Non-technical skills and otolaryngology: systematic review

2020 ◽  
Vol 134 (5) ◽  
pp. 415-418 ◽  
Author(s):  
R Bannon ◽  
K E Stewart ◽  
M Bannister

AbstractObjectivesThis study aimed to assess the published literature on non-technical skills in otolaryngology surgery and examine the applicability of any research to others’ practice, and to explore how the published literature can identify areas for further development and guide future research.MethodsA systematic review was conducted using the following key words: ‘otolaryngology’, ‘otorhinolaryngology’, ‘ENT’, ‘ENT surgery’, ‘ear, nose and throat surgery’, ‘head and neck surgery’, ‘thyroid surgery’, ‘parathyroid surgery’, ‘otology’, ‘rhinology’, ‘laryngology’ ‘skull base surgery’, ‘airway surgery’, ‘non-technical skills’, ‘non technical skills for surgeons’, ‘NOTSS’, ‘behavioural markers’ and ‘behavioural assessment tool’.ResultsThree publications were included in the review – 1 randomised, controlled trial and 2 cohort studies – involving 78 participants. All were simulation-based studies involving training otolaryngology surgeons.ConclusionLittle research has been undertaken on non-technical skills in otolaryngology. Training surgeons’ non-technical skill levels are similar across every tested aspect. The research already performed can guide further studies, particularly amongst non-training otolaryngology surgeons and in both emergency and elective non-simulated environments.

Medicinus ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 62
Author(s):  
Moryella Monica ◽  
Andree Kurniawan

<p><strong>Introduction: </strong>The World Health Organization (WHO) announced the Coronavirus 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) toward the end of January 2020. There is still limited evidence to explain the gastrointestinal involvement in COVID-19. In this study, we aimed to further investigate current evidence describing the gastrointestinal involvement in COVID-19 patients.</p><p><strong>Methods: </strong>This systematic review has been registered in PROSPERO (CRD42020181584). A systematic search of literature for observational and randomized controlled trial was conducted in PubMed, PubMed central, and Google Scholar through April 16, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Newcastle-Ottawa Quality assessment tool.<strong> </strong></p><p><strong>Results: </strong>A total of 1,480 articles were screened from which 12 articles with 5584 subjects were selected. SARS-CoV-2 can invade human body by binding to angiotensin converting enzyme 2 (ACE-2) receptor which also located to small intestinal epithelial cells, crypt cells and colon. The virus itself may cause disorders of the intestinal flora. The diagnosis should be based on a set of symptoms diarrhoea, nausea, vomiting, abdominal discomfort or pain, combined with positivity of faecal PCR test. Treatment of COVID-19 mainly is supportive care. The probiotic may modulate the gut microbiota to alter the gastrointestinal symptoms and reduced enteritis, ventilator associated pneumonia, and reverse certain side effect of antibiotics<strong>.</strong></p><p><strong>Conclusion: </strong>Our synthesis of literature showed that there was no good evidence yet in overall area of gastrointestinal manifestations in COVID-19. Future research is needed to explore all areas, especially in mechanism and treatments</p>


2009 ◽  
Vol 21 (4) ◽  
pp. 158-168 ◽  
Author(s):  
Danielle Gaynor ◽  
Hannah Cock ◽  
Niruj Agrawal

Objective:There is a lack of clarity about the most useful intervention for functional non-epileptic attacks (FNEA). Outcomes for this condition remain often poor, with considerable personal, social and economic impact. In order to guide clinical practice and future research in this area, we have performed a systematic review of the published literature on the psychological treatment of FNEA.Methods:A comprehensive literature search was carried out using key words: non-epileptic seizures; psychogenic seizures; psychogenic non-epileptic seizures; pseudoseizures; funny turns; non-epileptic attack; hysterical seizures; and pseudoepileptic. Studies specifically looking at psychological treatment of FNEA were identified. Studies of patients also having comorbid organic seizure disorders were excluded.Results:17 studies that met the inclusion criteria were identified. A broad variety of psychological interventions for FNEA has been investigated. Only one randomised controlled trial has been completed to date. Existing evidence appears to suggest that various psychological treatments, including presenting the diagnosis, psychoeducation, behavioural therapies and mixed modality treatments, may be effective.Conclusion:While a range of psychological treatments may be beneficial for this patient group, we do not have clear evidence to suggest which treatment is most efficacious. Specific elements of presenting the diagnosis and psychoeducation may be required in addition to traditional cognitive behavioural therapeutic approaches. Large, methodologically robust studies are urgently required to establish the most effective form of treatment.


2014 ◽  
Vol 29 (9) ◽  
pp. 2728-2735 ◽  
Author(s):  
Oliver Brunckhorst ◽  
Shahab Shahid ◽  
Abdullatif Aydin ◽  
Craig McIlhenny ◽  
Shahid Khan ◽  
...  

2021 ◽  
Author(s):  
Zofia Zukowska ◽  
Emily Eisner ◽  
Ling Li ◽  
Stephanie Allan ◽  
Andrew Ian Gumley

Introduction: Fears of relapse in people diagnosed with schizophrenia have long been recognised as an impediment to recovery and wellbeing. However, the extent of the empirical basis for the fear of relapse concept is unclear. A systematic review is required to collate available evidence and define future research directions.Methods: A pre-registered systematic search (PROSPERO CRD42020196964) of four databases (PubMed, MEDLINE-Ovid, PsycINFO-Ovid, and Cochrane Central Register of Controlled Trials) was conducted from their inception to 05/04/2021. Results: We found 9 eligible studies. Of these, 4 were quantitative descriptive studies and 1 was a randomised controlled trial, and 4 were qualitative. The available quantitative evidence suggests fear of relapse may have concurrent positive relationships with depression. Qualitative synthesis suggests fear of relapse is a complex phenomenon with behavioural and emotional components which has both direct and indirect effects on wellbeing.Conclusions: Evidence in this area is limited and research is urgently needed to refine existing fear of relapse measurement tools and to examine relationships with wellbeing rather than just psychopathology. Nonetheless, clinicians should be aware that fear of relapse exists and comprises of fears of losing personal autonomy, losing social and occupational functioning and previous traumatic experiences and that fear of relapse appears to impact carers as well as those diagnosed with schizophrenia.


Author(s):  
Julia Heffernan ◽  
Ewan McDonald ◽  
Elizabeth Hughes ◽  
Richard Gray

Police, ambulance and mental health tri-response services are a relatively new model of responding to people experiencing mental health crisis in the community, but limited evidence exists examining their efficacy. To date there have been no systematic reviews that have examined the association between the tri-response model and rates of involuntary detentions. A systematic review examining co-response models demonstrated possible reduction in involuntary detention, however, recommended further research. The aim of this protocol is to describe how we will systematically review the evidence base around the relationship of the police, ambulance mental health tri-response models in reducing involuntary detentions. We will search health, policing and grey literature databases and include clinical evaluations of any design. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool and a narrative synthesis will be undertaken to synthesis key themes. Risk of bias and extracted data will be summarized in tables and results synthesis tabulated to identify patterns within the included studies. The findings will inform future research into the effectiveness of tri-response police, ambulance, and mental health models in reducing involuntary detentions.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Robert W. Jordan ◽  
Gurdip S. Chahal ◽  
Anna Chapman

Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes.Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure.Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn.Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e052547
Author(s):  
Amy Coe ◽  
Catherine Kaylor-Hughes ◽  
Susan Fletcher ◽  
Elizabeth Murray ◽  
Jane Gunn

ObjectiveTo identify and characterise activities for deprescribing used in general practice and to map the identified activities to pioneering principles of deprescribing.SettingPrimary care.Data sourcesMedline, EMBASE (Ovid), CINAHL, Australian New Zealand Clinical Trials Registry (ANZCTR), Clinicaltrials.gov, ISRCTN registry, OpenGrey, Annals of Family Medicine, BMC Family Practice, Family Practice and British Journal of General Practice (BJGP) from inception to the end of June 2021.Study selectionIncluded studies were original research (randomised controlled trial, quasi-experimental, cohort study, qualitative and case studies), protocol papers and protocol registrations.Data extractionScreening and data extraction was completed by one reviewer; 10% of the studies were independently reviewed by a second reviewer. Coding of full-text articles in NVivo was conducted and mapped to five deprescribing principles.ResultsFifty studies were included. The most frequently used activities were identification of appropriate patients for deprescribing (76%), patient education (50%), general practitioners (GP) education (48%), and development and use of a tapering schedule (38%). Six activities did not align with the five deprescribing principles. As such, two principles (engage practice staff in education and appropriate identification of patients, and provide feedback to staff about deprescribing occurrences within the practice) were added.ConclusionActivities and guiding principles for deprescribing should be paired together to provide an accessible and comprehensive guide to deprescribing by GPs. The addition of two principles suggests that practice staff and practice management teams may play an instrumental role in sustaining deprescribing processes within clinical practice. Future research is required to determine the most of effective activities to use within each principle and by whom.


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