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Research and Theory For Nursing Practice Jun 2024The interfacility transfer places the patient at greater risk for poor outcomes due to outdated, inaccurate, or miscommunication of patient information at the time of...
The interfacility transfer places the patient at greater risk for poor outcomes due to outdated, inaccurate, or miscommunication of patient information at the time of transfer. Rural patients are at greater risk for poor outcomes due to experiencing a higher rate of transfers because of healthcare inequities related to limited access to specialty and critical care services. This paper systematically reviewed the literature to describe the current state of interfacility transfer communication practices and methods in the United States. The review followed the 2020 Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and checklist. PubMed, CINAHL, and Scopus were searched using MeSH terms and keywords. Inclusion criteria: peer-reviewd research articles published in English from 2013 to 2022 in the United States, and included both adult and pediatric patient transfers. It was noted that there is a lack of research on nursing-based interfacility transfer communication practices and methods. A total of 763 articles were reviewed, and 24 met eligibility for inclusion. The following coded themes were identified in the research literature: transfer patient characteristics and geographic barriers, communication challenges, transfer process, interoperability, digital intervention, and standardized transfer tools. The development and implementation of an integrated standardized interfacility transfer communication tool are warranted to decrease miscommunication and improve patient outcomes. The integration of technologies such as telehealth, the use of health information exchanges, and improved interoperability between health systems can improve communication and outcomes for all transfer patients but specifically rural transfers. Additionally, healthcare workers, particularly those in rural areas, need adequate infrastructure and financial resources to achieve positive patient outcomes.
PubMed: 38849138
DOI: 10.1891/RTNP-2023-0113 -
International Journal of Gynaecology... Jun 2024While a systematic review exists detailing neonatal sepsis outcomes from clinical trials, there remains an absence of a qualitative systematic review capturing the... (Review)
Review
BACKGROUND
While a systematic review exists detailing neonatal sepsis outcomes from clinical trials, there remains an absence of a qualitative systematic review capturing the perspectives of key stakeholders.
OBJECTIVES
Our aim is to identify outcomes from qualitative research on any intervention to prevent or improve the outcomes of neonatal sepsis that are important to parents, other family members, healthcare providers, policymakers, and researchers as a part of the development of a core outcome set (COS) for neonatal sepsis.
SEARCH STRATEGY
A literature search was carried out using MEDLINE, EMBASE, CINAHL, and PsycInfo databases.
SELECTION CRITERIA
Publications describing qualitative data relating to neonatal sepsis outcomes were included.
DATA COLLECTION AND ANALYSIS
Drawing on the concepts of thematic synthesis, texts related to outcomes were coded and grouped. These outcomes were then mapped to the domain headings of an existing model.
MAIN RESULTS
Out of 6777 records screened, six studies were included. Overall, 19 outcomes were extracted from the included studies. The most frequently reported outcomes were those in the domains related to parents, healthcare workers and individual organ systemas such as gastrointestinal system. The remaining outcomes were classified under the headings of general outcomes, miscellaneous outcomes, survival, and infection.
CONCLUSIONS
The outcomes identified in this review are different from those reported in neonatal sepsis clinical trials, thus highlighting the importance of incorporating qualitative studies into COS development to encapsulate all relevant stakeholders' perspectives.
PubMed: 38842248
DOI: 10.1002/ijgo.15725 -
Balkan Medical Journal Jun 2024Type 1 diabetes is one of the most common chronic diseases in children. Wearable technology (insulin pumps and continuous glucose monitoring devices) that makes diabetes...
BACKGROUND
Type 1 diabetes is one of the most common chronic diseases in children. Wearable technology (insulin pumps and continuous glucose monitoring devices) that makes diabetes management relatively simple, in addition to education and follow-ups, enhances the quality of life and health of individuals with diabetes.
AIMS
To evaluate the impact of wearable technology on metabolic management and the quality of life in children and adolescents with type 1 diabetes.
STUDY DESIGN
Systematic review and meta-analysis.
METHODS
The Preferred Reporting System for Systematic Reviews and Meta-Analyses was used to conduct a systematic review and meta-analysis. PubMed, Web of Science, MEDLINE, Cochrane Library, EBSCO, Ulakbim and Google Scholar were searched in July 2022 and July 2023 using predetermined keywords. The methodological quality of the studies was evaluated using the Joanna Briggs Institute's Critical Appraisal Checklists for randomized controlled experimental and cross-sectional studies. The meta-analysis method was used to pool the data.
RESULTS
Eleven studies published between 2011 and 2022 were included. The total sample size of the included studies was 1,853. The meta-analysis revealed that the decrease in hemoglobin A1C (HbA1c) level in those using wearable technology was statistically significant [mean difference (MD): -0.33, Z = 2.54, = 0.01]. However, the technology had no effect on the quality of life [standardized mean difference (SMD): 0.44, Z = 1.72, = 0.09]. The subgroup analyses revealed that the decrease in the HbA1c level occurred in the cross-sectional studies (MD: -0.49, Z = 2.54, = 0.01) and the 12-19 (MD = 0.59, Z = 4.40, < 0.001) and 4-18 age groups (MD: -0.31, Z = 2.56, = 0.01). The subgroup analyses regarding the quality of life revealed that there was no difference according to the research design. However, the quality of life was higher in the wearable technology group than in the control group in the 8-12 and 4-18 age groups (SMD: 1.32, Z = 2.31, = 0.02 and SMD: 1.00, Z = 5.76, < 0.001, respectively).
CONCLUSION
Wearable technology effectively reduces the HbA1c levels in children and adolescents with type 1 diabetes in some age groups. However, it does not affect the quality of life.
PubMed: 38829237
DOI: 10.4274/balkanmedj.galenos.2024.2024-2-115 -
The Pan African Medical Journal 2024Chronic kidney disease (CKD) is commonly complicated by anemia. Treating dialysis-dependent patients with anemia, including daprodustat and other inhibitors of prolyl... (Meta-Analysis)
Meta-Analysis Comparative Study Review
Chronic kidney disease (CKD) is commonly complicated by anemia. Treating dialysis-dependent patients with anemia, including daprodustat and other inhibitors of prolyl hydroxylase of hypoxia-inducible factor, recombinant human erythropoietin (rhEPO), and iron supplements. We conducted this study to test our postulation; daprodustat is superior to rhEPO and other conventional treatments respecting efficacy and safety parameters. We made systematic search through PubMed, Web of Science, Scopus, and Cochrane. Seven unique trials were eventually included for systematic review; six of them with a sample size of 759 patients entered our network meta-analysis (NMA). Daprodustat 25-30 mg was associated with the greatest change in serum hemoglobin (MD=1.86, 95%CI= [1.20; 2.52]), ferritin (MD= -180.84, 95%CI= [-264.47; -97.20]), and total iron binding capacity (TIBC) (MD=11.03, 95%CI= [3.15; 18.92]) from baseline values. Dialysis-dependent patients with anemia had a significant increment in serum Hemoglobin and TIBC and a reduction in serum ferritin, in a dose-dependent manner, when administered daprodustat.
Topics: Humans; Anemia; Renal Dialysis; Hemoglobins; Renal Insufficiency, Chronic; Glycine; Ferritins; Barbiturates; Network Meta-Analysis; Erythropoietin; Recombinant Proteins; Dose-Response Relationship, Drug; Iron
PubMed: 38828426
DOI: 10.11604/pamj.2024.47.114.37278 -
International Emergency Nursing Jun 2024It is necessary to evaluate the accuracy of peripheral thermometer in outpatient and emergency temperature measurement of children by diagnostic meta-analysis, to... (Review)
Review
BACKGROUND
It is necessary to evaluate the accuracy of peripheral thermometer in outpatient and emergency temperature measurement of children by diagnostic meta-analysis, to provide evidence for clinical temperature measurement and nursing care of children.
METHODS
Two authors searched PubMed, Web of science, CINAHL, EBSCO, OVID, Embase, CNKI, Wanfang and Weipu databases for studies on the temperature measurement accuracy of peripheral thermometer in children in outpatient and emergency department until November 20, 2023.
RESULTS
10 studies involving 3448 children were included. The combined sensitivity was 82 % (95 % CI: 81 % ∼ 84 %), the combined specificity was 88 % (95 % CI: 87 % ∼ 89 %), the combined positive likelihood ratio was 11. 35 (95 % CI: 6. 07 ∼ 21). 20), the combined negative likelihood ratio was 0.20 (95 % CI: 0.14 ∼ 0.29). The odds ratio of combined diagnosis was 58.02 (95 % CI: 30.66 ∼ 109.76), and the area under ROC curve (AUC) was 0.95.
CONCLUSIONS
The peripheral temperature measurement can reflect a certain core temperature, among which the infrared tympanic membrane thermometer has the highest sensitivity, which is worthy of clinical application.
PubMed: 38824868
DOI: 10.1016/j.ienj.2024.101460 -
PharmacoEconomics May 2024Maternal-perinatal interventions delivered during pregnancy or childbirth have unique characteristics that impact the health-related quality of life (HRQoL) of the...
BACKGROUND
Maternal-perinatal interventions delivered during pregnancy or childbirth have unique characteristics that impact the health-related quality of life (HRQoL) of the mother, fetus, and newborn child. However, maternal-perinatal cost-utility analyses (CUAs) often only consider either maternal or child health outcomes. Challenges include, but are not limited to, measuring fetal, newborn, and infant health outcomes, and assessing their impact on maternal HRQoL. It is also important to recognize the impact of maternal-perinatal health on family members' HRQoL (i.e., family spillover effects) and to incorporate these effects in maternal-perinatal CUAs.
OBJECTIVE
The aim was to systematically review the methods used to include health outcomes of pregnant women, fetuses, and children and to incorporate family spillover effects in maternal-perinatal CUAs.
METHODS
A literature search was conducted in Medline, Embase, EconLit, Cochrane Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Network of Agencies for Health Technology Assessment (INAHTA), and the Pediatric Economic Database Evaluation (PEDE) databases from inception to 2020 to identify maternal-perinatal CUAs that included health outcomes for pregnant women, fetuses, and/or children. The search was updated to December 2022 using PEDE. Data describing how the health outcomes of mothers, fetuses, and children were measured, incorporated, and reported along with the data on family spillover effects were extracted.
RESULTS
Out of 174 maternal-perinatal CUAs identified, 62 considered the health outcomes of pregnant women, and children. Among the 54 quality-adjusted life year (QALY)-based CUAs, 12 included fetal health outcomes, the impact of fetal loss on mothers' HRQoL, and the impact of neonatal demise on mothers' HRQoL. Four studies considered fetal health outcomes and the effects of fetal loss on mothers' HRQoL. One study included fetal health outcomes and the impact of neonatal demise on maternal HRQoL. Furthermore, six studies considered the impact of neonatal demise on maternal HRQoL, while four included fetal health outcomes. One study included the impact of fetal loss on maternal HRQoL. The remaining 26 only included the health outcomes of pregnant women and children. Among the eight disability-adjusted life year (DALY)-based CUAs, two measured fetal health outcomes. Out of 174 studies, only one study included family spillover effects. The most common measurement approach was to measure the health outcomes of pregnant women and children separately. Various approaches were used to assess fetal losses in terms of QALYs or DALYs and their impact on HRQoL of mothers. The most common integration approach was to sum the QALYs or DALYs for pregnant women and children. Most studies reported combined QALYs and incremental QALYs, or DALYs and incremental DALYs, at the family level for pregnant women and children.
CONCLUSIONS
Approximately one-third of maternal-perinatal CUAs included the health outcomes of pregnant women, fetuses, and/or children. Future CUAs of maternal-perinatal interventions, conducted from a societal perspective, should aim to incorporate health outcomes for mothers, fetuses, and children when appropriate. The various approaches used within these CUAs highlight the need for standardized measurement and integration methods, potentially leading to rigorous and standardized inclusion practices, providing higher-quality evidence to better inform decision-makers about the costs and benefits of maternal-perinatal interventions. Health Technology Assessment agencies may consider providing guidance for interventions affecting future lives in future updates.
PubMed: 38819718
DOI: 10.1007/s40273-024-01397-5 -
Frontiers in Pediatrics 2024A potential association between the onset of diabetes and normal birth weight (NBW) has been discovered. Diverse conclusions and study methodologies exist regarding the...
BACKGROUND
A potential association between the onset of diabetes and normal birth weight (NBW) has been discovered. Diverse conclusions and study methodologies exist regarding the connection between low birth weight (LBW) and impaired glucose tolerance in children, underscoring the need for further robust research. Our institution is embarking on this study to thoroughly examine the association between LBW and impaired glucose tolerance in children.
METHODS
We conducted searches on Cochrane Library, ScienceDirect, EMBASE, PubMed, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature data (CBM) online database, VIP full-text Database, and Wanfang Database to identify correlation analyses or case-control studies investigating the relationship between LBW and abnormal glucose tolerance in children. The search spanned from January 2010 to September 2023. The quality of observational studies was evaluated using the Newcastle-Ottawa Scale (NOS) tool. Data synthesis was performed using the statistical software RevMan 5.3 for meta-analysis.
RESULTS
Based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, we finally included 10 clinical control studies consisting of a total of 2971 cases. There wasn't considerably change in blood sugar levels among LBW, NBW and high birth weight (HBW) infants (> 0.05). There was no significant difference in insulin levels between LBW infants and NBW infants (> 0.05). The HOMA-IR of LBW infants was considerably higher than that of NBW infants (< 0.05). The risk of abnormal glucose tolerance in LBW infants was 0.42 times higher than that in NBW and HBW infants [Fisher's = 0.42, 95% CI = (0.09, 0.75), = 0.01].
CONCLUSION
LBW is associated with an increased risk of abnormal glucose tolerance, as indicated by elevated HOMA-IR level in LBW infants compared to NBW and HBW pediatric population. Further research is needed to confirm and expand upon these findings to better understand the complex relationship between LBW and impaired glucose tolerance in children.
PubMed: 38783917
DOI: 10.3389/fped.2024.1362076 -
Physical & Occupational Therapy in... May 2024To review the literature on the effects of vestibular training on motor function and balance in children and youth with cerebral palsy. (Review)
Review
Short-Term Effects of Vestibular Training on Gross Motor Function in Children and Youth with Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
AIMS
To review the literature on the effects of vestibular training on motor function and balance in children and youth with cerebral palsy.
METHODS
Eight databases (MEDLINE-PubMed, PEDro, Cochrane Library, OTSeeker, Web of Science, Scopus Database, CINAHL and SPORTDiscus.) were searched up to May 15th, 2023. Studies comparing vestibular training with other types of interventions. The DerSimonian and Laird method was employed using random effects models to calculate the pooled estimate of the effect size with confidence intervals of 95%. The risk of bias was assessed with the Cochrane Collaboration's tool and the Grading of Recommendations Assessment, Development and Evaluation approach was used to judge the certainty of the evidence for all outcomes.
RESULTS
Eight studies were included comprising 226 participants with cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of vestibular training program compared to other technique(s) for Gross Motor Function Measure (-0.471; 95% confidence intervals: -0.919 to -0.023) and balance (-0.546; 95% confidence intervals: -0.916 to -0.176).
CONCLUSIONS
Vestibular training has potential benefits in the short-term as a therapeutic approach for improving gross motor function and the balance in children and youth with cerebral palsy, but further research is needed.
PubMed: 38764313
DOI: 10.1080/01942638.2024.2350385 -
Pediatric Research May 2024The risk factors for central venous access device-related thrombosis (CRT) in children are not fully understood. We used evidence-based medicine to find the risk factors...
BACKGROUND
The risk factors for central venous access device-related thrombosis (CRT) in children are not fully understood. We used evidence-based medicine to find the risk factors for CRT by pooling current studies reporting risk factors of CRT, aiming to guide clinical diagnosis and treatment.
METHODS
A systematic search of PubMed, Web of Science, Embase, Cochrane Library, Scopus, CNKI, Sinomed, and Wanfang databases was conducted. RevMan 5.4 was employed for data analysis.
RESULTS
The review included 47 studies evaluating 262,587 children with CVAD placement. Qualitative synthesis and quantitative meta-analysis identified D-dimer, location of insertion, type of catheter, number of lumens, catheter indwelling time, and central line-associated bloodstream infection as the most critical risk factors for CRT. Primarily due to observational design, the quality of evidence was regarded as low certainty for these risk factors according to the GRADE approach.
CONCLUSION
Because fewer high-quality studies are available, larger sample sizes and well-designed prospective studies are still needed to clarify the risk factors affecting CRT. In the future, developing pediatric-specific CRT risk assessment tools is important. Appropriate stratified preventive strategies for CRT according to risk assessment level will help improve clinical efficiency, avoid the occurrence of CRT, and alleviate unnecessary suffering of children.
IMPACT
This is the latest systematic review of risk factors and incidence of CRT in children. A total of 47 studies involving 262,587 patients were included in our meta-analysis, according to which the pooled prevalence of CRT was 9.1%. This study identified several of the most critical risk factors affecting CRT in children, including D-dimer, insertion location, type of catheter, number of lumens, catheter indwelling time, and central line-associated bloodstream infection (CLABSI).
PubMed: 38760472
DOI: 10.1038/s41390-024-03225-0 -
Journal of Medical Systems May 2024Virtual reality (VR) is becoming increasingly popular to train health-care professionals (HCPs) to acquire and/or maintain cardiopulmonary resuscitation (CPR) basic or... (Review)
Review
INTRODUCTION
Virtual reality (VR) is becoming increasingly popular to train health-care professionals (HCPs) to acquire and/or maintain cardiopulmonary resuscitation (CPR) basic or advanced skills.
AIM
To understand whether VR in CPR training or retraining courses can have benefits for patients (neonatal, pediatric, and adult), HCPs and health-care organizations as compared to traditional CPR training.
METHODS
A systematic review (PROSPERO: CRD42023431768) following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. In June 2023, the PubMed, Cochrane Library, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched and included studies evaluated in their methodological quality with Joanna Briggs Institute checklists. Data were narratively summarized.
RESULTS
Fifteen studies published between 2013 and 2023 with overall fair quality were included. No studies investigated patients' outcomes. At the HCP level, the virtual learning environment was perceived to be engaging, realistic and facilitated the memorization of the procedures; however, limited decision-making, team building, psychological pressure and frenetic environment were underlined as disadvantages. Moreover, a general improvement in performance was reported in the use of the defibrillator and carrying out the chest compressions. At the organizational level, one study performed a cost/benefit evaluation in favor of VR as compared to traditional CPR training.
CONCLUSIONS
The use of VR for CPR training and retraining is in an early stage of development. Some benefits at the HCP level are promising. However, more research is needed with standardized approaches to ensure a progressive accumulation of the evidence and inform decisions regarding the best training methodology in this field.
Topics: Cardiopulmonary Resuscitation; Humans; Virtual Reality; Health Personnel
PubMed: 38748244
DOI: 10.1007/s10916-024-02063-1