Estimating the incubation period of acute Q fever, a systematic review

AbstractEstimates of the incubation period for Q fever vary substantially between different reviews and expert advice documents. We systematically reviewed and quality appraised the literature to provide an evidence-based estimate of the incubation period of the Q fever by the aerosolised infection route. Medline (OVIDSP) and EMBASE were searched with the search limited to human studies and English language. Eligible studies included persons with symptomatic, acute Q fever, and defined exposure toCoxiella burnetti. After review of 7115 titles and abstracts, 320 records were screened at full-text level. Of these, 23 studies contained potentially useful data and were quality assessed, with eight studies (with 403 individual cases where the derivation of incubation period was possible) being of sufficient quality and providing individual-level data to produce a pooled summary. We found a median incubation period of 18 days, with 95% of cases expected to occur between 7 and 32 days after exposure.

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Care of the Postpartum Patient in the Emergency Department: A Systematic Review with Implications for Maternal Mortality

American Journal of Perinatology ◽

10.1055/s-0041-1732455 ◽

2021 ◽

Author(s):

Kellie A. Mitchell ◽

Alison J. Haddock ◽

Hamad Husainy ◽

Lauren A. Walter ◽

Indranee Rajapreyar ◽

...

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Maternal Mortality ◽

Social Services ◽

Full Text ◽

Postpartum Period ◽

English Language ◽

Case Reports ◽

Private Insurance ◽

Maternal Deaths

Objective Approximately one-third of maternal deaths occur postpartum. Little is known about the intersection between the postpartum period, emergency department (ED) use, and opportunities to reduce maternal mortality. The primary objectives of this systematic review are to explore the incidence of postpartum ED use, identify postpartum disease states that are evaluated in the ED, and summarize postpartum ED use by race/ethnicity and payor source. Study Design We searched PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov, Cochrane CENTRAL, Social Services Abstracts, and Scopus from inception to September 19, 2019. Each identified abstract was screened by two authors; the full-text manuscripts of all studies deemed to be potential candidates were then reviewed by the same two authors and included if they were full-text, peer-reviewed articles in the English language with primary patient data reporting care of a female in the ED in the postpartum period, defined as up to 1 year after the end of pregnancy. Results A total of 620 were screened, 354 records were excluded and 266 full-text articles were reviewed. Of the 266 full-text articles, 178 were included in the systematic review; of these, 108 were case reports. Incidence of ED use by postpartum females varied from 4.8 to 12.2% in the general population. Infection was the most common reason for postpartum ED evaluation. Young females of minority race and those with public insurance were more likely than whites and those with private insurance to use the ED. Conclusion As many as 12% of postpartum women seek care in the ED. Young minority women of lower socioeconomic status are more likely to use the ED. Since approximately one-third of maternal deaths occur in the postpartum period, successful efforts to reduce maternal mortality must include ED stakeholders. Systematic Review Registration CRD42020151126. Key Points

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Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-018568 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018568 ◽

Cited By ~ 8

Author(s):

Jeffrey Braithwaite ◽

Luke Testa ◽

Gina Lamprell ◽

Jessica Herkes ◽

Kristiana Ludlow ◽

...

Keyword(s):

Systematic Review ◽

Health System ◽

Health Systems ◽

Full Text ◽

English Language ◽

Secondary Data ◽

Primary Data ◽

Change Strategies ◽

Screening Process ◽

Sustainable Health

IntroductionThe sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system.Methods and analysisThe protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies.Ethics and disseminationAs no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems.

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Impairment of Caloric Function After Cochlear Implantation

Journal of Speech Language and Hearing Research ◽

10.1044/2015_jslhr-h-15-0010 ◽

2015 ◽

Vol 58 (4) ◽

pp. 1387-1395 ◽

Cited By ~ 7

Author(s):

Heide Kuang ◽

Heather H. Haversat ◽

Elias M. Michaelides

Keyword(s):

Systematic Review ◽

Cochlear Implantation ◽

English Language ◽

Review Article ◽

Slow Phase ◽

Evidence Based ◽

Slow Phase Velocity ◽

Overlapping Data ◽

Vestibular Symptoms ◽

Review Current

Purpose This article seeks to review current literature on caloric function following cochlear implantation while analyzing any correlations of caloric function changes with vestibular symptoms. Method This article is a systematic review of evidence-based literature. English language articles published between 1980 and 2014 that presented some form of caloric data from cochlear implant (CI) patients and that did not solely analyze overlapping data from a previous study were reviewed. Twenty-five articles met these criteria. Results Of the 439 individuals tested, 37% of patients demonstrated reduced maximum slow-phase velocity, and 34% had onset of caloric asymmetry post-CI. Conclusions This review article found that cochlear implantation can affect caloric responses but is variable. When counseling patients preoperatively, possible effects of CI on labyrinthine function should be discussed.

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Artificial Intelligence Techniques: Analysis, Application, and Outcome in Dentistry—A Systematic Review

BioMed Research International ◽

10.1155/2021/9751564 ◽

2021 ◽

Vol 2021 ◽

pp. 1-15

Author(s):

Naseer Ahmed ◽

Maria Shakoor Abbasi ◽

Filza Zuberi ◽

Warisha Qamar ◽

Mohamad Syahrizal Bin Halim ◽

...

Keyword(s):

Artificial Intelligence ◽

Systematic Review ◽

Full Text ◽

Patient Management ◽

English Language ◽

Clinical Performance ◽

Research Question ◽

Time Saving ◽

Artificial Intelligence Techniques ◽

Clinical Scenarios

Objective. The objective of this systematic review was to investigate the quality and outcome of studies into artificial intelligence techniques, analysis, and effect in dentistry. Materials and Methods. Using the MeSH keywords: artificial intelligence (AI), dentistry, AI in dentistry, neural networks and dentistry, machine learning, AI dental imaging, and AI treatment recommendations and dentistry. Two investigators performed an electronic search in 5 databases: PubMed/MEDLINE (National Library of Medicine), Scopus (Elsevier), ScienceDirect databases (Elsevier), Web of Science (Clarivate Analytics), and the Cochrane Collaboration (Wiley). The English language articles reporting on AI in different dental specialties were screened for eligibility. Thirty-two full-text articles were selected and systematically analyzed according to a predefined inclusion criterion. These articles were analyzed as per a specific research question, and the relevant data based on article general characteristics, study and control groups, assessment methods, outcomes, and quality assessment were extracted. Results. The initial search identified 175 articles related to AI in dentistry based on the title and abstracts. The full text of 38 articles was assessed for eligibility to exclude studies not fulfilling the inclusion criteria. Six articles not related to AI in dentistry were excluded. Thirty-two articles were included in the systematic review. It was revealed that AI provides accurate patient management, dental diagnosis, prediction, and decision making. Artificial intelligence appeared as a reliable modality to enhance future implications in the various fields of dentistry, i.e., diagnostic dentistry, patient management, head and neck cancer, restorative dentistry, prosthetic dental sciences, orthodontics, radiology, and periodontics. Conclusion. The included studies describe that AI is a reliable tool to make dental care smooth, better, time-saving, and economical for practitioners. AI benefits them in fulfilling patient demand and expectations. The dentists can use AI to ensure quality treatment, better oral health care outcome, and achieve precision. AI can help to predict failures in clinical scenarios and depict reliable solutions. However, AI is increasing the scope of state-of-the-art models in dentistry but is still under development. Further studies are required to assess the clinical performance of AI techniques in dentistry.

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Everywhere is Nowhere: A Systematic Review of Menstrual Health and Hygiene Management (MHHM) as a Human Right

10.21203/rs.2.19997/v1 ◽

2020 ◽

Author(s):

Suruchi Sood ◽

Sarah Stevens ◽

Maho Okumura ◽

Astha Ramaiya ◽

Michael Hauer

Keyword(s):

Systematic Review ◽

Human Rights ◽

Full Text ◽

Child Protection ◽

English Language ◽

Grey Literature ◽

Hygiene Management ◽

Sanitation And Hygiene ◽

Menstrual Health ◽

Rights Issue

Abstract Background: In many countries, stigma surrounds menstruation, which impacts several Sustainable Development Goals, including good health, quality education, gender equality, and water and sanitation. Despite its relationship with several development issues, menstrual health and hygiene management among adolescents has until recently been ignored by practitioners and researchers. This paper is a systematic review of existing literature and argues that menstrual health and hygiene management is a human rights issue, cross-cutting through development domains of health, education, nutrition, child protection, and water, sanitation, and hygiene. Methods: Four coders independently screened PubMed, Academic OneFile, and Google Scholar to obtain articles using iterations of the key terms: menstrual health; adolescents; health outcomes; education; nutrition; water, sanitation, and hygiene; and child protection. English language primary studies in peer-reviewed or grey literature articles published after 2000, that mentioned adolescents, health or hygiene, and menstruation or menstrual were included. A 9-item scale was used to rate selected full-text articles as strong, moderate, or weak. Synthesis of the results were narrative and examined the relationships between menstrual health and hygiene management and the cross-cutting domains.Results: In total, 28,745 articles were screened, with 84 articles included in the full-text review and quality assessment. Nine articles were coded as “strong” (10.8%), 46 (55.4%) as “moderate,” and 28 (33.7%) as “weak.” More than 60% of the articles examined the relationship between menstrual health and hygiene management and health (37.3%) or water, sanitation, and hygiene (25.3%). Only 11 manuscripts examined menstrual health and hygiene management as a cross-cutting issue impacting more than one development domain.Conclusions: Access to adequate facilities and menstrual health and hygiene management resources are the most common relationships documented within literature. However, there is little focus on menstrual health and hygiene management in the context of other development domains, highlighting the fact that poor menstrual health and hygiene management has not been studied as a human rights issue, negatively impacting millions of girls. Using a cross-cutting, human rights framework to address inadequate menstrual health and hygiene management is fundamental to promoting menstrual health and hygiene management with dignity among girls and women across the globe.

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An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain. Part I: Introduction and General Considerations

January 2018 - Pain Physician ◽

10.36076/ppj.2013/16/s1 ◽

2013 ◽

Vol 2s;16 (2s;4) ◽

pp. S1-S48

Author(s):

Laxmaiah Manchikanti

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Pain Management ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Methodological Quality ◽

Expert Advice ◽

Evidence Based ◽

Consensus Statements ◽

Interventional Pain Management

In 2011, the Institute of Medicine (IOM) re-engineered its definition of clinical guidelines as follows: “clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefit and harms of alternative care options.” This new definition departs from a 2-decade old definition from a 1990 IOM report that defined guidelines as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.” The revised definition clearly distinguishes between the term “clinical practice guideline” and other forms of clinical guidance derived from widely disparate development processes, such as consensus statements, expert advice, and appropriate use criteria. The IOM committee acknowledged that for many clinical domains, high quality evidence was lacking or even nonexistent. Even though the guidelines are important decisionmaking tools, along with expert clinical judgment and patient preference, their value and impact remains variable due to numerous factors. Some of the many factors that impede the development of clinical practice guidelines include bias due to a variety of conflicts of interest, inappropriate and poor methodological quality, poor writing and ambiguous presentation, projecting a view that these are not applicable to individual patients or too restrictive with elimination of clinician autonomy, and overzealous and inappropriate recommendations, either positive, negative, or non-committal. Consequently, a knowledgeable, multidisciplinary panel of experts must develop guidelines based on a systematic review of the existing evidence, as recently recommended by the IOM. Chronic pain is a complex and multifactorial phenomenon associated with significant economic, social, and health outcomes. Interventional pain management is an emerging specialty facing a disproportionate number of challenges compared to established medical specialties, including the inappropriate utilization of ineffective and unsafe techniques. In 2000, the American Society of Interventional Pain Physicians (ASIPP) created treatment guidelines to help practitioners. There have been 5 subsequent updates. These guidelines address the issues of systematic evaluation and ongoing care of chronic or persistent pain, and provide information about the scientific basis of recommended procedures. These guidelines are expected to increase patient compliance; dispel misconceptions among providers and patients, manage patient expectations reasonably; and form the basis of a therapeutic partnership between the patient, the provider, and payers. Key words: Evidence-based medicine (EBM), comparative effectiveness research (CER), clinical practice guidelines, systematic reviews, meta-analysis, interventional pain management, evidence synthesis, methodological quality assessment, clinical relevance, recommendations.

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Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline for the Diagnosis of Patients with Positional Plagiocephaly

Neurosurgery ◽

10.1227/neu.0000000000001427 ◽

2016 ◽

Vol 79 (5) ◽

pp. E625-E626 ◽

Cited By ~ 6

Author(s):

Catherine Mazzola ◽

Lissa C. Baird ◽

David F. Bauer ◽

Alexandra Beier ◽

Susan Durham ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Clinical Examination ◽

Full Text ◽

Evidence Based ◽

X Rays ◽

Class Iii ◽

Positional Plagiocephaly ◽

Evidence Based Guideline

Abstract BACKGROUND: No evidence-based guidelines exist for the imaging of patients with positional plagiocephaly. OBJECTIVE: The objective of this systematic review and evidence-based guideline is to answer the question, Is imaging necessary for infants with positional plagiocephaly to make a diagnosis. METHODS: The National Library of Medicine Medline database and the Cochrane Library were queried with the use of MeSH headings and key words relevant to imaging as a means to diagnose plagiocephaly. Abstracts were reviewed, and an evidentiary table was assembled summarizing the studies and the quality of evidence (Classes I-III). Based on the quality of the literature, a recommendation was rendered (Level I, II, or III). RESULTS: A total of 42 full-text articles were selected for review. Of these, 10 were eliminated; thus, 32 full-text were manuscripts selected. There was no Class I evidence, but 2 Class II and 30 Class III studies were included. Three-dimensional cranial topographical imaging, ultrasound, skull x-rays, computed tomography, and magnetic resonance imaging were investigated. CONCLUSION: Clinical examination is most often sufficient to diagnose plagiocephaly (quality, Class III; strength, Level III). Within the limits of this systematic review, the evidence suggests that imaging is rarely necessary and should be reserved for cases in which the clinical examination is equivocal. Many of the imaging studies were not designed to address the diagnostic utility of the imaging modality, and authors were actually assessing the utility of the imaging in longitudinal follow-up, not initial diagnosis. For this reason, some of the studies reviewed were downgraded in Level of Evidence. When needed, 3-dimensional cranial topographical photo, skull x-rays, or ultrasound imaging is almost always sufficient for definitive diagnosis. Computed tomography scanning should not be used to diagnose plagiocephaly, but it may be necessary to rule out craniosynostosis. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_2.

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Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-4184 ◽

2013 ◽

Vol 98 (6) ◽

pp. 2239-2246 ◽

Cited By ~ 60

Author(s):

Marion Bretault ◽

Adrien Boillot ◽

Ludivine Muzard ◽

Christine Poitou ◽

Jean-Michel Oppert ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Meta Analysis ◽

Individual Level ◽

Level Data

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Barriers to Implementation of Evidence Based Practice in Zahedan Teaching Hospitals, Iran, 2014

Nursing Research and Practice ◽

10.1155/2015/357140 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 12

Author(s):

Mohammad Khammarnia ◽

Mahsa Haj Mohammadi ◽

Zahra Amani ◽

Shahab Rezaeian ◽

Fatemeh Setoodehzadeh

Keyword(s):

English Language ◽

Evidence Based Practice ◽

Cross Sectional Study ◽

Organizational Level ◽

Teaching Hospitals ◽

Evidence Based ◽

Cross Sectional ◽

Individual Level ◽

Barriers To Implementation ◽

The Individual

This study aimed to determine the barriers to implementation of EBP among nurses. This cross-sectional study was conducted in Zahedan City, South East of Iran, in 2014. The questionnaire of barriers to implementation of EBP consists of 27 statements which was distributed among 280 nurses. More than half of the participants agreed that 56% and 57% of barriers to implementation of evidence based practice are related to organizational and individual aspects, respectively. Participants identified barriers at organizational level included the lack of human resources (78.3%), lack of internet access at work (72.2%), and heavy workload (70.0%). Barrier at individual level included lack of time to read literature (83.7%), lack of ability to work with computer (68.8%), and insufficient proficiency in English language (62.0%). Age, educational level, job experience, and employment status were associated with organizational barriers to implementation of EBP. At the individual level only education was associated with barriers to implementation of EBP. Barriers to implementation of EBP occur at both individual and organizational levels. The indicator of quality in nursing practice is EBP. Hence, familiarity with EBP is recommended for Iranian nurses. In addition, knowledge of barriers will help health care system and policy makers to provide a culture of EBP.

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Barriers and facilitators to deprescribing in primary care: a systematic review

BJGP Open ◽

10.3399/bjgpopen20x101096 ◽

2020 ◽

Vol 4 (3) ◽

pp. bjgpopen20X101096 ◽

Cited By ~ 1

Author(s):

Alison Jayne Doherty ◽

Paul Boland ◽

Janet Reed ◽

Andrew J Clegg ◽

Anne-Marie Stephani ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Decision Making ◽

Search Strategy ◽

Health Management ◽

Decision Makers ◽

Barriers And Facilitators ◽

Evidence Based ◽

Individual Level ◽

Whole Systems

BackgroundManaging polypharmacy is a challenge for healthcare systems globally. It is also a health inequality concern as it can expose some of the most vulnerable in society to unnecessary medications and adverse drug-related events. Care for most patients with multimorbidity and polypharmacy occurs in primary care. Safe deprescribing interventions can reduce exposure to inappropriate polypharmacy. However, these are not fully accepted or routinely implemented.AimTo identify barriers and facilitators to safe deprescribing interventions for adults with multimorbidity and polypharmacy in primary care.Design & settingA systematic review of studies published from 2000, examining safe deprescribing interventions for adults with multimorbidity and polypharmacy.MethodA search of electronic databases: MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature (CINHAL), Cochrane, and Health Management Information Consortium (HMIC) from inception to 26 Feb 2019, using an agreed search strategy. This was supplemented by handsearching of relevant journals, and screening of reference lists and citations of included studies.ResultsIn total, 40 studies from 14 countries were identified. Cultural and organisational barriers included: a culture of diagnosing and prescribing; evidence-based guidance focused on single diseases; a lack of evidence-based guidance for the care of older people with multimorbidities; and a lack of shared communication, decision-making systems, tools, and resources. Interpersonal and individual-level barriers included: professional etiquette; fragmented care; prescribers’ and patients’ uncertainties; and gaps in tailored support. Facilitators included: prudent prescribing; greater availability and acceptability of non-pharmacological alternatives; resources; improved communication, collaboration, knowledge, and understanding; patient-centred care; and shared decision-making.ConclusionA whole systems, patient-centred approach to safe deprescribing interventions is required, involving key decision-makers, healthcare professionals, patients, and carers.

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