OP74 Stoma Cover Use By Fully Laryngectomized Patients

2019 ◽  
Vol 35 (S1) ◽  
pp. 18-18
Author(s):  
Simon Deblois ◽  
Sylvain L'Espérance ◽  
Martin Coulombe ◽  
Luigi Lepanto ◽  
Marc Rhainds
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Methodological Quality ◽  
Conflicts Of Interest ◽  
Clinical Effectiveness ◽  
Conclusive Evidence ◽  
Future Research ◽  
Common Clinical Practice ◽  
Study Designs ◽  
Heat And Moisture

IntroductionThe use of stoma covers has been a common clinical practice for laryngectomized patients for several years. In the province of Québec, Canada, laryngectomized patients can obtain stoma covers through a dedicated program providing them with medical supplies and voice re-education services. For many years, the program's supply has included cloth and/or foam covers, but the supply of Heat and Moisture Exchangers (HME) has been limited. Two hospital-based HTA units joined their expertise to assess the opportunity of providing HMEs to more patients, depending on their clinical characteristics.MethodsTheir joined assessment rested on a systematic review (SR) and a field assessment. The systematic review aimed at assessing the efficacy, clinical effectiveness and safety of various types of stoma covers. The field inquiries intended to assess the perceptions of clinicians and managers towards stoma covers in clinical practice.ResultsWe included 27 studies in the SR. Most of them appraised the clinical effectiveness or safety of HME filters. Their methodological quality was very low with potential conflicts of interest whereas many studies were financed by the industry. The heterogeneity of study designs, expected outcomes and paucity of comparative studies prevented the pooling of results. Industry sponsorship appeared to be an important issue, since 17 of the included studies were sponsored. The SR did not provide conclusive evidence concerning the efficacy, clinical effectiveness and safety of the various types of stoma covers. The field inquiries intended to assess the perceptions of clinicians and managers towards stoma covers in clinical practice. It showed that industry representatives are quite active in clinical settings, promoting their products. Clinicians’ opinions and preferences were coherent with the systematic review main observations: in a context where the quality of the evidence is low, clinicians’ recommendations of stoma protectors for laryngectomies are mainly based on their professional experience and academic training.ConclusionsFuture research of high methodological quality would strengthen the evidence concerning the relative efficacy and safety of different stoma protectors. These studies would help define evidence-based allocation criteria and set parameters so that the choice of a stoma protector is best adapted to a laryngectomized patients’ condition.

Methodological quality of clinical practice guidelines for nutrition and weight gain during pregnancy: a systematic review

2019 ◽  
Vol 78 (7) ◽  
pp. 546-562 ◽  
Author(s):  
Maria G Grammatikopoulou ◽  
Xenophon Theodoridis ◽  
Konstantinos Gkiouras ◽  
Maria Lampropoulou ◽  
Arianna Petalidou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Weight Gain ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Maternal Nutrition ◽  
Conflicts Of Interest ◽  
Data Extraction ◽  
Institute Of Medicine

Abstract Context Ensuring a healthy pregnancy and achieving optimal gestational weight gain (GWG) are important for maternal and child health. Nevertheless, the nutritional advice provided during pregnancy is often conflicting, suggesting limited adherence to clinical practice guidelines (CPGs). Objective The aim of this review was to identify all CPGs on maternal nutrition and GWG and to critically appraise their methodological quality. Data Sources The MEDLINE/PubMed, Cochrane, Guidelines International Network, and BMJ Best Practice databases, along with gray literature, were searched from inception until February 2019 for CPGs and consensus, position, and practice papers. Study Selection Clinical practice guidelines published in English and containing advice on maternal nutrition or GWG were eligible. Data Extraction Two authors independently extracted data on items pertaining to maternal nutrition or GWG, and CPGs were appraised using the AGREE II instrument. Results Twenty-two CPGs were included. All scored adequately in the “scope” domain, but most were considered inadequate with regard to stakeholder involvement, rigor of development, applicability, and editorial independence. Many CPGs lacked patient or dietician involvement, and more than half did not disclose funding sources or conflicts of interest. Guidance on GWG was based mostly on Institute of Medicine thresholds, while nutrition recommendations appeared scattered and heterogeneous. Conclusion Despite the importance of maternal nutrition and the plethora of advising bodies publishing relevant guidance, there is room for substantial improvement in terms of development standards and content of nutritional recommendations. Systematic review registration PROSPERO registration number CRD42019120898.

scholarly journals A systematic review of interventions to improve acute hospital care for people with dementia

2021 ◽  
Author(s):  
Melanie Karrer ◽  
Angela Schnelli ◽  
Adelheid Zeller ◽  
Hanna Mayer
Keyword(s):  
Systematic Review ◽  
Hospital Care ◽  
Current Evidence ◽  
Future Research ◽  
Acute Hospital Care ◽  
Hand Search ◽  
People With Dementia ◽  
Acute Hospitals ◽  
Delirium Management ◽  
Study Designs

Abstract The aim of this study was to provide an overview of interventions targeting hospital care of patients with dementia. We conducted a systematic review, including interventional study designs. We searched five electronic databases, conducted a hand search and performed citation tracking. To assess risk of bias, we used Cochrane Collaboration’s tool, ROBANS and AMSTAR. We narratively summarized the outcomes.The findings of twenty studies indicated a broad range of interventions and outcomes. We categorised the interventions into eight intervention types. Educational programmes were the most reported intervention type and resulted in improved staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were effective in improving patient-related outcomes. However, current evidence is insufficient to declare which interventions are effective in improving dementia care in acute hospitals. Future research should focus on relevant patient and family caregiver outcomes and must to consider the complexity of the interventions. Trial registration: PROSPERO: CRD42018111032.

scholarly journals Incentives and Support Programs to Improve Adherence to Tuberculosis Treatment

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Charlotte Wells ◽  
Melissa Severn
Keyword(s):  
High Risk ◽  
Methodological Quality ◽  
Clinical Effectiveness ◽  
Conclusive Evidence ◽  
Active Tuberculosis ◽  
Tuberculosis Treatment ◽  
Support Programs ◽  
Evidence Based ◽  
Evidence Based Guidelines

Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment. Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment. The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high. The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality.

scholarly journals Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brett Williams ◽  
Bronwyn Beovich
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Methodological Quality ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Measurement Properties ◽  
Future Research ◽  
Health Measurement ◽  
Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

A Detailed Five-Year Review of Medical Device Additive Manufacturing Research and its Potential for Translation to Clinical Practice

2015 ◽  
Author(s):  
Katherine Stephenson
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Additive Manufacturing ◽  
3D Printing ◽  
Medical Device ◽  
Development Stage ◽  
Medical Device Design ◽  
Device Development ◽  
Near Term ◽  
Common Clinical Practice

This paper provides a systematic review of over 350 publications that document specific medical device examples in which the design and manufacturing relied on additive manufacturing processes (more popularly referred to as “3d Printing”). Existing reviews on 3d printing for medical device design focus on the range of clinical applications and potential uses for this technology. However, existing work tends to omit key medical device development and regulatory requirements pertaining to the use of 3d printing for technology translation. These omissions often present a skewed view of each device’s potential for rapid translation to commercialization and common clinical practice. To fill gaps in existing literature, this review includes medical device journal articles and identifies each article’s country of origin, the product development stage in which 3d printing was used, and the device’s specific type and classification under the U.S. Food and Drug Administration. The findings from this systematic review provide a detailed international snapshot of current additive manufacturing research and its near term potential for changing clinical practice.

scholarly journals A systematic review of mediators of physical activity, nutrition, and screen time in adolescents: Implications for future research and clinical practice

2017 ◽  
Vol 65 (5) ◽  
pp. 530-548 ◽  
Author(s):  
Stephanie Kelly ◽  
Janna Stephens ◽  
Jacqueline Hoying ◽  
Colleen McGovern ◽  
Bernadette Mazurek Melnyk ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Clinical Practice ◽  
Screen Time ◽  
Future Research

scholarly journals The in vitro effects of platelet products on the biophysiological functions of human bone marrow mesenchymal stromal cells: a systematic review

2021 ◽  
Vol 41 ◽  
pp. 269-315
Author(s):  
J Vun ◽  
◽  
M Panteli ◽  
E Jones ◽  
PV Giannoudis
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Clinical Practice ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Future Research ◽  
Signalling Molecules ◽  
Combined Use ◽  
In Vitro Effects

Platelet products (PP) and bone-marrow aspirate are popular sources of osteoinductive signalling molecules and osteogenic bone marrow mesenchymal stromal cells (BM-MSCs) used in the treatment of impaired bone healing. However, the combined use of PP and BM-MSCs in clinical studies has reported mixed results. Understanding the cellular and molecular interactions between PP and BM-MSCs plays the important role of guiding future research and clinical application. This systematic review investigates the effects of PP on the biophysiological functions of BM-MSCs in in vitro human studies, including (i) proliferation, (ii) migration, (iii) differentiation, (iv) growth factor/cytokine/protein expression, (v) immunomodulation, (vi) chemotactic effect on haematopoietic stem cells, (vii) response to apoptotic stress, and (viii) gene expression. In vitro studies in human have demonstrated the multi-faceted ‘priming effect’ of PP on the biophysiological functions of BM-MSCs. PP has been shown to improve proliferation, migration, osteogenic differentiation, reaction to apoptotic stress as well as immunomodulatory, pro-angiogenic and pro-inflammatory capacities of BM-MSCs. Several factors are highlighted that restrict the transferability of these findings into clinical practice. Therefore, more collaborative in vitro research in humans modelled to reflect clinical practice is required to better understand the effects of PP exposure on the biophysiological function(s) of BM-MSCs in human.

scholarly journals A Systematic Review of Unpublished and Non-Refereed Music Therapy Mental Health Papers Found via Google Scholar

2018 ◽  
Vol 18 (2) ◽  
Author(s):  
Melody R Peterson ◽  
Michael J Silverman
Keyword(s):  
Mental Health ◽  
United States ◽  
Systematic Review ◽  
Clinical Practice ◽  
Music Therapy ◽  
The United States ◽  
Google Scholar ◽  
Future Research ◽  
Mental Health Literature ◽  
Doctoral Dissertations

As Google Scholar searches yield unpublished papers, it may inadvertently impact the perception of the music therapy literature for clinicians, researchers, and service users. Therefore, the purpose of this systematic review was to identify and analyze the current literature comprised of unpublished and non-refereed papers regarding music therapy and mental health from January 2000 to September 2017 located via Google Scholar. After establishing inclusion and exclusion criteria, papers were identified using a variety of combinations of music therapy and mental health keywords. Twenty-one papers met inclusion criteria. Sixteen papers were master’s theses and five were doctoral dissertations. Almost half of the papers (n = 8) involved adolescents with mental health diagnoses. Although not all papers contained data, more papers contained qualitative data (n = 10) than quantitative data (n = 3). The unpublished music therapy and mental health literature may represent a valuable resource for guiding clinical practice and research. As the majority of authors were affiliated with universities outside the United States, perhaps there is greater interest in mental health outside the United States. It is concerning that many identified papers required additional login credentials. Implications for clinical practice, limitations, and suggestions for future research are provided.

scholarly journals Trochanteric pain in patients undergoing total hip arthroplasty: A protocol for a systematic review

2018 ◽  
Author(s):  
Daniel Axelrod ◽  
Kim Madden ◽  
Laura Banfield ◽  
Mitchell Winemaker ◽  
Justin deBeer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Diagnostic Methods ◽  
Cochrane Library ◽  
Future Research ◽  
Total Hip ◽  
Review Management ◽  
The Cochrane Library ◽  
Study Designs

Background: Total hip arthroplasty (THA) is one of the most common surgical procedures. Although THA surgeries are typically very successful, between 3% and 17% of all patients experience trochanteric pain after surgery. Unfortunately, there remains little high quality and reproducible evidence surrounding this disorder, especially following total hip replacement. The objectives of this review are to describe, among pre-operative or post-operative primary THA patients the prevalence, treatments, prognosis, risk factors, and diagnostic methods available for trochanteric pain. Methods: This is a protocol for a descriptive systematic review of trochanteric pain among THA patients. We will include studies of all study designs, with the exception of non-systematic reviews and expert opinion, with no date limits. We will search Medline, Embase, CINAHL, and the Cochrane Library using the Ovid search interface. We will also search the reference lists of included studies for possible missed studies. We will use the systematic review management software Rayyan to assist with study screening. Two reviewers will independently review studies for inclusion and extract data into a study-specific database. Discussion: This study will add to the literature by comprehensively and systematically evaluating the available literature on trochanteric pain after THA. Previous studies have been conducted on the topic but they were not comprehensive or did not review the literature systematically. Additionally, our study will critically evaluate the methodological quality of the included studies, adding an evidence-based component to the review. This review will help orthopaedic surgeons better care for patients with trochanteric pain after THA, and will identify knowledge gaps for future research. Registration: This protocol will be registered on PROSPERO

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