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Journal of Robotic Surgery Jun 2024The aim of this review is to map the current research on the needs of gynecological patients treated with robotic surgery. Systematic Rapid Review. Pubmed, Web of... (Review)
Review
The aim of this review is to map the current research on the needs of gynecological patients treated with robotic surgery. Systematic Rapid Review. Pubmed, Web of Science, Google Scholar. Search was limited from the years 2017-2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed. Rapid review is a synthesis of information produced in a shorter time than systematic reviews, which allows clinical nurses to access evidence in the decision-making process. The methodological steps implemented were the following: (1) needs assessment and topic selection, (2) study development, (3) literature search, (4) screening and study selection, (5) data extraction, (6) risk-of-bias assessment and (7) knowledge synthesis. The search yielded 815 articles, 746 were excluded after screening the title and abstract, and 69 full-text syntheses were performed. Only 10 articles were included in the final analysis. This research evaluated the effects of robotic surgery on the patient under seven themes; operative time, length of stay, complications, estimated blood loss, pain, survivor, and conversion. Five studies were on endometrial cancer, one study on gynecologic cancer, two studies on hysterectomy, one study on patient safety, and one study on cervical cancer. The results show that robotic surgery can change the needs of patients by solving ongoing problems in gynecological patients. This requires a better understanding of robotic surgery procedures while facilitating nursing care over patient care.
Topics: Humans; Robotic Surgical Procedures; Female; Patient Care; Gynecologic Surgical Procedures; Operative Time; Length of Stay; Blood Loss, Surgical; Hysterectomy; Patient Safety; Postoperative Complications; Endometrial Neoplasms; Genital Neoplasms, Female; Uterine Cervical Neoplasms
PubMed: 38896293
DOI: 10.1007/s11701-024-01955-1 -
BMC Oral Health Jun 2024Knowledge about patient safety in orthodontics is scarce. Lack of standardisation and a common terminology hinders research and limits our understanding of the... (Review)
Review
BACKGROUND
Knowledge about patient safety in orthodontics is scarce. Lack of standardisation and a common terminology hinders research and limits our understanding of the discipline. This study aims to 1) summarise current knowledge about patient safety incidents (PSI) in orthodontic care by conducting a systematic literature search, 2) propose a new standardisation of PSI terminology and 3) propose a future research agenda on patient safety in the field of orthodontics.
METHODS
A systematic literature search was performed in the main online sources of PubMed, Web of Science, Scopus and OpenGrey from their inception to 1 July 2023. Inclusion criteria were based on the World Health Organization´s (WHO) research cycle on patient safety. Studies providing information about the cycle's steps related to orthodontics were included. Study selection and data extraction were performed by two of the authors.
RESULTS
A total of 3,923 articles were retrieved. After review of titles and abstracts, 41 articles were selected for full-text review and 25 articles were eligible for inclusion. Seven provided information on the WHO's research cycle step 1 ("measuring harm"), twenty-one on "understanding causes" (step 2) and twelve on "identifying solutions" (step 3). No study provided information on Steps 4 and 5 ("evaluating impact" or "translating evidence into safer care").
CONCLUSION
Current evidence on patient safety in orthodontics is scarce due to a lack of standardised reporting and probably also under-reporting of PSIs. Current literature on orthodontic patient safety deals primarily with "measuring harms" and "understanding causes of patient safety", whereas less attention has been devoted to initiatives "identifying solutions", "evaluating impact" and "translating evidence into safer care". The present project holds a proposal for a new categorisation, terminology and future research agenda that may serve as a framework to support future research and clinical initiatives to improve patient safety in orthodontic care.
REGISTRATION
PROSPERO (CRD42022371982).
Topics: Humans; Patient Safety; Orthodontics; Terminology as Topic
PubMed: 38890596
DOI: 10.1186/s12903-024-04375-7 -
Journal of the American Heart... Jun 2024Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the standard treatment for SVASD, data on outcomes have been confined to small cohorts. Thus, we conducted a systematic review of the outcomes of SVASD repair.
METHODS AND RESULTS
The primary outcome was death. Secondary outcomes encompassed atrial fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular accident, reoperation, residual septal defect, superior vena cava obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences of outcomes were calculated using a random-effects model. Forty studies involving 1320 patients who underwent SVASD repair were included. The majority were male patients (55.4%), with 88.0% presenting with associated anomalous pulmonary venous connection. The weighted mean age was 18.6±12.5 years, and the overall weighted mean follow-up period was 8.6±10.4 years. The in-hospital mortality rate was 0.24%, with a 30-day mortality rate of 0.5% reported in 780 patients. Incidences of atrial fibrillation, sinus node dysfunction, pacemaker insertion, and cerebrovascular accident over the long-term follow-up were 3.3% (2.18%-4.93%), 6.5% (5.09%-8.2%), 2.23% (1.34%-3.57%), and 2.03% (0.89%-2.46%) respectively. Reoperation occurred in 1.36% (0.68%-2.42%) of surgeries, residual septal defect in 1.34% (0.69%-2.42%), superior vena cava obstruction in 1.76% (1.02%-2.9%), and reimplanted pulmonary vein obstruction in 1.4% (0.7%-2.49%).
CONCLUSIONS
This is the first comprehensive analysis of outcomes following surgical repair of SVASD. The findings affirm the safety and effectiveness of surgery, establishing a reference point for evaluating emerging transcatheter therapies. Safety and efficacy profiles comparable to surgical repair are essential for widespread adoption of transcatheter treatments.
Topics: Humans; Heart Septal Defects, Atrial; Treatment Outcome; Cardiac Surgical Procedures; Postoperative Complications; Male; Adolescent; Young Adult; Female; Child; Hospital Mortality; Adult
PubMed: 38874063
DOI: 10.1161/JAHA.123.033686 -
BMC Geriatrics Jun 2024Wearing hip protectors is a measure used to prevent hip fractures caused by falls. However, its protective effect has remained controversial in previous studies. This... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Wearing hip protectors is a measure used to prevent hip fractures caused by falls. However, its protective effect has remained controversial in previous studies. This study provides a rationale for the use of hip protectors by pooling all the current meta-analysis evidence.
METHODS
We conducted an umbrella review of all the current meta-analysis articles about the efficacy of hip protectors to reduce hip fractures and falls in communities and/or institutions. Major databases including EMBASE, Cochrane Library, PubMed and Web of Science, were searched up to June 2022. Two reviewers screened the studies, extracted the data, and conducted the methodological quality assessment independently. The primary outcome was the association statistic (odds ratio (OR), relative risk (RR), etc.) reported in the meta-analysis that quantified the influence of the intervention on hip fractures and falls compared to that of the control group. Narrative synthesis was also conducted. Forest plots and the AMSTAR score were used to describe the results and quality of the pooled literature, respectively.
RESULTS
A total of six meta-analysis articles were included in the study. Hip protectors were effective at reducing hip fractures in older individuals who were in institutions (nursing or residential care settings) but not in communities (RR = 0.70, 95% CI 0.58 to 0.85, I = 42%, P < 0.001) (RR = 1.12, 95% CI 0.94 to 1.34, I = 0%, P = 0.20), and they did not reduce falls (RR = 1.01, 95% CI 0.90 to 1.13, I = 0%, P = 0.89).
CONCLUSIONS
Hip protectors are effective at preventing hip fractures in institutionalized older adults but not in community-dwelling older adults.
TRIAL REGISTRATION
This study has been registered in PROSPERO (PROSPERO ID: CRD42022351773).
Topics: Humans; Hip Fractures; Accidental Falls; Protective Devices; Aged; Meta-Analysis as Topic
PubMed: 38867191
DOI: 10.1186/s12877-024-05122-x -
Journal of Safety Research Jun 2024Advancements in the modern construction industry have contributed to the development of a range of technology-based interventions to improve the safety behavior of...
INTRODUCTION
Advancements in the modern construction industry have contributed to the development of a range of technology-based interventions to improve the safety behavior of front-line construction workers. Notwithstanding the extensive research on safety behavior, there is still a paucity of research on assessing technology interventions of safety behavior to provide an overview of their strengths and limitations. The present study aims to bridge this gap in the literature and identify the main trends of research.
METHOD
A systematic review and critical content analysis are adopted to capture an overview of the state of knowledge on safety behavior technologies. As a result of searching Scopus, Web of Science, and Google Scholar databases in the period from Jan 2010 to Feb 2023, a total of 359 potential studies went through the systematic screening process and finally, 48 representative studies were selected followed by an assessment of the feasibility and applicability of the safety behavior technologies.
RESULTS
It was found that safety behavior technology is characterized by seven technologies including virtual-reality simulation (T1), eye-tracking technology (T2), prediction modeling of safety behavior (T3), computer-based training (T4), drone/sensor-based hazard monitoring (T5), vision-based behavior monitoring (T6), and real-time positioning (T7).
CONCLUSIONS
This research improves understanding of the status of safety behavior technologies and provides a critical review of their feasibility from the perspective of four assessment criteria including application, limitation, benefit, and feasibility.
PRACTICAL APPLICATIONS
The categorizations of technologies add value to the body of knowledge in terms of generic requirements for their implementation and adaptation on construction sites.
Topics: Humans; Construction Industry; Safety Management; Feasibility Studies; Occupational Health; Technology
PubMed: 38858051
DOI: 10.1016/j.jsr.2024.04.006 -
Health Informatics Journal 2024: This systematic review and meta-analysis aimed to investigate the effect of fall prevention interventions using information and communication technology (ICT). : A... (Meta-Analysis)
Meta-Analysis
: This systematic review and meta-analysis aimed to investigate the effect of fall prevention interventions using information and communication technology (ICT). : A comprehensive search across four databases was performed. The inclusion criteria were fall prevention interventions including telehealth, computerized balance training, exergaming, mobile application education, virtual reality exercise, and cognitive-behavioral training for community-dwelling adults aged ≥60 years. : Thirty-four studies were selected. Telehealth, smart home systems, and exergames reduced the risk of falls (RR = 0.63, 95% CI [0.54, 0.75]). Telehealth and exergame improved balance (MD = 3.30, 95% CI [1.91, 4.68]; MD = 4.40, 95% CI [3.09, 5.71]). Telehealth improved physical function (SMD = 0.69, 95% CI [0.23, 1.16]). Overall, ICT fall interventions improved fall efficacy but not cognitive function. For quality of life (QOL), mixed results were found depending on the assessment tools. : Future investigations on telehealth, smart home systems, or exergames are needed to motivate older adults to exercise and prevent falls.
Topics: Humans; Accidental Falls; Aged; Telemedicine; Independent Living; Quality of Life; Information Technology
PubMed: 38825745
DOI: 10.1177/14604582241259324 -
Journal of Medical Internet Research May 2024Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause... (Review)
Review
BACKGROUND
Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause significant data breaches in digital health information systems, which threaten patient safety and privacy.
OBJECTIVE
From a sociotechnical perspective, this paper explores why digital health care systems are vulnerable to cyberattacks and provides sociotechnical solutions through a systematic literature review (SLR).
METHODS
An SLR using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted by searching 6 databases (PubMed, Web of Science, ScienceDirect, Scopus, Institute of Electrical and Electronics Engineers, and Springer) and a journal (Management Information Systems Quarterly) for articles published between 2012 and 2022 and indexed using the following keywords: "(cybersecurity OR cybercrime OR ransomware) AND (healthcare) OR (cybersecurity in healthcare)." Reports, review articles, and industry white papers that focused on cybersecurity and health care challenges and solutions were included. Only articles published in English were selected for the review.
RESULTS
In total, 5 themes were identified: human error, lack of investment, complex network-connected end-point devices, old legacy systems, and technology advancement (digitalization). We also found that knowledge applications for solving vulnerabilities in health care systems between 2012 to 2022 were inconsistent.
CONCLUSIONS
This SLR provides a clear understanding of why health care systems are vulnerable to cyberattacks and proposes interventions from a new sociotechnical perspective. These solutions can serve as a guide for health care organizations in their efforts to prevent breaches and address vulnerabilities. To bridge the gap, we recommend that health care organizations, in partnership with educational institutions, develop and implement a cybersecurity curriculum for health care and intelligence information sharing through collaborations; training; awareness campaigns; and knowledge application areas such as secure design processes, phase-out of legacy systems, and improved investment. Additional studies are needed to create a sociotechnical framework that will support cybersecurity in health care systems and connect technology, people, and processes in an integrated manner.
Topics: Computer Security; Humans; Delivery of Health Care; Patient Safety
PubMed: 38820579
DOI: 10.2196/46904 -
Cureus Apr 2024Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer often diagnosed at advanced stages, highlighting the urgent need for early detection strategies. This... (Review)
Review
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer often diagnosed at advanced stages, highlighting the urgent need for early detection strategies. This systematic review explores the potential of fecal and urinary biomarkers for early PDAC detection. A comprehensive search identified eight relevant studies investigating various biomarkers, including proteins, metabolites, microbial profiles, DNA mutations, and non-coding RNAs. Promising findings suggest that urinary biomarkers related to metabolic alterations, inflammatory processes, fecal microbiome profiles, and fecal miRNAs hold diagnostic potential even at early stages of PDAC. Combining biomarkers into panels may enhance diagnostic accuracy. Challenges such as validation in larger cohorts, standardization of protocols, and regulatory approval must be addressed for clinical translation. Despite these hurdles, non-invasive urinary and fecal biomarkers represent a promising avenue for improving PDAC outcomes through early detection.
PubMed: 38813271
DOI: 10.7759/cureus.59248 -
Children (Basel, Switzerland) May 2024Pediatric basilar skull fractures (BSFs) are a rare type of traumatic head injury that can cause debilitating complications without prompt treatment. Here, we sought to... (Review)
Review
Pediatric basilar skull fractures (BSFs) are a rare type of traumatic head injury that can cause debilitating complications without prompt treatment. Here, we sought to review the literature and characterize the clinical features, management, and outcomes of pediatric BSFs. We identified 21 relevant studies, excluding reviews, meta-analyses, and non-English articles. The incidence of pediatric BSFs ranged from 0.0001% to 7.3%, with falls from multi-level heights and traffic accidents being the primary causes (9/21). The median presentation age ranged from 3.2 to 12.8 years, and the mean age of patients across all studies was 8.68 years. Up to 55% of pediatric BSFs presented with intracranial hematoma/hemorrhage, along with pneumocephalus and edema. Cranial nerve palsies were a common complication (9/21), with the facial nerve injured most frequently (7/21). While delayed cranial nerve palsy was reported in a few studies (4/21), most resolved within three months post-admission. Other complications included CSF leaks (10/21) and meningitis (4/21). Management included IV fluids, antiemetics, and surgery (8/21) to treat the fracture directly, address a CSF leak, or achieve cranial nerve compression. Despite their rarity, pediatric skull base fractures are associated with clinical complications, including CSF leaks and cranial nerve palsies. Given that some of these complications may be delayed, patient education is critical.
PubMed: 38790559
DOI: 10.3390/children11050564 -
Age and Ageing May 2024Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence.
METHODS
Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE.
RESULTS
Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2,451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low-impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance versus usual care, mean difference (MD) = 1.36; 95% CI -3.57 to 0.85), Sit-to-Stand (dance versus exercise MD = -0.85; 95% CI -2.64 to 0.93: dance versus education MD = -1.64; 95% CI -4.12 to 0.85), Berg Balance Scale (dance versus usual care MD = 0.61; 95% CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall, certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls.
CONCLUSIONS
There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found.
PROSPERO REGISTRATION
CRD42022382908.
Topics: Humans; Accidental Falls; Aged; Dance Therapy; Dancing; Cost-Benefit Analysis; Male; Female; Postural Balance; Treatment Outcome; Risk Factors; Age Factors; Aged, 80 and over
PubMed: 38776214
DOI: 10.1093/ageing/afae104