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Patient Education and Counseling Feb 2024Feedback frameworks/models focus on certain aspects of the feedback process, but a coherent and systematic model is lacking. A meta-ethnography was conducted to identify... (Review)
Review
OBJECTIVES
Feedback frameworks/models focus on certain aspects of the feedback process, but a coherent and systematic model is lacking. A meta-ethnography was conducted to identify and synthesise guidance for optimising feedback interactions in undergraduate clinical communication simulations.
METHODS
A systematic search of 4 electronic databases and grey literature was conducted. Following Noblit and Hare's seven phases for conducting meta-ethnography, key themes and concepts were synthesised to provide new interpretations of components in effective feedback interactions.
RESULTS
373 publications were identified and 14 included for the final synthesis, which informed the development of a new Feedback Kidney Model. The Model illustrates the interconnections of various components that allow for effective feedback interactions. The main processes include preparation, proactivity, analysis and feedback information, reception and response, and influencing factors.
CONCLUSIONS
This meta-ethnography moves beyond providing an up-to-date synthesis of feedback guidance to proposing the brand-new Feedback Kidney Model, which can guide medical education and future research into how feedback is co-constructed and utilised to promote learning.
PRACTICE IMPLICATIONS
Clinical communication should incorporate meta-cognitive training and using this Model will help students better utilise on-site face-to-face feedback to enhance their learning and improve future communication with patients.
Topics: Humans; Anthropology, Cultural; Communication; Feedback; Kidney; Qualitative Research; Students
PubMed: 37948906
DOI: 10.1016/j.pec.2023.108050 -
Journal of Orthopaedic Surgery and... Nov 2023To systematically evaluate the efficacy and safety of Gushukang (GSK) capsules in the treatment of primary osteoporosis. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically evaluate the efficacy and safety of Gushukang (GSK) capsules in the treatment of primary osteoporosis.
METHODS
Randomized controlled trials related to the treatment of primary osteoporosis were collected through online retrieval of the China National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Biomedical Literature Database (Sino-Med), VIP, US National Library of Medicine (PubMed), Web of Science and Cochrane library. The literature was searched from January 1, 2000, to March 17, 2022. The risk bias and quality of the trials included in the meta-analysis were evaluated with the Cochrane Collaboration's risk assessment tool. The effect size was expressed as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs).
RESULTS
A total of 24 randomized controlled clinical trials (RCTs) were incorporated into this systematic review. The 2363 patients were all primary osteoporosis patients, of whom 1197 were in the observation group and 1166 were in the control group. GSK capsule group was superior to conventional medication group in improving beta type I collagen carboxy-terminal peptide (β-CTX) (MD - 0.28, 95% CI [- 0.31, - 0.25]), while in improving prepeptide of type I procollagen (PINP), conventional medications group was superior to GSK capsule group (MD - 1.37, 95% CI [- 1.92, - 0.82]), and there were no significant differences between the two groups in overall efficacy (OE) (OR 1.62, 95% CI [0.89, 2.98]), increase of bone mineral density (BMD) (lumbar spine: MD - 0.02, 95% CI [- 0.08, 0.04]; femoral neck: MD - 0.01, 95% CI [- 0.07, 0.05]; hip: MD 0.01, 95% CI [- 0.02, 0.02]), enhancement of alkaline phosphatase (ALP) (MD - 1.37, 95% CI [- 13.29, 10.55]), serum calcium (S-Ca) (MD 0.02, 95% CI [- 0.13, 0.17]), bone glutamyl protein (BGP) (MD 3.75, 95% CI [- 12.26, 19.76]), safety (OR 0.37, 95% CI [0.07, 2.02]) and pain relief (MD 0.32, 95% CI [- 0.59, 1.22]). GSK capsule combined with conventional medications group was superior to conventional medications group in improvement of OE (OR 3.19, 95% CI [2.20, 4.63]), BMD (lumbar spine (MD 0.06, 95% CI [0.02, 0.10]), femoral neck (MD 0.08, 95% CI [0.03, 0.13]), hip (MD 0.14, 95% CI [0.08, 0.21]) and other parts (MD 0.04, 95% CI [0.03, 0.05]), ALP (MD - 5.56, 95% CI [- 10.08, - 1.04]), β-CTX (MD - 0.15, 95% CI [- 0.18, - 0.12]) and pain relief (MD - 1.25, 95% CI [- 1.83, - 0.68]), but there was no difference in S-Ca (MD 0.02, 95% CI [- 0.13, 0.17]), BGP (MD 1.30, 95% CI [- 0.29, 2.89]), PINP (MD 1.30, 95% CI [- 0.29, 2.89]), serum phosphorus (S-P) (MD 0.01, 95% CI [- 0.09, 0.12]) and safety (OR 0.71, 95% CI [0.38, 1.35]).
CONCLUSION
GSK capsules can effectively treat primary osteoporosis, and when combined with conventional medications, the drug significantly increased bone mineral density, relieved pain and improved bone metabolism-related indicators in primary osteoporosis patients with better efficacy. However, due to the inclusion of Chinese literature and possible publication bias, the reliability of conclusions still requires more high-quality RCTs to enhance.
Topics: United States; Humans; Osteoporosis; Medicine, Chinese Traditional; Pain
PubMed: 37940992
DOI: 10.1186/s13018-023-04264-9 -
Forensic Science International Dec 2023Vertebrate scavengers frequently affect forensic casework by feeding on human remains or by scattering body parts and bones. Therefore, animal activity can influence... (Review)
Review
Vertebrate scavengers frequently affect forensic casework by feeding on human remains or by scattering body parts and bones. Therefore, animal activity can influence complete recovery of bodies, trauma analysis, and the estimation of the postmortem interval (PMI), potentially hampering identification of the deceased and elucidation of the perimortem circumstances. Experimental research is well suited to investigate scavengers and their impact on carcasses over time, generating knowledge on the forensic relevance of certain scavenger species or communities. However, there are currently no systematised standards to conduct these investigations with a forensic focus, impeding comparison and synthesis of the studies. In our work, we performed a systematic literature review and found 79 publications featuring terrestrial experiments on vertebrate scavenging and/or scattering within a forensic context. We extracted 21 variables describing the study environment, experimental design and the specimens. The results show that there is considerable inconsistency in the study designs and that some of the variables are insufficiently reported. We point out research questions and areas that require attention in future studies, stressing the importance of infrequently mentioned or applied variables. Furthermore, we recommend guidelines to include and report a list of variables in forensic scavenging and scattering experiments. These guidelines will help standardising future research in the field, facilitating inter-study consolidation of results and conclusions, and consequently, inform forensic casework.
Topics: Animals; Humans; Postmortem Changes; Feeding Behavior; Forensic Anthropology; Cadaver; Autopsy
PubMed: 37931469
DOI: 10.1016/j.forsciint.2023.111862 -
JBI Evidence Synthesis Feb 2024The objective of this review was to critically appraise and synthesize qualitative evidence of older persons' perceptions and experiences of community palliative care.
OBJECTIVE
The objective of this review was to critically appraise and synthesize qualitative evidence of older persons' perceptions and experiences of community palliative care.
INTRODUCTION
Palliative care focuses on the relief of symptoms and suffering at the end of life and is needed by approximately 56.8 million people globally each year. An increase in aging populations coupled with the desire to die at home highlights the growing demand for community palliative care. This review provides an understanding of the unique experiences and perceptions of older adults receiving community palliative care.
INCLUSION CRITERIA
This review appraised qualitative studies examining the perceptions and experiences of older adults (65 years or older) receiving community palliative care. Eligible research designs included, but were not limited to, ethnography, grounded theory, and phenomenology.
METHODS
A search of the literature across CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid SP), Web of Science Core Collection, and Scopus databases was undertaken in July 2021 and updated November 1, 2022. Included studies were published in English between 2000 and 2022. The search for unpublished studies included ProQuest Dissertations and Theses. Study selection, quality appraisal, and data extraction were performed by 2 independent reviewers. Findings from the included studies were pooled using the JBI meta-aggregation method.
RESULTS
Nine qualitative studies involving 98 participants were included in this review. A total of 100 findings were extracted and grouped into 14 categories. Four synthesized findings evolved from these categories: i) Older persons receiving palliative care in the community recognize that their life is changed and come to terms with their situation, redefining what is normal, appreciating life lived, and celebrating the life they still have by living one day at a time; ii) Older persons receiving palliative care in the community experience isolation and loneliness exacerbated by their detachment and withdrawal from and by others; iii) Older persons receiving palliative care in the community face major challenges managing prevailing symptoms, medication management difficulties, and costs of medical care and equipment; and iv) Older persons want to receive palliative care and to die at home; however, this requires both informal and formal supports, including continuity of care, good communication, and positive relationships with health care providers.
CONCLUSIONS
Experiences and perceptions of community palliative care vary among older adults. These are influenced by the individual's expectations and needs, available services, and cost. Older adults' input into decision-making about their care is fundamental to their needs being met and is contingent on effective communication between the patient, family, and staff across services. Policy that advocates for trained palliative care staff to provide care is necessary to optimize care outcomes, while collaboration between staff and services is critical to enabling holistic care, managing symptoms, and providing compassionate care and support.
Topics: Humans; Aged; Aged, 80 and over; Palliative Care; Qualitative Research; Anthropology, Cultural; Health Personnel; Aging
PubMed: 37930393
DOI: 10.11124/JBIES-22-00353 -
Hawai'i Journal of Health & Social... Oct 2023Numerous studies have used survey instruments to measure the degree of cultural identity/identification for a racial group to examine how they identify with their...
Numerous studies have used survey instruments to measure the degree of cultural identity/identification for a racial group to examine how they identify with their heritage or cultural group. However, only a few systematic reviews have summarized the survey instruments for Native Hawaiians, Pacific Islanders, and Filipinos. This systematic review aimed to summarize reliable and validated survey instruments that assessed the cultural identity/identification of Native Hawaiians, Pacific Islanders, and Filipinos in 3 steps: (1) identifying studies that meet the inclusion and exclusion criteria; (2) evaluating the psychometric properties of the instrument with reported validity and reliability test results; and (3) summarizing the selected studies. A search was conducted in PubMed, PsycINFO, Web of Science, and Health and Psychosocial Instruments databases for published articles related to the cultural identification for the 3 racial groups. Sixteen unique articles met the inclusion/exclusion criteria: 7 for Filipinos, 3 for Native Hawaiians, 1 for Pacific Islanders, 2 for Asian Americans, and 3 for non-specific Indigenous people. Three reviewers assessed the psychometric properties of the 16 articles using the pre-determined criteria and summarized the survey instruments and study outcomes. All the selected articles discussed their survey instrument's validity. This review can serve as a resource for researchers who want to apply a culturally tailored survey instrument for Native Hawaiians, Pacific Islanders, and Filipinos in their research studies.
Topics: Humans; Culture; Reproducibility of Results; Social Identification; Surveys and Questionnaires; White; Asian American Native Hawaiian and Pacific Islander; Southeast Asian People
PubMed: 37901674
DOI: No ID Found -
BMC Public Health Oct 2023Indigenous populations in Canada and the United States (US) have maintained reciprocal relationships with nature, grounded in respect for and stewardship of the... (Review)
Review
BACKGROUND
Indigenous populations in Canada and the United States (US) have maintained reciprocal relationships with nature, grounded in respect for and stewardship of the environment; however, disconnection from traditional food systems has generated a plethora of physical and mental health challenges for communities. Indigenous food sovereignty including control of lands were found to be factors contributing to these concerns. Therefore, our aim was to conduct a scoping review of the peer-reviewed literature to describe Indigenous disconnection from Indigenous food systems (IFS) in Canada and the US.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-SR) and Joanna Briggs Institute guidelines, we searched MEDLINE, SCOPUS, International Bibliography of the Social Sciences, Sociological Abstracts, and Bibliography of Native North Americans. Data was extracted from 41 studies and a narrative review completed based on study themes.
RESULTS
The overarching theme identified in the included studies was the impact of colonization on IFS. Four sub-themes emerged as causes for Indigenous disconnection from traditional food systems, including: climate change; capitalism; legal change; and socio-cultural change. These sub-themes highlight the multiple ways in which colonization has impacted Indigenous food systems in Canada and the US and important areas for transformation.
CONCLUSIONS
Efforts to reconnect Indigenous knowledge and values systems with future food systems are essential for planetary health and sustainable development. Traditional knowledge sharing must foreground authentic Indigenous inclusion within policymaking.
Topics: United States; Humans; Canada; Mental Health; Indigenous Peoples
PubMed: 37885000
DOI: 10.1186/s12889-023-16997-7 -
Dementia (London, England) Nov 2023People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help...
People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation.
Topics: Humans; Prospective Studies; Dementia; Language; Cultural Diversity; Australia
PubMed: 37871120
DOI: 10.1177/14713012231206292 -
Osteoporosis International : a Journal... Mar 2024This review aims to evaluate the accuracy of various mandibular radiomorphometric indices in comparison with DEXA BMD measurements in the diagnosis of osteopenia and... (Meta-Analysis)
Meta-Analysis Review
This review aims to evaluate the accuracy of various mandibular radiomorphometric indices in comparison with DEXA BMD measurements in the diagnosis of osteopenia and osteoporosis based on a meta-analysis of the sensitivity and specificity of the indices. PRISMA statement was followed. The materials for analysis were collected in August 2023 by searching three databases: PubMed Central, Web of Science, and Scopus. The selection of studies consisted of three selection stages, and 64 articles were finally obtained. Quality assessment was performed with the QUADAS-2 tool, and the general methodological quality of retrieved studies was low. Statistical analysis was performed based on 2 × 2 tables and estimated sensitivity and specificity were obtained using SROC curves. The most used indices were MCI, MCW and PMI. The best results in detecting reduced BMD obtained for MCW ≤ 3 mm, estimated sensitivity and specificity were 0.712 (95% CI, 0.477-0.870) and 0.804 (95% CI, 0.589-0.921), respectively. The most prone to the risk of bias is the MCI due to the examiner's subjectivism. Radiomorphometric indices of the mandible can be useful as a screening tool to identify patients with low BMD, but should not be used as a diagnostic method. Further research needs to focus on analysing the ability of the indices to detect osteoporosis and also in combination the indices with clinical parameters.
Topics: Humans; Bone Density; Absorptiometry, Photon; Radiography, Panoramic; Osteoporosis; Mandible
PubMed: 37870561
DOI: 10.1007/s00198-023-06949-7 -
Translational Behavioral Medicine Feb 2024A growing number of organizations are prioritizing diversity, equity, and inclusion (DEI) and antiracism in the workplace, including investing resources in DEI or...
A growing number of organizations are prioritizing diversity, equity, and inclusion (DEI) and antiracism in the workplace, including investing resources in DEI or antiracism training. However, such trainings vary widely in curriculum, objectives, delivery, and evaluation, with little known about the efficacy of existing trainings. The aim of this systematic review is to evaluate training characteristics, measures, and results of peer-reviewed studies (published between 2000 and 2022) testing DEI or antiracism trainings. Studies were identified using Google Scholar, JSTOR, and a university library database. Key search terms included "diversity, equity, and inclusion training"; "antiracism training"; and "effect," "impact," "outcome," or "evaluation." The search yielded N = 15 DEI training studies and N = 8 antiracism training studies. The majority of studies (75% of antiracism training; 66.6% of DEI training) utilized a one-time training session. Content, objectives, measures, and impact varied widely across studies. Randomized designs were uncommon (13%), and over 70% of studies had majority female participants. Findings highlight several strategies to advance the field of DEI and antiracism training, such as shifting curriculum from targeting individual knowledge to supporting behavioral and organizational change, providing longitudinal training, standardizing outcomes of interest, and implementing rigorous evaluation methods.
Topics: Female; Humans; Antiracism; Diversity, Equity, Inclusion; Curriculum; Knowledge; Universities
PubMed: 37857367
DOI: 10.1093/tbm/ibad061 -
Alternative Therapies in Health and... Nov 2023Diabetic nephropathy (DN), also known as diabetic kidney disease (DKD), has caused enormous economic pressure and serious health problems worldwide. TCM practitioners... (Meta-Analysis)
Meta-Analysis
CONTEXT
Diabetic nephropathy (DN), also known as diabetic kidney disease (DKD), has caused enormous economic pressure and serious health problems worldwide. TCM practitioners commonly use a combination of Astragalus membranaceus (A. membranaceus) and Rhizoma Dioscoreae (R. Dioscoreae) in the treatment of DN. Research is still lacking on the therapeutic effects of TCM for DN.
OBJECTIVE
The systematic review and meta-analysis intended to evaluate whether the combination of A. membranaceus and R. Dioscoreae together with Western medicine can provide better efficacy against DN than treatment with traditional Western medicine alone, to provide a clinical medical basis for the use of the TCM combination.
DESIGN
The research team performed a performed a systematic narrative review by searching the Web of Science, Science Direct, Pubmed, China National Knowledge Infrastructure (CNKI), VIP, Wanfang, Chinese Science and Technology Journal Database, and Biomedical Literature Chinese Database from databases' inceptions to May 2023. The team used the keywords astragalus and yam, diabetic nephropathy, antidiabetic, and 24-h urinary protein.
SETTING
The review and meta-analysis occurred at Jiangxi Hospital of Integrated Traditional China and Western Medicine in Nanchang, Jiangxi, China.
INTERVENTION
To perform a subgroup analysis, the research team divided the studies into two groups based on the TCM treatment course, with one subgroup receiving treatment for ≤4 weeks and the second receiving treatment for >4 weeks, to judge whether a time-dependence existed for the effects of the TCM combination on UP.
OUTCOME MEASURE
All studies used 24-h urinary protein (UP) as the outcome measure.
RESULTS
In all studies, all heterogeneous (P < .01, I2 = 94%, the intervention groups had a significantly greater reduction in 24-h UP than the control groups did (P < .05). The heterogeneity for a treatment course of ≤4 weeks was P < .01, I2 = 97%, and for a course of >4 weeks was P < .01, I2 = 87%. For both ≤4 weeks and >4 weeks, the intervention groups had a significantly greater reduction in 24-h UP than the control groups did, with P < .01 and P < .01, respectively. The protein effect wasn't time dependent.
CONCLUSIONS
A. membranaceus and R. Dioscoreae can significantly reduce UP production, and inhibition of UP wasn't time-dependent.
Topics: Humans; Diabetic Nephropathies; Dioscorea; Astragalus propinquus; Drugs, Chinese Herbal; Medicine, Chinese Traditional; Hypoglycemic Agents; Diabetes Mellitus
PubMed: 37856796
DOI: No ID Found