assessed for bias using the Cochrane risk of bias tool. Results were synthesized narratively. Evidence was interpreted according to the GRADE framework. We identified 8,836 records. Of these, five studies met our inclusion criteria. Two studies compared BI with no BI, and three studies compared BI with information only. Studies varied in characteristics such as substances targeted, screening procedures, and BI administered. Outcomes were mostly reported by a single study, leading to limited or uncertain confidence in effect estimates. Insufficient evidence exists as to whether BIs, as part of SBIRT, are effective or ineffective for reducing the use of, or harms associated with nonmedical use of, psychoactive substances when these interventions are administered to nontreatment-seeking, screen-detected populations. Updating this review with emerging evidence will be important. CRD42012002414.

Simulation-Based Bronchoscopy Training

PubMed Central

Kennedy, Cassie C.; Maldonado, Fabien

2013-01-01

Background: Simulation-based bronchoscopy training is increasingly used, but effectiveness remains uncertain. We sought to perform a comprehensive synthesis of published work on simulation-based bronchoscopy training. Methods: We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, and Scopus for eligible articles through May 11, 2011. We included all original studies involving health professionals that evaluated, in comparison with no intervention or an alternative instructional approach, simulation-based training for flexible or rigid bronchoscopy. Study selection and data abstraction were performed independently and in duplicate. We pooled results using random effects meta-analysis. Results: From an initial pool of 10,903 articles, we identified 17 studies evaluating simulation-based bronchoscopy training. In comparison with no intervention, simulation training was associated with large benefits on skills and behaviors (pooled effect size, 1.21 [95% CI, 0.82-1.60]; n = 8 studies) and moderate benefits on time (0.62 [95% CI, 0.12-1.13]; n = 7). In comparison with clinical instruction, behaviors with real patients showed nonsignificant effects favoring simulation for time (0.61 [95% CI, −1.47 to 2.69]) and process (0.33 [95% CI, −1.46 to 2.11]) outcomes (n = 2 studies each), although variation in training time might account for these differences. Four studies compared alternate simulation-based training approaches. Inductive analysis to inform instructional design suggested that longer or more structured training is more effective, authentic clinical context adds value, and animal models and plastic part-task models may be superior to more costly virtual-reality simulators. Conclusions: Simulation-based bronchoscopy training is effective in comparison with no intervention. Comparative effectiveness studies are few. PMID:23370487

Social ecology of resilience and Sumud of Palestinians.

PubMed

Marie, Mohammad; Hannigan, Ben; Jones, Aled

2018-01-01

The aim of this article is to provide an overview of theoretical perspectives and practical research knowledge in relation to 'resilience', the resilience of Palestinians in particular and the related concept of 'Sumud'. 'Sumud' is a Palestinian idea that is interwoven with ideas of personal and collective resilience and steadfastness. It is also a socio-political concept and refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. The concept of 'resilience' has deep roots, going back at least to the 10th century when Arabic scholars suggested strategies to cope with life adversity. In Europe, research into resilience extends back to the 1800s. The understanding of resilience has developed over four overlapping waves. These focus on individual traits, protective factors, ecological assets and (in the current wave) social ecological factors. The current wave of resilience research focuses on the contribution of cultural contextualisation and is an approach that is discussed in this article, which draws on Arabic and English language literature located through a search of multiple databases (CINAHL, British Nursing Index, ASSIA, MEDLINE, PsycINFO and EMBASE). Findings suggest that 'Sumud' is linked to the surrounding cultural context and can be thought of as an innovative, social ecological, approach to promoting resilience. We show that resilience is a prerequisite to 'Sumud', meaning that the individual has to be resilient in order to stay and not to leave their place, position or community. We close by pressing the case for studies which investigate resilience especially in underdeveloped countries such as Palestine (occupied Palestinian territories), and which reveal how resilience is embedded in pre-existing cultural contexts.

Systematic review of the quality and generalizability of studies on the effects of opioids on driving and cognitive/psychomotor performance.

PubMed

Mailis-Gagnon, Angela; Lakha, Shehnaz Fatima; Furlan, Andrea; Nicholson, Keith; Yegneswaran, Balaji; Sabatowski, Rainer

2012-07-01

The effect of opioids on driving performance has been much debated. Driving is a complex task requiring integration of psychomotor, cognitive, motor and decision-making skills, visual-spatial abilities, divided attention, and behavioral and emotional control. The objective of this systematic review was to assess the quality of studies and to revisit the concept that patients on stable opioids are safe to drive as it applies to everyday practice. We searched MEDLINE, EMBASE, PSYCinfo, CENTRAL, TRANSPORT, CINAHL, reference lists of retrieved articles and narrative reviews, for studies on chronic cancer and noncancer pain patients on opioids, tested by driving, driving simulator, or cognitive/psychomotor tests. Methodological quality was assessed with Methodological Index for Nonrandomized Studies, cognitive/psychomotor tests were appraised regarding their sensitivity and validation, and whether confounding variables potentially affecting the study conclusions were recorded. The results were analyzed both quantitatively and qualitatively. We included 35 studies (2044 patients, 1994 controls), 9% of the studies were of poor, 54% of fair, and 37% of high quality; 3 quarters of the studies used high sensitivity cognitive tests. Amount and dose of opioids varied largely in many studies. Mean number of possible but unreported confounders was 2.2 (range, 0 to 4), relating to failure of the studies to mention co-prescriptions with psychotropic effects, pain severity, sleep disorder or daytime somnolence, and/or significant depressive or anxiety-related problems. The commonly held concept that "chronic pain patients on stable opioids are safe to drive" cannot be generalized to all such patients in everyday practice, but may be applicable only to a subset who meet certain criteria.

Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review.

PubMed

Fearnley, Rachel; Boland, Jason W

2017-03-01

Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family's needs would help ensure appropriate support. To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals' communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents' feelings of supporting their children. A systematic literature review and narrative synthesis. Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent's illness. There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents' illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent's illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise.

Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review

PubMed Central

Fearnley, Rachel; Boland, Jason W.

2016-01-01

Background: Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family’s needs would help ensure appropriate support. Aim: To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals’ communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents’ feelings of supporting their children. Design: A systematic literature review and narrative synthesis. Data sources: Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent’s illness. Results: There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents’ illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Conclusion: Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent’s illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise. PMID:27383635

The Effectiveness of Singing or Playing a Wind Instrument in Improving Respiratory Function in Patients with Long-Term Neurological Conditions: A Systematic Review.

PubMed

Ang, Kexin; Maddocks, Matthew; Xu, Huiying; Higginson, Irene J

2017-03-01

Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care. To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions. Systematic review of published randomized controlled trials and observational studies examining singing or playing wind instruments to improve respiratory function in individuals with long-term neurological conditions. Articles meeting specified inclusion criteria were identified through a search of the Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, CAIRSS for Music, WHO International Clinical Trials Registry Platform Search Portal, and AMED databases as early as 1806 through March 2015. Information on study design, clinical populations, interventions, and outcome measures was extracted and summarized using an electronic standardized coding form. Methodological quality was assessed and summarized across studies descriptively. From screening 584 references, 68 full texts were reviewed and five studies included. These concerned 109 participants. The studies were deemed of low quality, due to evidence of bias, in part due to intervention complexity. No adverse effects were reported. Overall, there was a trend toward improved respiratory function, but only one study on Parkinson's disease had significant between-group differences. The positive trend in respiratory function in people with long-term neurological conditions following singing or wind instrument therapy is of interest, and warrants further investigation. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The Power of the Web: A Systematic Review of Studies of the Influence of the Internet on Self-Harm and Suicide in Young People

PubMed Central

Daine, Kate; Hawton, Keith; Singaravelu, Vinod; Stewart, Anne; Simkin, Sue; Montgomery, Paul

2013-01-01

Background There is concern that the internet is playing an increasing role in self-harm and suicide. In this study we systematically review and analyse research literature to determine whether there is evidence that the internet influences the risk of self-harm or suicide in young people. Methods An electronic literature search was conducted using the PsycINFO, MEDLINE, EMBASE, Scopus, and CINAHL databases. Articles of interest were those that included empirical data on the internet, self-harm or suicide, and young people. The articles were initially screened based on titles and abstracts, then by review of the full publications, after which those included in the review were subjected to data extraction, thematic analysis and quality rating. Results Youth who self-harm or are suicidal often make use of the internet. It is most commonly used for constructive reasons such as seeking support and coping strategies, but may exert a negative influence, normalising self-harm and potentially discouraging disclosure or professional help-seeking. The internet has created channels of communication that can be misused to ‘cyber-bully’ peers; both cyber-bullying and general internet use have been found to correlate with increased risk of self-harm, suicidal ideation, and depression. Correlations have also been found between internet exposure and violent methods of self-harm. Conclusions Internet use may exert both positive and negative effects on young people at risk of self-harm or suicide. Careful high quality research is needed to better understand how internet media may exert negative influences and should also focus on how the internet might be utilised to intervene with vulnerable young people. PMID:24204868