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PloS One 2017Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other... (Review)
Review
BACKGROUND
Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff.
OBJECTIVES
This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing.
METHODS
A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours.
RESULTS
Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours.
CONCLUSIONS
This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff.
Topics: Burnout, Professional; Delivery of Health Care; Health Personnel; Health Promotion; Humans; Leadership; Mental Health; United Kingdom; Workplace
PubMed: 29200422
DOI: 10.1371/journal.pone.0188418 -
Clinical and Experimental Dental... Dec 2022This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers. (Review)
Review
OBJECTIVES
This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers.
MATERIALS AND METHODS
Based on the PICO question and the search terms, an electronic search was performed in Google Scholar, PubMed (MEDLINE), Scopus, Cochrane Library, Web of Science, Science Direct, Wiley, Ovid, and SAGE for articles published up to July 2022. After including English in vitro studies that evaluated posterior ceramic occlusal overlays at the posterior with ceramic restorations by following the PRISMA statement, the extracted data was tabulated. The methodological quality of the included studies was evaluated. Risk of bias assessment was done independently by two authors using the modified MINORS scale.
RESULTS
About 3138 search results were screened, of which 22 were selected due to their titles. Twenty-one full-text articles were assessed for eligibility. Seventeen in-vitro studies were finalized for the extraction of quantitative data. All 17 articles had a low risk of bias and were retained. The influencing items for evaluating the research were different in most studies; therefore, qualitative synthesis of the results was feasible. They generally included preparation design, material thickness, depth of preparation in the tooth, internal divergence angle, and finish line. Meta-analysis was not done due to heterogeneity of preparation types and evaluation methods. Results revealed that fracture resistance of occlusal veneers is higher than normal mastication force, and it is sufficient to prepare the occlusal surface, use a self-etching primer for bonding, and an acceptable minimum ceramic thickness. The marginal discrepancy of occlusal veneers is clinically acceptable. However, this systematic review faces some limitations due to the lack of in vivo studies, different preparation designs in included studies, different follow-ups, and lack of comprehensive explanations in articles.
CONCLUSIONS
The preparation design of occlusal veneers influences both marginal adaptation and fracture resistance. Various preparation designs are proven to have clinically acceptable fracture strength and marginal adaptation.
Topics: Dental Porcelain; Dental Veneers; Flexural Strength; Dental Stress Analysis; Materials Testing; Ceramics
PubMed: 36062841
DOI: 10.1002/cre2.653 -
International Journal of Sport... Sep 2021Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in...
Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in moderation, but its alcohol content may confer some negative effects. Despite beer's popularity, no review has explored its effects on exercise performance, recovery, and adaptation. Thus, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two reviewers. The search resulted in 16 studies that were appraised and reviewed. The mean PEDro score was 5.1. When individuals are looking to rehydrate postexercise, a low-alcohol beer (<4%) may be more effective. If choosing a beer higher in alcoholic content (>4%), it is advised to pair this with a nonalcoholic option to limit diuresis, particularly when relatively large volumes of fluid (>700 ml) are consumed. Adding Na+ to alcoholic beer may improve rehydration by decreasing fluid losses, but palatability may decrease. These conclusions are largely based on studies that standardized beverage volume, and the results may not apply equally to situations where people ingest fluids and food ad libitum. Ingesting nonalcoholic, polyphenol-rich beer could be an effective strategy for preventing respiratory infections during heavy training. If consumed in moderation, body composition and strength qualities seem largely unaffected by beer. Mixed results that limit sweeping conclusions are owed to variations in study design (i.e., hydration and exercise protocols). Future research should incorporate exercise protocols with higher ecological validity, recruit more women, prioritize chronic study designs, and use ad libitum fluid replacement protocols for more robust conclusions.
Topics: Alcohol Drinking; Beer; Dehydration; Exercise; Female; Fluid Therapy; Humans; Water-Electrolyte Balance
PubMed: 34284350
DOI: 10.1123/ijsnem.2021-0064 -
The American Journal of Occupational... 2018This systematic review examined the effectiveness of specific sensory techniques and sensory environmental modifications to improve participation of children with... (Review)
Review
This systematic review examined the effectiveness of specific sensory techniques and sensory environmental modifications to improve participation of children with sensory integration (SI) difficulties. Abstracts of 11,436 articles published between January 2007 and May 2015 were examined. Studies were included if designs reflected high levels of evidence, participants demonstrated SI difficulties, and outcome measures addressed function or participation. Eight studies met inclusion criteria. Seven studies evaluated effects of specific sensory techniques for children with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder: Qigong massage, weighted vests, slow swinging, and incorporation of multisensory activities into preschool routines. One study of sensory environmental modifications examined adaptations to a dental clinic for children with ASD. Strong evidence supported Qigong massage, moderate evidence supported sensory modifications to the dental care environment, and limited evidence supported weighted vests. The evidence is insufficient to draw conclusions regarding slow linear swinging and incorporation of multisensory activities into preschool settings.
Topics: Adolescent; Autism Spectrum Disorder; Child; Child Health Services; Humans; Occupational Therapy; Psychomotor Performance; Young Adult
PubMed: 29280714
DOI: 10.5014/ajot.2018.029413 -
Journal of Medical Internet Research May 2021Health care organizations are increasingly working with eHealth. However, the integration of eHealth into regular health care is challenging. It requires organizations... (Review)
Review
BACKGROUND
Health care organizations are increasingly working with eHealth. However, the integration of eHealth into regular health care is challenging. It requires organizations to change the way they work and their structure and care processes to be adapted to ensure that eHealth supports the attainment of the desired outcomes.
OBJECTIVE
The aims of this study are to investigate whether there are identifiable indicators in the structure, process, and outcome categories that are related to the successful integration of eHealth in regular health care, as well as to investigate which indicators of structure and process are related to outcome indicators.
METHODS
A systematic literature review was conducted using the Donabedian Structure-Process-Outcome (SPO) framework to identify indicators that are related to the integration of eHealth into health care organizations. Data extraction sheets were designed to provide an overview of the study characteristics, eHealth characteristics, and indicators. The extracted indicators were organized into themes and subthemes of the structure, process, and outcome categories.
RESULTS
Eleven studies were included, covering a variety of study designs, diseases, and eHealth tools. All studies identified structure, process, and outcome indicators that were potentially related to the integration of eHealth. The number of indicators found in the structure, process, and outcome categories was 175, 84, and 88, respectively. The themes with the most-noted indicators and their mutual interaction were inner setting (51 indicators, 16 interactions), care receiver (40 indicators, 11 interactions), and technology (38 indicators, 12 interactions)-all within the structure category; health care actions (38 indicators, 15 interactions) within the process category; and efficiency (30 indicators, 15 interactions) within the outcome category. In-depth examination identified four most-reported indicators, namely "deployment of human resources" (n=11), in the inner setting theme within the structure category; "ease of use" (n=16) and "technical issue" (n=10), both in the technology theme within the structure category; and "health logistics" (n=26), in the efficiency theme within the outcome category.
CONCLUSIONS
Three principles are important for the successful integration of eHealth into health care. First, the role of the care receiver needs to be incorporated into the organizational structure and daily care process. Second, the technology must be well attuned to the organizational structure and daily care process. Third, the deployment of human resources to the daily care processes needs to be aligned with the desired end results. Not adhering to these points could negatively affect the organization, daily process, or the end results.
Topics: Delivery of Health Care; Humans; Outcome and Process Assessment, Health Care; Telemedicine
PubMed: 33970123
DOI: 10.2196/27180 -
Archives of Suicide Research : Official... 2022The safety planning intervention (SPI) is gaining momentum in suicide prevention practice and research. This systematic review sought to determine the effectiveness of...
The safety planning intervention (SPI) is gaining momentum in suicide prevention practice and research. This systematic review sought to determine the effectiveness of the SPI for adults experiencing suicide-related distress. Systematic searches of international, peer-reviewed literature were conducted in six databases (Cochrane Trials, Embase, Emcare, Medline, PsycINFO and Web of Science), including terms for safety planning, suicide, and suicide-related outcomes. A total of 565 results were included for screening. Result screening (title/abstract and full-text), data extraction and critical appraisal were conducted in duplicate. Twenty-six studies met the inclusion criteria. Studies were primarily quantitative ( = 20), largely with general adult or veteran samples; a small number of studies explored the perspectives of staff and significant others. Half of the studies included the SPI as a standalone intervention, while the other half examined the SPI in combination with other interventions. Most interventions were delivered in-person, with a hard-copy safety plan created, while a smaller number explored internet-based interventions. Primary measures included: suicidality (ideation, behavior, deaths; 10 studies), suicide-related outcomes (depression, hopelessness; 5 studies) and treatment outcomes (hospitalizations, treatment engagement; 7 studies). The evidence supports improvements in each of these domains, with complementary findings from the remaining quantitative and qualitative studies suggesting that the SPI is a feasible and acceptable intervention. While positive, these findings are limited by the heterogeneity of interventions and study designs, making the specific impact of the SPI difficult to both determine and generalize. Conversely, this also points to the flexibility of the SPI.HighlightsThe Safety Planning Intervention (SPI) is a valuable indicated intervention for general adult and veteran populations experiencing suicide-related distress, primarily in face-to-face, clinical settings.Quantitative findings indicate associations between the SPI and improvements in suicidal ideation and behavior, decreases in depression and hopelessness, along with reductions in hospitalizations and improvements in treatment attendance.Qualitative studies suggest the SPI is acceptable and feasible, with areas for development.SPIs have been shown to be adaptable to the clinical area in its modality (digital or paper-based), delivery (face-to-face or online), facilitation (clinician or self-administered) and multiplicity (as stand-alone or combined intervention).
Topics: Adult; Humans; Suicidal Ideation; Treatment Outcome; Veterans; Suicide Prevention
PubMed: 33913799
DOI: 10.1080/13811118.2021.1915217 -
JBI Database of Systematic Reviews and... Jan 2018To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults.
OBJECTIVE
To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults.
INTRODUCTION
Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented.
INCLUSION CRITERIA
The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression. Participants selected on the basis of specific illness or with a terminal diagnosis were excluded. The comparator was usual care, alternative therapeutic interventions or no intervention. The primary outcome was frailty. Secondary outcomes included: (i) cognition, quality of life, activities of daily living, caregiver burden, functional capacity, depression and other mental health-related outcomes, self-perceived health and social engagement; (ii) drugs and prescriptions, analytical parameters, adverse outcomes and comorbidities; (iii) costs, and/or costs relative to benefits and/or savings associated with implementing the interventions for frailty. Experimental study designs, cost effectiveness, cost benefit, cost minimization and cost utility studies were considered for inclusion.
METHODS
Databases for published and unpublished studies, available in English, Portuguese, Spanish, Italian and Dutch, from January 2001 to November 2015, were searched. Critical appraisal was conducted using standardized instruments from the Joanna Briggs Institute. Data was extracted using the standardized tools designed for quantitative and economic studies. Data was presented in a narrative form due to the heterogeneity of included studies.
RESULTS
Twenty-one studies, all randomized controlled trials, with a total of 5275 older adults and describing 33 interventions, met the criteria for inclusion. Economic analyses were conducted in two studies. Physical exercise programs were shown to be generally effective for reducing or postponing frailty but only when conducted in groups. Favorable effects on frailty indicators were also observed after the interventions, based on physical exercise with supplementation, supplementation alone, cognitive training and combined treatment. Group meetings and home visits were not found to be universally effective. Lack of efficacy was evidenced for physical exercise performed individually or delivered one-to-one, hormone supplementation and problem solving therapy. Individually tailored management programs for clinical conditions had inconsistent effects on frailty prevalence. Economic studies demonstrated that this type of intervention, as compared to usual care, provided better value for money, particularly for very frail community-dwelling participants, and had favorable effects in some of the frailty-related outcomes in inpatient and outpatient management, without increasing costs.
CONCLUSIONS
This review found mixed results regarding the effectiveness of frailty interventions. However, there is clear evidence on the usefulness of such interventions in carefully chosen evidence-based circumstances, both for frailty itself and for secondary outcomes, supporting clinical investment of resources in frailty intervention. Further research is required to reinforce current evidence and examine the impact of the initial level of frailty on the benefits of different interventions. There is also a need for economic evaluation of frailty interventions.
Topics: Adaptation, Psychological; Aged; Disease Progression; Frailty; Humans; Independent Living; Primary Health Care
PubMed: 29324562
DOI: 10.11124/JBISRIR-2017-003382 -
Journal of Athletic Training May 2020To determine the effects of an eccentric hamstrings strength-training program, performed for at least 4 weeks by healthy adults, on muscle architecture and eccentric... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To determine the effects of an eccentric hamstrings strength-training program, performed for at least 4 weeks by healthy adults, on muscle architecture and eccentric strength.
DATA SOURCES
A systematic search was performed up to October 2018 in the following electronic databases: PubMed, PEDro, CINAHL and SPORTDiscus. Combinations of the following search terms were used: , , , , , , , , , , and .
STUDY SELECTION
Included articles were randomized controlled trials that allowed comparisons between isolated eccentric strength training of the biceps femoris muscle and other programs.
DATA EXTRACTION
Data from the included studies were extracted by 2 independent reviewers. These data included the study design, participant characteristics, inclusion and exclusion criteria of clinical studies, exercise and intervention characteristics, outcome measures, and the main results of the study. When meta-analysis was possible, we performed quantitative analysis. Ten randomized controlled trials were included.
DATA SYNTHESIS
Limited to moderate evidence indicated that eccentric strength training was associated with an increase in fascicle length (mean difference [MD] = 1.97; 95% confidence interval [CI] = 1.48, 2.46), an increase in muscle thickness (MD = 0.10; 95% CI = 0.06, 0.13), and a decrease in pennation angle (MD = 2.36; 95% CI = 1.61, 3.11). Conflicted to moderate evidence indicated that eccentric hamstrings strength was increased after eccentric strength training compared with concentric strength training (standardized mean difference [SMD] = 1.06; 95% CI = 0.26, 1.86), usual level of activity (SMD = 2.72; 95% CI = 1.68, 3.77), and static stretching (SMD = 0.39; 95% CI = -0.97, 1.75).
CONCLUSIONS
In healthy adults, an eccentric strength-training program produced architectural adaptations on the long head of the biceps femoris muscle and increased eccentric hamstrings strength.
Topics: Adaptation, Physiological; Adult; Athletic Injuries; Hamstring Muscles; Humans; Muscle Strength; Resistance Training
PubMed: 32216654
DOI: 10.4085/1062-6050-194-19 -
Body Image Jun 2023Functionality appreciation is a component of positive body image that refers to respecting and honoring the body for what it is capable of doing. A growing number of... (Meta-Analysis)
Meta-Analysis Review
Functionality appreciation is a component of positive body image that refers to respecting and honoring the body for what it is capable of doing. A growing number of studies have investigated the features, correlates, and outcomes of functionality appreciation, yet a synthesis of this literature is missing. We conducted a systematic review and meta-analysis of research on functionality appreciation. Fifty-six studies were included (85 % cross-sectional). Random effects meta-analyses were performed on 21 cross-sectional correlates and on seven randomized trials of psychological interventions that assessed functionality appreciation as an outcome. Meta-analyses showed that functionality appreciation was consistently associated with fewer body image problems, lower levels of eating disorder symptoms, and better mental health and wellbeing. Functionality appreciation was unrelated to age and gender, but weakly (and negatively) related to body mass index. Preliminary evidence from prospective designs suggests that the appreciation of body functionality may promote adaptive eating patterns and prevent maladaptive eating and body image patterns over time. Psychological interventions designed to cultivate functionality appreciation in full or in part produced greater improvements in this construct than control conditions. Findings confirm that functionality appreciation is associated with numerous wellbeing constructs and could serve as a potentially useful target for intervention.
Topics: Humans; Body Image; Cross-Sectional Studies; Feeding Behavior; Feeding and Eating Disorders; Mental Health
PubMed: 36796304
DOI: 10.1016/j.bodyim.2023.02.002 -
Current Opinion in Psychology Oct 2022What types of honesty interventions have been tested and to what extent? We conducted a systematic literature review of single-element intervention studies designed to... (Review)
Review
What types of honesty interventions have been tested and to what extent? We conducted a systematic literature review of single-element intervention studies designed to curtail individual-level dishonesty and classified the obtained interventions in a taxonomy that encompasses three frameworks: nudging, economic, and internal-reward. We find moral reminders that we classify as educative nudges as well as external commitments (pledges, oaths, honor codes) and priming that we classify under the internal-reward framework to be the most frequently studied interventions, whereas architectural nudges (defaults, sludge) have hardly been developed. Most importantly, we identify two areas for improvement essential for our collective ability to successfully translate and scale honesty interventions: a more thorough examination of the interventions' underlying psychological processes and precise description of the experimental designs.
Topics: Deception; Humans; Morals; Reward; Sewage
PubMed: 35921754
DOI: 10.1016/j.copsyc.2022.101410