scholarly journals Enhancing Active Engagement for Dementia Caregivers: A Synthesis of Interventions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 278-278
Author(s):  
Jacqueline Eaton
Keyword(s):  
Meta Analysis ◽  
Active Engagement ◽  
Inclusion Criteria ◽  
Active Components ◽  
Dementia Caregivers ◽  
Intervention Delivery ◽  
Dementia Caregiving ◽  
Play Action ◽  
Psychoeducational Interventions ◽  
Engagement Technique

Abstract In a recent meta-analysis of interventions for dementia caregivers, psychoeducational interventions were found to be effective only if they required caregivers to apply knowledge and skills through active engagement. This emphasizes the importance of understanding which intervention components enhance application in order to improve caregiving interventions and the mechanisms by which they work. The purpose of this presentation is to identify and assess elements of active engagement within dementia caregiving interventions. Articles included in this review were published between 2009 and 2018 and identified as psychoeducational dementia caregiving interventions. Each intervention was assessed to describe: 1) how active engagement was defined, 2) the logistics for implementing the active engagement techniques, 3) and the process for evaluating active engagement components. Of 36 articles meeting inclusion criteria, 25 mentioned active engagement components of the intervention. Active components included discussion, problem-solving, practice, role-play, action plans, and homework. Only five articles provided partial descriptions of the active components, five mentioned assessing active engagement, and only one study examined the efficacy of an engagement technique. This demonstrates a significant gap in our understanding of interventions for dementia caregivers. Active engagement enhances outcomes, yet to our knowledge, the specific steps taken to engage caregivers actively and the mechanisms by which these work are unclear. This is a barrier to optimizing active engagement within intervention delivery. Clarifying processes and methods for testing mechanisms of action can further enhance caregiver engagement with interventions.

Meta-Analysis of Criterion Validity for Curriculum-Based Measurement in Written Language

2016 ◽  
Vol 51 (2) ◽  
pp. 72-82 ◽  
Author(s):  
John Elwood Romig ◽  
William J. Therrien ◽  
John W. Lloyd
Keyword(s):  
Grade Level ◽  
Meta Analysis ◽  
Criterion Validity ◽  
Written Language ◽  
Curriculum Based Measurement ◽  
Inclusion Criteria ◽  
Correct Word

We used meta-analysis to examine the criterion validity of four scoring procedures used in curriculum-based measurement of written language. A total of 22 articles representing 21 studies ( N = 21) met the inclusion criteria. Results indicated that two scoring procedures, correct word sequences and correct minus incorrect sequences, have acceptable criterion validity with commercially developed and state- or locally developed criterion assessments. Results indicated trends for scoring procedures at each grade level. Implications for researchers and practitioners are discussed.

scholarly journals Association between Oral Hygiene and Metabolic Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (13) ◽  
pp. 2873
Author(s):  
Cornelia Melinda Adi Santoso ◽  
Fera Ketti ◽  
Taufan Bramantoro ◽  
Judit Zsuga ◽  
Attila Nagy
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Oral Hygiene ◽  
Reference Lists ◽  
Meta Analysis ◽  
Tooth Brushing ◽  
Inclusion Criteria ◽  
Poor Oral Hygiene ◽  
Dental Visits ◽  
Substantial Heterogeneity

Emerging evidence has linked poor oral hygiene to metabolic syndrome (MetS), but previously, no summary of evidence has been conducted on the topic. This systematic review and meta-analysis aims to evaluate the associations of oral hygiene status and care with MetS. A systematic search of the PubMed and Web of Science databases from inception to March 17, 2021, and examination of reference lists was conducted to identify eligible observational studies. A random-effects model was applied to pool the effects of oral hygiene status and care on MetS. Thirteen studies met the inclusion criteria and had sufficient methodological quality. Good oral hygiene status (OR = 0.30 (0.13–0.66); I2 = 91%), frequent tooth brushing (OR = 0.68 (0.58–0.80); I2 = 89%), and frequent interdental cleaning (OR = 0.89 (0.81–0.99); I2 = 27%) were associated with a lower risk of MetS. Only one study examined the association between dental visits and MetS (OR = 1.10 (0.77–1.55)). Our findings suggested that there might be inverse associations of oral hygiene status, tooth-brushing frequency, and interdental cleaning with MetS. However, substantial heterogeneity for tooth-brushing frequency and inconsistent results for oral hygiene status in subgroup analyses were observed. There was insufficient evidence for the association between dental visits and MetS. Further longitudinal studies are needed to investigate these associations.

scholarly journals Comparison of clinical efficacy and safety between dexmedetomidine and propofol among patients undergoing gastrointestinal endoscopy: a meta-analysis

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110327
Author(s):  
Weihua Liu ◽  
Wenli Yu ◽  
Hongli Yu ◽  
Mingwei Sheng
Keyword(s):  
Clinical Efficacy ◽  
Lower Risk ◽  
Gastrointestinal Endoscopy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Similar Efficacy ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Inclusion Criteria ◽  
Weighted Mean

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.

scholarly journals Caffeine and Cognitive Functions in Sports: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 868
Author(s):  
Jorge Lorenzo Calvo ◽  
Xueyin Fei ◽  
Raúl Domínguez ◽  
Helios Pareja-Galeano
Keyword(s):  
Systematic Review ◽  
Reaction Time ◽  
Cognitive Performance ◽  
Cognitive Functions ◽  
Web Of Science ◽  
Meta Analysis ◽  
Caffeine Intake ◽  
Inclusion Criteria ◽  
Research Protocols ◽  
The Relationship

Cognitive functions are essential in any form of exercise. Recently, interest has mounted in addressing the relationship between caffeine intake and cognitive performance during sports practice. This review examines this relationship through a structured search of the databases Medline/PubMed and Web of Science for relevant articles published in English from August 1999 to March 2020. The study followed PRISMA guidelines. Inclusion criteria were defined according to the PICOS model. The identified records reported on randomized cross-over studies in which caffeine intake (as drinks, capsules, energy bars, or gum) was compared to an identical placebo situation. There were no filters on participants’ training level, gender, or age. For the systematic review, 13 studies examining the impacts of caffeine on objective measures of cognitive performance or self-reported cognitive performance were selected. Five of these studies were also subjected to meta-analysis. After pooling data in the meta-analysis, the significant impacts of caffeine only emerged on attention, accuracy, and speed. The results of the 13 studies, nevertheless, suggest that the intake of a low/moderate dose of caffeine before and/or during exercise can improve self-reported energy, mood, and cognitive functions, such as attention; it may also improve simple reaction time, choice reaction time, memory, or fatigue, however, this may depend on the research protocols.

scholarly journals Association between serum visfatin levels and psoriasis and their correlation with disease severity: a meta-analysis

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110023
Author(s):  
Qian Zou ◽  
Jiawei Si ◽  
Yatao Guo ◽  
Jiayu Yu ◽  
Huijuan Shi
Keyword(s):  
Body Mass Index ◽  
Meta Analysis ◽  
Severity Index ◽  
Cochrane Library ◽  
Control Group ◽  
Inclusion Criteria ◽  
Subgroup Analyses ◽  
Mean Differences ◽  
The Cochrane Library ◽  
Psoriasis Severity

Objective To determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis. Methods The electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates. Results A total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI ( r = 0.51, 95% CI 0.14, 0.75). Conclusions This meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.

scholarly journals Outcomes associated with modern treatment paradigms in connective tissue disease (CTD)-associated pulmonary arterial hypertension (PAH): a meta-analysis of randomized controlled trials (RCTs)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V McLaughlin ◽  
C Zhao ◽  
J.G Coghlan ◽  
L.S Chung ◽  
S.C Mathai ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Treatment Effect ◽  
Meta Analysis ◽  
Response To Treatment ◽  
Funding Source ◽  
Class Iii ◽  
Inclusion Criteria ◽  
Private Company ◽  
Mortality Event

Abstract Background CTD-PAH has historically represented a PAH subtype with poor prognosis. New therapies, as well as combination therapy approaches targeting multiple pathways have been approved for PAH based on RCTs. CTD-PAH patients comprise a subgroup of the RCT populations and efficacy analyses are based on subgroup analyses which can be less reliable than the overall analysis. We conducted a meta-analysis of RCTs of approved PAH therapies to evaluate outcomes of patients with CTD-PAH. Purpose To use meta-analysis to determine response to treatment in patients with CTD-PAH. Methods The PubMed and EMBASE databases were searched for English-only articles published between January 1, 2000 and November 25, 2019. Inclusion criteria were multicenter RCTs that enrolled adults with WHO group 1 pulmonary hypertension (PAH); enrollment in 2000 or later; long-term clinical morbidity and/or mortality event or 6-minute walk distance (6MWD) as an efficacy endpoint reported for ≥30 patients with CTD-PAH; and evaluation of a US Food and Drug Administration-approved PAH therapy. The primary outcomes were treatment effect as measured by the study time to first morbidity or morality event and change in 6MWD from baseline to between 3–6 months, per the data provided in each article. Results from individual studies were combined using a random-effects model for overall study population (PAH patients) and the subgroup of CTD-PAH patients. Results Ten RCTs (N=4329 PAH patients; n=1263 (29%) with CTD-PAH) met inclusion criteria and were included in the meta-analysis. At baseline, PAH patients had a mean age of 50 years, approximately 78% were female, and approximately 58% had functional class III or IV disease. These characteristics were balanced between treatment and control groups. Baseline 6MWD was 356 m for the overall population and 337 m for patients with CTD-PAH. Five RCTs (N=3172; n=941 with CTD-PAH [30%]) reported hazard ratios (HRs) for time to a morbidity or mortality event by drug treatment and PAH etiology: overall population HR=0.63 (95% confidence interval [CI], 0.56–0.72; P<0.001); CTD-PAH population HR=0.64 (95% CI, 0.51–0.80; P<0.001) (Figure). Nine RCTs reported mean change with drug treatment from baseline to 3 to 6 months in 6MWD for PAH and CTD patients: 33.9 m (95% CI, 21.9–45.9; P<0.001) in the overall population; 20.2 m (95% CI, 10.8–29.7; P<0.001) in CTD-PAH patients. Conclusions The improvement in 6MWD in patients with CTD-PAH is smaller than in those with other types of PAH, perhaps reflecting comorbidities and CTD-induced mobility constraints, independent of their cardiopulmonary capacity. Data from long term clinical morbidity/mortality endpoint studies in this large group of patients with CTD-PAH demonstrate that these patients derive significant benefit from currently available PAH therapies which, in many patients, comprised the addition of a drug targeting a second or third pathway involved in the pathophysiology of PAH. Treatment effect on morbidity/mortality Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Actelion Pharmaceuticals US, Inc.

scholarly journals LO84: The incidence of fall-related intracranial bleeding in older adults taking anticoagulants, antiplatelets and neither medication: a meta-analysis

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S38-S38
Author(s):  
K. de Wit ◽  
D. Nishijima ◽  
S. Mason ◽  
R. Jeanmonod ◽  
S. Parpia ◽  
...  
Keyword(s):  
Older Adults ◽  
Meta Analysis ◽  
Grey Literature ◽  
Random Effect ◽  
Intracranial Bleeding ◽  
Inclusion Criteria ◽  
Antiplatelet Medication ◽  
Cochrane Database ◽  
Random Effect Models ◽  
Anticoagulant Medication

Introduction: It is unclear whether anticoagulant or antiplatelet medications increase the risk for intracranial bleeding in older adults after a fall. Our aim was to report the incidence of intracranial bleeding among older adults presenting to the emergency department (ED) with a fall, among patients taking anticoagulants, antiplatelet medications, both medications and neither medication. Methods: This was a systematic review and meta-analysis, PROSPERO reference CRD42019122626. Medline, EMBASE (via OVID 1946 - July 2019), Cochrane, Database of Abstracts of Reviews of Effects databases and the grey literature were searched for studies reporting on older adults who were evaluated after a fall. We included prospective studies conducted in the ED where more than 80% of the cohort were 65 years or older and had fallen. We contacted study authors for aggregate data on intracranial bleeding in patients prescribed anticoagulant medication, antiplatelet medication and neither medication. Incidences of intracranial bleeding were pooled using random effect models, and I2 index was used to assess heterogeneity. Results: From 7,240 publication titles, 10 studies met inclusion criteria. The authors of 8 of these 10 studies provided data (on 9,489 patients). All studies scored low or moderate risk of bias. The pooled incidence of intracranial bleeding among patients taking an anticoagulant medication was 5.1% (n = 5,016, 95% Confidence Interval (CI): 4.1 to 6.3%) I2 = 42%, a single antiplatelet 6.4% (n = 2,148, 95% CI: 5.4 to 7.6%) I2 = 75%, both anticoagulant and antiplatelet medications 5.9% (n = 212, 95% CI: 1.3 to 13.5%) I2 = 72%, and neither of these medications 4.8% (n = 1,927, 95% CI: 3.5 to 6.2%) I2 = 50%. A sensitivity analysis restricted to patients who had a head CT in the ED reported incidences of 6.1% (n = 3,561, 95% CI: 3 to 8.3%), 8.4% (n = 1,781, 95% CI: 5.5 to 11.8%), 6.7% (n = 206, 95% CI 1.5 to 15.2%) and 6.6% (n = 1,310, 95% CI: 5.0 to 8.4%) respectively. Conclusion: The incidence of fall-related intracranial bleeding in older ED patients was similar among patients who take anticoagulant medication, antiplatelet medication, both and neither medication, although there was heterogeneity between study findings.

scholarly journals Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Beatrice Thielmann ◽  
Robert Pohl ◽  
Irina Böckelmann
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Systematic Reviews ◽  
Web Of Science ◽  
Meta Analysis ◽  
Emergency Physicians ◽  
Inclusion Criteria ◽  
Objective Monitoring ◽  
Prisma Statement ◽  
Health Studies

Abstract Background The workloads of emergency physicians are severe. The prevalence of burnout among emergency physicians is higher than with other physicians or compared to the general population. The analysis of heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this paper is to systematically evaluate the literature on heart rate variability as an objective indicator for mental stress of emergency physicians. Methods A systematic literature review examining heart rate variability of emergency physicians in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. PubMed, Ovid, Cochrane Libary, Scopus, and Web of Science electronic databases were used. The methodological quality was evaluated by using a modified STARD for HRV. Results Two studies matched the inclusion criteria by using HRV between alert intervention and two other studies were considered that used HRV in other question areas. It showed an adaptation of HRV under stress. The studies were not comparable. Conclusions There is a need for occupational health studies that examine strains and stress of emergency physicians. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.

scholarly journals Assessment of changes in efficacy of antimalarials: a systematic review and network meta-regression

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S W Youdom ◽  
R S Tchouenkou ◽  
E-P Ndong-Nguema ◽  
L K Basco
Keyword(s):  
Systematic Review ◽  
Uncomplicated Malaria ◽  
Data Science ◽  
Meta Analysis ◽  
Decision Makers ◽  
Inclusion Criteria ◽  
Antimalarial Drug Resistance ◽  
Consistency Model ◽  
Meta Regression ◽  
Methodological Studies

Abstract Background The fight against diseases such as malaria requires the synthesis of evidence from existing studies to inform decision makers. Indeed, at a cross road of antimalarial drug resistance, several artemisinin-based combination therapies (ACT) with multiple doses are available to fight uncomplicated malaria. However, little is known on how these combinations are combined as well as how different formulations are tested. Methods A systematic review was performed to identify randomized trials. Articles were sought by hand-searching and scanning references. Additional covariates effect on treatment outcome was assessed, and a modeling approach to reduce heterogeneity among trials was evaluated. We explored one single interaction effect for all treatment with age as the main covariate in a meta-regression. A Bayesian analysis was used to implement the consistency and inconsistency models under the WinBUGS software. Ranking measure was used to obtain a hierarchy of the competing interventions. Results In total, 77 articles meet the inclusion criteria with 15 combinations tested in 36,000 patients. Results were compared to that of frequentist approach and presented according to the Prisma NMA checklist. The consistency model showed a good performance than the inconsistency model under the hypothesis of homogeneity. It was found that compared to artemether-lumefantrine, the dihydro-artemisinin-piperaquine was more effective before (B, OR = 1.83; 95% CI = 1.31-2.56) and after (A, OR = 1.70; 95% CI = 1.20-2.43) covariate adjustment, and occupied the top rank. Conclusions The application of the methods described here may be helpful to gain better understanding of treatment efficacy and improve future decisions in malaria programs. Based on the available evidence, this study demonstrated the superiority of DHAP among currently recommended ACT in preventing as well as treating uncomplicated malaria. Key messages Choosing the best therapy requires data triangulation and data science. Network meta-analysis could be a solution but need more methodological studies.

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