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Recherche En Soins Infirmiers 2021Falls among hospitalized frail elderly patients are a worrying, major daily phenomenon.
INTRODUCTION
Falls among hospitalized frail elderly patients are a worrying, major daily phenomenon.
CONTEXT
Inadequate footwear, frequently observed in this population, is one of the main risk factors behind falls. Several hospitals use non-slip socks as a preventive measure. However, in the context of evidence-based medicine, it is important to verify the existence of strong evidence for their effectiveness.
OBJECTIVE
The aim of this study is to determine the preventive effectiveness of non-slip socks.
METHOD
Five databases were investigated (PubMed, PEDro, Cochrane, ScienceDirect, and Google Scholar). Eligibility criteria were established (using the PICO method), for studies including elderly hospitalized patients.
RESULTS
Seven studies were included. Non-slip socks showed a preventive effect in reducing the recurrence of falls (p=0.009) and the prevalence of falls related to urinary incontinence.
DISCUSSION
Several studies conclude on the added value of non-slip socks compared to traditional socks or slippers. The limitations inherent in the selected studies are taken into account when drawing conclusions.
CONCLUSION
Footwear that is considered safe by therapists and secure by the patient is currently the most recommended option. However, more clinical studies are needed to support our findings.
Topics: Accidental Falls; Aged; Frail Elderly; Hospitalization; Hospitals; Humans; Risk Factors
PubMed: 35724024
DOI: 10.3917/rsi.146.0060 -
Age and Ageing Nov 2023Falls are a leading cause of injury and mortality among older adults. While multiple strategies are effective at reducing fall risk, uptake is low. Understanding how...
BACKGROUND
Falls are a leading cause of injury and mortality among older adults. While multiple strategies are effective at reducing fall risk, uptake is low. Understanding how older adults think about fall risk and prevention activities can inform outreach initiatives and engagement.
METHODS
We systematically searched PubMed, SCOPUS and Google Scholar for articles published between January 2015 and April 2023. Studies were eligible if they reported on knowledge or perception of fall risk and/or prevention among community-dwelling older adults.
RESULTS
We included 53 studies from 20 different countries. Over half of the studies used qualitative methods, 19 used quantitative, and three used mixed methods. Most of the older adults could identify some fall risk factors and the consequences of falls. However, many older adults did not view themselves as at-risk for falls. Some older adults consider falls an inevitable part of ageing, while others believe that falls can be prevented. Cultural context may play a role in shaping these beliefs. Several studies reported on older adults' experiences and the perceived barriers and facilitators of participating in fall prevention activities.
CONCLUSION
Improving the accuracy of older adults' perceptions of their own fall risk and highlighting the fact that many falls are preventable are two key messages that may help motivate older adults to take action to prevent falls. Older adults cite their healthcare provider as a trusted source of prevention information, and clinicians can leverage this opportunity to inform and motivate older adult patients about fall prevention.
Topics: Humans; Aged; Risk Factors; Aging; Health Personnel; Perception
PubMed: 38016017
DOI: 10.1093/ageing/afad220 -
Medicine Sep 2023Transjugular intrahepatic portosystemic shunt (TIPS) can be an effective treatment for cirrhotic patients who develop variceal bleeding and ascites. However, TIPS... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Transjugular intrahepatic portosystemic shunt (TIPS) can be an effective treatment for cirrhotic patients who develop variceal bleeding and ascites. However, TIPS placement is associated with an increased risk of developing hepatic encephalopathy (HE). Recently, there have been efforts to use the typical medical therapies prophylactically in patients undergoing TIPS placement to prevent post-TIPS HE.
METHODS
We conducted literature searches in MEDLINE, Embase, CINAHL, Scopus, and Cochrane to examine studies that use prophylactic medical therapy for preventing post-TIPS HE. A narrative synthesis and grading of recommendations assessment assessment were done for all studies. Meta-analysis was performed for eligible studies using the Mantel-Haenszel method random-effects model. Nine hundred twenty-one articles were screened and 5 studies were included in the study after 2 levels of screening. The medications studied were rifaximin, lactulose, lactitol, L-Ornithine-L-aspartate (LOLA), albumin, and combination therapies.
RESULTS
Narrative results showed that lactulose, lactitol, LOLA and albumin prophylaxis were not associated with reduction in HE occurrence or mortality. A combination of rifaximin and lactulose was found to be associated with lower occurrence of HE, and the results were not different when LOLA was added. Meta-analysis (n = 3) showed that rifaximin treatment was not associated with changes in HE occurrences.
CONCLUSION
In conclusion, a vast majority of medications were not found to be effective post-TIPS HE prophylaxis when used alone. A rifaximin and lactulose combination therapy may be beneficial. Overall, there is significant limitation in the current data and more studies are needed to yield more robust meta-analysis results in the future.
Topics: Humans; Hepatic Encephalopathy; Lactulose; Rifaximin; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Albumins; Primary Prevention
PubMed: 37746955
DOI: 10.1097/MD.0000000000035266 -
Journal of Pediatric Nursing 2023It has been reported in various studies that identifying risk and protective factors and outcomes of cyberbullying perpetration (CP) and cyberbullying victimization (CV)... (Meta-Analysis)
Meta-Analysis Review
PROBLEM
It has been reported in various studies that identifying risk and protective factors and outcomes of cyberbullying perpetration (CP) and cyberbullying victimization (CV) is crucial for educational strategies to fight against cyberbullying. The main purpose of the present study is to conduct a meta-analysis and systematic review to identify which risk and protective factors are more strongly associated with CP/CV and possible consequences of CP/CV among children and youth in Türkiye.
ELIGIBILITY CRITERIA
Various databases, including PubMed, Web of Science (WoS), ProQuest, ERIC, SCOPUS, Turkish Psychiatry Index, DergiPark, and National Dissertation/Thesis Center of Türkiye were searched to identify relevant studies.
SAMPLE
Fifty-nine studies met the inclusion criteria included in the present study.
RESULTS
Results revealed that the strongest risk factor was traditional bullying for CP (r = 0.47, p < .001) and traditional victimization for CV (r = 0.43, p < .001). The strongest protective factor was social skill for CP (r = -0.45, p < .001) and empathy for CV (r = -0.25, p < .001). In addition, involvement in CP behaviors had the strongest effect on negative self-concept (r = 0.28, p < .001), while exposure to CV on anxiety (r = 0.35, p < .001).
CONCLUSIONS
Although this study has some limitations, the study's findings are important source of information for many professionals, such as pediatric nurses, school psychological counselors, psychologists, and policymakers to further educational strategies for children and young people in Türkiye.
IMPLICATIONS
The study findings would be useful for developing educational programs to strengthen protective factors and reduce risk factors to prevent cyberbullying perpetration behaviors.
Topics: Child; Humans; Adolescent; Cyberbullying; Turkey; Bullying; Crime Victims; Risk Factors
PubMed: 37696170
DOI: 10.1016/j.pedn.2023.09.003 -
Eating and Weight Disorders : EWD Dec 2022Eating disorders (EDs) and high body mass index (BMI) are two important public health issues with significant health and cost impacts. The aim of this systematic review... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Eating disorders (EDs) and high body mass index (BMI) are two important public health issues with significant health and cost impacts. The aim of this systematic review and meta-analysis was to establish whether interventions are effective in preventing both issues.
METHODS
Electronic databases were searched up to 10 May 2021. Studies were included if they were randomised or quasi-randomised controlled trials that evaluated a preventive intervention (regardless of its aim to prevent ED, high BMI or both) and reported both EDs and BMI-related outcomes. Both narrative synthesis and meta-analysis were used to synthesise the results. Publication bias was also investigated.
RESULTS
Fifty-four studies were included for analysis. The primary aim of the studies was ED prevention (n = 23), high BMI prevention (n = 21) and both ED and high BMI prevention (n = 10). Meta-analysis results indicated that preventive interventions had a significant effect on several ED outcomes including dieting, shape and weight concerns, body dissatisfaction, negative affect, eating disorder symptoms and internalization, with effect sizes ranging from - 0.16 (95% CI - 0.27, - 0.06) to - 0.61 (95% CI - 0.29, - 0.04). Despite several studies that demonstrated positive impacts on BMI, there was no significant effect on BMI-related measures in the meta-analysis. The risk of publication bias was low for the majority of the pooled effect results.
CONCLUSION
Preventive interventions were effective for either high BMI or EDs. However, there is limited evidence to show that current preventive interventions were effective in reducing both outcomes. Further research is necessary to explore the risk factors that are shared by these weight-related disorders as well as effective prevention interventions.
LEVEL OF EVIDENCE
Level I: systematic review.
Topics: Humans; Body Mass Index; Risk Factors; Feeding and Eating Disorders; Body Dissatisfaction; Exercise
PubMed: 36029370
DOI: 10.1007/s40519-022-01458-8 -
Hepatobiliary & Pancreatic Diseases... Dec 2023Post-hepatectomy liver failure (PHLF) is a leading cause of postoperative mortality after liver surgery. Due to its significant impact, it is imperative to understand... (Review)
Review
BACKGROUND
Post-hepatectomy liver failure (PHLF) is a leading cause of postoperative mortality after liver surgery. Due to its significant impact, it is imperative to understand the risk stratification and preventative strategies for PHLF. The main objective of this review is to highlight the role of these strategies in a timeline centered way around curative resection.
DATA SOURCES
This review includes studies on both humans and animals, where they addressed PHLF. A literature search was conducted across the Cochrane Library, Embase, MEDLINE/PubMed, and Web of Knowledge electronic databases for English language studies published between July 1997 and June 2020. Studies presented in other languages were equally considered. The quality of included publications was assessed using Downs and Black's checklist. The results were presented in qualitative summaries owing to the lack of studies qualifying for quantitative analysis.
RESULTS
This systematic review with 245 studies, provides insight into the current prediction, prevention, diagnosis, and management options for PHLF. This review highlighted that liver volume manipulation is the most frequently studied preventive measure against PHLF in clinical practice, with modest improvement in the treatment strategies over the past decade.
CONCLUSIONS
Remnant liver volume manipulation is the most consistent preventive measure against PHLF.
Topics: Humans; Hepatectomy; Liver Neoplasms; Liver Failure; Liver Function Tests; Postoperative Complications; Retrospective Studies
PubMed: 36973111
DOI: 10.1016/j.hbpd.2023.03.001 -
American Journal of Preventive Medicine Jan 2022Intimate partner violence and sexual violence are widespread and often occur early in life. This systematic review examines the effectiveness of interventions for... (Review)
Review
INTRODUCTION
Intimate partner violence and sexual violence are widespread and often occur early in life. This systematic review examines the effectiveness of interventions for primary prevention of intimate partner violence and sexual violence among youth.
METHODS
Studies were identified from 2 previous systematic reviews and an updated search (January 2012-June 2016). Included studies were implemented among youth, conducted in high-income countries, and aimed to prevent or reduce the perpetration of intimate partner violence or sexual violence. In 2016-2017, Guide to Community Preventive Services (Community Guide) methods were used to assess effectiveness as determined by perpetration, victimization, or bystander action. When heterogeneity of outcomes prevented usual Community Guide methods, the team systematically applied criteria for favorability (statistically significant at p<0.05 or approaching significance at p<0.10) and consistency (75% of results in the same direction).
RESULTS
A total of 28 studies (32 arms) met inclusion and quality of execution criteria. Interventions used combinations of teaching healthy relationship skills, promoting social norms to protect against violence, or creating protective environments. Overall, 18 of 24 study arms reported favorable results on the basis of the direction of effect for decreasing perpetration; however, favorability for bystander action diminished with longer follow-up. Interventions did not demonstrate consistent results for decreasing victimization. A bridge search conducted during Fall 2020 confirmed these results.
DISCUSSION
Interventions for the primary prevention of intimate partner violence and sexual violence are effective in reducing perpetration. Increasing bystander action may require additional follow-up as effectiveness diminishes over time. Findings may inform researchers, school personnel, public health, and other decision makers about effective strategies to prevent intimate partner violence and sexual violence among youth.
Topics: Adolescent; Crime Victims; Humans; Intimate Partner Violence; Sex Offenses; Sexual Behavior; Sexual Partners
PubMed: 34772564
DOI: 10.1016/j.amepre.2021.06.021 -
Journal of Gastrointestinal Surgery :... Nov 2023This systematic review explored different medications and methods for prevention and treatment of pouchitis after restorative proctocolectomy with ileal pouch-anal... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This systematic review explored different medications and methods for prevention and treatment of pouchitis after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).
METHODS
PubMed, Scopus, and Web of Science were searched for randomized clinical trials that assessed prevention or treatment of pouchitis. The systematic review was reported in line with updated 2020 PRISMA guidelines. Risk of bias in the trials included was assessed using the ROB-2 tool and certainty of evidence was assessed using GRADE. The main outcomes were the incidence of new pouchitis episodes in the preventative studies and resolution or improvement of active pouchitis in the treatment studies.
RESULTS
Fifteen randomized trials were included. A meta-analysis of 7 trials on probiotics revealed significantly lower odds of pouchitis with the use of probiotics (RR: 0.26, 95% CI: 0.16-0.42, I = 20%, p < 0.001) and similar odds of adverse effects to placebo (RR: 2.43, 95% CI: 0.11-55.9, I = 0, p = 0.579). One trial investigated the prophylactic role of allopurinol in preventing pouchitis and found a comparable incidence of pouchitis in the two groups (31% vs 28%; p = 0.73). Seven trials assessed different treatments for active pouchitis. One recorded the resolution of pouchitis in all patients treated with ciprofloxacin versus 67% treated with metronidazole. Both budesonide enema and oral metronidazole were associated with similar significant improvement in pouchitis (58.3% vs 50%, p = 0.67). Rifaximin, adalimumab, fecal microbiota transplantation, and bismuth carbomer foam enema were not effective in treating pouchitis.
CONCLUSIONS
Probiotics are effective in preventing pouchitis after IPAA. Antibiotics, including ciprofloxacin and metronidazole, are likely effective in treating active pouchitis.
Topics: Humans; Pouchitis; Metronidazole; Colitis, Ulcerative; Randomized Controlled Trials as Topic; Proctocolectomy, Restorative; Ciprofloxacin; Anastomosis, Surgical
PubMed: 37815701
DOI: 10.1007/s11605-023-05841-3 -
Journal of Trace Elements in Medicine... May 2022The COVID-19 pandemic has severely affected the world's population in the last two years. Along with non-pharmacological public health interventions, major efforts have... (Review)
Review
BACKGROUND AND AIM
The COVID-19 pandemic has severely affected the world's population in the last two years. Along with non-pharmacological public health interventions, major efforts have also been made to identify effective drugs or active substances for COVID-19 prevention and treatment. These include, among many others, the trace elements zinc and selenium, based on laboratory studies and some observational human studies. However, both of these study designs are not adequate to identify and approve treatments in human medicine, and experimental studies in the form of randomized controlled trials are needed to demonstrate the effectiveness and the safety of any interventions.
METHODS
We undertook a systematic review in which we searched for published and unpublished clinical trials using zinc or selenium supplementation to treat or prevent COVID-19 in the Pubmed, Scopus and ClinicalTrials databases up to 10 January 2022.
RESULTS
Amongst the published studies, we did not find any trial with selenium, whereas we retrieved four eligible randomized clinical trials using zinc supplementation, only one of which was double-blind. One of these trials looked at the effect of the intervention on the rate of new SARS-CoV-2 infections, and three at the COVID-19 clinical outcome in already infected individuals. The study populations of the four trials were very heterogeneous, ranging from uninfected individuals to those hospitalized for COVID-19. Only two studies investigated zinc alone in the intervention arm with no differences in the endpoints. The other two studies examined zinc in association with one or more drugs and supplements in the intervention arm, therefore making it impossible to disentangle any specific effects of the element. In addition, we identified 22 unpublished ongoing clinical trials, 19 on zinc, one on selenium and two on both elements.
CONCLUSION
No trials investigated the effect of selenium supplementation on COVID-19, while the very few studies on the effects of zinc supplementation did not confirm efficacy. Therefore, preventive or therapeutic interventions against COVID-19 based on zinc or selenium supplementation are currently unjustified, although when the results of the on-going studies are published, this may change our conclusion.
Topics: Humans; Selenium; Zinc; COVID-19; Pandemics; SARS-CoV-2; Dietary Supplements; Randomized Controlled Trials as Topic
PubMed: 35217499
DOI: 10.1016/j.jtemb.2022.126956 -
Dental and Medical Problems 2023White spot lesions (WSLs) are one of the most common adverse effects following comprehensive fixed orthodontic treatment. The purpose of this review was to evaluate... (Review)
Review
White spot lesions (WSLs) are one of the most common adverse effects following comprehensive fixed orthodontic treatment. The purpose of this review was to evaluate recent studies addressing the prevention and treatment of these lesions. Electronic databases were searched for English-written studies published between 2015 and October 2020 involving randomized clinical trials aiming at prevention or treatment of orthodontically induced WSLs using the following keywords in their title or abstracts: randomized clinical trial OR randomized controlled trial AND white spot OR caries OR demineralization OR decalcification OR remineralization. From the 23 papers which met the inclusion criteria, 11 were on preventive methods, while 12 addressed treatment protocols. However, most of the reviewed studies had a high risk of bias. The results of this review strongly support the importance of oral hygiene observation in preventing WSLs. Sodium fluoride varnish 5% was confirmed to be effective in the treatment of these lesions, as well as in the prevention of WSLs in patients with suboptimal oral hygiene. In addition, immediate CO2 laser irradiation after bonding can effectively prohibit formation of WSLs during orthodontic treatment. The literature also illustrates a promising masking effect of resin infiltration for the treatment of WSLs. However, little scientific evidence supports the effectiveness of Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) against WSLs, although more clinical trials with long-term follow-up are needed. Oral hygiene maintenance is crucial in the prevention of WSLs, and 5% sodium fluoride varnish and CO2 laser irradiation are recommended in patients with compromised oral hygiene. In the case of WSL formation, fluoride varnish and resin infiltration are effective treatment modalities.
Topics: Humans; Cariostatic Agents; Fluorides, Topical; Tooth Remineralization; Dental Caries; Sodium; Randomized Controlled Trials as Topic
PubMed: 37815515
DOI: 10.17219/dmp/140964