-
Respiratory Medicine May 2009The effectiveness of multiple interventions in asthma and chronic obstructive pulmonary disease (COPD) is unclear. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The effectiveness of multiple interventions in asthma and chronic obstructive pulmonary disease (COPD) is unclear.
OBJECTIVE
To examine the effectiveness of multiple interventions as compared to single interventions or usual care on health outcomes and health care utilisation within the context of integrated disease management in asthma and COPD.
METHODS
MEDLINE and the Cochrane Library (1995-May 2008) were searched for controlled trials. Two reviewers independently extracted data and assessed study quality. Meta-analyses were performed on quality of life and health care utilisation data. Furthermore, the effects of multiple interventions versus single interventions and usual care were assessed qualitatively.
RESULTS
Of the 36 studies included, 17 targeted double interventions (patient-related and organisational interventions); 19 studies performed triple interventions (patient-related, professional-directed and organisational interventions). They were heterogeneous in terms of (combinations of) interventions, outcomes measured, study design and setting. Pooled data showed that studied disease management programmes significantly improved quality of life on several domains. Patients within triple intervention programmes had less chance of at least one hospital admission compared with usual care. No significant effects were found in number of emergency department visits. Qualitative analyses revealed positive trends on process improvements and satisfaction. Inconclusive results were reported on symptoms; no effects were found in lung function.
CONCLUSION
In spite of the heterogeneity of disease management studies in asthma and COPD care, this review showed promising improvements in quality of life and reductions in hospitalisations, especially for triple intervention programmes.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asthma; Disease Management; Evidence-Based Medicine; Health Resources; Hospitalization; Humans; Middle Aged; Outcome and Process Assessment, Health Care; Pulmonary Disease, Chronic Obstructive; Quality of Life; Randomized Controlled Trials as Topic; Young Adult
PubMed: 19155168
DOI: 10.1016/j.rmed.2008.11.017 -
Environmental Management May 2023The ability to adopt novel tools continues to become more important for governments and environmental managers tasked with balancing economic development, social needs...
The ability to adopt novel tools continues to become more important for governments and environmental managers tasked with balancing economic development, social needs and environmental protection. An example of an emerging technology that can enable flexible, cost-effective data collection for conservation and environmental management is Unmanned Aerial Vehicles (UAVs). It is clear that UAVs are beginning to be adopted for a diversity of purposes, identification of barriers to their use is the first step in increasing their uptake amongst the environmental management community. Identifying the barriers to UAV usage will enable research and management communities to confidently utilise these powerful pieces of technology. However, the implementation of this technology for environmental research has received little overall assessment attention. This systematic literature review has identified 9 barrier categories (namely Technological, Analytical and Processing, Regulatory, Cost, Safety, Social, Wildlife impact, work suitability and others) inhibiting the uptake of UAV technologies. Technological barriers were referenced in the literature most often, with the inability of UAVs to perform in poor weather (such as rain or windy conditions) commonly mentioned. Analytical and Processing and Regulatory barriers were also consistently reported. It is likely that some barriers identified will lessen with time (e.g. technological and analytical barriers) as this technology continues to evolve.
Topics: Animals; Unmanned Aerial Devices; Animals, Wild; Remote Sensing Technology; Technology; Data Collection
PubMed: 36525068
DOI: 10.1007/s00267-022-01768-8 -
Information Systems Frontiers : a... 2020Emergency management (EM) has always been a concern of people from all walks of life due to the devastating impacts emergencies can have. The global outbreak of COVID-19...
Emergency management (EM) has always been a concern of people from all walks of life due to the devastating impacts emergencies can have. The global outbreak of COVID-19 in 2020 has pushed EM to the top topic. As mobile phones have become ubiquitous, many scholars have shown interest in using mobile phone data for EM. This paper presents a systematic literature review about the use of mobile phone data for EM that includes 65 related articles written between 2014 and 2019 from six electronic databases. Five themes in using mobile phone data for EM emerged from the reviewed articles, and a systematic framework is proposed to illustrate the current state of the research. This paper also discusses EM under COVID-19 pandemic and five future implications of the proposed framework to guide future work.
PubMed: 32952439
DOI: 10.1007/s10796-020-10057-w -
Journal of Medical Internet Research Apr 2021Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently... (Review)
Review
BACKGROUND
Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently to electronic health records. In addition to securely managing data, blockchain has significant advantages in distributing data access, control, and ownership to end users. Due to this attribute, among others, the use of blockchain to power personal health records (PHRs) is especially appealing.
OBJECTIVE
This review aims to examine the current landscape, design choices, limitations, and future directions of blockchain-based PHRs.
METHODS
Adopting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a cross-disciplinary systematic review was performed in July 2020 on all eligible articles, including gray literature, from the following 8 databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science, and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form.
RESULTS
A total of 58 articles met the inclusion criteria. In the review, we found that the blockchain PHR space has matured over the past 5 years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual application of blockchain in PHRs is intended for the health care industry, the majority of the articles were found in engineering or computer science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the most common design choices. Although 18 articles described a tethered blockchain PHR, all of them were at the conceptual stage.
CONCLUSIONS
This review revealed that although research interest in blockchain PHRs is increasing and that the space is maturing, this technology is still largely in the conceptual stage. Being the first systematic review on blockchain PHRs, this review should serve as a basis for future reviews to track the development of the space.
Topics: Blockchain; Delivery of Health Care; Electronic Health Records; Health Records, Personal; Humans; Technology
PubMed: 33847591
DOI: 10.2196/25094 -
Bulletin of Emergency and Trauma Jan 2019To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which... (Review)
Review
OBJECTIVE
To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance.
METHOD
The necessary information in the first stage was collected by searching these keywords: "Lean principles" "Lean Six Sigma", "Lean Process", "Lean thinking", "Lean Methodology", "Toyota Production System lean processing", "lean techniques", "emergency department", "emergency medicine", "emergency room" and "emergency care " . And in the next stage the keywords such as "lean management" and "emergency" was collected from SID, Medlib, IranDoc, Google Scholar, MagIran, IranMedex data bases. For extracting the data data-extracting forms was prepared. The information we got from the forms was organized in information-extracting forms and was analyzed manually. The diagrams were drawn in Excel: 2010.
RESULTS
Finally, 26 essays have been included. Most of the studies were accomplished in Canada and U.S.A. only in one of the cases, the authors used the control group. Each of these terms, "lean techniques" and "lean principals", with five times repetitions had the highest frequency. The most important team of implementation of lean management included: hospital management team or the manager of Emergency department, physicians, nurses, staffs and external counselors. Generally, 51 indicators were studied which among them the length of stay and the timing had the most frequency. After implementation of lean management, almost all studied indicators have significantly improved. 14 barriers, 14 facilitators and 10 effective factors were recognized in implementing the lean management.
CONCLUSION
According to the studies, responsibility of organization's senior management and his/her supports; increasing the knowledge of the characteristics and dimension of lean among the providers of health service; and decreasing the resistance and consulting with external counselors can have great effect on the success of lean management.
PubMed: 30719461
DOI: 10.29252/beat-070102. -
The Cochrane Database of Systematic... Aug 2017Essential tremor (ET) is one of the most common movement disorders. The treatment is primarily based on pharmacological agents. Although primidone and propranolol are... (Review)
Review
BACKGROUND
Essential tremor (ET) is one of the most common movement disorders. The treatment is primarily based on pharmacological agents. Although primidone and propranolol are well established treatments in clinical practice, they can be ineffective in 25% to 55% of patients, and can produce serious adverse events in a large percentage of them. For these reasons, it may be worthwhile evaluating the treatment alternatives for ET. Zonisamide has been suggested as a potentially useful agent for the treatment of ET but there is uncertainty about its efficacy and safety.
OBJECTIVES
To assess the effect on functional abilities and the safety profile of zonisamide in adults with essential tremor (ET).
SEARCH METHODS
We carried out a systematic search, without language restrictions to identify all relevant trials. We searched CENTRAL, MEDLINE, Embase, NICE, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) to January 2017. We searched BIOSIS Citation Index (2000 to January 2017) for conference proceedings. We handsearched grey literature and examined the reference lists of identified studies and reviews.
SELECTION CRITERIA
We included all randomised controlled trials (RCTs) of zonisamide versus placebo or any other treatment. We included studies in which the diagnosis of ET was made according to accepted and validated diagnostic criteria. We excluded studies conducted in patients presenting secondary forms of tremor or reporting only neurophysiological parameters to assess outcomes.
DATA COLLECTION AND ANALYSIS
Two review authors independently collected and extracted data using a data collection form. We assessed the risk of bias and the quality of evidence.We used inverse variance methods for continuous outcomes and measurement scales. We compared differences between treatment groups as mean differences. We combined results for dichotomous outcomes using Mantel-Haenszel methods and obtained risk differences to compare treatment groups. We used Review Manager 5 software for data management and analysis.
MAIN RESULTS
We only considered one study eligible for this review (20 participants). Assessments of risk of bias for most domains were unclear or low. Adverse events were only reported in participants from the zonisamide group, making it possible that they were aware of treatment group assignment. We are uncertain as to the effects of zonisamide on motor tasks (mean difference (MD) -0.00, 95% confidence interval (CI) -1.51 to 1.51, very low-quality evidence) and functional disabilities (MD -0.30, 95% CI -1.23 to 0.63, very low-quality evidence) when compared with placebo. Three participants in the zonisamide group (30%) and two participants in the placebo group (20%) discontinued the treatment and withdrew from the study for any reason (very low-quality evidence), however the increased risk of withdrawal in the zonisamide group was statistically non-significant (risk difference (RD) 0.1, 95% CI -0.28 to 0.48). Six participants in the zonisamide group (60%) and none of the participants in the placebo group (0%) developed adverse events (AEs), with a RD of 0.60 (95% CI 0.28 to 0.92; very low quality evidence). The most common AEs, experienced with zonisamide treatment, were headache, nausea, fatigue, sleepiness, and diarrhoea. Quality of life was not assessed in the study included.
AUTHORS' CONCLUSIONS
Based on currently available data, there is insufficient evidence to assess the efficacy and safety of zonisamide treatment for ET.
Topics: Anticonvulsants; Essential Tremor; Humans; Isoxazoles; Randomized Controlled Trials as Topic; Zonisamide
PubMed: 28836659
DOI: 10.1002/14651858.CD009684.pub2 -
La Clinica Terapeutica 2019This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS)...
This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were: LEGO therapy, Social Use of Language Programme, Let's Face It! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT's benefits and limitations in AS patients.
Topics: Asperger Syndrome; Child; Cognitive Behavioral Therapy; Data Management; Humans; Occupational Therapy; Randomized Controlled Trials as Topic; Severity of Illness Index; Treatment Outcome
PubMed: 31612197
DOI: 10.7417/CT.2019.2164 -
Healthcare (Basel, Switzerland) Feb 2021Blockchain technology was introduced through Bitcoin in a 2008 whitepaper by the mysterious Satoshi Nakamoto. Since its inception, it has gathered great attention... (Review)
Review
Blockchain technology was introduced through Bitcoin in a 2008 whitepaper by the mysterious Satoshi Nakamoto. Since its inception, it has gathered great attention because of its unique properties-immutability and decentralized authority. This technology is now being implemented in various fields such as healthcare, IoT, data management, etc., apart from cryptocurrencies. As it is a newly emerging technology, researchers and organizations face many challenges in integrating this technology into other fields. Consent management is one of the essential processes in an organization because of the ever-evolving privacy laws, which are introduced to provide more control to users over their data. This paper is a systematic review of Blockchain's application in the field of consent and privacy data management. The review discusses the adaptation of Blockchain in healthcare, IoT, identity management, and data storage. This analysis is formed on the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and a process of systematic mapping review. We provide analysis of the development, challenges, and limitations of blockchain technology for consent management.
PubMed: 33535465
DOI: 10.3390/healthcare9020137 -
Clinical Rehabilitation Jan 2024To synthesize the evidence of the effectiveness of self-management interventions during the peri-hospitalization period. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To synthesize the evidence of the effectiveness of self-management interventions during the peri-hospitalization period.
DATA SOURCES
Three databases (i.e. PubMed, Web of Science, and Scopus) were systematically searched.
REVIEW METHODS
Full-text randomized controlled studies that assessed the effects of self-management interventions initiated during the peri-hospitalization period in patients with stroke were included. Two independent reviewers performed data extraction. A third reviewer was available for discrepancies. The methodological quality was evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2). Data were pooled and a meta-analysis was performed.
RESULTS
Eight studies comprising 1030 participants were included. The self-management interventions showed considerable heterogeneity in their protocols, although most of them included an individualized plan based on the patient's needs. The meta-analysis was performed with data from the self-efficacy domains. The pooled results showed a trend towards the self-management intervention on quality of life (1.07, 95% confidence interval [CI] 0.52 to 1.63; = 0.0002) but neither in dependence (0.80, 95% CI -0.14 to 1.74; = 0.10) nor in self-efficacy (0.77, 95% CI -0.44 to 1.98; = 0.21).
CONCLUSION
Most of the studies reviewed suggest that self-management interventions had an impact on dependency, quality of life and self-efficacy when compared with usual care, written materials about stroke, or post-discharge rehabilitation recommended by a physician. However, the evidence in this review neither supports nor refutes self-management interventions used in addition to usual care, or other interventions, to improve dependency, quality of life and/or self-efficacy in patients' post-stroke.
Topics: Humans; Quality of Life; Patient Discharge; Self-Management; Aftercare; Hospitalization; Stroke
PubMed: 37551095
DOI: 10.1177/02692155231193563