scholarly journals Womens health-related quality of life substantially improves with tailored cardiac rehabilitation: a systematic review and meta-analysis

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
S Chung ◽  
D Candelaria ◽  
R Gallagher
Keyword(s):  
Cardiac Rehabilitation ◽  
Short Form ◽  
Meta Analysis ◽  
Bodily Pain ◽  
Future Research ◽  
Specific Patient ◽  
Role Physical ◽  
Patient Reported ◽  
Quasi Experimental ◽  
Randomised Controlled

Abstract Funding Acknowledgements Type of funding sources: None. Background Women have poorer outcomes from coronary heart disease (CHD) compared to men and participation in exercise-based cardiac rehabilitation (EBCR) offers an opportunity for improvement. However, synthesised evidence for women-specific patient-reported outcomes are often lacking. We aimed to synthesise HRQL outcomes from EBCR in women with CHD. Methods Four electronic databases (PUBMED, CINAHL, SCOPUS and Cochrane) were searched for studies reporting HRQL using validated measures in women attending EBCR. Two reviewers independently screened papers and extracted data. Random effects model (RevMan v5.4) was used for analysis. Results Eleven studies (1292 women participants) were included: six observational, three randomised controlled trials, and two quasi-experimental design. Seven studies were included in the meta-analyses. EBCR participation was associated with HRQL benefits in several domains of the Short-Form (SF-12 or 36). Improvements were greatest in Role Physical (MD 19.09 95% CI 2.37, 35.81), Physical Functioning (MD 10.43, 95% CI 2.60, 18.27) and Vitality (MD 9.59, 95% CI 0.31, 18.86). When tailored components were added to traditional EBCR, gains in HRQL were also observed, specifically in Bodily Pain (MD 9.82, 95% CI 4.43, 15.21), Role Physical (MD 8.48, 95% CI 1.31, 9.97), Vitality (MD 8.17, 95% CI 3.79, 12.55), General Health (MD 5.64, 95% CI 1.31, 9.97), and Physical Function (MD 5.61, 95% CI 0.83, 10.40) domains. Conclusion Women attending EBCR achieve clinically meaningful improvements in multiple areas of HRQL, and additional benefits were seen when strategies tailored to their needs and preferences were included. Future research should focus on promoting EBCR uptake in women.

scholarly journals Dietary Interventions for Gastroparesis in Pediatric and Adult Populations: A Systematic Review Protocol

2020 ◽  
Author(s):  
Debra Okafor ◽  
Tanya Su ◽  
Keya Lee ◽  
Bruno Chumpitazi ◽  
Robert J Shulman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Treatment Options ◽  
Future Research ◽  
Dietary Interventions ◽  
Time Data ◽  
Comprehensive Overview ◽  
Specific Patient ◽  
Patient Reported

Abstract Background: Dietary interventions are the first-line treatment for patients with gastroparesis. It is unclear which diets are the most efficacious as well as clear guidance as to which diets should be recommended to adult versus pediatric patients. We plan to conduct this systematic review to assess the literature on the efficacy and effectiveness of dietary interventions on clinical outcomes in adult and pediatric patients with gastroparesis. Methods: We will search PubMed and EMBASE databases, evaluating randomized control trials and cohort studies that reported dietary interventions in gastroparesis. Our primary outcomes are to evaluate changes in symptom-specific patient-reported outcomes, changes in perception of quality of life, and changes in gastric emptying time. Data collected from the studies will be analyzed using meta-analysis. Depending on the outcome, we will use quantitative summary estimates (e.g., standardized mean difference with 95% Confidence Intervals, 95%CI) or dichotomous outcomes (e.g., odds ratio and 95%CI).Discussion: This review will explore the use of dietary interventions in the treatment of both adult and pediatric patients with gastroparesis, which has yet to be published in the literature. By assessing what has been investigated by researchers as effective non-pharmacologic treatments in patients, and providing a comprehensive overview of treatment options, healthcare providers will be able to better guide patient care. Furthermore, this review will act as a means to provide direction for future research. Systematic Review Registration: PROSPERO registration ID: CRD42020210536.

scholarly journals Deprescribing intervention activities mapped to guiding principles for use in general practice: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e052547
Author(s):  
Amy Coe ◽  
Catherine Kaylor-Hughes ◽  
Susan Fletcher ◽  
Elizabeth Murray ◽  
Jane Gunn
Keyword(s):  
General Practice ◽  
Family Practice ◽  
Data Extraction ◽  
Controlled Trial ◽  
Future Research ◽  
Original Research ◽  
Practice Staff ◽  
Quasi Experimental ◽  
Guiding Principles ◽  
Randomised Controlled

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.

Using routine databases to evaluate Electronic Palliative Care Co-ordination Systems (EPaCCS)

2021 ◽  
pp. bmjebm-2019-111332
Author(s):  
Christina Sian Chu
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Research Quality ◽  
Patient Reported ◽  
Quasi Experimental ◽  
Randomised Controlled ◽  
Study Designs

In response to the government’s drive to expand Electronic Palliative Care Co-ordination Systems (EPaCCS) across England by 2020, further evidence for this intervention needs to be established quickly. With palliative and end-of-life care research being an underfunded area, the availability and lower costs of routine databases make it an attractive resource to integrate into studies evaluating EPaCCS without jeopardising research quality. This article describes how routine databases can be used to address the current paucity of high-quality evidence; they can be used in a range of study designs, including randomised controlled trials and quasi-experimental designs, and may also be able to contribute quality of life or patient-reported outcome measures.

scholarly journals Racial and socioeconomic disparities in patient experience of clinician empathy: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034247 ◽  
Author(s):  
Brian W Roberts ◽  
Christian J Trzeciak ◽  
Nitin K Puri ◽  
Anthony J Mazzarelli ◽  
Stephen Trzeciak
Keyword(s):  
Systematic Review ◽  
Patient Experience ◽  
Meta Analysis ◽  
Socioeconomic Disparities ◽  
Future Research ◽  
Individual Patient Level ◽  
Patient Reported ◽  
Original Manuscript ◽  
Methodological Guidelines ◽  
Care Measure

IntroductionClinician empathy is a vital component of high-quality healthcare. Healthcare disparities may reflect a societal lack of empathy for disadvantaged persons in general, and recent research suggests that socioeconomic disparities exist in patient satisfaction with clinicians. However, it is currently unclear if there are disparities in patient experience of empathy from clinicians. Our objective is to systematically analyse the scientific literature to test the hypothesis that racial and socioeconomic status (SES) disparities exist in patient-reported experience of clinician empathy.Methods and analysisIn accordance with published methodological guidelines for conducting a systematic review, we will analyse studies reporting patient assessment of clinician empathy using the Consultation and Relational Empathy (CARE) measure, which to date is the most commonly used and well-validated methodology in clinical research for measuring clinician empathy from the patient’s perspective. We will use a standardised data collection template and assess study quality (risk of bias) using the Newcastle-Ottawa Scale. We will abstract data for the CARE measure stratified by race and SES, and we will contact the corresponding authors to obtain stratified data by race/SES if not reported in the original manuscript. Where appropriate, we will pool the data and perform quantitative meta-analysis to test if non-white (compared to white) patients and low SES (compared to high SES) patients report lower scores for clinician empathy.Ethics and disseminationNo individual patient-level data will be collected and thus the proposed systematic review does not require ethical approval. This systematic review will test if racial and SES differences exist in patient experience of clinician empathy, and will inform future research to help promote healthcare equity.PROSPERO registration numberCRD42019142809.

scholarly journals Academic Achievement and Peer Tutoring in Mathematics: A Comparison Between Primary and Secondary Education

SAGE Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 215824402092929 ◽  
Author(s):  
Francisco Alegre ◽  
Lidón Moliner ◽  
Ana Maroto ◽  
Gil Lorenzo-Valentin
Keyword(s):  
Secondary Education ◽  
Elementary Education ◽  
Peer Tutoring ◽  
Meta Analysis ◽  
Future Research ◽  
Control Group ◽  
Educational Levels ◽  
Primary And Secondary Education ◽  
Academic Benefits ◽  
Quasi Experimental

Peer tutoring in Mathematics has reported academic benefits across many educational levels, from Preschool to Higher Education. However, recent literature reviews and meta-analysis state that students experience higher gains in Primary or Elementary Education (ages 7–12 years) than in secondary education or middle school and high school (ages 13–18 years). This study examined the effects of peer tutoring on students’ mathematics achievement in primary and secondary education under similar settings. 89 students from first, fourth, seventh, and ninth grades participated in the study. The design of this research was quasi-experimental with pretest–posttest without control group. The statistical analysis reported significant improvements for both, Primary and Secondary Education. The comparison between these educational levels showed that there were no significant differences in the increments of the students’ marks. The global effect size reported for the experience was Cohen’s d = 0.78. The main conclusion is that Peer Tutoring in Mathematics reports similar academic benefits for both, Primary and Secondary Education. Future research must be conducted as the superiority of Peer Tutoring in Primary over Secondary Education has yet to be proved in the Mathematics subject.

The Effects of Tier 2 Mathematics Interventions for Students With Mathematics Difficulties: A Meta-Analysis

2020 ◽  
pp. 001440292096918
Author(s):  
Asha K. Jitendra ◽  
Ahmed Alghamdi ◽  
Rebecca Edmunds ◽  
Nicole M. McKevett ◽  
John Mouanoutoua ◽  
...  
Keyword(s):  
Variance Estimation ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Future Research ◽  
Tier 2 ◽  
Mathematics Interventions ◽  
Treatment Groups ◽  
Tier 2 Interventions ◽  
Mathematics Difficulties ◽  
Quasi Experimental

This meta-analysis examined the effectiveness of supplemental Tier-2 mathematics interventions for students with mathematics difficulties (MD). We reviewed 39 experimental and quasi-experimental studies that included 40 independent samples, with 61 treatment groups. Utilizing robust variance estimation (RVE), results revealed a treatment effect of 0.41. Mixed-effects meta-regression analyses revealed that Tier-2 interventions were moderated by intervention model type, group size, and type of measure. We present recommendations for future research and implementation of mathematics practices.

scholarly journals Safety and effectiveness of a Tai Chi-based cardiac rehabilitation programme for chronic coronary syndrom patients: study protocol for a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036061
Author(s):  
Jing Ma ◽  
Jian wei Zhang ◽  
Hua Li ◽  
Lian shan Zhao ◽  
Ai ying Guo ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Outcome Measures ◽  
Tai Chi ◽  
Short Form ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Cardiac Rehabilitation Programme ◽  
Tai Chi Exercise ◽  
Randomised Controlled

IntroductionPreliminary evidence from clinical observations suggests that Tai Chi exercise may offer potential benefits for patients with chronic coronary syndrom (CCS). However, the advantages for CCS patients to practice Tai Chi exercise as rehabilitation have not been rigorously tested and there is a lack of consensus on its benefits. This study aims to develop an innovative Tai Chi Cardiac Rehabilitation Program (TCCRP) for CCS patients and to assess the efficacy, safety and acceptability of the programme.Methods and analysisWe propose to conduct a multicentre randomised controlled clinical trial comprising of 150 participants with CCS. The patients will be randomly assigned in a 1:1 ratio into two groups. The intervention group will participate in a supervised TCCRP held three times a week for 3 months. The control group will receive supervised conventional exercise rehabilitation held three times a week for 3 months. The primary and secondary outcomes will be assessed at baseline, 1 month, 3 months after intervention and after an additional 3-month follow-up period. Primary outcome measures will include a score of 36-Item Short Form Survey and Chinese Perceived Stress Scale. The secondary outcome measures will include body composition, cardiopulmonary exercise test, respiratory muscle function, locomotor skills, echocardiogram, New York Heart Association classification, heart rate recovery time and laboratory examination. Other measures also include Seattle Angina Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Berg Balance Scale. All adverse events will be recorded and analysed.Ethics and disseminationThis study conforms to the principles of the Declaration of Helsinki and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of Chinese People’s Libration Army General Hospital (approval number: S2019-060-02). Findings from this study will be published and presented at conferences for widespread dissemination of the results.Trial registration numberNCT03936504.

scholarly journals Translation and Validation of the Danish Version of the Zurich Claudication Questionnaire

2020 ◽  
pp. 219256822094774
Author(s):  
Jamal Bech Bouknaitir ◽  
Leah Y. Carreon ◽  
Stig Brorson ◽  
Mikkel Østerheden Andersen
Keyword(s):  
Internal Consistency ◽  
Discriminant Validity ◽  
Short Form ◽  
Strong Association ◽  
Healthy Controls ◽  
Floor Effect ◽  
Specific Patient ◽  
Danish Version ◽  
Patient Reported ◽  
Responsiveness To Change

Study Design: Validation study. Objectives: To translate and validate the Zurich Claudication Questionnaire (ZCQ) into a Danish version of the disease-specific patient-reported outcome measure (PROM) for patients with lumbar spinal stenosis (LSS), which assesses symptom severity, physical function, and satisfaction after surgery. Method: Translation into a Danish version of the original questionnaire by back- and forward-translating the questionnaire and finally transforming a prefinal test version into a final and cross-cultural adapted version. Validation was performed as a cohort study assessing floor-ceiling effects, internal consistency, test-retest reproducibility, criterion validity, discriminant validity, and responsiveness to change. Results: Fifty-three patients were consecutively included in the study, 53 healthy controls were matched. Floor effect was seen in the postoperative data. Internal consistency, Cronbach’s alpha was good to excellent. Substantial test-retest reproducibility was found using Cohen’s weighted kappa. The Danish ZCQ showed moderate to strong association with similar domains of Oswestry Disability Index, Short Form 36, Euro QoL 5D, visual analogue scale–leg and back. The questionnaire showed significant responsiveness to change and a significant discriminant validity between LSS patients and healthy controls. Conclusion: This study shows the Danish translation of the original ZCQ to be well understood by Danish patients. The Danish version is furthermore a reliable and valid questionnaire, which is responsive to change.

scholarly journals A Systematic Review of the Effect of Expectancy on Treatment Responses to Acupuncture

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Ben Colagiuri ◽  
Caroline A. Smith
Keyword(s):  
Meta Analysis ◽  
Future Research ◽  
Placebo Acupuncture ◽  
Study Characteristics ◽  
Treatment Responses ◽  
Methodological Considerations ◽  
Randomised Controlled ◽  
Study Designs ◽  
The Relationship ◽  
Relevant Outcome

Randomised controlled trials (RCTs) of acupuncture often find equivalent responses to real and placebo acupuncture despite both appearing superior to no treatment. This raises questions regarding the mechanisms of acupuncture, especially the contribution of patient expectancies. We systematically reviewed previous research assessing the relationship between expectancy and treatment responses following acupuncture, whether real or placebo. To be included, studies needed to assess and/or manipulate expectancies about acupuncture and relate these to at least one health-relevant outcome. Nine such independent studies were identified through systematic searches of Medline, PsycInfo, PubMed, and Cochrane Clinical Trials Register. The methodology and reporting of these studies were quite heterogeneous, meaning that meta-analysis was not possible. A descriptive review revealed that five studies found statistically significant effects of expectancy on a least one outcome, with three also finding evidence suggestive of an interaction between expectancy and type of acupuncture (real or placebo). While there were some trends in significant effects in terms of study characteristics, their generality is limited by the heterogeneity of study designs. The differences in design across studies highlight some important methodological considerations for future research in this area, particularly regarding whether to assess or manipulate expectancies and how best to assess expectancies.

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