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Patient Education and Counseling Sep 2023Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of... (Review)
Review
OBJECTIVE
Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of cancer patients, where those affected have the opportunity to exchange and normalize their feelings among equals.
METHODS
A systematic review searching four different databases (MEDLINE, PsycInfo, CINAHL and Web of Science) was conducted. We included studies investigating psychosocial peer-group interventions for offspring of cancer patients. A narrative synthesis summarised the characteristics of the interventions and the findings on effects and evaluation.
RESULTS
Ten articles on seven different peer-group interventions were analysed. Research designs and intervention concepts were heterogeneous. Overall, high acceptance, feasibility and positive effects of peer-group support were reported. Significant effects were found in six studies, e.g. in relation to psychological well-being, quality of life and coping skills.
CONCLUSION
Peer-group interventions are an accepted and helpful form of support. Providing children and adolescents of cancer patients for example with psychoeducation, community and coping strategies, thereby impacting on psychological well-being.
PRACTICE IMPLICATIONS
For comprehensive care, it seems to be important to offer support throughout the parent's cancer journey and to offer support flexibly as needed through group services as well as individual sessions.
Topics: Humans; Child; Adolescent; Quality of Life; Parents; Emotions; Adaptation, Psychological; Neoplasms
PubMed: 37331281
DOI: 10.1016/j.pec.2023.107844 -
Journal of Advanced Nursing Mar 2024To understand the strategies used to continue providing psychosocial support to cancer patients during the pandemic, including outcomes and implications beyond the... (Review)
Review
AIMS
To understand the strategies used to continue providing psychosocial support to cancer patients during the pandemic, including outcomes and implications beyond the pandemic.
DESIGN
A systematic review of original research.
DATA SOURCES
ProQuest Health & Medicine, CINAHL Complete (via EBSCOhost), Scopus, and PubMed were searched for original work published between January 2020 and December 2022.
METHODS
Abstract and title screening identified eligible articles for full-text review. Following a full-text review, data were extracted from eligible articles, and a risk of bias assessment was conducted. A synthesis without meta-analysis was performed.
RESULTS
Thirty-four articles met the selection criteria. These articles provide evidence that systematic adaptations during the pandemic improved the assessment and screening of psychological needs and/or increased the number of clients accessing services. Additionally, while the pandemic was associated with decreased psychosocial well-being for cancer patients, five intervention studies reported improvements in psychosocial well-being. Barriers, strategies, and recommendations were described.
CONCLUSION
Adapting psychosocial support during a pandemic can be successful, achieved relatively quickly, and can increase the uptake of support for people experiencing cancer.
IMPLICATIONS FOR PATIENT CARE
It is imperative that these adaptations continue beyond the pandemic to maximize adaptive psychosocial outcomes for a group vulnerable to ongoing mental health concerns.
IMPACT
While the COVID-19 pandemic was associated with increased psychosocial need for cancer patients, evidence in the review suggested that adaptations made to service delivery facilitated increased access for patients who may not previously have been able to access support. Additionally, improvements in psychosocial well-being were achieved. These findings are relevant for clinicians and decision-makers who fund and design psychosocial support services for cancer patients.
REPORTING METHOD
The review was guided by PRISMA Guidelines and the SWiM Reporting Guideline.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contribution.
PubMed: 38553869
DOI: 10.1111/jan.16175 -
Journal of Sport and Health Science May 2024B cells represent a crucial component of adaptive immunity that ensures long-term protection from infection by generating pathogen-specific immunoglobulins. Exercise...
BACKGROUND
B cells represent a crucial component of adaptive immunity that ensures long-term protection from infection by generating pathogen-specific immunoglobulins. Exercise alters B cell counts and immunoglobulin levels, but evidence-based conclusions on potential benefits for adaptive immunity are lacking. This systematic review assessed current literatures on the impact of acute exercise and exercise training on B cells, immunoglobulins, and markers of secretory immunity in human biofluids.
METHODS
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, MEDLINE, Web of Science, and Embase were searched on March 8, 2023. Non-randomized controlled trials and crossover trials investigating the impact of acute exercise or exercise training on B cell counts and proportions, immunoglobulin levels, salivary flow rate, or secretory immunoglobulin A secretion rate were included. Quality and reporting of exercise training studies were assessed using the Tool for the Assessment of Study Quality and reporting in Exercise. Study characteristics, outcome measures, and statistically significant changes were summarized tabularly.
RESULTS
Of the 67 eligible studies, 22 applied acute exercise and 45 applied exercise training. All included outcomes revealed significant alterations over time in acute exercise and exercise training context, but only a few investigations showed significant differences compared to control conditions. Secretory and plasma immunoglobulin A levels were most consistently increased in response to exercise training.
CONCLUSION
B cell-related outcomes are altered by acute exercise and exercise training, but evidence-based conclusions cannot be drawn with high confidence due to the large heterogeneity in populations and exercise modalities. Well-designed trials with large sample sizes are needed to clarify how exercise shapes B cell-related immunity.
Topics: Humans; Adaptive Immunity; B-Lymphocytes; Biomarkers; Exercise; Immunoglobulin A, Secretory; Saliva
PubMed: 37832643
DOI: 10.1016/j.jshs.2023.10.002 -
Veterinary World Oct 2023In recent years, artificial intelligence (AI) has become increasingly necessary in the life sciences, particularly medicine and healthcare. This study aimed to...
BACKGROUND AND AIM
In recent years, artificial intelligence (AI) has become increasingly necessary in the life sciences, particularly medicine and healthcare. This study aimed to systematically review the literature and critically analyze multiple databases on the use of AI in veterinary medicine to assess its challenges. We aim to foster an understanding of the effects that can be approached and applied for professional awareness.
MATERIALS AND METHODS
This study used multiple electronic databases with information on applied AI in veterinary medicine based on the current guidelines outlined in PRISMA and Cochrane for systematic review. The electronic databases PubMed, Embase, Google Scholar, Cochrane Library, and Elsevier were thoroughly screened through March 22, 2023. The study design was carefully chosen to emphasize evidence quality and population heterogeneity.
RESULTS
A total of 385 of the 883 citations initially obtained were thoroughly reviewed. There were four main areas that AI addressed; the first was diagnostic issues, the second was education, animal production, and epidemiology, the third was animal health and welfare, pathology, and microbiology, and the last was all other categories. The quality assessment of the included studies found that they varied in their relative quality and risk of bias. However, AI aftereffect-linked algorithms have raised criticism of their generated conclusions.
CONCLUSION
Quality assessment noted areas of AI outperformance, but there was criticism of its performance as well. It is recommended that the extent of AI in veterinary medicine should be increased, but it should not take over the profession. The concept of ambient clinical intelligence is adaptive, sensitive, and responsive to the digital environment and may be attractive to veterinary professionals as a means of lowering the fear of automating veterinary medicine. Future studies should focus on an AI model with flexible data input, which can be expanded by clinicians/users to maximize their interaction with good algorithms and reduce any errors generated by the process.
PubMed: 38023280
DOI: 10.14202/vetworld.2023.2143-2149 -
Journal of the American Medical... Nov 2023Social isolation and loneliness are major public health concerns. Informal dementia caregivers are particularly vulnerable, as many are older adults themselves and at...
OBJECTIVE
Social isolation and loneliness are major public health concerns. Informal dementia caregivers are particularly vulnerable, as many are older adults themselves and at elevated risk of adverse mental and physical health outcomes. Technology-based interventions could offer accessible, affordable, and convenient solutions. A previous review included Internet-based supportive interventions for informal dementia caregivers published up to 2013; however, new publications, technological advances, and targeted outcomes justify conducting this scoping review. Here, we identified and synthesized recent technology-based interventions that addressed social isolation and loneliness among informal dementia caregivers.
DESIGN
Scoping review.
SETTING AND PARTICIPANTS
Informal dementia caregivers in the community.
METHODS
Following Arksey and O'Malley's scoping review framework, we conducted a systematic search of peer-reviewed studies across 6 databases within the last 11 years, including identifying research questions, selecting relevant studies, charting data, and summarizing results.
RESULTS
From the 2937 articles identified, 10 eligible studies were included in this review. The intervention type, format, and duration varied widely. Three categories of interventions to address social isolation and loneliness among informal dementia caregivers included technology-assisted peer support, newly developed Web-based multicomponent psychoeducational programs and platforms, and virtual adaptation and modification of existing programs. Predominantly qualitative evidence suggests that technology-based interventions have the potential to reduce feelings of loneliness and improve caregiver well-being. Quantitative evidence tends to be preliminary and inconclusive.
CONCLUSIONS AND IMPLICATIONS
The findings offer preliminary evidence for technology-based interventions to reduce or prevent social isolation and loneliness in informal dementia caregivers. Technology-based interventions addressing social isolation and loneliness in informal dementia caregivers have the potential to overcome barriers to low uptake of services and withdrawal from interventions and improve the sustainability of the interventions. In the long run, by reducing or preventing social isolation and loneliness in informal dementia caregivers, the transition from home care to facility-based care might be delayed.
Topics: Humans; Caregivers; Dementia; Loneliness; Social Isolation; Technology
PubMed: 37678415
DOI: 10.1016/j.jamda.2023.08.005 -
PeerJ 2024Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular... (Meta-Analysis)
Meta-Analysis
Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis.
BACKGROUND
Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular function, and mental health in people with obesity and type 2 diabetes mellitus (T2DM). The aim of the present study was to synthesize the available data on the effectiveness of combined aerobic and resistance training (CART) on glycemic control, blood pressure, inflammation, cardiorespiratory fitness (CRF), and quality of life (QoL) in overweight and obese individuals with T2DM.
METHODS
A database search was carried out in PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar from inception up to May 2023. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used, and data were analyzed using standardized mean differences and 95% confidence intervals. The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42022355612).
RESULTS
A total of 21,612 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants (mean age: 57 ± 7 years) who met the eligibility criteria. CART demonstrated significant improvements in body mass index, glycated hemoglobin, systolic and diastolic blood pressure, C-reactive protein, tumor necrosis factor-alpha, interleukin-6, CRF, and QoL compared to ST. These findings highlight the significance of exercise interventions such as CART as essential elements within comprehensive diabetes management strategies, ultimately enhancing overall health outcomes in individuals with T2DM and overweight/obesity.No differences were found in resting heart rate between CART and ST. An uncertain risk of bias and poor quality of evidence were found among the eligible studies.
CONCLUSION
These outcomes show clear evidence considering the positive role of CART in inducing beneficial changes in various cardiometabolic and mental health-related indicators in patients with T2DM and concurrent overweight/obesity. More studies with robust methodological design are warranted to examine the dose-response relationship, training parameters configuration, and mechanisms behind these positive adaptations.
Topics: Humans; Middle Aged; Blood Glucose; Blood Pressure; Cardiorespiratory Fitness; Diabetes Mellitus, Type 2; Exercise; Glycemic Control; Inflammation; Obesity; Overweight; Quality of Life; Resistance Training
PubMed: 38887616
DOI: 10.7717/peerj.17525 -
Pain Management Nursing : Official... Aug 2023This review and meta-analysis aims to reveal how pain education interventions affect registered nurses' pain management. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This review and meta-analysis aims to reveal how pain education interventions affect registered nurses' pain management.
DESIGN
A systematic review and meta-analysis DATA SOURCES: PubMed, Scopus, CINAHL (EBSCOhost), and ERIC REVIEW METHODS: A systematic search of four electronic databases was conducted to identify relevant peer-reviewed English or Finnish-language articles published between 2008 and 2021. The review included a quality appraisal and a meta-analysis of articles providing group-level data before and after the intervention (n = 12). The methods followed the PRISMA guidelines.
RESULTS
Overall, 23 articles met the inclusion criteria for the review, of which 15 were evaluated as good quality. Based on the articles on document audits (n = 10), pain education interventions reduced the risk of not receiving the best pain management by 40%, whereas based on the articles on patients' experiences (n = 4), they reduced the risk by 25%. The study quality and design of these articles were considerably heterogenous.
CONCLUSIONS
Pain education study strategies varied widely among the included articles. These articles used multivariate interventions without systematization or sufficient opportunity to transfer the study protocols. It can be concluded that versatile pain nursing education interventions, as well as auditing of pain nursing and its documentation combined with feedback, can be effective to nurses in adapting pain management and assessment practices and increasing patient satisfaction. However, further research is required in this regard. In addition, well-designed, implemented, and reproducible evidence-based pain education intervention is required in the future.
Topics: Humans; Education, Nursing; Pain; Nursing Care; Language; Nurses
PubMed: 37032260
DOI: 10.1016/j.pmn.2023.03.004 -
Nursing Open Jan 2024To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery. (Meta-Analysis)
Meta-Analysis Review
AIM
To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery.
BACKGROUND
There has been a shift in the practice of elective surgery, from inpatient to ambulatory treatment. Accordingly, more patients are undergoing day surgery and expected to care for themselves at home. To our knowledge, an updated metasynthesis on patients' experiences of day surgery across diverse contexts and continents is lacking.
DESIGN
Meta-ethnography.
METHODS
MEDLINE, EMBASE and CINAHL were systematically searched for qualitative research in English published between 2006 and 2023. Noblit and Hare's meta-ethnographic approach guided the synthesis of findings from 12 qualitative studies, and the eMERGe Reporting Guidance was used in the writing of this article.
RESULTS
Four themes were revealed: (1) requests for tailored information, (2) challenges of recognising and understanding postoperative symptoms, (3) being dependent on continuous professional and personal support and (4) calling for individual adaptation.
CONCLUSION
Our meta-ethnography indicates there is a need to improve information provision to better prepare patients for the processes of day surgery and recovery and promote their self-care abilities. Our findings highlight the importance of ensuring adequate levels of individualised care and support throughout the treatment process.
RELEVANCE TO CLINICAL PRACTICE
To improve quality of care in day surgery practice, implementation of interventions to enhance information provision and promote self-care during recovery at home may be considered. Pre-admission appointments that incorporate provision of tailored information and assessment of the patients' individual needs of care and support, home conditions and access to assistance from family/friends can be recommended.
Topics: Adult; Humans; Ambulatory Surgical Procedures; Anthropology, Cultural; Elective Surgical Procedures; Qualitative Research
PubMed: 38268268
DOI: 10.1002/nop2.2055 -
American Journal of Kidney Diseases :... Oct 2023Central venous catheters (CVCs) are widely used for hemodialysis but are prone to burdensome and costly bloodstream infections. We determined whether multifaceted...
RATIONALE & OBJECTIVE
Central venous catheters (CVCs) are widely used for hemodialysis but are prone to burdensome and costly bloodstream infections. We determined whether multifaceted quality improvement interventions in hemodialysis units can prevent hemodialysis catheter-related bloodstream infections (HDCRBSI).
STUDY DESIGN
Systematic review.
SETTING & STUDY POPULATIONS
PubMed, EMBASE, and CENTRAL were searched from inception to April 23, 2022, to identify randomized trials, time-series analyses, and before-after studies that examined the effect of multifaceted quality improvement interventions on the incidence of HDCRBSI or access-related bloodstream infections (ARBSI) among people receiving hemodialysis outside of the intensive care unit (ICU).
DATA EXTRACTION
Two people independently extracted data and assessed the risk of bias and quality of evidence using validated tools.
ANALYTICAL APPROACH
Intervention effects, validity, and characteristics of studies with the same design were compared. Differences between study designs were described.
RESULTS
We included 21 studies from 8,824 identified by our search. Among 15 studies that measured HDCRBSI, 2 methodologically heterogenous cluster randomized trials reported discordant intervention effects, 2 interrupted time-series analyses reported favorable interventions with discordant patterns of effect, and 11 before-after studies reported favorable interventions with a very high risk of bias. Among 6 studies that only measured ARBSI, 1 time-series analysis and 1 before-after study did not find a favorable intervention effect, and 4 before-after studies reported a favorable effect with a very high risk of bias. The overall quality of evidence was low for HDCRBSI and very low for ARBSI.
LIMITATIONS
Nine definitions of HDCRBSI were used. Ten studies included hospital-based and satellite facilities but did not report separate intervention effects for each type of facility.
CONCLUSIONS
Multifaceted quality improvement interventions may prevent HDCRBSI outside the ICU. However, evidence supporting them is of low quality, and further carefully conducted studies are warranted.
REGISTRATION
Registered at PROSPERO with registration number CRD42021252290.
PLAIN-LANGUAGE SUMMARY
People with kidney failure rely on central venous catheters to facilitate life-sustaining hemodialysis treatments. Unfortunately, hemodialysis catheters are a common source of problematic bloodstream infections. Quality improvement programs have effectively prevented catheter-related infections in intensive care units, but it is unclear whether they can be adapted to patients using hemodialysis catheters in the community. In a systematic review that included 21 studies, we found that most quality improvement programs were reported to be successful. However, the findings were mixed among higher-quality studies, and overall the quality of evidence was low. Ongoing quality improvement programs should be complemented by more high-quality research.
Topics: Humans; Quality Improvement; Central Venous Catheters; Intensive Care Units; Sepsis; Catheter-Related Infections
PubMed: 37178814
DOI: 10.1053/j.ajkd.2023.02.006 -
AIDS (London, England) Aug 2023To identify types, evidence, and study gaps of alternative HIV preexposure prophylaxis (PrEP) care delivery models in the published literature.
OBJECTIVES
To identify types, evidence, and study gaps of alternative HIV preexposure prophylaxis (PrEP) care delivery models in the published literature.
DESIGN
Systematic review and narrative synthesis.
METHODS
We searched in the US Centers for Disease Control and Prevention (CDC) Prevention Research Synthesis (PRS) database through December 2022 (PROSPERO CRD42022311747). We included studies published in English that reported implementation of alternative PrEP care delivery models. Two reviewers independently reviewed the full text and extracted data by using standard forms. Risk of bias was assessed using the adapted Newcastle-Ottawa Quality Assessment Scale. Those that met our study criteria were evaluated for efficacy against CDC Evidence-Based Intervention (EBI) or Evidence-Informed Intervention (EI) criteria or Health Resources and Services Administration Emergency Strategy (ES) criteria, or for applicability by using an assessment based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework.
RESULTS
This review identified 16 studies published between 2018 and 2022 that implemented alternative prescriber ( n = 8), alternative setting for care ( n = 4), alternative setting for laboratory screening ( n = 1), or a combination of the above ( n = 3) . The majority of studies were US-based ( n = 12) with low risk of bias ( n = 11). None of the identified studies met EBI, EI, or ES criteria. Promising applicability was found for pharmacists prescribers, telePrEP, and mail-in testing.
CONCLUSIONS
Delivery of PrEP services outside of the traditional care system by expanding providers of PrEP care (e.g. pharmacist prescribers), as well as the settings of PrEP care (i.e. telePrEP) and laboratory screening (i.e. mail-in testing) may increase PrEP access and care delivery.
Topics: Humans; HIV Infections; Delivery of Health Care; Risk; Pre-Exposure Prophylaxis; Anti-HIV Agents
PubMed: 37199602
DOI: 10.1097/QAD.0000000000003601