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Behavioral Sciences (Basel, Switzerland) Jan 2021The objective of this review was to understand how participants experience the decision-making process regarding the place of care for the elderly. Therefore, we... (Review)
Review
The objective of this review was to understand how participants experience the decision-making process regarding the place of care for the elderly. Therefore, we conducted a systematic review of qualitative studies. The articles were included if they were original studies with qualitative/mixed methodology, written in English/Spanish, and that approached the decision-making process regarding the place of care for the elderly, already experienced by the participants. Forty-four articles were included, identifying experiences, both negative and positive. Negative experiences have been the most frequently reported experiences by all population groups; fear was the most relevant experience for the elderly, whereas concern was the most relevant for family members and professionals. This review has not only found a great variability of experiences, but also, it has deepened the differences between groups and the situations motivating/generating these experiences. This review highlights a wide range of experiences of those directly involved in the entire decision-making process on the place of care for the elderly. In future research it would be interesting to carry out qualitative primary studies conducted with professionals and other relevant people involved in this decision-making process, in order to know first-hand how they experience this process.
PubMed: 33494258
DOI: 10.3390/bs11020014 -
The Journal of Prosthetic Dentistry Dec 2016Radiotherapy has been considered a contraindication for rehabilitation with dental implants because it can change the survival rate of implants. Nevertheless, the... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Radiotherapy has been considered a contraindication for rehabilitation with dental implants because it can change the survival rate of implants. Nevertheless, the installation of implants in irradiated patients has been used with varying success.
PURPOSE
The purpose of this systematic review was to compare the success rate of implants placed in irradiated human bone tissue with that of implants placed in nonirradiated areas.
MATERIAL AND METHODS
Searches were performed in the EMBASE, Cochrane, and PubMed/Medline databases up to December 2013 to identify clinical trials addressing the subject. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The relative risks of implant failure and survival curves were calculated considering a confidence interval of 95%. Heterogeneity was analyzed by using a funnel chart.
RESULTS
A total of 40 studies involving 2220 participants and 9231 dental implants were selected. The survival curve of the studies indicated a survival rate of 84.3% for implants installed in irradiated bone tissue. The meta-analysis indicated statistically significant differences (P<.001) between item success rates of implants placed in irradiated areas and those of implants placed in nonirradiated areas.
CONCLUSIONS
Dental implants installed in the irradiated area of an oral cavity have a high survival rate, but strict monitoring is needed to prevent complications, thereby reducing possible failures.
Topics: Dental Implants; Dental Restoration Failure; Equipment Failure Analysis; Head and Neck Neoplasms; Humans; Jaw; Kaplan-Meier Estimate
PubMed: 27460315
DOI: 10.1016/j.prosdent.2016.04.025 -
Journal of Clinical Medicine Jan 2024The aim of the present systematic review was to investigate the influence of hypertension on the dental implant failure rate. (Review)
Review
PURPOSE
The aim of the present systematic review was to investigate the influence of hypertension on the dental implant failure rate.
METHODS
An electronic search was undertaken in four databases, plus a manual search of journals. The I statistic was used to check heterogeneity and the inverse-variance method was used for the meta-analysis. The estimate of relative effect for dichotomous outcome was expressed as an odds ratio (OR).
RESULTS
The review included 24 publications. There were 4874 implants (257 failures) placed in hypertensive patients and 16,192 implants (809 failures) placed in normotensive patients. A pairwise meta-analysis showed that implants in hypertensive patients did not have a higher risk of failure than implants placed in normotensive patients (OR 1.100, = 0.671). The log OR of implant failure between hypertensive and normotensive patients did not significantly change with the follow-up time ( = 0.824).
CONCLUSIONS
This review suggests that implants in hypertensive patients do not present higher odds of failure in comparison to normotensive patients. However, further research on this topic, with the use of more rigorous criteria to diagnose patients as being hypertensive, as well as clearer information about the pharmacological management of the condition in the patients, is recommended.
PubMed: 38256633
DOI: 10.3390/jcm13020499 -
Journal of Psychiatric and Mental... Nov 2017WHAT IS KNOWN ON THE SUBJECT?: Psychiatric patients have generally negative experiences of being exposed to coercive measures. Existing research has generally not... (Review)
Review
"Treat me with respect". A systematic review and thematic analysis of psychiatric patients' reported perceptions of the situations associated with the process of coercion.
UNLABELLED
WHAT IS KNOWN ON THE SUBJECT?: Psychiatric patients have generally negative experiences of being exposed to coercive measures. Existing research has generally not investigated coercion as a process; that is, it does not address issues that arise before, during and after exposure to coercion. A part of existing research within the area does not clarify and define the type of coercive measure(s) investigated. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Patients place great significance on the link between the positive and negative perceived impact of a coercive situation and the professionals' ability and willingness to interact and communicate respectfully. Psychiatric patients associate the use of seclusion, physical restraint/holding, mechanical restraint and forced medication with strong negative perceptions and wish to be treated with respect by professionals, rather than being subjected to the professionals' control. What patients perceive as moderating factors in regard to the use of coercive measures is currently under-researched. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Increased sensitivity to the patient's views of the situation at each point in the coercive process would help professionals to respond to the patients' individual needs. Professionals need to articulate concern and empathy towards patients and to improve communication skills before, during and after a coercive incident. Greater emphasis should be placed on de-escalation and the use of non-coercive strategies or coping skills before the initiation of coercive measures.
ABSTRACT
Introduction There is a lack of research into psychiatric patients' perceptions of coercion that discriminates between different types of coercive measures, while also investigating patients' perceptions of undergoing coercion as a process. This knowledge is required to improve our understanding and provide a foundation for improving clinical practice. Aims To review existing research literature in order to investigate adult psychiatric patients' reported perceptions of situations before, during and after specific and defined types of coercive measures, and to investigate what patients perceive as moderating factors, in regard to the use of these coercive measures. Method A systematic review and thematic analysis of 26 peer-reviewed studies was undertaken. Results The analysis identified six themes and additional subthemes, where "interactions with professionals" and "communication" were predominant themes across the timeline of coercion. Altogether, themes were associated with either "positive or negative patient-perceived impact." Implications for practice Increased sensitivity to patients' views of the situation at each point in the process is desirable in order to respond to the patients' individual needs. Professionals also need to articulate concern and empathy towards the patient and to improve communication skills before, during and after a coercive incident. Use of de-escalation and noncoercive strategies is required. Relevance statement Coercion within psychiatric/mental health care remains controversial, and repeated international calls have recommended a reduction of their use. This review indicates that greater attention to how patients perceive the use of coercive measures (before, during, and after incidents) needs to be considered in order to improve the evidence-based and clinical practice.
Topics: Coercion; Humans; Inpatients; Mentally Ill Persons; Patient Isolation; Professional-Patient Relations; Restraint, Physical
PubMed: 28665512
DOI: 10.1111/jpm.12410 -
Dentistry Journal Sep 2023To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate... (Review)
Review
OBJECTIVES
To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate and delayed placement in adults.
METHODS
A search for the relevant literature was performed using the databases of CENTRAL, MEDLINE and Scopus. The studies found were limited to publications between 2014 and 2022, written in the English language, peer-reviewed, and were randomised trials or comparative studies. The quality of the evidence was assessed using the Cochrane Risk of Bias 2.0 and Risk of Bias in Non-randomised Studies-of Interventions appraisal tools and implant survival, and the primary outcome was meta-analysed using RevMan v.5.3.
RESULTS
A total of 10 studies were eligible for inclusion, including six randomised controlled trials and four non-randomised comparative studies. Five of the six randomised trials observed a low risk of bias, while the comparative studies had a moderate-to-serious risk of bias. The search strategy resulted in 341 implants placed immediately into fresh extraction sites (332 survived, 97.4%) and 359 implants inserted into delayed sites (350 survived, 97.5%).
CONCLUSION
The meta-analysis demonstrated that there was no significant difference in the implant survival rates between immediately placed implants and implants placed using a delayed timing protocol (risk ratio 0.99; 95% CI 0.96, 1.02, Z = 0.75, = 0.45). However, the detailed analysis showed that slightly more implant failures happened in the immediate dental implant placement group, with survival rates in some studies ranging between 90 and 95%, while the delayed placement group had survival rates of more than 95%.
PubMed: 37754338
DOI: 10.3390/dj11090218 -
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 -
European Journal of Vascular and... Apr 2017Endovascular abdominal aortic aneurysm repair (EVAR) sometimes requires internal iliac artery (IIA) coverage to achieve a landing zone in the external iliac artery. The... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Endovascular abdominal aortic aneurysm repair (EVAR) sometimes requires internal iliac artery (IIA) coverage to achieve a landing zone in the external iliac artery. The aim of this study was to determine complication rates following IIA exclusion.
MATERIALS AND METHODS
A systematic review of key journals was undertaken from January 1980 to April 2016. Studies detailing occlusion (using coils or plugs) or coverage of the IIA with outcome data were included. Weighted means were calculated for continuous variables. Meta-analysis was performed when comparative data were available. Quality was assessed using the GRADE system.
RESULTS
Sixty-one non-randomised studies (2671 patients; 2748 IIAs) were analysed. Fifteen per cent of EVARs require IIA sacrifice. Buttock claudication (BC) occurred in 27.9% of patients, although 48.0% resolved after 21.8 months. BC rates were 32.6% with coils, 23.8% with plugs, and 12.9% with coverage alone, and less with unilateral (vs. bilateral) IIA treatment (OR 0.57, 95% CI 0.36-0.91). More proximal coil placement resulted in lower rates of BC (OR 0.12, 95% CI 0.03-0.48). Erectile dysfunction occurred in 10.2% of males, with higher rates after coiling. Type II endoleaks were more frequent after covering alone; however re-interventions were rare. Significant ischaemic events (bowel/gluteal/spinal ischaemia) were very rare. Plugs were quicker to place and required less radiation (p < .001) than coils. GRADE scoring was very low for all outcomes.
CONCLUSION
Overall the quality of reported data on IIA sacrifice is poor. Buttock claudication and erectile dysfunction occurred frequently after IIA sacrifice. Where both options are technically possible, plugs could be considered preferential to coils, and placed as proximally in the IIA as possible.
Topics: Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Chi-Square Distribution; Embolization, Therapeutic; Endovascular Procedures; Humans; Iliac Artery; Odds Ratio; Postoperative Complications; Prosthesis Design; Risk Factors; Treatment Outcome
PubMed: 28242154
DOI: 10.1016/j.ejvs.2017.01.009 -
The Journal of Prosthetic Dentistry Jan 2022Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the... (Meta-Analysis)
Meta-Analysis Review
Biomechanical and histomorphometric analysis of endosteal implants placed by using the osseodensification technique in animal models: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the osseodensification technique on primary implant stability, bone-implant contact, and bone area frequency occupancy is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to investigate the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification technique in animal models.
MATERIAL AND METHODS
An electronic search through Medline/PubMed, Lilacs, and Science Direct databases, and an additional manual search of the reference list of included articles was conducted by using specific keywords and Medical Subject Headings (MeSH) terms for articles in the English language and published up to April 31, 2020. Only animal studies comparing the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification and conventional drilling protocol were included. The SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using Animal Research: Reporting in Vivo Experiments (ARRIVE) guidelines.
RESULTS
Nine studies were included. The results of the meta-analysis showed that the pooled weighted mean difference of the insertion torque value for the primary implant stability of endosseous dental implants placed by using the osseodensification technique was 2.270 (95% confidence interval [CI]=1.147 to 3.393; P<.001), the weighted mean difference of the percentage of bone-implant contact at 3 weeks was 0.487 (95% CI=0.220 to 0.754; P=.114), the weighted mean difference of the percentage of bone-implant contact at 6 weeks was 0.565 (95% CI=0.219 to 0.911; P=.448), the weighted mean difference of the percentage of bone area frequency occupancy at 3 weeks was 0.679 (95% CI=0.265 to 1.093; P=.073), and the weighted mean difference of the percentage of bone area frequency occupancy at 6 weeks was 0.391 (95% CI=-0.204 to 0.986; P=.027).
CONCLUSIONS
Limited data from animal studies suggest that the primary implant stability, bone-implant contact, and bone area frequency occupancy significantly improved for the endosteal implants placed by using the osseodensification technique compared with conventional drilling protocol. However, additional laboratory and clinical studies are recommended to provide stronger evidence.
Topics: Animals; Dental Implantation, Endosseous; Dental Implants; Osseointegration; Osteotomy; Torque
PubMed: 33139057
DOI: 10.1016/j.prosdent.2020.07.004 -
Palliative Medicine Jan 2020People with serious mental illness have greater mortality risk than the general population. They experience health care inequalities throughout life; it is not clear if...
BACKGROUND
People with serious mental illness have greater mortality risk than the general population. They experience health care inequalities throughout life; it is not clear if this persists to end of life.
AIM
Assess the empirical evidence describing end-of-life care and place of death for people with serious mental illness.
DESIGN
A systematic review of original, peer-reviewed research, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analysed using a narrative synthesis approach.
DATA SOURCES
Five online databases (Embase, PsycArticles, PsycINFO, Medline, PubMed) and additional sources were searched (without time restriction) for primary research reporting health care utilisation in the last year of life or place of death in adults with serious mental illness.
RESULTS
After full-text screening, 23 studies were included. We found studies reporting hospital admissions, emergency department care, palliative care, and general practitioner (GP) visits at end of life. We found conflicting evidence for the association between serious mental illness and end-of-life care, although different patient groups, settings and measures were used across studies. People with serious mental illness were more likely to die in care homes than the general population. There were no patterns for other places of death.
CONCLUSIONS
The evidence was sparse and heterogeneous, demonstrating variability in patterns and reporting of health care use and with little consensus on where people with serious mental illness are likely to die. Given that people with serious mental illness have increased mortality risk, this gap in the knowledge around end-of-life care outcomes is concerning; this area of research needs further development.
Topics: Death; Female; Healthcare Disparities; Humans; Male; Mental Disorders; Severity of Illness Index; Terminal Care
PubMed: 31608768
DOI: 10.1177/0269216319867847 -
BMC Geriatrics Aug 2017This study aimed to synthesize the current literature examining the association between migration and cognitive function among middle-aged and older adults. (Review)
Review
BACKGROUND
This study aimed to synthesize the current literature examining the association between migration and cognitive function among middle-aged and older adults.
METHODS
We used the PRISMA as a guideline for this systematic review and searched the following databases: PubMed, CINAHL, EMBASE, and Global Health.
RESULTS
Twenty-five published studies were included. Twenty-two studies were focused on international migrants, while only 3 studied internal migrants. Fourteen studies were conducted in the United States, followed by UK (n = 2), Israel (n = 2), India (n = 2) and other countries like Canada and Australia. Some studies showed that middle-aged and older migrants demonstrated poorer cognitive function comparing to non-migrants in hosting places; while other studies indicated no association between migration and cognitive function. A higher level of acculturation was associated with better performance on cognitive function tests among migrants.
CONCLUSION
It is unclear how or whether migration and cognitive function are related. The quality of current literature suffered from methodological deficiencies. Additional research is needed to examine the linkages using more comprehensive measures of migration and cognitive function.
Topics: Acculturation; Aged; Cognition; Emigration and Immigration; Humans; Middle Aged; Transients and Migrants
PubMed: 28818064
DOI: 10.1186/s12877-017-0585-2