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Brain Sciences Feb 2021This systematic review was carried out to compile and assess original studies that included economic evaluations of neurological physiotherapy interventions. A thorough... (Review)
Review
This systematic review was carried out to compile and assess original studies that included economic evaluations of neurological physiotherapy interventions. A thorough search of PubMED, Cochrane and Embase was developed using keywords such as health economics, neurological physiotherapy and cost analysis, and studies published during the last six-year term were selected. A total of 3124 studies were analyzed, and 43 were eligible for inclusion. Among the studies analyzed, 48.8% were interventions for stroke patients, and 13.9% were focused on Parkinson's disease. In terms of the countries involved, 46.5% of the studies included were developed in the UK, and 13.9% were from the USA. The economic analysis most frequently used was cost-utility, implemented in 22 of the studies. A cost-effectiveness analysis was also developed in nine of those studies. The distribution of studies including an economic evaluation in this discipline showed a clear geographic dominance in terms of the pathology. A clear upward trend was noted in the economic evaluation of interventions developed in neurological physiotherapy. However, these studies should be promoted for their use in evidence-based clinical practice and decision-making.
PubMed: 33669731
DOI: 10.3390/brainsci11020265 -
Insects Jun 2021The impact of elevated CO (eCO) on plant-pollinator interactions is poorly understood. This study provides the first systematic review of this topic and identifies...
The impact of elevated CO (eCO) on plant-pollinator interactions is poorly understood. This study provides the first systematic review of this topic and identifies important knowledge gaps. In addition, we present field data assessing the impact of eCO (150 ppm above ambient) on bluebell ()-pollinator interactions within a mature, deciduous woodland system. Since 1956, only 71 primary papers have investigated eCO effects on flowering time, floral traits and pollination, with a mere 3 studies measuring the impact on pollination interactions. Our field experiment documented flowering phenology, flower visitation and seed production, as well as the abundance and phenology of dominant insect pollinators. We show that first and mid-point flowering occurred 6 days earlier under eCO, but with no change in flowering duration. Syrphid flies and bumble bees were the dominant flower visitors, with peak activity recorded during mid- and late-flowering periods. Whilst no significant difference was recorded in total visitation or seed set between eCO and ambient treatments, there were clear patterns of earlier flowering under eCO accompanied by lower pollinator activity during this period. This has implications for potential loss of synchrony in pollination systems under future climate scenarios, with associated long-term impacts on abundance and diversity.
PubMed: 34206033
DOI: 10.3390/insects12060512 -
Nurse Education in Practice May 2023To identify and synthesise theories that support the design and delivery of digital learning interventions in nursing and midwifery education. (Review)
Review
AIMS /OBJECTIVES
To identify and synthesise theories that support the design and delivery of digital learning interventions in nursing and midwifery education.
BACKGROUND
A range of educational and other theories are used to support nursing and midwifery education, including when e-learning interventions are being designed and delivered. However, there is a limited understanding of how theory is applied across the wide range of digital learning interventions to inform pedagogical research and practice.
DESIGN
A systematic review.
METHODS
CINAHL, ERIC, MEDLINE and PubMed were searched using key terms. Studies were screened by independent reviewers checking the title, abstract and full text against eligibility criteria. Due to the theoretical focus of the review, critical appraisal was not undertaken. Data were extracted and synthesised using a descriptive approach.
RESULTS
Thirty-four studies were included. Twenty theories were identified from a range of scientific disciplines, with the Technology Acceptance Model and Theory of Self-Efficacy employed most often. Theoretical frameworks were used to inform and explain how the digital learning interventions were designed or implemented in nursing and midwifery education. The sample were mainly undergraduate nursing students and the digital learning interventions encompassed animation, blended approaches, general technologies, mobile, online, virtual simulation and virtual reality applications which were used mainly in university settings.
CONCLUSIONS
This systematic review found a range of theories that support the design and delivery on digital learning interventions in nursing and midwifery education. While a single theory, the Technology Acceptance Model, tended to dominate the literature, the evidence base is peppered with numerous theoretical models that need to be examined more rigorously to ascertain their utility in improving the design or implementation of digital forms of learning to improve pedagogical research and practice in nursing and midwifery.
Topics: Pregnancy; Humans; Female; Education, Nursing, Baccalaureate; Midwifery; Computer-Assisted Instruction; Students, Nursing; Learning; Education, Nursing
PubMed: 37060735
DOI: 10.1016/j.nepr.2023.103635 -
BMC Infectious Diseases Feb 2014Human Salmonellosis is one of the major diseases in Ethiopia and several factors including under and mal-nutrition and HIV-AIDS may substantially contribute to its... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Human Salmonellosis is one of the major diseases in Ethiopia and several factors including under and mal-nutrition and HIV-AIDS may substantially contribute to its occurrence. Despite its importance, surveillance and monitoring systems are not in place and a comprehensive picture of its epidemiology is not available. The objectives of this study were to systematically review and estimate the prevalence of the disease and identify the dominant serogroups and serotypes in Ethiopia.
METHODS
Published studies on Salmonellosis in Ethiopia were electronically and manually searched. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included sample sizes, the numbers of Salmonella positive samples, serogroups and serotypes. The variations in prevalence estimates attributable to heterogeneities were assessed and pooled prevalence was estimated by the random effects model.
RESULTS
Twenty studies carried out between 1974 and 2012 were eligible. The pooled prevalence estimates of Salmonella in stool samples of diarrheic children, diarrheic adults and carriers were 8.72%, 5.68%, and 1.08% respectively. Invasive infections in children (5.71%) and adults (0.76%) were significantly different (p < 0.001). Non-typhi isolates accounted for 57.9% of the isolates from patients. Serogroup D occurred more frequently than serogroups C and B. S. Concord, S. Typhi, S. Typhimurium and S. Paratyphi were dominant and accounted for 82.1% of the serotypes isolated from patients.
CONCLUSION
The prevalence of Salmonellosis is considerable and most infections are due to four serotypes. The results imply the need for a policy to promote public hygiene and regularly screen individuals in contact with food items for public consumption.
Topics: Communicable Disease Control; Cross-Sectional Studies; Ethiopia; Food Contamination; Humans; Prevalence; Salmonella; Salmonella Infections; Serogroup
PubMed: 24552273
DOI: 10.1186/1471-2334-14-88 -
BMC Medical Genetics Jan 2014Nitric oxide (NO) has numerous functions in the kidney, including control of renal and glomerular hemodynamics, by interfering at multiple pathological and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nitric oxide (NO) has numerous functions in the kidney, including control of renal and glomerular hemodynamics, by interfering at multiple pathological and physiologically critical steps of nephron function. Endothelial NOS (eNOS) gene has been considered a potential candidate gene to diabetic nephropathy (DN) susceptibility. Endothelial nitric oxide synthase gene (eNOS-3) polymorphisms have been associated with DN, however some studies do not confirm this association. The analyzed polymorphisms were 4b/4a, T-786C, and G986T.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was used in this report. Case-control studies that had diabetic patients with DN as cases and diabetic patients without nephropathy as controls, as well as that evaluated at least one of the three polymorphisms of interest were considered eligible. All studies published up until December 31st, 2012 were identified by searching electronic databases. Hardy-Weinberg equilibrium assessment was performed. Gene-disease association was measured using odds ratio estimation based on the following genetic contrast/models: (1) allele contrast; (2) additive model; (3) recessive model; (4) dominant model and (4) co-dominant model.
RESULTS
Twenty-two studies were eligible for meta-analysis (4b/a: 15 studies, T-786C: 5 studies, and G984T: 12 studies). Considering 4b/a polymorphism, an association with DN was observed for all genetic models: allele contrast (OR = 1.14, CI: 1.04-1.25); additive (OR = 1.77, CI: 1.37-2.28); recessive (OR = 1.77, CI: 1.38-2,27); dominant (OR = 1.12, CI: 1.01-1.24), with the exception for co-dominance model. As well, T-786C polymorphism showed association with all models, with exception for co-dominance model: allele contrast (OR = 1.22, CI: 1.07-1.39), additive (OR = 1.52, CI: 1.18-1.97), recessive (OR = 1.50, CI: 1.16-1.93), and dominant (OR = 1.11, CI: 1.01-1.23). For the G894T polymorphism, an association with DN was observed in allelic contrast (OR = 1.12, CI: 1.03-1.25) and co-dominance models (OR = 1.13, CI: 1.04-1.37).
CONCLUSIONS
In the present study, there was association of DN with eNOS 4b/a and T-786C polymorphism, which held in all genetic models tested, except for co-dominance model. G894T polymorphism was associated with DN only in allele contrast and in co-dominance model. This data suggested that the eNOS gene could play a role in the development of DN.
Topics: Animals; Diabetic Nephropathies; Genetic Predisposition to Disease; Humans; Nitric Oxide Synthase Type III; Polymorphism, Genetic
PubMed: 24433471
DOI: 10.1186/1471-2350-15-9 -
Frontiers in Psychiatry 2018The aim of the study was a systematic review of studies evaluating psychotherapeutic treatment approaches in anorexia nervosa and to compare their efficacy. Weight gain... (Review)
Review
The aim of the study was a systematic review of studies evaluating psychotherapeutic treatment approaches in anorexia nervosa and to compare their efficacy. Weight gain was chosen as the primary outcome criterion. We also aimed to compare treatment effects according to service level (inpatient vs. outpatient) and age group (adolescents vs. adults). The data bases PubMed, Cochrane Library, Web of Science, Cinahl, and PsychInfo were used for a systematic literature search (until Feb 2017). Search terms were adapted for data base, combining versions of the search terms and . Studies were selected using pre-defined in- and exclusion criteria. Data were extracted by two independent coders using piloted forms. Network-meta-analyses were conducted on all RCTs. For a comparison of service levels and age groups, standard mean change (SMC) statistics were used and naturalistic, non-randomized studies included. Eighteen RCTs (trials on adults: 622 participants; trials on adolescents: 625 participants) were included in the network meta-analysis. SMC analyses were conducted with 38 studies (1,164 participants). While family-based approaches dominate interventions for adolescents, individual psychotherapy dominates in adults. There was no superiority of a specific approach. Weight gains were more rapid in adolescents and inpatient treatment. Several specialized psychotherapeutic interventions have been developed and can be recommended for AN. However, adult and adolescent patients should be distinguished, as groups differ in terms of treatment approaches considered suitable as well as treatment response. Future trials should replicate previous findings and be multi-center trials with large sample sizes to allow for subgroup analyses. Patient assessment should include variables that can be considered relevant moderators of treatment outcome. It is desirable to explore adaptive treatment strategies for subgroups of patients with AN. Identifying and addressing maintaining factors in AN remains a major challenge.
PubMed: 29765338
DOI: 10.3389/fpsyt.2018.00158 -
JAMA Network Open Nov 2020Many patients are admitted to the intensive care unit following surgery, and some of them will experience incomplete recovery. For patients in this situation,...
IMPORTANCE
Many patients are admitted to the intensive care unit following surgery, and some of them will experience incomplete recovery. For patients in this situation, preoperative discussions regarding patient values and preferences may direct care decisions. Existing literature shows that it is uncommon for surgeons to have these conversations preoperatively; it is unclear whether anesthesia professionals engage with patients on this topic prior to surgery.
OBJECTIVE
To review the literature on communication between patients and anesthesia professionals, with a focus on discussions related to postoperative critical care.
EVIDENCE REVIEW
MEDLINE and Web of Science were searched using specific search criteria from January 1980 to April 2020. Studies describing encounters between patients and anesthesia professionals were selected, and data regarding study objectives, study design, methodology, measures, outcomes, patient characteristics, and clinical setting were extracted and collated. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed.
FINDINGS
A total of 12 studies including 1284 individual patient encounters were eligible for inclusion in the review. These studies demonstrated that communication between patients and anesthesia professionals related to postoperative care is rare: only 2 studies reported communication regarding adverse postoperative events, and this communication behavior was reported in only 46 of 1284 consultations (3.6%) across all studies. Additional findings were that communication during these encounters is dominated by anesthetic planning and perioperative logistics, with variable discussion of perioperative risks vs benefits and infrequent elicitation of patient values and preferences. Some data suggest that patients wish to be involved in perioperative decision-making but are often limited by an incomplete understanding of risks and benefits.
CONCLUSIONS AND RELEVANCE
This systematic review found that communication in anesthesia is dominated by anesthetic planning and discussion of preoperative logistics, whereas postoperative critical care is rarely discussed. Most patients who are admitted to an intensive care unit after a major operation will not have had a discussion regarding goals of care specific to protracted recovery or prolonged intensive care with their anesthesiologist.
Topics: Anesthesiology; Critical Care; Decision Making; Humans; Patient Preference; Physician-Patient Relations; Postoperative Care
PubMed: 33180130
DOI: 10.1001/jamanetworkopen.2020.23503 -
Antibiotics (Basel, Switzerland) Feb 2020is a common bacterial colonizer of humans and a variety of animal species. Many strains have zoonotic potential, moving between humans and animals, including livestock,... (Review)
Review
is a common bacterial colonizer of humans and a variety of animal species. Many strains have zoonotic potential, moving between humans and animals, including livestock, pets, and wildlife. We examined publications reporting on presence in a variety of wildlife species in order to more cohesively review distribution of strains and antibiotic resistance in wildlife. Fifty-one studies were included in the final qualitative synthesis. The most common types documented included ST398, ST425, ST1, ST133, ST130, and ST15. A mix of methicillin-resistant and methicillin-susceptible strains were noted. A number of molecular types were identified that were likely to be found in wildlife species, including those that are commonly found in humans or other animal species (including livestock). Additional research should include follow-up in geographic areas that are under-sampled in this study, which is dominated by European studies.
PubMed: 32085586
DOI: 10.3390/antibiotics9020089 -
Radiotherapy and Oncology : Journal of... Jun 2013Dominant cancer foci within the prostate are associated with sites of local recurrence post radiotherapy. In this systematic review we sought to address the question:... (Review)
Review
INTRODUCTION
Dominant cancer foci within the prostate are associated with sites of local recurrence post radiotherapy. In this systematic review we sought to address the question: "what is the clinical evidence to support differential boosting to an imaging defined GTV volume within the prostate when delivered by external beam or brachytherapy".
MATERIALS AND METHODS
A systematic review was conducted to identify clinical series reporting the use of radiation boosts to imaging defined GTVs.
RESULTS
Thirteen papers describing 11 unique patient series and 833 patients in total were identified. Methods and details of GTV definition and treatment varied substantially between series. GTV boosts were on average 8 Gy (range 3-35 Gy) for external beam, or 150% for brachytherapy (range 130-155%) and GTV volumes were small (<10 ml). Reported toxicity rates were low and may reflect the modest boost doses, small volumes and conservative DVH constraints employed in most studies. Variability in patient populations, study methodologies and outcomes reporting precluded conclusions regarding efficacy.
CONCLUSIONS
Despite a large cohort of patients treated differential boosts to imaging defined intra-prostatic targets, conclusions regarding optimal techniques and/or efficacy of this approach are elusive, and this approach cannot be considered standard of care. There is a need to build consensus and evidence. Ongoing prospective randomized trials are underway and will help to better define the role of differential prostate boosts based on imaging defined GTVs.
Topics: Humans; Male; Positron-Emission Tomography; Prostatic Neoplasms; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Tomography, Emission-Computed, Single-Photon; Tumor Burden
PubMed: 23791306
DOI: 10.1016/j.radonc.2013.04.027 -
Pain Physician Jan 2019Recently posterior cervical foraminotomy (PCF) performed using a minimally-invasive surgery (MIS) approach for cervical radiculopathy due to lateral disc herniation or... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Recently posterior cervical foraminotomy (PCF) performed using a minimally-invasive surgery (MIS) approach for cervical radiculopathy due to lateral disc herniation or osseous foraminal stenosis has gained popularity. As 2 dominating MIS techniques, whether FE-PCF or MI-PCF provides superior clinical outcomes remains controversial.
OBJECTIVES
To compare clinical success rate, overall incidence of complications and reoperation rate between full-endoscopic posterior cervical foraminotomy (FE-PCF) and microendoscopic posterior cervical foraminotomy (MI-PCF) for cervical radiculopathy.
STUDY DESIGN
A systematic review and meta-analysis.
METHODS
A literature search of Pubmed, Embase and Web of Science was conducted to identify comparative or single-arm studies concerning FE-PCF or MI-PCF. The pooled results were performed by calculating the effect size based on the logit event rate and reported with 95% confidence intervals (CI).
RESULTS
A total of 26 articles with 2003 patients (FE-PCF, 377; MI-PCF, 1626) were included. The pooled clinical success rate was 93.6% (CI: 90.0%-95.9%) for the FE group and 89.9% (CI: 86.6%-92.5%) for the MI group, which was not statistically significant (P = 0.908). Overall complication rates were 6.1% (CI: 3.2%-11.3%) and 3.5% (CI: 2.7%-4.6%) for the FE group and the MI group, respectively, with no significant difference (P = 0.128). Nevertheless, the specific constituents showed apparent disparity, with transient nerve root palsy in the FE group (12/16, 75.0%) and dural tear in the MI group (20/47, 42.6%) being the most commonly reported. the pooled reoperation rate, the FE group (4.8%, CI: 2.9%-7.8%) and the MI group (5.3%, CI: 3.4%-8.2%), also demonstrated no statistical difference (P = 0.741).
LIMITATIONS
The indirect comparison eroded the reliability of results inevitably due to the paucity of randomized clinical trials or high quality prospective cohort studies.
CONCLUSIONS
Both FE-PCF and MI-PCF can offer an effective and relatively secure treatment for cervical radiculopathy. There was no significant difference in the pooled outcomes of clinical success rate, complication rate and reoperation rate between the 2 approaches.
KEY WORDS
Cervical radiculopathy, full-endoscopic, microendoscopic, posterior cervical foraminotomy, clinical outcome, complication, reoperation, meta-analysis.
Topics: Cervical Vertebrae; Endoscopy; Foraminotomy; Humans; Male; Minimally Invasive Surgical Procedures; Radiculopathy; Treatment Outcome
PubMed: 30700067
DOI: No ID Found