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Applied Clinical Informatics May 2021Clinician burnout is a prevalent issue in healthcare, with detrimental implications in healthcare quality and medical costs due to errors. The inefficient use of health...
BACKGROUND
Clinician burnout is a prevalent issue in healthcare, with detrimental implications in healthcare quality and medical costs due to errors. The inefficient use of health information technologies (HIT) is attributed to having a role in burnout.
OBJECTIVE
This paper seeks to review the literature with the following two goals: (1) characterize and extract HIT trends in burnout studies over time, and (2) examine the evidence and synthesize themes of HIT's roles in burnout studies.
METHODS
A scoping literature review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with two rounds of searches in PubMed, IEEE Xplore, ACM, and Google Scholar. The retrieved papers and their references were screened for eligibility by using developed inclusion and exclusion criteria. Data were extracted from included papers and summarized either statistically or qualitatively to demonstrate patterns.
RESULTS
After narrowing down the initial 945 papers, 36 papers were included. All papers were published between 2013 and 2020; nearly half of them focused on primary care ( = 16; 44.4%). The most commonly studied variable was electronic health record (EHR) practices (e.g., number of clicks). The most common study population was physicians. HIT played multiple roles in burnout studies: it can contribute to burnout; it can be used to measure burnout; or it can intervene and mitigate burnout levels.
CONCLUSION
This scoping review presents trends in HIT-centered burnout studies and synthesizes three roles for HIT in contributing to, measuring, and mitigating burnout. Four recommendations were generated accordingly for future burnout studies: (1) validate and standardize HIT burnout measures; (2) focus on EHR-based solutions to mitigate clinician burnout; (3) expand burnout studies to other specialties and types of healthcare providers, and (4) utilize mobile and tracking technology to study time efficiency.
Topics: Burnout, Professional; Burnout, Psychological; Health Personnel; Humans; Medical Informatics; Physicians
PubMed: 34233369
DOI: 10.1055/s-0041-1731399 -
Supportive Care in Cancer : Official... Apr 2021Oral mucositis is a debilitating consequence of radiotherapy in patients with head and neck cancers. Radiation-induced oral mucositis (RIOM) can cause pain and weight...
BACKGROUND
Oral mucositis is a debilitating consequence of radiotherapy in patients with head and neck cancers. Radiation-induced oral mucositis (RIOM) can cause pain and weight loss, reduce quality of life and affect treatment outcomes.
METHODS
A systematic review was undertaken to identify and examine the efficacy of low-cost interventions to mitigate RIOM and to develop clinical guidelines based on the evidence.
RESULTS
The author identified three interventions: benzydamine hydrochloride mouth rinse (BHM), honey and oral glutamine (OG). The search identified twenty-four studies in total. Four studies examined BHM; all findings were favourable, although only one had moderate methodological quality, and the rest were low. The product was poorly tolerated by some participants in one study. Twelve studies examined honey. Eleven of these had favourable results; two studies had moderate methodological quality, and the rest were low. Eight studies examined OG. Six of these had favourable results; two studies had moderate methodological quality, and the rest were low.
CONCLUSION
The author cannot recommend BHM to mitigate RIOM due to the overall low quality of the studies and poor tolerance to the product. The author cannot recommend honey to mitigate RIOM due to weak evidence supporting the intervention. The author can recommend OG to mitigate RIOM. There is a need for high-quality studies with a consensus of the methodology to reduce heterogeneity and examination of the cost-effectiveness of the interventions.
Topics: Head and Neck Neoplasms; Humans; Quality of Life; Radiation Injuries; Stomatitis; Treatment Outcome
PubMed: 32889582
DOI: 10.1007/s00520-020-05548-0 -
TheScientificWorldJournal 2022We conducted a review of 26 articles published between 2009 and 2021 to determine human-wildlife conflict based on spatial and temporal patterns, biological components,... (Review)
Review
We conducted a review of 26 articles published between 2009 and 2021 to determine human-wildlife conflict based on spatial and temporal patterns, biological components, drivers of conflict, and mitigation methods used. We employed search, synthesis, appraisal, and analysis framework for review and VOSviewer software for network analysis. We included articles that only focused on relations between terrestrial wildlife and humans, while others deal with ecology, distribution, and biology of wildlife because it does not go with HWC. Forty-seven species of terrestrial vertebrates were reported in conflict-related studies, being Bovidae and Cercopithecidae the most frequently studied groups, of which eleven are found in threatened list species. The main drivers reported were land use change, proximity to protected areas, and illegal resource exploitation. In the management case, the use of traditional protection techniques such as fencing, guarding, and physical barriers was reported. About 178 keywords' analysis revealed a focus on "coexistence," "mitigation," and "food security." The literature focused mainly on larger mammals, led by Ethiopian authors, and excluded the social dimensions of HWC. Therefore, identifying conflict-prone species focuses on the social dimensions of coexistence, such as human attitudes towards terrestrial wildlife, and broadening the taxonomic and cultural breadth of HWC is required.
Topics: Animals; Animals, Wild; Conservation of Natural Resources; Ecology; Endangered Species; Ethiopia; Humans; Mammals
PubMed: 36072352
DOI: 10.1155/2022/2612716 -
Journal of Advanced Nursing Mar 2023The aim of this paper is to describe the strategies used by nurses and midwives to cope with experiences of dealing with perinatal death and maintain their satisfaction... (Review)
Review
AIM
The aim of this paper is to describe the strategies used by nurses and midwives to cope with experiences of dealing with perinatal death and maintain their satisfaction at work.
DESIGN
Systematic literature review, in accordance with the PRISMA Declaration.
DATA SOURCES
(2000-2021) Web of Science, PubMed, Scopus, CINALH and Dialnet, for articles in English and Spanish from the period between January 2000 and March 2021.
REVIEW METHODS
The outcome of the review was the perceptions of nurses and midwives who have cared for people in a situation of perinatal loss.
RESULTS
Thirteen studies were identified that evaluated the attitudes, experiences and needs of these healthcare professionals. The combined size of all samples was 2196 participants.
CONCLUSIONS
The negative effects on these professionals' satisfaction with their situation at work could be mitigated by covering their needs for knowledge, experience, and emotional and technical skills to deal with such events.
IMPACT
As potential protective factors against dissatisfaction in nurses and midwives during perinatal death experiences, we identified older age and experience in perinatal care and coping strategies based on communicating one's feelings to peers, empathetic listening to the families cared for, training and institutional support. No Patient or Public Contribution.
Topics: Pregnancy; Female; Humans; Midwifery; Perinatal Death; Parturition; Health Personnel; Nurses
PubMed: 36695342
DOI: 10.1111/jan.15572 -
Archives of Physical Medicine and... Jun 2024This review aimed to investigate the effectiveness of mHealth-supported active exercise interventions to reduce pain intensity and disability level in persons with hip... (Review)
Review
Effectiveness of mHealth interventions to improve pain intensity and functional disability in patients with hip or knee osteoarthritis: a systematic review and meta-analysis.
OBJECTIVE
This review aimed to investigate the effectiveness of mHealth-supported active exercise interventions to reduce pain intensity and disability level in persons with hip or knee OA.
DATA SOURCES
Three databases (PubMed, Cochrane Library, and Web of science) were systematically searched for randomized-controlled trials (RCTs) published between 01-01-2012 and 31-07-2023. PROSPERO registration number of this review was CRD42023394119.
STUDY SELECTION
We included only RCTs that were identified and screened by two independent reviewers (JM and GN). In addition, the reference lists of the identified studies were manually checked for further inclusion. Included studies had to provide a mHealth-supported active exercises for persons with hip or knee OA, and evaluate pain intensity and disability using both questionnaires and performance tests.
DATA EXTRACTION
From the included studies, the two independent authors extracted data using a predetermined Excel form. Characteristics of the interventions were described and a meta-analysis was performed.
DATA SYNTHESIS
Twelve RCTs were included, representing 1,541 patients with a mean age of 58.7±5 years, and a BMI of 28.8±3.1; females being more predominant than males with a total ratio female/male of 2.2. The methodological quality of the included studies was of moderate quality in 75% of the studies. There was no statistically significant difference between mHealth-supported active exercises compared to the interventions without mHealth in terms of pain reduction (SMD= -0.42 [95%CI -0.91; 0.07], p = 0.08) and disability mitigation (SMD = -0.36 [95%CI -0.81; 0.09], p = 0.10). However, a statistically significant difference was found between patient education combined with mHealth-supported active exercises compared to patient education alone in terms of pain (SMD= -0.42 [95%CI -0.61; -0.22], p<0.01) and disability (SMD= -0.27 [95%CI -0.46; -0.08], p < 0.01) reduction.
CONCLUSION
mHealth-supported exercises were found to be effective, especially when combined with patient education, in reducing pain and mitigating disability in patients with hip or knee OA.
PubMed: 38945508
DOI: 10.1016/j.apmr.2024.06.008 -
BJOG : An International Journal of... Apr 2024The healthcare sector is responsible for 4%-10% of global greenhouse gas emissions. Considering the broad range of care that obstetricians and gynaecologists provide,... (Review)
Review
BACKGROUND
The healthcare sector is responsible for 4%-10% of global greenhouse gas emissions. Considering the broad range of care that obstetricians and gynaecologists provide, mitigation strategies within this specialty could result in significant reductions of the environmental footprint across the whole healthcare industry.
OBJECTIVES
The aim of this review was to identify for what services, procedures and products within obstetric and gynaecological care the environmental impact has been studied, to assess the magnitude of such impact and to identify mitigation strategies to diminish it.
SEARCH STRATEGY
The search strategy combined terms related to environmental impact, sustainability, climate change or carbon footprint, with the field of obstetrics and gynaecology.
SELECTION CRITERIA
Articles reporting on the environmental impact of any service, procedure or product within the field of obstetrics and gynaecology were included. Included outcomes covered midpoint impact categories, CO emissions, waste generation and energy consumption.
DATA COLLECTION AND ANALYSIS
A systematic literature search was conducted in the databases of MEDLINE (Ovid), Embase (Ovid) and Scopus, and a grey literature search was performed on Google Scholar and two websites of gynaecological associations.
MAIN RESULTS
The scope of the investigated studies encompassed vaginal births, obstetric and gynaecological surgical procedures, menstrual products, vaginal specula and transportation to gynaecological oncologic consultations. Among the highest yielding mitigation strategies were displacing disposable with reusable materials and minimising content of surgical custom packs. The lowest yielding mitigation strategy was waste optimisation, including recycling.
CONCLUSIONS
This systematic review highlights opportunities for obstetricians and gynaecologists to decrease their environmental footprint in many ways. More high-quality studies are needed to investigate the environmental impact of other aspects of women's and reproductive health care.
Topics: Female; Humans; Gynecology; Obstetrics; Carbon Footprint
PubMed: 37604701
DOI: 10.1111/1471-0528.17637 -
Indian Journal of Ophthalmology Mar 2021The primary focus of this review was to establish the possible association of dysbiotic changes in the gut bacterial microbiomes with both intestinal and... (Review)
Review
The primary focus of this review was to establish the possible association of dysbiotic changes in the gut bacterial microbiomes with both intestinal and extra-intestinal diseases with emphasis on ocular diseases such as bacterial keratitis, fungal keratitis, uveitis, age-related macular degeneration, and ocular mucosal diseases. For this particular purpose, a systematic search was conducted using PubMed and Google Scholar for publications related to gut microbiome and human health (using the keywords: gut microbiome, ocular disease, dysbiosis, keratitis, uveitis, and AMD). The predictions are that microbiome studies would help to unravel dysbiotic changes in the gut bacterial microbiome at the taxonomic and functional level and thus form the basis to mitigate inflammatory diseases of the eye by using nutritional supplements or fecal microbiota transplantation.
Topics: Bacteria; Dysbiosis; Gastrointestinal Microbiome; Humans; Keratitis; Microbiota
PubMed: 33595467
DOI: 10.4103/ijo.IJO_1362_20 -
Journal of Environmental Health Science... Dec 2022Climate change is among the most renowned concerns of the current century, endangering the lives of millions of people worldwide. To comply with the United Nations... (Review)
Review
INTRODUCTION
Climate change is among the most renowned concerns of the current century, endangering the lives of millions of people worldwide. To comply with the United Nations Climate Change Conference (COP21), hospitals should be on track to reduce greenhouse gas emissions. Although hospitals contribute to climate change by emitting greenhouse gases, they are also affected by the health consequences of climate change. Despite all the guidance provided, hospitals need more radical measures to confront climate change. The current study was carried out to examine the components of hospitals' adaptation to climate change and to review measures to confront climate change in hospitals.
METHOD
This systematic review was designed and carried out in 2020. The required information was collected from international electronic databases including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar. Moreover, Iranian datasets such as Scientific Database (SID), Irandoc, Magiran, and IranMedex were reviewed. No restriction was considered in the methodology of the study. For the relevant thesis, the ProQuest database was also explored. The related sources were examined and the Snowball method was applied to find additional related studies. The research team also reviewed other accessible electronic resources, such as international guidelines and academic websites. The checklist of the Joanna Briggs Institute (JBI, 2017) was employed in order to evaluate the quality of the included papers. The studies published until June1, 2020, were included in the study.
RESULTS
Of 11,680 published documents in the initial search, the full-texts of 140 were read after evaluating the titles and abstracts, of which 114 were excluded due to lack of sufficient information related to countermeasures in hospitals. Finally, the full-texts of 26 studies were reviewed to extract the required components. Two strategies were found, including climate change mitigation and climate change adaptation, with 13 components including water, wastewater, energy, waste, green buildings, food, transportation, green purchasing policy, medicines, chemicals and toxins, technology, sustainable care models, and leadership in hospitals were identified as affecting these measures and strategies.
CONCLUSION
Considering the significance of climate change and strategies to confront it as one of the current challenges and priorities in the world, it is necessary to develop a framework and model to reduce the effects of climate change and adapt to climate changes in hospitals and other health centers. The identification and classification of the measures and components, influencing hospital adaptability and solutions for reducing the climate change impacts could be the first stage in developing this strategy. This is because it is impossible to create this framework without identifying these factors and their mutual impacts at the first. In the present study, through a systematic review using a comprehensive approach, the related components were explored and divided into two categories, including measures to reduce the effects and measures to adapt to climate change. The results of this study can be useful in developing a comprehensive action model to reduce greenhouse gas emissions and adapt hospitals to climate change.
PubMed: 36406601
DOI: 10.1007/s40201-022-00810-5 -
Academic Psychiatry : the Journal of... Feb 2018Being a healthcare professional can be a uniquely rewarding calling. However, the demands of training and practice can lead to chronic distress and serious... (Review)
Review
OBJECTIVE
Being a healthcare professional can be a uniquely rewarding calling. However, the demands of training and practice can lead to chronic distress and serious psychological, interpersonal, and personal health burdens. Although higher burnout, depression, and suicide rates have been reported in healthcare professionals, only a minority receive treatment. Concerns regarding confidentiality, stigma, potential career implications, and cost and time constraints are cited as key barriers. Web-based and mobile applications have been shown to mitigate stress, burnout, depression, and suicidal ideation among several populations and may circumvent these barriers. Here, we reviewed published data on such resources and selected a small sample that readily can be used by healthcare providers.
METHODS
We searched PubMed for articles evaluating stress, burnout, depression, and suicide prevention or intervention for healthcare students or providers and identified five categories of programs with significant effectiveness: Cognitive Behavioral Therapy (online), meditation, mindfulness, breathing, and relaxation techniques. Using these categories, we searched for Web-based (through Google and beacon.anu.edu.au -a wellness resource website) and mobile applications (Apple and mobile. va.gov/appstore ) for stress, burnout, depression, and suicide prevention and identified 36 resources to further evaluate based on relevance, applicability to healthcare providers (confidentiality, convenience, and cost), and the strength of findings supporting their effectiveness.
RESULTS
We selected seven resources under five general categories designed to foster wellness and reduce burnout, depression, and suicide risk among healthcare workers: breathing (Breath2Relax), meditation (Headspace, guided meditation audios), Web-based Cognitive Behavioral Therapy (MoodGYM, Stress Gym), and suicide prevention apps (Stay Alive, Virtual Hope Box).
CONCLUSIONS
This list serves as a starting point to enhance coping with stressors as a healthcare student or professional in order to help mitigate burnout, depression, and suicidality. The next steps include adapting digital health strategies to specifically fit the needs of healthcare providers, with the ultimate goal of facilitating in-person care when warranted.
Topics: Adaptation, Psychological; Burnout, Professional; Depression; Health Personnel; Humans; Internet; Mobile Applications; Students, Health Occupations; Surveys and Questionnaires; Suicide Prevention
PubMed: 29256033
DOI: 10.1007/s40596-017-0868-0 -
Cancers Jun 2023(1) Background: Several studies have described the psychological harms of testing for cancer. However, most were conducted in asymptomatic subjects and in cancers with a... (Review)
Review
Evaluating the Harms of Cancer Testing-A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These.
(1) Background: Several studies have described the psychological harms of testing for cancer. However, most were conducted in asymptomatic subjects and in cancers with a well-established screening programme. We sought to establish cancers in which the literature is deficient, and identify variables associated with psychological morbidity and interventions to mitigate their effect. (2) Methods: Electronic bibliographic databases were searched up to December 2020. We included quantitative studies reporting on variables associated with psychological morbidity associated with cancer testing and primary studies describing interventions to mitigate these. (3) Results: Twenty-six studies described individual, testing-related, and organisational variables. Thirteen randomised controlled trials on interventions were included, and these were categorised into five groups, namely the use of information aids, music therapy, the use of real-time videos, patient navigators and one-stop clinics, and pharmacological or homeopathic therapies. (4) Conclusions: The contribution of some factors to anxiety in cancer testing and their specificity of effect remains inconclusive and warrants further research in homogenous populations and testing contexts. Targeting young, unemployed patients with low levels of educational attainment may offer a means to mitigate anxiety. A limited body of research suggests that one-stop clinics and patient navigators may be beneficial in patients attending for diagnostic cancer testing.
PubMed: 37444445
DOI: 10.3390/cancers15133335