scholarly journals Letter to the editor. Healthcare workers on the edge of sanity due to COVID-19: Rapid review of the results of systematic reviews and meta-analyzes

2021 ◽  
Vol 83 ◽  
pp. 21-24
Author(s):  
Ivan Lozada-Martínez ◽  
Maria Bolaño-Romero ◽  
Luis Moscote-Salazar ◽  
Daniela Torres-Llinas ◽  
Amit Agrawal
Keyword(s):  
Systematic Reviews ◽  
Healthcare Workers ◽  
Rapid Review ◽  
Letter To The Editor

scholarly journals Personal protective equipment for reducing the risk of COVID-19 infection among healthcare workers involved in emergency trauma surgery during the pandemic: an umbrella review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045598
Author(s):  
Dylan P Griswold ◽  
Andres Gempeler ◽  
Angelos G Kolias ◽  
Peter J Hutchinson ◽  
Andres M Rubiano
Keyword(s):  
Health Systems ◽  
Systematic Reviews ◽  
Low Income ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Evidence Synthesis ◽  
Trauma Surgery ◽  
Experimental Studies ◽  
Protective Equipment ◽  
Cochrane Central Register

IntroductionMany healthcare facilities in low-income and middle-income countries are inadequately resourced and may lack optimal organisation and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialised care for patients. The objective of this broad evidence synthesis is to identify and summarise the available literature regarding the efficacy of different personal protective equipment (PPE) in reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments.MethodsWe will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials and over 30 other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Critical appraisal of eligible studies for methodological quality will be conducted. Data will be extracted using the standardised data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed and a summary of findings will be created.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.PROSPERO registration numberCRD42020198267.

First the Pandemic then the Tsunami: COVID-19 and Its Impact on Mental Health

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Keng Chuan SOH ◽  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Systematic Reviews ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Large Population ◽  
Well Being ◽  
Health Impact ◽  
Mental Wellbeing ◽  
Behavioural Patterns

Introduction: COVID-19 has undeniably and profoundly impacted everyday lives of the general public. One particular emphasis is the mental wellbeing of populations. This review serves to examine the mental health impact of the current pandemic. Methods: A review of the literature on PubMed was conducted, drawing from systematic reviews and large population studies about mental health consequences of the COVID-19 pandemic. The content was synthesized with the writer’s experience of daily life across different perspectives. Certain demographic sub-groups were examined, such as those under home quarantine or isolation, those who had contracted COVID-19, those with pre-existing psychiatric disorders, as well as healthcare workers and medical students. Results: Psychological well-being was adversely affected by the pandemic, although there is some controversy about the magnitude of this impact which is likely in relation to the timeline of the pandemic’s progression. Behavioural patterns such as spending habits during lockdowns might provide an early indication of mental health problems. Those who had contracted COVID-19 were found to have heightened levels of posttraumatic stress symptoms and depressive symptoms. Healthcare workers and medical students have faced comparable levels of anxiety, depressed mood and insomnia. The final results of some of the systematic reviews are still pending. Conclusion: The COVID-19 pandemic has profoundly impacted everyday life. If not already thecase, there is likely to be an anticipated tsunami of mental health concerns. This wouldmake a strong case for the anticipatory need of increased resource allocation to allowmental health services to meet this demand.

Low-calorie sweeteners and human health: a rapid review of systematic reviews

2020 ◽  
Author(s):  
Lesley Andrade ◽  
Kirsten M Lee ◽  
Allison C Sylvetsky ◽  
Sharon I Kirkpatrick
Keyword(s):  
Risk Factors ◽  
Systematic Reviews ◽  
Chronic Conditions ◽  
Disease Risk ◽  
Rapid Review ◽  
Anthropometric Measures ◽  
Low Calorie ◽  
Associated Risk Factors ◽  
Low Calorie Sweetener

Abstract Introduction Low-calorie sweeteners are increasingly prevalent in the food supply and their consumption has increased in recent decades. Although low-calorie sweeteners approved for use are considered safe from a toxicological perspective, their short- and long-term impacts on chronic disease risk remain uncertain. The aim of this review was to summarize the evidence from systematic reviews on low-calorie sweetener use and chronic conditions and risk factors in children and adults. Methods MEDLINE and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews of randomized and nonrandomized studies that considered low-calorie sweeteners in relation to type 2 diabetes, cardiovascular disease, cancer, anthropometric measures, hypertension, hyperglycemia, hyperlipidemia, insulin resistance, and dental caries. Data were extracted from 9 reviews deemed of moderate or high quality on the basis of AMSTAR-2. Results Narrative synthesis suggested inconsistent evidence on low-calorie sweetener use in relation to chronic conditions and associated risk factors, with nonrandomized studies suggesting positive associations and randomized studies suggesting negative or no associations. Conclusion Continued research on the long-term health impacts of low-calorie sweeteners across all life stages is warranted.

scholarly journals Young victims of youth violence: using youth workers in the emergency department to facilitate ‘teachable moments’ and to improve access to services

2020 ◽  
pp. edpract-2019-318251
Author(s):  
Elizabeth Wortley ◽  
Ann Hagell
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Youth Violence ◽  
Healthcare Workers ◽  
Physical Violence ◽  
Rapid Review ◽  
Youth Workers ◽  
Access To Services ◽  
The Uk ◽  
Improve Access

There have been rising concerns in the UK about the levels of serious violence between young people, especially serious physical violence and knife crime. Interactions with young people in the emergency department (ED) at the time of injury provide an opportunity for screening and intervention in order to reduce the risk of repeat attendances. However, paediatricians and other healthcare workers can feel unsure about the best way to intervene. Embedding youth workers in EDs has started in some UK hospitals, making use of a potential ‘teachable moment’ in the immediate aftermath of an event to help change behaviour. Based on a rapid review of the literature, we summarise the evidence for these types of interventions and present two practice examples. Finally, we discuss how EDs could approach the embedding of youth workers within their department and considerations required for this.

PP66 Hospital Cleaning: Detergent Or Disinfectant-Detergent? A Rapid Review

2018 ◽  
Vol 34 (S1) ◽  
pp. 92-93
Author(s):  
Kathleen Harkin ◽  
Anne Dee
Keyword(s):  
Systematic Reviews ◽  
Adverse Outcomes ◽  
Controlled Vocabulary ◽  
Rapid Review ◽  
Cochrane Library ◽  
Microbial Resistance ◽  
Low Level ◽  
Healthcare Environment ◽  
Environmental Surfaces ◽  
Routine Cleaning

Introduction:Healthcare-associated infections (HAIs) are an important, potentially preventable reason to maintain a clean healthcare environment. However, guidelines from Europe and North America do not concur—European guidelines recommend using neutral detergent (followed by chlorine-based disinfection (CBD) if required), whilst North American guidelines recommend using detergent or hospital-grade disinfectant-detergents for routine cleaning or decontamination of noncritical healthcare environmental surfaces. The objective of this study was to compare the effectiveness on rates of HAIs of: (i) disinfectant-detergents versus detergents; and (ii) the active ingredient of many disinfectant-detergents—quaternary ammonium compounds (QAC)—versus CBD.Methods:A rapid review of systematic reviews was conducted using the following search terms: keywords and controlled vocabulary terms for the concepts of “healthcare environmental surfaces” AND (“QAC-based disinfectants” OR “disinfectant-detergents” OR “decontamination”) AND (“environmental contamination” OR “colonization” OR “HAIs”). The search filters included systematic reviews, guidelines, and technology reports. The following databases were searched: The Cochrane Library; PubMed; and health technology assessment and guideline websites for gray literature. Systematic reviews of studies comparing the effects of disinfectant-detergents with detergent, or comparing QAC with CBD, on rates of HAIs in the healthcare environment were included. Reviews on the cleaning or disinfection of body surfaces or disinfection of invasive medical devices were excluded. Quality assessment was not conducted. Data extraction was performed using a pro forma.Results:The literature search resulted in 356 titles. From ninety-four potentially relevant abstracts, fifty-seven full-texts were evaluated: fifty-one were excluded (eight non-English) and six were included. All review authors cautioned that the evidence was low level, methodologically poor, subject to confounding, and didn't address adverse outcomes. The reviews identified eight relevant primary studies, three of which compared disinfectant-detergents with detergent and found no difference in rates of HAI. Five studies compared QAC with CBD. All five demonstrated that CBD was superior to QAC and reduced Clostridium difficile infection rates in outbreak contexts. Furthermore, QAC may induce sporulation and microbial resistance.Conclusions:Low-level evidence suggested that: there is no advantage in using disinfectant-detergents for routine cleaning of noncritical surfaces; CBD is superior to QAC-based disinfection in reducing clostridial infections; and QAC agents may induce sporulation or microbial resistance.

scholarly journals Pharmacological treatment of hyperactive delirium in people with COVID-19: rethinking conventional approaches

2020 ◽  
Vol 10 ◽  
pp. 204512532094270
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Davide Papola ◽  
Andrea Fagiolini ◽  
Serdar Dursun ◽  
...  
Keyword(s):  
Intensive Care ◽  
Drug Interactions ◽  
Systematic Reviews ◽  
Pharmacological Treatment ◽  
Medical Condition ◽  
Regulatory Elements ◽  
Rapid Review ◽  
Cochrane Library ◽  
Future Research ◽  
Acute Psychosis

People with coronavirus disease (COVID-19) might have several risk factors for delirium, which could in turn notably worsen the prognosis. Although pharmacological approaches for delirium are debated, haloperidol and other first-generation antipsychotics are frequently employed, particularly for hyperactive presentations. However, the use of these conventional treatments could be limited in people with COVID-19, due to the underlying medical condition and the risk of drug–drug interactions with anti-COVID treatments. On these premises, we carried out a rapid review in order to identify possible alternative medications for this particular population. By searching PubMed and the Cochrane Library, we selected the most updated systematic reviews of randomised trials on the pharmacological treatment of delirium in both intensive and non-intensive care settings, and on the treatment of agitation related to acute psychosis or dementia. We identified medications performing significantly better than placebo or haloperidol as the reference treatment in each population considered, and assessed the strength of association according to validated criteria. In addition, we collected data on other relevant clinical elements (i.e. common adverse events, drug-drug interactions with COVID-19 medications, daily doses) and regulatory elements (i.e. therapeutic indications, contra-indications, available formulations). A total of 10 systematic reviews were included. Overall, relatively few medications showed benefits over placebo in the four selected populations. As compared with placebo, significant benefits emerged for quetiapine and dexmedetomidine in intensive care unit (ICU) settings, and for none of the medications in non-ICU settings. Considering also data from indirect populations (agitation related to acute psychosis or dementia), aripiprazole, quetiapine and risperidone showed a potential benefit in two or three different populations. Despite limitations related to the rapid review methodology and the use of data from indirect populations, the evidence retrieved can pragmatically support treatment choices of frontline practitioners involved in the COVID-19 outbreak, and indicate future research directions for the treatment of delirium in particularly vulnerable populations.

scholarly journals Protocol for a constructivist metasynthesis of qualitative research of heroism and paramedic practice

2021 ◽  
Vol 6 (2) ◽  
pp. 34-39
Author(s):  
Nigel Rees ◽  
Julia Williams ◽  
Chloe Hogan ◽  
Lauren Smyth ◽  
Thomas Archer
Keyword(s):  
Systematic Reviews ◽  
Healthcare Workers ◽  
Meta Analysis ◽  
Public Support ◽  
Social Harm ◽  
Making Sense ◽  
Registration Number ◽  
Develop Theory ◽  
The Relationship ◽  
Qualitative Literature

Background: Exceptional demands have been placed on paramedics and other healthcare workers (HCWs) during the COVID-19 pandemic. An overwhelming outpouring of public support has unfolded, bringing into focus the relationship between paramedics, other HCWs and society, where they are portrayed as heroes. Scholars have studied the notion of heroism to society, and characteristics of such heroic status include: the voluntary nature of a heroic act, risk of physical or social harm, willingness to accept the consequences of action, acting for the benefit of others and without the expectation of gain. While some HCWs and paramedics may reflect these characteristics, many may not. Such heroic narratives can be damaging, stifling meaningful discussion around limits to duties, failing to acknowledge the importance of reciprocity and potentially imposing demands on paramedics and HCWs to be heroic.Aim: This article prospectively presents the protocol for a metasynthesis which aims to identify, appraise and synthesise the qualitative literature in order to develop theory on heroism and paramedic practice.Methods: Evolved grounded theory methodology is followed along with the procedural guidelines of Noblit and Hare (1988) to guide the analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) have also been adopted when preparing this protocol and will be followed in the study proper. The protocol has been registered with the International Prospective Register of Systematic Reviews PROSPERO 2021, registration number CRD42021234851.Results: We do not currently have results, but PRISMA guidelines will be followed when reporting our findings.Conclusion: Current narratives on heroism and paramedic practice are important in terms of the relationship between paramedics and society. The metasynthesis prospectively reported in this article serves as the first point in our journey of making sense of and developing theory on heroism and paramedic practice.

scholarly journals What are the consequences of caring for older people and what interventions are effective for supporting unpaid carers? A rapid review of systematic reviews

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046187
Author(s):  
Gemma F Spiers ◽  
Jennifer Liddle ◽  
Tafadzwa Patience Kunonga ◽  
Ishbel Orla Whitehead ◽  
Fiona Beyer ◽  
...  
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Well Being ◽  
Social Determinant ◽  
Rapid Review ◽  
Current Evidence ◽  
Effective Interventions ◽  
Summary Data ◽  
Social Determinant Of Health

ObjectivesTo identify and map evidence about the consequences of unpaid caring for all carers of older people, and effective interventions to support this carer population.DesignA rapid review of systematic reviews, focused on the consequences for carers of unpaid caring for older people, and interventions to support this heterogeneous group of carers. Reviews of carers of all ages were eligible, with any outcome measures relating to carers’ health, and social and financial well-being. Searches were conducted in MEDLINE, PsycInfo and Epistemonikos (January 2000 to January 2020). Records were screened, and included systematic reviews were quality appraised. Summary data were extracted and a narrative synthesis produced.ResultsTwelve systematic reviews reporting evidence about the consequences of caring for carers (n=6) and assessing the effectiveness of carer interventions (n=6) were included. The review evidence typically focused on mental health outcomes, with little information identified about carers’ physical, social and financial well-being. Clear estimates of the prevalence and severity of carer outcomes, and how these differ between carers and non-carers, were absent. A range of interventions were identified, but there was no strong evidence of effectiveness. In some studies, the choice of outcome measure may underestimate the full impact of an intervention.ConclusionsCurrent evidence fails to fully quantify the impacts that caring for older people has on carers’ health and well-being. Information on social patterning of the consequences of caring is absent. Systematic measurement of a broad range of outcomes, with comparison to the general population, is needed to better understand the true consequences of caring. Classification of unpaid caring as a social determinant of health could be an effective lever to bring greater focus and support to this population. Further work is needed to develop and identify suitable interventions in order to support evidence-based policymaking and practice.

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