scholarly journals Systematic review: non-adherence and non-persistence in intravitreal treatment

2020 ◽  
Vol 258 (10) ◽  
pp. 2077-2090 ◽  
Author(s):  
Christoph Ehlken ◽  
Focke Ziemssen ◽  
Nicole Eter ◽  
Ines Lanzl ◽  
Hakan Kaymak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Intravitreal Injection ◽  
Real Life ◽  
Clinical Results ◽  
Qualitative Studies ◽  
Treatment Center ◽  
Contributing Factors ◽  
Vegf Inhibitors ◽  
Intravitreal Treatment

Abstract Purpose Intravitreal injection of VEGF inhibitors has become the standard of care for different macular diseases within the last years resulting in improved visual outcomes. Under real-life conditions, however, the necessity for frequent retreatments and reexaminations poses a burden for patients and treatment centers. Non-adherence and non-persistence to intravitreal treatment may lead to inferior clinical outcomes, and knowledge of contributing factors is crucial to improve adherence. This systematic review analyzes current literature for potential factors involved in non-adherence and non-persistence. Methods A systematic search was conducted in PubMed and Embase including three different aspects of intravitreal injection therapy: (1) diseases with intravitreal injections as treatment, (2) intravitreal injection, and (3) aspects of therapy adherence or therapy persistence. Data from identified quantitative studies were further extracted and grouped according to WHO criteria (condition, socio-economy, therapy, patient, and health system). The methodological quality of identified studies was graded. Identified qualitative studies (i.e., interviews) were descriptively analyzed and their findings narratively reported. Results Twenty-four publications were included. In 16 of those publications, a quantitative data analysis was conducted, analyzing factors associated with non-adherence. Worse visual acuity at baseline and unfavorable development of visual acuity, higher age, and greater distance to the treatment center were associated with non-adherence, while there was inconsistent evidence for an association of comorbidity. In qualitative studies, high follow-up/treatment burden, fear and anxiety, disappointed patient expectations, and lack of motivation to continue treatment were reported as reasons for non-persistence. Conclusions Knowledge of potential barriers in IVT treatment may improve adherence and potentially clinical results. Improvements can be achieved particularly in the healthcare complex (organizational improvements) and the “patient” complex by establishing realistic expectations. Recurrent education of the patient may be necessary.

scholarly journals Nursing students’ experiences with faculty incivility in the clinical education context: a qualitative systematic review and meta-synthesis

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024383 ◽  
Author(s):  
Zheng Zhu ◽  
Weijie Xing ◽  
Lucylynn Lizarondo ◽  
Mengdi Guo ◽  
Yan Hu
Keyword(s):  
Systematic Review ◽  
Nursing Students ◽  
Clinical Education ◽  
Data Extraction ◽  
Included Study ◽  
Qualitative Studies ◽  
Contributing Factors ◽  
Open Communication ◽  
Eligibility Criteria ◽  
Deep Blue

ObjectiveThe aim of this study is to synthesise evidence for the experiences and perceptions of incivility during clinical education of nursing students.DesignWe used a meta-aggregation approach to conduct a systematic review of qualitative studies.Data sourcesPublished and unpublished papers from 1990 until 13 January 2018 were searched using electronic databases, including CINAHL, PubMed (MEDLINE), ProQuest Central, ProQuest Education Journals, ProQuest XML-Dissertations and Theses, Web of Science, Embase, EBSCO Discovery Service and PsycINFO. The search for unpublished studies included the Open Grey collection, conference proceedings and the Deep Blue Library.Eligibility criteriaWe included qualitative studies that focused on nursing students' perceptions and experiences of incivility from faculty during their clinical education.Data extraction and synthesisTwo reviewers independently appraised the methodological quality and extracted relevant data from each included study. Meta-aggregation was used to synthesise the data.ResultsA total of 3397 studies was returned from the search strategies. Eighteen studies fulfilled the inclusion criteria and were included in the meta-synthesis. Six synthesised findings were identified, covering features of incivility, manifestations of incivility, contributing factors, impacts on students, coping strategies and suggestions.ConclusionsThe results showed experiences of incivility during clinical education. However, the confidence was low for all synthesised findings. We suggest that nursing students should try to cope positively with incivility. Nurse managers and clinical preceptors should be aware of the prevalence and impact of incivility and implement policies and strategies to reduce incivility towards nursing students. Hospitals and universities should have an immediate response person or system to help nursing students confronting incivility and create an open communication environment.

Ensuring On-site Ebola Patient Monitoring and Follow-up: Development of a Laboratory Structure Embedded in an Ebola Treatment Center

2019 ◽  
Vol 13 (5-6) ◽  
pp. 1028-1034
Author(s):  
Anita Williams ◽  
Mathieu Amand ◽  
Rafael Van den Bergh ◽  
Hilde De Clerck ◽  
Annick Antierens ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Ebola Virus ◽  
Virus Disease ◽  
Real Life ◽  
Disease Outbreaks ◽  
Clinical Results ◽  
Ebola Virus Disease ◽  
Treatment Center ◽  
Risk Zones

ABSTRACTThe capacity to rapidly distinguish Ebola virus disease from other infectious diseases and to monitor biochemistry and viremia levels is crucial to the clinical management of suspected Ebola virus disease cases. This article describes the design and practical considerations of a laboratory straddling the high- and low-risk zones of an Ebola treatment center to produce timely diagnostic and clinical results for informed case management of Ebola virus disease in real-life conditions. This innovation may be of relevance for actors requiring flexible laboratory implementation in contexts of high-communicability, high-lethality disease outbreaks.

One-year real-life results on effect of intravitreal aflibercept in patients with diabetic macular oedema switched from ranibizumab

2020 ◽  
pp. 112067212092727
Author(s):  
Marko Lukic ◽  
Gwyn Williams ◽  
Zaid Shalchi ◽  
Praveen J Patel ◽  
Philip G Hykin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Early Treatment ◽  
Macular Oedema ◽  
Real Life ◽  
Diabetic Macular Oedema ◽  
Foveal Thickness ◽  
Macular Volume ◽  
Central Foveal Thickness ◽  
The Mean

Purpose To assess visual and optical coherence tomography–derived anatomical outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in patients switched from intravitreal ranibizumab (Lucentis®). Design Retrospective, cohort study. Participants Ninety eyes (of 67 patients) receiving intravitreal anti–vascular endothelial growth factor therapy were included. Methods This is a retrospective, real-life, cohort study. Each patient had visual acuity measurements and optical coherence tomography scans performed at baseline and 12 months after the first injection of aflibercept was given. Main Outcome Measures We measured visual acuities in Early Treatment Diabetic Retinopathy Study letters, central foveal thickness and macular volume at baseline and at 12 months after the first aflibercept injection was given. Results Ninety switched eyes were included in this study. The mean (standard deviation) visual acuity was 63 (15.78) Early Treatment Diabetic Retinopathy Study letters. At baseline, the mean (standard deviation) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. Mean change in visual acuity was +4 Early Treatment Diabetic Retinopathy Study letters (p = 0.0053). The mean change in macular volume was −1.53 mm 3 in SW group (p = 0.21), while the change in central foveal thickness was −136.8 μm (p = 0.69). Conclusion There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular oedema.

Motorcyclist injury risk as a function of real-life crash speed and other contributing factors

2019 ◽  
Vol 123 ◽  
pp. 374-386 ◽  
Author(s):  
Chengkai Ding ◽  
Matteo Rizzi ◽  
Johan Strandroth ◽  
Ulrich Sander ◽  
Nils Lubbe
Keyword(s):  
Injury Risk ◽  
Real Life ◽  
Contributing Factors

scholarly journals Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yueyang Zhong ◽  
Kai Wang ◽  
Xiaoning Yu ◽  
Xin Liu ◽  
Ke Yao
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Meta Analysis ◽  
Visual Quality ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Refractive Lens Exchange ◽  
Extended Depth Of Focus ◽  
Refractive Lens ◽  
Near Visual Acuity

AbstractThis meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: − 0.143, 95% CI: − 0.192 to − 0.010, P < 0.001 and MD: − 0.149, 95% CI: − 0.217 to − 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.

scholarly journals Long term results of accelerated 9 mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross Study 2

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Cosimo Mazzotta ◽  
Frederik Raiskup ◽  
Farhad Hafezi ◽  
Emilio A Torres-Netto ◽  
Ashraf Armia Balamoun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Continuous Light ◽  
Clinical Results ◽  
Asymmetry Index ◽  
Long Term Results ◽  
Distance Visual Acuity ◽  
Long Term Stability ◽  
Uncorrected Distance Visual Acuity

Abstract Purpose To assess clinical results of the 9 mW/5.4 J/cm2 accelerated crosslinking (ACXL) in the treatment of progressive keratoconus (KC) over a span of 5 years. Methods The prospective open non-randomized interventional study (Siena Eye-Cross Study 2) included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm2 ACXL at the Siena Crosslinking Centre, Italy. The mean age was 18.05 ± 5.6 years. The 20-min treatments were performed using the New KXL I (Avedro, Waltham, USA), 10 min of 0.1% HPMC Riboflavin soaking (VibeX Rapid, Avedro, Waltham, USA) and 10 min of continuous-light UV-A irradiation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Kmax, coma, minimum corneal thickness (MCT), surface asymmetry index (SAI), endothelial cell count (ECC) were measured, and corneal OCT performed. Results UDVA and CDVA improved significantly at the 3rd (P = 0.028), Δ + 0.17 Snellen lines and 6th postoperative month, respectively (P < 0.001), Δ + 0.23 Snellen lines. Kmax improved at the 6th postoperative month (P = 0.03), Δ − 1.49 diopters from the baseline value. Also, coma aberration value improved significantly (P = 0.004). A mild temporary haze was recorded in 14.77% of patients without affecting visual acuity and without persistent complications. Corneal OCT revealed a mean demarcation line depth at 332.6 ± 33.6 μm. Conclusion The 5-year results of Epi-Off 9 mW/5.4 J/cm2 ACXL demonstrated statistically significant improvements in UCVA and CDVA, corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia. Based on the results of the Siena Eye-Cross Study 2, the 9 mW/5.4 J/cm2 ACXL is a candidate to be  the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia, and thus optimize clinic workflow.

scholarly journals Correction to: Digital Tools for the Self-Assessment of Visual Acuity: A Systematic Review

2021 ◽  
Author(s):  
Janneau L. J. Claessens ◽  
Judith R. Geuvers ◽  
Saskia M. Imhof ◽  
Robert P. L. Wisse
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
The Self ◽  
Digital Tools ◽  
Self Assessment

scholarly journals More Than Two Decades of Research on Selective Traditions in Environmental and Sustainability Education—Seven Functions of the Concept

2021 ◽  
Vol 13 (12) ◽  
pp. 6524
Author(s):  
Per J. Sund ◽  
Niklas Gericke
Keyword(s):  
Systematic Review ◽  
Teacher Education ◽  
Sustainability Education ◽  
Qualitative Studies ◽  
The Other ◽  
Research Practice ◽  
Selective Tradition ◽  
Qualitative Systematic Review ◽  
Selective Traditions

This study investigates functions of the concept of selective traditions by means of a qualitative systematic review synthesis of earlier research. The study is based on a review method for integrating qualitative studies and looks for “themes” in or across them. In this case, it is about how the identified publications (twenty-four in total) use the concept of selective traditions. All but two studies stem from the Swedish context. The selective traditions relate to teachers’ approaches to the content, methods and purposes of environmental and sustainability education (ESE). Teachers mainly work within one specific selective tradition. Seven different functions were found in the publications of which five are claimed to be valuable for the development of ESE teaching, while the other two functions are useful in monitoring changes and development in ESE teaching. The results are discussed in terms of the consequences for research, practice and teacher education aiming at offering suggestions on how to develop future (transformative) ESE teaching.

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