A Systematic Review of the Physiological Effects of the Effortful Swallow Maneuver in Adults With Normal and Disordered Swallowing

Purpose This systematic review summarizes the biomechanical and functional effects of the effortful swallow in adults with and without dysphagia, highlighting clinical implications and future research needs. Specifically, the effects of the effortful swallow on swallowing physiology, safety, and efficiency were identified, as well as the strengths and limitations of current research. Method Recommendations specified by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. A literature search of three databases and relevant articles cited in the searched studies was performed. Two evaluators independently analyzed the studies for eligibility criteria, and final inclusion of studies was decided by consensus. Evaluators also assessed each study for quality of evidence. Results Twenty-three studies were included in this systematic review. Main findings indicated that the effortful swallow generated greater pressures in the tongue-to-palate, pharynx, upper esophageal sphincter, and esophageal regions. Inconsistent results for hyolaryngeal excursion were reported, as well as for swallowing function. Instructions of the effortful swallow varied greatly across studies. Two of the 23 studies were judged to be of high quality, and the remaining studies were of medium quality based on the quality indicators of this review. Conclusions Biomechanical effects of the effortful swallow included increased pressures in the oral, pharyngeal, and esophageal regions. Future investigations should address the effects of the effortful swallow in individuals with dysphagia and its potential role as a rehabilitative maneuver. Moreover, standardization of the effortful swallow instructions based on its physiological and functional effects is essential.

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A systematic review of meta-analyses in orthopaedic surgery between 2000 and 2016

The Bone & Joint Journal ◽

10.1302/0301-620x.100b10.bjj-2017-1142.r2 ◽

2018 ◽

Vol 100-B (10) ◽

pp. 1270-1274 ◽

Cited By ~ 3

Author(s):

A. Manta ◽

E. Opingari ◽

A. H. Saleh ◽

N. Simunovic ◽

A. Duong ◽

...

Keyword(s):

Systematic Review ◽

Orthopaedic Surgery ◽

Meta Analysis ◽

Eligibility Criteria ◽

Quality Review ◽

Orthopaedic Literature ◽

Medium Quality ◽

The Mean ◽

Meta Analyses

Aims The aims of this systematic review were to describe the quantity and methodological quality of meta-analyses in orthopaedic surgery published during the last 17 years. Materials and Methods MEDLINE, EMBASE, and PubMed, between 1 January 2000 and 31 December 2016, were searched for meta-analyses in orthopaedic surgery dealing with at least one surgical intervention. Meta-analyses were included if the interventions involved a human muscle, ligament, bone or joint. Results A total of 392 meta-analyses met eligibility criteria, for which the mean AMSTAR quality score was 7.1/11. There was a positive correlation between the year of publication and the quality of the meta-analysis (r = 0.238, p < 0.001). Between 2000 and 2011, the mean AMSTAR score corresponded to that of a medium quality review. However, between 2012 and 2016, the mean scores have been consistently equivalent to those of a high-quality review. The number of meta-analyses published increased 10-fold between 2005 and 2014. Conclusion The quantity and quality of meta-analyses in orthopaedic surgery which have been published has increased, reaching a plateau in 2012. Methodological flaws remain to be addressed in future meta-analyses in order to continue increasing the quality of the orthopaedic literature. Cite this article: Bone Joint J 2018;100-B:1270–4.

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Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0038-1675214 ◽

2018 ◽

Vol 40 (11) ◽

pp. 713-721 ◽

Cited By ~ 7

Author(s):

Iramar Nascimento ◽

Guilherme Dienstmann ◽

Matheus de Souza ◽

Raquel Fleig ◽

Carla Hoffmann ◽

...

Keyword(s):

Systematic Review ◽

Treatment Time ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Eligibility Criteria ◽

Time Segment ◽

Meta Analyses ◽

The Cochrane Collaboration ◽

Lower Correlation

Objective Does the use of metformin have an influence on the outcomes of preeclampsia (PE)? Sources of Data The descriptors pregnancy, metformin, treatment, and preeclampsia associated with the Boolean operators AND and OR were found in the MEDLINE, LILACS, Embase and Cochrane databases. A flowchart with exclusion criteria and inclusion strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and eligibility criteria was used. Data were extracted regarding the type of study, the applied dosage, treatment time, segment, bias risks, and the Patient, Intervention, Comparison and Outcome (PICO) strategy to identify the quality of the study. Selection of Studies Total number of journals in the initial search (n = 824); exclusions from repeated articles on different search engines (n = 253); exclusions after reading the titles, when the title had no correlations with the proposed theme (n = 164); exclusions due to incompatibility with the criteria established in the methodological analysis (n = 185), exclusion of articles with lower correlation with the objective of the present study (n = 187); and final bibliographic selection (n = 35). Data Collection At first, a systematic review of the literature was performed. Subsequently, from the main selection, randomized and non-randomized trials with metformin that presented their results in absolute and relative numbers of PE outcomes were selected. The variables were treated statistically in the meta-analysis with the Review Manager software (RevMan), version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration. Denmark in the Hovedistaden region. Synthesis of Data The study showed that metmorfin presented greater preventive effects for pregnancy-induced hypertension and was less effective for PE. Conclusion Metformin may gain place in preventive treatments for PE, once the dosages, the gestational age, and treatment time are particularly evaluated. A methodological strategy with an improved perspective of innovative and/or carefully progressive dosages during pregnancy to avoid side effects and the possibility of maternal-fetal risks is suggested.

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Systematic Reviews and Meta-Analysis in Spine Surgery—How Good Are They in Methodological Quality? A Systematic Review

Global Spine Journal ◽

10.1177/2192568220906810 ◽

2020 ◽

pp. 219256822090681 ◽

Cited By ~ 2

Author(s):

Muthu Sathish ◽

Ramakrishnan Eswar

Keyword(s):

Systematic Review ◽

Spine Surgery ◽

Systematic Reviews ◽

Methodological Quality ◽

Meta Analysis ◽

Eligibility Criteria ◽

Cochrane Database ◽

Critical Flaw ◽

Meta Analyses

Study Design: Systematic review. Objectives: To assess the methodological quality of systematic reviews and meta-analyses in spine surgery over the past 2 decades. Materials and Methods: We conducted independent and in duplicate systematic review of the published systematic reviews and meta-analyses between 2000 and 2019 from PubMed Central and Cochrane Database pertaining to spine surgery involving surgical intervention. We searched bibliographies to identify additional relevant studies. Methodological quality was evaluated with AMSTAR score and graded with AMSTAR 2 criteria. Results: A total of 96 reviews met the eligibility criteria, with mean AMSTAR score of 7.51 (SD = 1.98). Based on AMSTAR 2 criteria, 13.5% (n = 13) and 18.7% (n = 18) of the studies had high and moderate level of confidence of results, respectively, without any critical flaws. A total of 29.1% (n = 28) of the studies had at least 1 critical flaw and 38.5% (n = 37) of the studies had more than 1 critical flaw, so that their results have low and critically low confidence, respectively. Failure to analyze the conflict of interest of authors of primary studies included in review and lack of list of excluded studies with justification were the most common critical flaw. Regression analysis demonstrated that studies with funding and studies published in recent years were significantly associated with higher methodological quality. Conclusion: Despite improvement in methodological quality of systematic reviews and meta-analyses in spine surgery in current decade, a substantial proportion continue to show critical flaws. With increasing number of review articles in spine surgery, stringent measures must be taken to adhere to methodological quality by following PRISMA and AMSTAR guidelines to attain higher standards of evidence in published literature.

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Determining the effects of transcranial direct current stimulation on tinnitus and tinnitus-related outcomes: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-047191 ◽

2021 ◽

Vol 11 (3) ◽

pp. e047191

Author(s):

Bas Labree ◽

Derek J Hoare ◽

Lauren E Gascoyne ◽

Magdalena Sereda

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Adverse Effects ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Ethical Issues ◽

Future Research ◽

Direct Current Stimulation ◽

Meta Analyses

IntroductionTinnitus is the awareness of a sound in the ear or head in the absence of an external source. It affects around 10%–15% of people. About 20% of people with tinnitus also experience symptoms such as depression or anxiety that negatively affect their life. Transcranial direct current stimulation (tDCS) is a technique involving constant low-intensity direct current delivered via electrodes on the head. It is postulated to modulate (suppress or enhance) neural activity in the region between electrodes. As such, it represents a potential treatment option for tinnitus, as well as comorbid depression or anxiety. This systematic review will estimate the effects of tDCS on outcomes relevant to tinnitus. In addition, it will determine whether there is any relationship between stimulation parameters (electrode montage, current intensity, and length and frequency of stimulation sessions) and the effect of tDCS on these outcomes.Methods and analysisElectronic searches for peer-reviewed journal articles will be performed in the Cochrane Register of Studies online (the Cochrane Ear, Nose and Throat Disorders Group Register and CENTRAL, current issue), PubMed, EMBASE, CINAHL, LILACS, KoreaMed, IndMed, PakMediNet, CNKI, AMED, PsycINFO, Web of Science, ClinicalTrials.gov, ICTRP and Google Scholar using the following search terms: transcranial Direct Current Stimulation OR tDCS AND tinnitus OR depression OR anxiety OR quality of life OR adverse effects OR neurophys*.Searches were not limited by date. Methods are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). Randomised controlled trials will be included if they report at least one of the following outcomes: tinnitus symptom severity, anxiety or depression as measured by relevant validated instruments. Where available, data on quality of life, adverse effects and neurophysiological changes will also be reviewed. In addition to an analysis of the effect of each parameter, an analysis will be performed to uncover any interactions between parameters. Where appropriate, meta‐analyses will be performed.Ethics and disseminationThis systematic review will make use of secondary data only. As no data will be obtained from participants directly, ethical approval has not been sought. No other ethical issues are foreseen. Findings will be submitted for peer-reviewed publication and presented at academic conferences. The results of this review will inform future research.PROSPERO registration numberCRD42020185567.

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Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review

JMIR Medical Informatics ◽

10.2196/20359 ◽

2020 ◽

Vol 8 (8) ◽

pp. e20359 ◽

Cited By ~ 3

Author(s):

Clemens Kruse ◽

Joanna Fohn ◽

Nakia Wilson ◽

Evangelina Nunez Patlan ◽

Stephanie Zipp ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Narrative Analysis ◽

Future Research ◽

Medical Outcomes ◽

Quality Of Life Indicators ◽

Meta Analyses

Background Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. Objective This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. Methods This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. Results Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). Conclusions The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. Trial Registration PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. International Registered Report Identifier (IRRID) RR2-10.2196/15490

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Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review (Preprint)

10.2196/preprints.20359 ◽

2020 ◽

Author(s):

Clemens Kruse ◽

Joanna Fohn ◽

Nakia Wilson ◽

Evangelina Nunez Patlan ◽

Stephanie Zipp ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Narrative Analysis ◽

Future Research ◽

Medical Outcomes ◽

Quality Of Life Indicators ◽

Meta Analyses

BACKGROUND Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. OBJECTIVE This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. METHODS This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. RESULTS Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). CONCLUSIONS The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. CLINICALTRIAL PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. INTERNATIONAL REGISTERED REPORT RR2-10.2196/15490

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Perceived Parental Monitoring: A Systematic Review of Monitoring Instruments

Journal of Nursing Measurement ◽

10.1891/jnm-d-19-00045 ◽

2020 ◽

pp. JNM-D-19-00045

Author(s):

Caroline Handschuh ◽

Lidwine B. Mokkink ◽

Arlene Smaldone

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Parental Monitoring ◽

Future Research ◽

Measurement Instruments ◽

Parent Child Relationship ◽

Quality Of Reporting ◽

Meta Analyses ◽

Psychometric Quality

Background and purposeThe purpose of this systematic review was to evaluate parental monitoring instruments and the theoretical perspectives informing their development.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven databases were searched for original studies using a monitoring instrument. The psychometric properties of each identified instrument were assessed using the “COnsensus-based Standards for the selection of health status Measurement INstruments” (COSMIN) methodology.ResultsOf 2,245 articles identified, 72 studies representing six parental monitoring instruments met inclusion criteria. Quality of reporting on psychometric properties varied widely across instruments with only three including content validation studies.ConclusionsFindings of this review reveal inattention to the psychometric quality of child self-reported monitoring instruments. Future research must focus on the psychometric quality of instruments used to measure the parent–child relationship.

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Cognition-oriented treatments and physical exercise on cognitive function in Huntington's disease: Protocol for systematic review

10.1101/2021.08.12.21261956 ◽

2021 ◽

Author(s):

Katharine Huynh ◽

Leila Nategh ◽

Sharna Jamadar ◽

Nellie Georgiou-Karistianis ◽

Amit Lampit

Keyword(s):

Systematic Review ◽

Cognitive Function ◽

Physical Exercise ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Primary Outcome ◽

Eligibility Criteria ◽

Cognitive Interventions ◽

Meta Analyses

Introduction: Cognitive impairments are prevalent in Huntington's disease (HD), occurring many years prior to clinical diagnosis and are the most impactful on quality of life of patients. Cognitive interventions and exercise have been found to be efficacious in improving cognitive function in several clinical populations (e.g., older adults with mild cognitive impairment and dementia). However, the utility of cognitive interventions has not been systematically reviewed in HD. This systematic review aims to examine the efficacy of cognitive and physical interventions on cognitive function in HD. Methods: Electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL) were searched through till 10 May 2021 for interventional studies investigating the effect of cognition-oriented treatments and physical exercise on cognitive function in individuals with HD, compared to any control or no control. The primary outcome is change on objective measures of cognition. Additional outcomes include change in psychosocial, functional and neuroimaging measures. Variations of effects based on population and study factors will be considered. Risk of bias will be assessed using the Cochrane RoB 2 tool and ROBINS-I tool. Where appropriate, outcomes will be pooled using random-effects meta-analyses, heterogeneity will be examined using tau2 and I2 statistics, and moderators will be examined using meta-regression models. Discussion: This review will systematically evaluate the efficacy of cognitive and physical interventions on improving cognitive function in HD. The eligibility criteria and planned analyses will allow for a comprehensive assessment of certainty in the evidence that will inform future trials and clinical practice. Registration: This protocol was registered on PROSPERO (CRD42021259152).

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The Effectiveness of Protection Orders in Reducing Recidivism in Domestic Violence: A Systematic Review and Meta-Analysis

Trauma Violence & Abuse ◽

10.1177/1524838019882361 ◽

2019 ◽

pp. 152483801988236 ◽

Cited By ~ 2

Author(s):

Reinie Cordier ◽

Donna Chung ◽

Sarah Wilkes-Gillan ◽

Renée Speyer

Keyword(s):

Systematic Review ◽

Domestic Violence ◽

Meta Analysis ◽

Future Research ◽

Eligibility Criteria ◽

Protection Orders ◽

Legal Response ◽

Police Reports ◽

Reducing Recidivism ◽

Meta Analyses

Preventing and reducing domestic violence is a national and international social priority. Civil law protection orders (POs) have been the primary legal response to domestic violence internationally for a number of decades. However, evidence of their effectiveness is mixed due to variations in application within and across countries and variable quality of the research with most studies at high risk of bias. The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of POs in reducing violation rates of domestic violence, compare violation rates reported by victims and police reports, and identify factors that influence violation and reoffense. Two electronic databases were searched; two independent researchers screened abstracts. Data were collected and assessed methodologically, using the Kmet Checklist Appraisal Tool and National Health and Medical Research Council Hierarchy of Evidence. Twenty-five studies that evaluated the effectiveness of POs in reducing recidivism in domestic violence met the eligibility criteria. Meta-analyses of weighted means of violation in the studies were conducted. Violation rates were found to be higher for victim reports compared with police reports. Violation rates were reduced when POs used in combination with arrests. PO violation rates were lower among perpetrators without histories of arrest for committing violence, perpetrators not engaging in stalking, and where couples have had medium to high incomes. There is no consensus among the studies about what the most appropriate methodology is to measure PO effectiveness. Future research should establish a more unified approach to evaluating the effectiveness and violations of POs.

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Quality of life among cancer inpatients 80 years and older: a systematic review

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01685-0 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jorunn Drageset ◽

Reidun Karin Sandvik ◽

Leslie Sofia Pareja Eide ◽

Gunhild Austrheim ◽

Mary Fox ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Cancer Patients ◽

Patient Group ◽

Malignant Tumors ◽

Symptom Burden ◽

Eligibility Criteria ◽

Critical Appraisal Skills ◽

Meta Analyses

Abstract Objective The aim of this systematic review was to summarize and assess the literature on quality of life (QoL) among cancer patients 80 years and older admitted to hospitals and what QoL instruments have been used. Methods We searched systematically in Medline, Embase and Cinahl. Eligibility criteria included studies with any design measuring QoL among cancer patients 80 years and older hospitalized for treatment (surgery, chemotherapy or radiation therapy). Exclusion criteria: studies not available in English, French, German or Spanish. We screened the titles and abstracts according to a predefined set of inclusion criteria. All the included studies were assessed according to the Critical Appraisal Skills Programme checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement checklist was used to ensure rigor in conducting and reporting. This systematic review was registered in PROSPERO (CRD42017058290). Results We included 17 studies with 2005 participants with various cancer diagnoses and Classification of Malignant Tumors stages (TNM). The included studies used a range of different QoL instruments and had different aims and outcomes. Both cancer-specific and generic instruments were used. Only one of the 17 studies used an age-specific instrument. All the studies included patients 80 years and older in their cohort, but none specifically analyzed QoL outcomes in this particular subgroup. Based on findings in the age-heterogeneous population (age range 20–100 years), QoL seems to be correlated with the type of diagnosed carcinoma, length of stay, depression and severe symptom burden. Conclusion We were unable to find any research directly exploring QoL and its determinants among cancer patients 80 years and older since none of the included studies presented specific analysis of data in this particular age subgroup. This finding represents a major gap in the knowledge base in this patient group. Based on this finding, we strongly recommend future studies that include this increasingly important and challenging patient group to use valid age- and diagnosis-specific QoL instruments.

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