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Ochsner Journal 2024The rapid evolution of neuroendovascular intervention has resulted in the inclusion of endovascular techniques as a core competency in neurosurgical residency training.... (Review)
Review
The rapid evolution of neuroendovascular intervention has resulted in the inclusion of endovascular techniques as a core competency in neurosurgical residency training. We conducted a literature review of studies involving the training of neurosurgical residents in cerebrovascular and endovascular neurosurgery. We reviewed the evolution of cerebrovascular neurosurgery and the effects of these changes on residency, and we propose interventions to supplement contemporary training. A total of 48 studies were included for full review. Studies evaluated trainee education and competency (29.2%, 14/48), neuroendovascular training models (20.8%, 10/48), and open cerebrovascular training models (52.1%, 25/48), with some overlap. We used a qualitative analysis of reviewed reports to generate a series of suggested training supplements to optimize cerebrovascular education. Cerebrovascular neurosurgery is at a crossroads where trainees must develop disparate skill sets with inverse trends in volume. Continued longitudinal exposure to both endovascular and open cerebrovascular surgical fields should be mandated in general resident education, and blended learning tactics using adjunct simulation systems and models should be incorporated with didactics to both optimize learning and alleviate restraints placed by decreased volume and autonomy.
PubMed: 38510222
DOI: 10.31486/toj.23.0118 -
Clinical Neurology and Neurosurgery Aug 2023External ventricular drains (EVDs) are used to monitor and treat elevated intracranial pressure. EVDs are often placed blindly without the use of imaging guidance, and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
External ventricular drains (EVDs) are used to monitor and treat elevated intracranial pressure. EVDs are often placed blindly without the use of imaging guidance, and successful placement with respect to pass attempts and final catheter location may suffer as a result of this freehand technique.
METHODS
A systematic literature search was conducted in PubMed, Embase, Web of Science, and Cochrane databases to identify studies pertaining to freehand EVD placement through March 30, 2022. Studies were included if they reported percentage of EVDs placed successfully on the first pass attempt, or final catheter location as defined by the Kakarla Grading System. Pooled weighted incidence estimates and 95% confidence intervals (95%CI) were calculated using a random effects model.
RESULTS
Of the 2964 results returned from the literature search, 39 studies were included in this meta-analysis. These studies reported on 6313 EVDs placed via freehand technique in 6070 patients with the following respective incidence: successful EVD placement on the first attempt (78%, 95%CI: 67-86%); placement with a Kakarla Grade of 1 (optimal location) (72%, 95%CI: 66-77%); hemorrhage (7%, 95%CI: 6-10%), and infection (5%, 95%CI: 3-8%).
CONCLUSIONS
Only 78% of EVDs in this meta-analysis were placed successfully on the first pass, and only 72% of final placements were deemed optimal. This represents a relatively high rate of suboptimal outcomes with respect to EVD placement, which could potentially be avoided with the use of navigation-assisted placement techniques.
Topics: Humans; Ventriculostomy; Drainage; Intracranial Hypertension; Catheters; Databases, Factual; Retrospective Studies
PubMed: 37399698
DOI: 10.1016/j.clineuro.2023.107852 -
Journal of Cancer Survivorship :... Sep 2023Mobile phone applications are positioned to support, educate, and empower cancer survivors during post-treatment care. We undertook a review to assess the utility of... (Review)
Review
PURPOSE
Mobile phone applications are positioned to support, educate, and empower cancer survivors during post-treatment care. We undertook a review to assess the utility of such smartphone applications; determine whether their use correlates with improved quality of life and other self-reported outcomes; and understand the feasibility of integrating mobile apps into routine follow-up care.
METHODS
MEDLINE, EMBASE, Emcare, and PsycINFO databases were searched for studies evaluating apps that addressed at least one of the five Cancer Survivorship Care Quality Framework (CSCQF) domains published up until December 2021. Studies were narratively synthesized. Implementation barriers and facilitators were mapped against the Technology Acceptance Model.
RESULTS
Twenty-three primary studies were included in this review. Only three randomized controlled trials (RCTs) were identified. Studies generally found mobile apps to be feasible, acceptable, and well-placed to support survivorship care. Health promotion was the most predominant CSCQF domain with apps primarily aiming to support exercise and dietary changes. The domains of monitoring for cancer recurrence (n=5) and management of co-morbidities (n=1) were underrepresented. Barriers to app use included greater time since active treatment, lack of familiarity with technology, and content not tailored to the user.
CONCLUSIONS
Mobile apps are both feasible and acceptable in supporting the transition between active treatment and follow-up care. However, understanding the utility of such apps is limited by the low number of RCTs.
IMPLICATIONS FOR CANCER SURVIVORS
Mobile apps have the potential to be useful support tools for patients post-treatment. However, given the number of apps developed, targeted, and available to cancer survivors, practical guidance to help cancer survivors choose appropriate apps is needed.
PubMed: 37700151
DOI: 10.1007/s11764-023-01435-9 -
Disaster Medicine and Public Health... Sep 2023Major incidents are occurring in increasing frequency, and place significant stress on existing health-care systems. Simulation is often used to evaluate and improve the... (Review)
Review
Major incidents are occurring in increasing frequency, and place significant stress on existing health-care systems. Simulation is often used to evaluate and improve the capacity of health systems to respond to these incidents, although this is difficult to evaluate. A scoping review was performed, searching 2 databases (PubMed, CINAHL) following PRISMA guidelines. The eligibility criteria included studies addressing whole hospital simulation, published in English after 2000, and interventional or observational research. Exclusion criteria included studies limited to single departments or prehospital conditions, pure computer modelling and dissimilar health systems to Australia. After exclusions, 11 relevant studies were included. These studies assessed various types of simulation, from tabletop exercises to multihospital events, with various outcome measures. The studies were highly heterogenous and assessed as representing variable levels of evidence. In general, all articles had positive conclusions with respect to the use of major incidence simulations. Several benefits were identified, and areas of improvement for the future were highlighted. Benefits included improved understanding of existing Major Incident Response Plans and familiarity with the necessary paradigm shifts of resource management in such events. However, overall this scoping review was unable to make definitive conclusions due to a low level of evidence and lack of validated evaluation.
Topics: Humans; Australia; Computer Simulation; Hospitals; Mass Casualty Incidents
PubMed: 37655589
DOI: 10.1017/dmp.2023.120 -
European Journal of Dental Education :... May 2024Assessment ensures that undergraduate students and postgraduate trainees are providing optimal patient care. Numerous assessment methods are currently being used within...
INTRODUCTION
Assessment ensures that undergraduate students and postgraduate trainees are providing optimal patient care. Numerous assessment methods are currently being used within the United Kingdom. Therefore, the purpose of this review was to provide an overview of the methods used to assess competency in exodontia and compare methods against criteria defined for good assessment.
MATERIALS AND METHODS
A systematic narrative review was carried out. Databases were electronically searched for published studies assessing the competence of undergraduate students and postgraduate trainees in exodontia up to October 2023.The validity, reproducibility, equivalence, feasibility, educational impact, catalytic effect and acceptability of each assessment method was considered.
RESULTS
In this review, 591 undergraduate students (n = 529) and postgraduate dental trainees (n = 62) had their competence in exodontia assessed. Undergraduate students were assessed on simple exodontia with forceps and elevators, whereas postgraduate trainees were assessed on the surgical removal of mandibular third molars. Only one study took place in a simulated dental environment, the remaining (n = 7) took place in a clinical environment. A range of formative and summative assessment methods were identified including structured clinical objective tests (SCOT), self-assessment, peer assessment and logbooks. Common marking criteria such as global rating and checklist scales were also highlighted.
CONCLUSION
This review highlights the lack of evidence to support one form of assessment and the lack of consensus on assessment within the United Kingdom. Further research related to this topic, alongside the opinion of trainees and trainers is required to improve assessments. This will maximise learning opportunities for trainees and translate to better patient care.
Topics: Humans; Clinical Competence; Reproducibility of Results; Education, Dental; Tooth Extraction; United Kingdom
PubMed: 37961850
DOI: 10.1111/eje.12976 -
BMC Pregnancy and Childbirth Apr 2024Depression is one of the most common mental disorders in the postpartum period. Depression can decrease self-efficacy in breastfeeding by reducing the mother's... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Depression is one of the most common mental disorders in the postpartum period. Depression can decrease self-efficacy in breastfeeding by reducing the mother's self-confidence. Considering the conflicting results regarding the relationship between postpartum depression and breastfeeding self-efficacy, this systematic review was conducted to investigate the relationship between breastfeeding self-efficacy and postpartum depression.
METHOD
In this systematic review, published articles in PubMed, Scopus, Web of Sciences, Cochrane Library, and Google Scholar databases were searched using English keywords "Self-efficacy, breastfeeding, breastfeeding Self-efficacy, depression, postpartum depression" without publication date limit. Data analysis was done with employing STATA14 software. Heterogeneity was assessed using I index which was 0%. Therefore, the fixed effects method was used to combine the data and perform meta-analysis.
RESULT
The results of the meta-analysis showed that based on the fixed effect method, depression was associated with decreased breastfeeding self-efficacy on the first day (SMD = 0.62, 95%CI: -0.830, -0.41, p = 0.0001) and on the third day (SMD = 0.84, 95% CI: -0.55,1.14, p = 0.0001). The Begg and Manzumdar test revealed no publication bias, with p = 0.317.
CONCLUSION
Postpartum depression may be associated with a decrease in the mother's breastfeeding self-efficacy and placing mother in a condition to pay low attention to her maternal role. Therefore, healthcare providers should provide adequate support according to the needs of mothers and develop diagnostic and treatment protocols to improve the level of maternal health.
Topics: Female; Humans; Depression, Postpartum; Self Efficacy; Breast Feeding; Mothers; Postpartum Period
PubMed: 38609849
DOI: 10.1186/s12884-024-06465-4 -
Frontiers in Psychology 2024Our main research question in this article was: What are the competence structures for innovative processes? Both the nature of the unforeseen and innovation are related...
INTRODUCTION
Our main research question in this article was: What are the competence structures for innovative processes? Both the nature of the unforeseen and innovation are related to something unknown, i.e., that competence needs to be developed to be able to handle situations and solutions that are not yet completely known. In our article, we address the question of how studies of innovation describe and use concepts of competence in various forms.
METHOD
We performed a systematic review of the relation between the unforeseen and innovation. In this systematic review we followed the Non-Interventional, Reproducible, and Open (NIRO) Systematic Reviews protocol. The identification of studies via databases and registers was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA) statement. The various types of competence found in the literature review were grouped in such a way that we could develop a structure to use as the basis for a new concept of competence needed in order to initiate and implement innovative processes. We refer to this overview of different competence types as designated competence structures for innovative processes. The searches resulted in the following number of abstracts, respectively Web of Science (2997), ERIC (454), and PsycInfo (550), meaning that a total of 3,768 abstracts were found to be relevant. The 3,768 abstracts were imported into the program Covidence for screening in the first search.
RESULTS
After completing the evaluation process in accordance with the PRISMA checklist and flow diagram, 32 abstracts were found to be relevant for our research question as they were related to competence for the unforeseen and innovation.
CONCLUSION
Few of the studies we investigated specifically mention competence. Another finding is that the innovation literature describes the activities that should take place linked to what it refers to as competence. Thus, the innovation research field does not define what the competence is or what it consists of, at either individual or group level, but rather describes the activities that contribute to successful innovation in an organization with little emphasis on how this competence should be developed. Training perspectives are lacking when it comes to innovation literature perspectives on competence.
PubMed: 38572200
DOI: 10.3389/fpsyg.2024.1166878 -
Journal of Clinical Medicine Mar 2024Obesity is invariably accompanied by autonomic dysfunction, although data in pediatric populations are conflicting. We conducted a systematic review and meta-analysis... (Review)
Review
Obesity is invariably accompanied by autonomic dysfunction, although data in pediatric populations are conflicting. We conducted a systematic review and meta-analysis of 12 studies (totaling 1102 participants) comparing obese and normal-weight subjects (5-18 years of age), defined as body mass index >95th or <85th percentile, respectively. Using a random-effects model, we report the standardized mean differences (SMD) of sympathetic and vagal indices of heart rate variability. Autonomic dysfunction was present in the obesity group, based on the average SMD in the standard deviation of sinus intervals (at -0.5340), and on the ratio of low (LF)- to high (HF)-frequency spectra (at 0.5735). There was no difference in sympathetic activity, but the heterogeneity among the relevant studies weakens this result. SMD in HF (at 0.5876), in the root mean square of successive differences between intervals (at -0.6333), and in the number of times successive intervals exceeded 50 ms divided by the total number of intervals (at -0.5867) indicated lower vagal activity in the obesity group. Autonomic dysfunction is present in obese children and adolescents, attributed to lower vagal activity. Further studies are needed in various pediatric cohorts, placing emphasis on sympathetic activity.
PubMed: 38610619
DOI: 10.3390/jcm13071854 -
Le Infezioni in Medicina 2023Toxocariasis is an infection caused in canines, felines, humans, and other vertebrates by species of the genus , such as and . The embryonated eggs of these parasites... (Review)
Review
INTRODUCTION
Toxocariasis is an infection caused in canines, felines, humans, and other vertebrates by species of the genus , such as and . The embryonated eggs of these parasites are the main form of acquisition of the infection both for definitive hosts, such as the dog and the cat, respectively and for paratenic hosts, such as humans and other vertebrates. Toxocariasis infection in humans causes visceral larva migrans syndrome. When deposited on park soils, environmental contamination becomes a risk for environmental, human, and animal health.
OBJECTIVE
To systemically estimate the prevalence of spp. eggs in park soils in Latin America.
METHODS
A systematic review and meta-analysis were performed to evaluate the prevalence of eggs in park soils in Latin America, defined by copro-parasitological, molecular and immunological techniques. We searched PubMed, Scopus, Web of Sciences, Embase, LILACS and SciELO for studies published from 1900 through 28 January 2023. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% confidence intervals (95% CI). Heterogeneity was measured through I statistics.
RESULTS
Forty-nine studies (2,508 parks and 12,833 samples) were included, of whom 44 had a low risk of bias. The pooled prevalence of eggs in parks in Latin America was 50.0% (95% CI: 40.0%-60.0%). Argentina had the highest prevalence of eggs in parks (100%), followed by Brazil (66%) and Venezuela (63%). The pooled prevalence of eggs in soil samples was 20.0% (95% CI: 14.0%-26.0%); in faecal samples, it was 13.0% (95% CI: 6.0%-23.0%).
CONCLUSION
The presence of eggs in public parks in Latin America is a zoonotic and public health threat for the people who go to these places, especially if children play on the ground with dirt or contaminated objects; since many pet owners and general public are not adequately informed about the mode of transmission of this parasite.
PubMed: 37701393
DOI: 10.53854/liim-3103-7 -
Nursing Open Dec 2023To explore the factors that affect the quality of interactions between nursing personnel and the informal caregivers of people with memory disorders. (Review)
Review
Quality of interaction between the nursing personnel and the informal caregivers of people with memory disorders: A systematic review and metasummary of qualitative studies.
AIM
To explore the factors that affect the quality of interactions between nursing personnel and the informal caregivers of people with memory disorders.
DESIGN
Systematic review and metasummary of qualitative empirical research.
METHODS
The literature search targeted studies concerning the professional care interactions between nursing personnel and the informal caregivers of people with progressive memory disorders. The search in PubMed, CINAHL, PsycINFO and Scopus covered records from the earliest possible date up to December 2020. The data were summarised using a qualitative metasummary method. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist was used to validate the reporting process.
RESULTS
Ten articles were included. As presented in 33 statements, the factors affecting the quality of interactions were related to (1) expectations, (2) memory disorders, (3) interaction strategies, (4) time and place of interactions and (5) organisational aspects. Meeting the individual interactional needs of informal caregivers is recommended. The results provide guidance for improving the quality of interactions between nursing personnel and informal caregivers.
Topics: Humans; Caregivers; Qualitative Research; Nursing Staff; Nurses
PubMed: 37828798
DOI: 10.1002/nop2.2029