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Implementation Science : IS Jun 2024Studies of implementation strategies range in rigor, design, and evaluated outcomes, presenting interpretation challenges for practitioners and researchers. This... (Review)
Review
BACKGROUND
Studies of implementation strategies range in rigor, design, and evaluated outcomes, presenting interpretation challenges for practitioners and researchers. This systematic review aimed to describe the body of research evidence testing implementation strategies across diverse settings and domains, using the Expert Recommendations for Implementing Change (ERIC) taxonomy to classify strategies and the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework to classify outcomes.
METHODS
We conducted a systematic review of studies examining implementation strategies from 2010-2022 and registered with PROSPERO (CRD42021235592). We searched databases using terms "implementation strategy", "intervention", "bundle", "support", and their variants. We also solicited study recommendations from implementation science experts and mined existing systematic reviews. We included studies that quantitatively assessed the impact of at least one implementation strategy to improve health or health care using an outcome that could be mapped to the five evaluation dimensions of RE-AIM. Only studies meeting prespecified methodologic standards were included. We described the characteristics of studies and frequency of implementation strategy use across study arms. We also examined common strategy pairings and cooccurrence with significant outcomes.
FINDINGS
Our search resulted in 16,605 studies; 129 met inclusion criteria. Studies tested an average of 6.73 strategies (0-20 range). The most assessed outcomes were Effectiveness (n=82; 64%) and Implementation (n=73; 56%). The implementation strategies most frequently occurring in the experimental arm were Distribute Educational Materials (n=99), Conduct Educational Meetings (n=96), Audit and Provide Feedback (n=76), and External Facilitation (n=59). These strategies were often used in combination. Nineteen implementation strategies were frequently tested and associated with significantly improved outcomes. However, many strategies were not tested sufficiently to draw conclusions.
CONCLUSION
This review of 129 methodologically rigorous studies built upon prior implementation science data syntheses to identify implementation strategies that had been experimentally tested and summarized their impact on outcomes across diverse outcomes and clinical settings. We present recommendations for improving future similar efforts.
Topics: Humans; Implementation Science; Delivery of Health Care
PubMed: 38915102
DOI: 10.1186/s13012-024-01369-5 -
Archives of Physical Medicine and... Jun 2024To examine the evidence regarding FES-cycling's physiological and clinical effects. (Review)
Review
OBJECTIVE
To examine the evidence regarding FES-cycling's physiological and clinical effects.
DATA SOURCES
The study was conducted in accordance with PRISMA. PubMed, EMBASE, Cochrane Review, CINAHL, Scopus, Sport Discus, and Web of Science databases were used.
STUDY SELECTION
Randomized controlled trials involving FES-cycling were included. Studies that didn't involve FES-cycling in the intervention group or without the control group were excluded. Two reviewers screened titles and abstracts and then conducted a blinded full-text evaluation. A third reviewer resolved discrepancies.
DATA EXTRACTION
Meta-analysis was performed using inverse variance for continuous data with effect measured by mean difference and random effects analysis model. A 95% confidence interval was adopted. The significance level was set at p<.05, and trends were declared at p=.05 to ≤ .10. The I method was used for heterogeneity analysis. The minimal clinically important difference was calculated. Methodological quality was assessed by the risk-of-bias tool for randomized trials. The GRADE method was used for the quality of the evidence analysis.
RESULTS
A total of 52 studies were included. Metabolic, cardiocirculatory, ventilatory, and peripheral muscle oxygen extraction variables presented statistical (p<.05) and clinically important differences favoring FES-cycling, with moderate to high certainty of evidence. It also presented statistical (p<.05) and clinically important improvement in cardiorespiratory fitness, leg and total body lean mass, power, physical fitness in intensive care (moderate to high certainty of evidence), and torque (low certainty of evidence). It presented a trend (p=.05 to ≤.10) of improvement in muscle volume, spasticity, and mobility (low to moderate certainty of evidence). It showed no difference (p>.10) in six-minute walking distance, muscle cross-sectional area, bone density, and length of ICU stay (low to moderate certainty of evidence).
CONCLUSIONS
FES-cycling exercise is a more intense stimulus modality than other comparative therapeutic modalities and presented clinically important improvement in several clinical outcomes.
PubMed: 38914190
DOI: 10.1016/j.apmr.2024.06.003 -
BMC Public Health Jun 2024Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies,... (Review)
Review
BACKGROUND
Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland.
METHODS
Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites. Resources were included if published, reviewed, or updated between January 2011 and May 2022. Data were extracted into Excel and coded using NVivo. The review design included the involvement of the "Healthy Reproductive Years" Patient and Public Involvement and Engagement advisory panel.
RESULTS
The searches identified 273 resources, and a subsequent audit with healthcare professionals in Northern Ireland revealed five additional preconception health-related resources. A wide range of resource types were identified, and preconception health was often not the only focus of the resources reviewed. Resources proposed approaches to improve preconception health and care, such as the need for improved awareness and access to care, preconceptual counselling, multidisciplinary collaborations, and the adoption of a life-course approach. Many behavioural (e.g., folic acid intake, smoking), biomedical (e.g., mental and physical health conditions), and environmental and social (e.g., deprivation) factors were identified and addressed in the resources reviewed. In particular, pre-existing physical health conditions were frequently mentioned, with fewer resources addressing psychological factors and mental health. Overall, there was a greater focus on women's, rather than men's, behaviours.
CONCLUSIONS
This scoping review synthesised existing resources available in the UK and Ireland to identify a wide range of common approaches and factors that influence preconception health and care. Efforts are needed to implement the identified resources (e.g., strategies, guidelines) to support people of childbearing age to access preconception care and optimise their preconception health.
Topics: Humans; Preconception Care; Ireland; Female; United Kingdom; Health Policy; Practice Guidelines as Topic; Pregnancy
PubMed: 38909211
DOI: 10.1186/s12889-024-19188-0 -
PharmacoEconomics Jun 2024This review presents a critical appraisal of differences in the methodologies and quality of model-based and empirical data-based cost-utility studies on continuous...
Evaluating the Cost-Utility of Continuous Glucose Monitoring in Individuals with Type 1 Diabetes: A Systematic Review of the Methods and Quality of Studies Using Decision Models or Empirical Data.
INTRODUCTION
This review presents a critical appraisal of differences in the methodologies and quality of model-based and empirical data-based cost-utility studies on continuous glucose monitoring (CGM) in type 1 diabetes (T1D) populations. It identifies key limitations and challenges in health economic evaluations on CGM and opportunities for their improvement.
METHODS
The review and its documentation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews. Searches for articles published between January 2000 and January 2023 were conducted using the MEDLINE, Embase, Web of Science, Cochrane Library, and Econlit databases. Published studies using models and empirical data to evaluate the cost utility of all CGM devices used by T1D patients were included in the search. Two authors independently extracted data on interventions, populations, model settings (e.g., perspectives and time horizons), model types and structures, clinical outcomes used to populate the model, validation, and uncertainty analyses. They subsequently met to confirm consensus. Quality was assessed using the Philips checklist for model-based studies and the Consensus Health Economic Criteria (CHEC) checklist for empirical studies. Model validation was assessed using the Assessment of the Validation Status of Health-Economic decision models (AdViSHE) checklist. The extracted data were used to generate summary tables and figures. The study protocol is registered with PROSPERO (CRD42023391284).
RESULTS
In total, 34 studies satisfied the selection criteria, two of which only used empirical data. The remaining 32 studies applied 10 different models, with a substantial majority adopting the CORE Diabetes Model. Model-based studies often lacked transparency, as their assumptions regarding the extrapolation of treatment effects beyond available evidence from clinical studies and the selection and processing of the input data were not explicitly stated. Initial scores for disagreements concerning checklists were relatively high, especially for the Philips checklist. Following their resolution, overall quality scores were moderate at 56%, whereas model validation scores were mixed. Strikingly, costing approaches differed widely across studies, resulting in little consistency in the elements included in intervention costs.
DISCUSSION AND CONCLUSION
The overall quality of studies evaluating CGM was moderate. Potential areas of improvement include developing systematic approaches for data selection, improving uncertainty analyses, clearer reporting, and explaining choices for particular modeling approaches. Few studies provided the assurance that all relevant and feasible options had been compared, which is required by decision makers, especially for rapidly evolving technologies such as CGM and insulin administration. High scores for disagreements indicated that several checklists contained questions that were difficult to interpret consistently for quality assessment. Therefore, simpler but comprehensive quality checklists may be needed for model-based health economic evaluation studies.
PubMed: 38904911
DOI: 10.1007/s40273-024-01388-6 -
Journal of Perianesthesia Nursing :... Jun 2024Stress response is a common complication during extubation, mainly manifested by dramatic hemodynamic fluctuations. Transcutaneous electrical acupoint stimulation (TEAS)...
Effect of Transcutaneous Electrical Acupoint Stimulation on Extubation-Related Stress Response in Noncardiac Surgery Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
PURPOSE
Stress response is a common complication during extubation, mainly manifested by dramatic hemodynamic fluctuations. Transcutaneous electrical acupoint stimulation (TEAS) is widely applied in the perioperative period. We performed this meta-analysis to evaluate whether the TEAS could relieve the stress response during extubation in noncardiac surgery patients.
DESIGN
A systematic review and meta-analysis of randomized controlled trials.
METHODS
We searched six databases (PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, CNKI, and Wan Fang) for relevant literature. A risk of bias assessment was executed based on the Cochrane Criteria. We applied RevMan5.4.1 software to analyze data. When the χ test did not show heterogeneity, we adopted the fixed-effect model. Otherwise, the random-effect model was used.
FINDINGS
ln total, 12 randomized controlled trials with 1,347 participants were enrolled in this meta-analysis. Meta-analysis showed the heart rate and mean arterial pressure of the intervention group were significantly lower than the control group at immediately, 5 minutes, and 10 minutes after extubation. The occurrence rate of emergency agitation (RR 0.39, 95% CI [0.26,0.60]) and postoperative delirium (RR 0.40, 95% CI [0.22, 0.72] were also lower in the TEAS group. The consumption of propofol (standardized mean difference (SMD) 0.47, 95% CI [-0.77, -0.18]) and remifentanil (SMD 1.49, 95% CI [-2.01, -0.96]) of the intervention group were also significantly reduced compared with the control group.
CONCLUSIONS
TEAS was beneficial for improving stress response during extubation, emergence agitation, postoperative delirium, and reduced the consumption of intraoperative propofol and remifentanil, but it was necessary to note the limitations of the current evidence.
PubMed: 38904602
DOI: 10.1016/j.jopan.2024.01.015 -
Frontiers in Psychology 2024This study analyzes the existing academic literature to identify the effects of artificial intelligence (AI) on human resource (HR) activities, highlighting both...
INTRODUCTION
This study analyzes the existing academic literature to identify the effects of artificial intelligence (AI) on human resource (HR) activities, highlighting both opportunities and associated challenges, and on the roles of employees, line managers, and HR professionals, collectively referred to as the HR triad.
METHODS
We employed the scoping review method to capture and synthesize relevant academic literature in the AI-human resource management (HRM) field, examining 27 years of research (43 peer-reviewed articles are included).
RESULTS
Based on the results, we propose an integrative framework that outlines the five primary effects of AI on HR activities: task automation, optimized HR data use, augmentation of human capabilities, work context redesign, and transformation of the social and relational aspects of work. We also detail the opportunities and challenges associated with each of these effects and the changes in the roles of the HR triad.
DISCUSSION
This research contributes to the ongoing debate on AI-augmented HRM by discussing the theoretical contributions and managerial implications of our findings, along with avenues for future research. By considering the most recent studies on the topic, this scoping review sheds light on the effects of AI on the roles of the HR triad, enabling these key stakeholders to better prepare for this technological change. The findings can inform future academic research, organizations using or considering the application of AI in HRM, and policymakers. This is particularly timely, given the growing adoption of AI in HRM activities.
PubMed: 38903456
DOI: 10.3389/fpsyg.2024.1360401 -
Nurse Education in Practice Jun 2024This study aims to carry out a meta-analysis of attitudes, knowledge, and skills level of nursing students and nurses in EBP, providing a reference for optimizing EBP... (Review)
Review
AIM/OBJECTIVE
This study aims to carry out a meta-analysis of attitudes, knowledge, and skills level of nursing students and nurses in EBP, providing a reference for optimizing EBP education strategies.
BACKGROUND
At present, no meta-analysis has been performed to quantitatively synthesize the attitudes, knowledge and skill levels of nursing students and nurses toward EBP. This makes it difficult to precisely identify the true level of EBP among nurses, implying that there is no evidence to support the adoption of EBP teaching strategies approaches.
DESIGN
A total of 9 Chinese and English databases including CNKI, Wan fang, VIP, CBM, PubMed, Embase, Web of Science, Cochrane Library and CINAHL were used to search cross-sectional quantitative articles on EBP attitudes, knowledge and skills level of nurses and nursing students. The search time limit was from the inception of the database to September 2023.
METHODS
Two researchers independently screened the literature and extracted the data. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the quality of the included studies. Stata15.0 software was used for statistical analysis to summarize the scores of EBP attitude, knowledge and skills level of nursing students and nurses included in the study.
RESULTS
A total of 25 cross-sectional studies from 13 countries were included, involving 11363 nursing students and nurses. The meta-analysis results revealed that nursing students and nurses lacked evidence-based practical knowledge and skills, with pooled mean scores of 3.06 (95 % CI: 2.72, 3.39), 2.91 (95 % CI: 2.60, 3.22), 4.31 (95 % CI: 4.08, 4.54) and 4.45 (95 % CI: 4.20, 4.70). In contrast, nursing students and nurses revealed a positive attitude towards EBP, with pooled mean scores of 3.57 (95 % CI: 3.28, 3.86) and 5.11 (95 % CI: 4.80, 5.42). Subgroup analysis revealed that senior nursing students and nurses with master's degree or above had higher attitudes, knowledge and skills.
CONCLUSIONS
In summary, nursing students and nurses have a positive attitude towards EBP. However, they seem to lack the necessary knowledge and skills. Therefore, nursing educators should consider this as an opportunity to strengthen the teaching of their evidence-based practical knowledge and skills. This will lay a reference for developing nursing discipline.
PubMed: 38901274
DOI: 10.1016/j.nepr.2024.104024 -
Aquatic Toxicology (Amsterdam,... Jun 2024The presence of microplastics in the aquatic environment has attracted widespread attention. A large number of studies have assessed the effects of microplastics on the... (Review)
Review
The presence of microplastics in the aquatic environment has attracted widespread attention. A large number of studies have assessed the effects of microplastics on the respiratory system of aquatic animals, but the results are not directly comparable across studies due to inconsistent evaluation criteria. Therefore, we adopted an integrated research approach that can integrate and parse complex data to improve reliability, conducted a systematic review and meta-analysis of 35 published studies, and elucidated the mechanisms of microplastic damage to cells. The results showed that PE had the greatest impact on aquatic animals, and fish were the most sensitive to the effects caused by microplastics, with oxidative stress induced by exposure concentrations exceeding 1000 µg/L or exposure times exceeding 28 days, leading to depletion of antioxidant defenses, cellular damage, inflammatory responses, and behavioral abnormalities. As this review is based on existing studies, there may be limitations in terms of literature quality, data availability and timeliness. In conclusion, we suggest to combat microplastic pollution by limiting plastic use, promoting plastic substitution and recycling, and enhancing microplastic capture degradation technologies.
PubMed: 38901219
DOI: 10.1016/j.aquatox.2024.107003 -
Journal of Neuroimmune Pharmacology :... Jun 2024Traumatic brain injury (TBI) is a leading cause of mortality and morbidity amongst trauma patients. Its treatment is focused on minimizing progression to secondary... (Review)
Review
Traumatic brain injury (TBI) is a leading cause of mortality and morbidity amongst trauma patients. Its treatment is focused on minimizing progression to secondary injury. Administration of propranolol for TBI maydecrease mortality and improve functional outcomes. However, it is our sense that its use has not been universally adopted due to low certainty evidence. The literature was reviewed to explore the mechanism of propranolol as a therapeutic intervention in TBI to guide future clinical investigations. Medline, Embase, and Scopus were searched for studies that investigated the effect of propranolol on TBI in animal models from inception until June 6, 2023. All routes of administration for propranolol were included and the following outcomes were evaluated: cognitive functions, physiological and immunological responses. Screening and data extraction were done independently and in duplicate. The risk of bias for each individual study was assessed using the SYCLE's risk of bias tool for animal studies. Three hundred twenty-three citations were identified and 14 studies met our eligibility criteria. The data suggests that propranolol may improve post-TBI cognitive and motor function by increasing cerebral perfusion, reducing neural injury, cell death, leukocyte mobilization and p-tau accumulation in animal models. Propranolol may also attenuate TBI-induced immunodeficiency and provide cardioprotective effects by mitigating damage to the myocardium caused by oxidative stress. This systematic review demonstrates that propranolol may be therapeutic in TBI by improving cognitive and motor function while regulating T lymphocyte response and levels of myocardial reactive oxygen species. Oral or intravenous injection of propranolol following TBI is associated with improved cerebral perfusion, reduced neuroinflammation, reduced immunodeficiency, and cardio-neuroprotection in preclinical studies.
Topics: Propranolol; Animals; Brain Injuries, Traumatic; Neuroprotective Agents; Humans; Disease Models, Animal; Drug Evaluation, Preclinical; Adrenergic beta-Antagonists
PubMed: 38900343
DOI: 10.1007/s11481-024-10121-1 -
Helicobacter 2024Due to irregular antibiotic use, the rate of antibiotic resistance to Helicobacter pylori (H. pylori) is increasing and varies from region to region. Therefore, for the... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Due to irregular antibiotic use, the rate of antibiotic resistance to Helicobacter pylori (H. pylori) is increasing and varies from region to region. Therefore, for the purpose of further clarifying the changes in antibiotic resistance rates nowadays, we conducted a systematic review and meta-analysis to update and assess the 10-year trend of primary H. pylori antibiotic resistance rate to the commonly prescribed antibiotics worldwide.
MATERIALS AND METHODS
According to the PRISMA statement, we systematically searched electronic databases for studies that assessed rates of H. pylori resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin, or tetracycline published from 2013 to 2023. AHRQ was adopted to estimate methodological quality and publication bias in the included studies, and statistical analysis was performed using Stata 17.0.
RESULTS
We identified 163 studies, comprising 47,002 isolates from 36 countries. The meta-analysis showed that the primary antibiotic resistance rate of H. pylori varied widely among antibiotics. Subgroup analysis showed higher rates of antibiotic resistance in the adult population than in children, and a general trend of increased resistance was observed from 2013 to 2023. There was considerable heterogeneity (I > 75%) among all analyses, which may be due to high variability in resistance rates across the global regions.
CONCLUSIONS
Resistance of H. pylori to antibiotics has reached alarming levels worldwide, which has a great effect on the efficacy of treatment. Local surveillance networks are required to select appropriate eradication regimens for each region.
Topics: Helicobacter pylori; Humans; Helicobacter Infections; Anti-Bacterial Agents; Drug Resistance, Bacterial; Global Health
PubMed: 38898622
DOI: 10.1111/hel.13103