Types, characteristics and anatomic location of physical signs in elder abuse: a systematic review

Abstract Purpose Elder abuse is a worldwide problem with serious consequences for individuals and society. The recognition of elder abuse is complex due to a lack of awareness and knowledge. In this systematic review, types, characteristics and anatomic location of physical signs in elder abuse were identified. Methods Databases of MEDLINE, COCHRANE, EMBASE and CINAHL were searched. The publication dates ranged from March 2005 to July 2020. In addition to the electronic searches, the reference lists and citing of included articles were hand-searched to identify additional relevant studies. The quality of descriptive and mixed-methods studies was assessed. Results The most commonly described physical signs in elder abuse were bruises. The characteristics of physical signs can be categorized into size, shape and distribution. Physical signs were anatomically predominantly located on the head, face/maxillofacial area (including eyes, ears and dental area), neck, upper extremities and torso (especially posterior). Physical signs related to sexual elder abuse were mostly located in the genital and perianal area and often accompanied by a significant amount of injury to non-genital parts of the body, especially the area of the head, arms and medial aspect of the thigh. Conclusions Most common types, characteristics and anatomic location of physical signs in elder abuse were identified. To enhance (early) detection of physical signs in elder abuse, it is necessary to invest in (more) in-depth education and to include expertise from a forensic physician or forensic nurse in multidisciplinary team consultations.

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459 - Psychometric properties of the Geriatric Anxiety Inventory : A systematic review

International Psychogeriatrics ◽

10.1017/s1041610220003117 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 180-180

Author(s):

Philippe Landreville ◽

Alexandra Champagne ◽

Patrick Gosselin

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Internal Consistency ◽

Methodological Quality ◽

The Body ◽

Self Report ◽

Test Reliability ◽

Cosmin Checklist ◽

Validity Indices

Background.The Geriatric Anxiety Inventory (GAI) is a widely used self-report measure of anxiety symptoms in older adults. Much research has been conducted on the psychometric properties of the GAI in various populations and using different language versions. Previous reviews of this literature have examined only a small proportion of studies in light of the body of research currently available and have not evaluated the methodological quality of this research. We conducted a systematic review of the psychometric properties of the GAI.Method.Relevant studies (N = 30) were retrieved through a search of electronic databases (Pubmed, PsycINFO, CINAHL, EMBASE and Google Scholar) and a hand search. The methodological quality of the included studies was assessed by two independent reviewers using the ‘‘COnsensusbased Standards for the selection of health status Measurement INstruments’’ (COSMIN) checklist.Results.Based on the COSMIN checklist, internal consistency and test reliability were mostly rated as poorly assessed (62.1% and 70% of studies, respectively) and quality of studies examining structural validity was mostly fair (60% of studies). The GAI showed adequate internal consistency and test-retest reliability. Convergent validity indices were highest with measures of generalized anxiety and lowest with instruments that include somatic symptoms. A substantial overlap with measures of depression was reported. While there was no consensus on the factorial structure of the GAI, several studies found it to be unidimensional.Conclusions.The GAI presents satisfactory psychometric properties. However, future efforts should aim to achieve a higher degree of methodological quality.

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A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs

BMC Veterinary Research ◽

10.1186/s12917-019-2227-8 ◽

2020 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Laura E. Selmic ◽

Audrey Ruple

Keyword(s):

Systematic Review ◽

Tumor Recurrence ◽

The Body ◽

Surgical Margins ◽

Data Abstraction ◽

Local Tumor ◽

Local Tumor Recurrence ◽

Cutaneous Mast Cell ◽

Fascial Plane

Abstract Background Traditionally, wide lateral surgical margins of 3 cm and one fascial plane deep have been recommended for resection of canine cutaneous mast cell tumor (MCT). Several studies have been published assessing surgical margins of less than this traditional recommendation. The objective of this systematic review was to determine if resection MCT with lateral surgical margins < 3 cm results in low rates of incomplete resection and local tumor recurrence. Systematic searches of digital bibliographic databases were performed with two authors (AR & LES) screening abstracts to identify relevant scientific articles. Studies regarding surgical treatment of dogs with cutaneous MCT were reviewed. Data abstraction was performed and the quality of individual studies and the strength of the body of evidence for utilization of surgical margins < 3 cm for removal of MCTs was assessed. Results From the initial 78 citations identified through the database searches, four articles were retained for data abstraction after both relevance screenings were performed. Two studies were retrospective observational studies, one was a prospective case series and one was a prospective clinical trial. Assessment of the quality level of the body of evidence identified using the GRADE system was low. Excision of MCT at 2 cm and 3 cm was associated with comparably low rates of incomplete excision and recurrence. Conclusions Despite the low quality of the overall body of evidence, a recommendation can be made that resection of canine cutaneous MCTs (< 4 cm) of Patnaik grade I and II with 2 cm lateral margins and 1 fascial plane deep results in low rates of incomplete excision and local tumor recurrence.

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Safety and efficacy of perioperative benzodiazepine administration: study protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-031895 ◽

2019 ◽

Vol 9 (12) ◽

pp. e031895

Author(s):

Jessica Spence ◽

Jack Young ◽

Waleed Alhazzani ◽

Richard Whitlock ◽

Frédérick D'Aragon ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Random Effect ◽

Random Effect Model ◽

Cognitive Change ◽

The Body ◽

Pool Data ◽

Intraoperative Awareness ◽

The Impact

IntroductionPerioperative benzodiazepines are used because of their anxiolytic, sedative and amnestic effects. Evidence has demonstrated an association of benzodiazepines with adverse neuropsychiatric effects. Nonetheless, because of their potential benefits, perioperative benzodiazepines continue to be used routinely. We seek to evaluate the body of evidence of the risks and benefits of benzodiazepine use during the perioperative period.Methods and analysisWe will search Cochrane CENTRAL, MEDLINE, EMBASE, PsychINFO, CINAHL and Web of Science from inception to March 2019 for randomised controlled trials (RCTs) and observational studies evaluating the administration of benzodiazepine medications as compared with all other medications (or nothing) in patients undergoing cardiac and non-cardiac surgery. We will exclude studies assessing the use of benzodiazepines for procedural sedation or day surgery. We will examine the impact of giving these medications before, during and after surgery. Outcomes of interest include the incidence of delirium, duration of delirium, postprocedure cognitive change, the incidence of intraoperative awareness, patient satisfaction/quality of life/quality of recovery, length-of-stay (LOS) in the intensive care unit (ICU), hospital LOS and in-hospital mortality.Reviewers will screen references and assess eligibility using predefined criteria independently and in duplicate. Two reviewers will independently collect data using prepiloted forms. We will present results separately for RCTs and observational studies. We will pool data using a random effect model and present results as relative risk with 95% CIs for dichotomous outcomes and mean difference with 95% CI for continuous outcomes. We will pool adjusted ORs for observational studies. We will assess risk of bias for individual studies using the Cochrane Collaboration tool for RCTs. For observational studies, we will use tools designed by the Clinical Advances through Research and Information Translation group. Quality of evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationThis systematic review involves no patient contact and no interaction with healthcare providers or systems. As such, we did not seek ethics board approval. We will disseminate the findings of our systematic review through the presentation at peer-reviewed conferences and by seeking publication in a peer-reviewed journal.PROSPERO registration numberCRD42019128144

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Effectiveness of trauma centers verification: Protocol for a systematic review

Systematic Reviews ◽

10.1186/s13643-019-1239-6 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 3

Author(s):

Brice Batomen ◽

Lynne Moore ◽

Mabel Carabali ◽

Pier-Alexandre Tardif ◽

Howard Champion ◽

...

Keyword(s):

Systematic Review ◽

Trauma Center ◽

Assessment Tool ◽

Meta Analysis ◽

The Body ◽

World Health ◽

Trauma Patients ◽

Assessment Development ◽

Health Organization

Abstract Background The implementation of trauma systems in many high-income countries over the last 50 years has led to important reductions in injury mortality and disability in many healthcare jurisdictions. Injury organizations including the American College of Surgeons and the Trauma Association of Canada as well as the World Health Organization provide consensus-based recommendations on resources and processes for optimal injury care. Many hospitals treating trauma patients seek verification to demonstrate that they meet these recommendations. This process may be labeled differently across jurisdictions. In Canada for example, it is called accreditation, but it has the same objective and very similar modalities. The objective of the study described in this protocol is to systematically review evidence on the effectiveness of trauma center verification for improving clinical processes and patient outcomes in injury care. Methods We will perform a systematic review of studies evaluating the association between trauma center verification and hospital mortality (primary outcome), as well as morbidity, resource utilization, and processes of care (secondary outcomes). We will search CINAHL, EMBASE, HealthStar, MEDLINE, and ProQuest databases, as well as key injury organization websites for gray literature. We will assess the methodological quality of studies using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool. We are planning to conduct a meta-analysis if feasible based on the number of included studies and their heterogeneity. We will evaluate the quality of cumulative evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group methodology. Discussion This review will provide a synthesis of the body of evidence on trauma center verification effectiveness. Results could reinforce current verification modalities and may suggest ways to optimize them. Results will be published in a peer-reviewed journal and presented at an international clinical conference. Systematic review registration PROSPERO CRD42018107083.

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A systematic review of the systematic review of post COVID-19 syndrome

The Journal of Medicine, Law & Public Health ◽

10.52609/jmlph.v2i1.33 ◽

2022 ◽

Vol 2 (1) ◽

pp. 64-69

Author(s):

Abdulmohsen Alhumayn ◽

Ibrahim Alsaif ◽

Joud Enabi ◽

Sharafaldeen Bin Nafisah

Keyword(s):

Systematic Review ◽

Reference Lists ◽

Ground Glass Opacity ◽

Common Symptom ◽

General Health Status ◽

Diffusion Capacity ◽

Appropriate Care ◽

And Diffusion

Background: The declaration of the COVID-19 pandemic triggered a global inquiry into the transmission, mortality, risk factors, and management of the disease. Recently, however, attention has shifted toward its long-term consequences. There is a need for a better understanding of the predictors and symptoms of post-COVID syndrome, to ensure appropriate care for patients recovering from COVID-19 beyond the acute phase. Methods: We searched PubMed, Google Scholar, Cochrane databases, and available data in the PROSPERO databases. We also explored the reference lists of included articles and any systematic reviews identified therein. We searched the keywords "Post Covid", "Post COVID syndrome", "Post- Covid" and "PostCOVID", until July 2021. Results: Of 8167 articles, 13 were included. The syndrome affects several systems with variable prevalence. Fatigue and sleep disturbance is the most common symptom of acute post-COVID syndrome, observed in more than two-thirds of patients, while a reduction in quality of life and general health status was noted in up to 69%. Furthermore, a reduced aerobic and diffusion capacity was seen in 38% of patients up to one month after presumed recovery from infection. Radiologically, in up to 52% of patients, a ground-glass opacity (GGO) was noted beyond three months post-infection. The incidence of new psychiatric illness increased from as early as 14 days after infection and up to three or six months. Hearing impairment or loss, whether sensorineural or conductive, was noted in up to 8.3% of patients, and tinnitus was seen in up to 4.2%. Conclusion: Overall, given the variability in the manifestation of post-COVID syndrome, a multidisciplinary team is required to better serve these patients. We therefore urge the establishment of such teams, encompassing internal medicine, pulmonology, cardiology, and neurocognitive services.

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COVID-19:Major Metabolic and Immunological Relationships in Obesity

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt2135 ◽

2021 ◽

pp. 26-31

Author(s):

Mariana Tolentino Chaves ◽

Ana Paula Tolentino Chaves

Keyword(s):

Systematic Review ◽

Scientific Basis ◽

The Body ◽

Important Predictor ◽

Inflammatory Factors ◽

Cochrane Library ◽

Current Prevalence ◽

Medium Quality ◽

Review Model

Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There are a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of metainflammation.

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Physical activity promotion for multimorbid patients in primary care settings: A protocol for a systematic review evaluating health benefits and harms.

10.31219/osf.io/ka8yu ◽

2020 ◽

Author(s):

Simone Schweda ◽

Inga Krauß

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Systematic Review ◽

Primary Care ◽

Health Benefits ◽

The Body ◽

Cochrane Library ◽

Primary Care Settings ◽

Activity Promotion

Background: To date multimorbidity has not received much attention in health policies, even though multiple chronic diseases put high demands on the health care system in industrial nations. Enormous costs of care and a physically, mentally and socially reduced quality of life are common consequences of multimorbidity. Physical activity (PA) has a positive preventive and therapeutic effect on common non-communicable . The objective of this study will be to evaluate the halth benefits and harms of PA interventions for sedentary adults with multimorbidity in primary care settings. Methods: This is the study protocol for a systematic review. We will serach PubMed, MEDLINE (Ovid), Web of Science, CINHAL and the Cochrane Library (from inception onwards). In addition, clinical trial registers and reference lists of included studies will be searched. We will include randomised controlled trials, quasi-experimental and non-randomised trials examining the health benefits and harms of PA interventions with or without additional lifestyle interventions for sedentary adult patients with multimorbidity (e.g. two or more chronic non-communicable diseases) in primary care. Eligible control groups will be standard care, placebo or medications. Two reviewers will independently screen all citations, abstracts data and full text articles. The primary outcomes will be health related quality of life and mortality. Secondary outcomes will include cardiovascular fitness, muscular strength and disease specific outcomes (e.g. depression score), biomarkers as well as control of metabolic risk factors (e.g. blood pressure, HBA1c, body weight) and any adverse event. The study methodological quality will be appraised using appropriate tools. If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g. study design, geographical location, or type of intervention). Strength of the body of evidence will be assessed according to the Grading of Recommendations Assessment (GRADE). Discussion: This review will evaluate the evidence on health benefits and harms of PA interventions for sedentary adults with multimorbidity in primary care settings. We anticipate our findings to be of interest to patients, their families, caregivers and healthcare professionals in selecting and conducting optimal health promotion programs. Possible implications for further research will be discussed.

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COVID-19: Major Metabolic and Immunological Relationships in Obesity

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt21213 ◽

2021 ◽

pp. 87-93

Author(s):

Mariana Tolentino Chaves ◽

Ana Paula Tolentino Chaves

Keyword(s):

Systematic Review ◽

Scientific Basis ◽

The Body ◽

Important Predictor ◽

Inflammatory Factors ◽

Cochrane Library ◽

Current Prevalence ◽

Medium Quality ◽

Review Model

Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There is a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of met inflammation.

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Prehabilitation Programs for Cancer Patients: a Systematic Review of Randomized-controlled Trials

10.21203/rs.3.rs-694509/v1 ◽

2021 ◽

Author(s):

Jose F Meneses-Echavez ◽

Andrés F. Loaiza-Betancur ◽

Víctor Díaz-López ◽

Andrés M. Echavarría-Rodríguez ◽

Hector R Triana-R

Keyword(s):

Systematic Review ◽

Exercise Training ◽

Randomized Controlled Trials ◽

Usual Care ◽

Cancer Patients ◽

The Body ◽

Controlled Trials ◽

Promising Alternative ◽

Randomized Controlled

Abstract Background: Prehabilitation programs focusing on exercise training as the main component are known as a promising alternative for improving patients’ outcomes before surgical treatment of different cancers. This systematic review aimed to determine the effects of prehabilitation programs compared with usual care for cancer patients.Methods/design: We searched CENTRAL, MEDLINE, and EMBASE from inception to 2020, and hand-searched clinical trial registries. We included randomized controlled trials (RCTs) in adults, survivors of any type of cancer, that compared prehabilitation programs focusing on exercise training as the major component with usual care or other active interventions. Outcome measures were health-related quality of life (HRQL), muscular strength, postoperative complications, average length of stay (ALOS), handgrip strength, and physical activity levels. Two reviewers independently selected the studies, extracted data, assessed the risk of bias and the quality of evidence using the GRADE approach.Results: 14 RCTs published between 2010-2020 met our inclusion criteria (n=1044 participants). Colorectal and lung cancers were the most common diagnoses with 5 studies (36%) each. The studies showed concerns regarding outcome measurement, selective reporting, and attrition. Four comparisons were identified: combined training vs rehabilitation/usual care; high-intensity interval training vs usual care; respiratory muscle training plus aerobic training vs usual care, and pelvic floor training vs usual care. The studies provided no clear evidence of an effect between groups. We assessed the certainty of the body of evidence as very low, downgraded due to serious study limitations and imprecision.Conclusion: It is uncertain whether prehabilitation programs compared with usual care have an effect in cancer patients. We have very little confidence in the results and the true effect is likely to be substantially different from these. Further research is needed before we could draw a more certain conclusion.Systematic review registration: CRD42019125658

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Effect of Different Exercise and Nutrition in Reducing Risk of Obesity: Systematic Review

International Journal of Sport Exercise and Health Research ◽

10.31254/sportmed.3106 ◽

2021 ◽

Vol 3 (1) ◽

pp. 24-27

Author(s):

Mulugeta Worku ◽

Keyword(s):

Systematic Review ◽

Aerobic Exercise ◽

The Body ◽

Cross Sectional ◽

Medical Centers ◽

Obesity And Overweight ◽

Human Quality ◽

Intensity Training ◽

Excessive Accumulation

The systematic review mainly focuses on the effects of a variety of exercises to reduce the risk of obesity. Primarily, patients’ cheek health status in medical centers or hospitals before doing any exercise programs. To reduce obesity and have good, smart, body composition different scholars recommended that they have to perform aerobic exercise for 30 minutes five days per week are good. Obesity is a serious problem for sedentary peoples and caused by excessive accumulation of fat in the body and lack of exercise training to control overweight. It affects daily human quality of spirit and health conditions. Aerobic exercise, resistance training and intensity training are very important to reduce risk of obesity health problems such as high blood pressure, cancer and diabetes. The article reviewed from survey research, experimental and cross sectional research design researches. Lack of regular exercise, sedentary lifestyle and consuming fatty foods leads persons to obesity and overweight. Conclusion engaging in physical activity helps to have good posture and simply reduce the medical costs of persons

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