scholarly journals Quality and Safety Indicators in Anesthesia

2009 ◽  
Vol 110 (5) ◽  
pp. 1158-1175 ◽  
Author(s):  
Guy Haller ◽  
Johannes Stoelwinder ◽  
Paul S. Myles ◽  
John McNeil
Keyword(s):  
Systematic Review ◽  
Scientific Evidence ◽  
Professional Organizations ◽  
Anesthesia Care ◽  
Quality And Safety ◽  
Quality Initiatives ◽  
Clinical Indicators ◽  
Governmental Agencies ◽  
And Performance ◽  
Development And Validation

Clinical indicators are increasingly developed and promoted by professional organizations, governmental agencies, and quality initiatives as measures of quality and performance. To clarify the number, characteristics, and validity of indicators available for anesthesia care, the authors performed a systematic review. They identified 108 anesthetic clinical indicators, of which 53 related also to surgical or postoperative ward care. Most were process (42%) or outcome (57%) measures assessing the safety and effectiveness of patient care. To identify possible quality issues, most clinical indicators were used as part of interhospital comparison or professional peer-review processes. For 60% of the clinical indicators identified, validity relied on expert opinion. The level of scientific evidence on which prescriptive indicators ("how things should be done") were based was high (1a-1b) for 38% and low (4-5) for 62% of indicators. Additional efforts should be placed into the development and validation of anesthesia-specific quality indicators.

A Systematic Review of CrossFit® Workouts and Dietary and Supplementation Interventions to Guide Nutritional Strategies and Future Research in CrossFit®

2020 ◽  
pp. 1-19
Author(s):  
Ricardo Augusto Silva de Souza ◽  
André Guedes da Silva ◽  
Magda Ferreira de Souza ◽  
Liliana Kataryne Ferreira Souza ◽  
Hamilton Roschel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Muscle Fatigue ◽  
High Intensity ◽  
Scientific Evidence ◽  
Metabolic Stress ◽  
Optimal Recovery ◽  
Future Research ◽  
Nutritional Recommendations ◽  
And Performance ◽  
Nutritional Strategies

CrossFit® is a high-intensity functional training method consisting of daily workouts called “workouts of the day.” No nutritional recommendations exist for CrossFit® that are supported by scientific evidence regarding the energetic demands of this type of activity or dietary and supplement interventions. This systematic review performed in accordance with PRISMA guidelines aimed to identify studies that determined (a) the physiological and metabolic demands of CrossFit® and (b) the effects of nutritional strategies on CrossFit® performance to guide nutritional recommendations for optimal recovery, adaptations, and performance for CrossFit® athletes and direct future research in this emerging area. Three databases were searched for studies that investigated physiological responses to CrossFit® and dietary or supplementation interventions on CrossFit® performance. Various physiological measures revealed the intense nature of all CrossFit® workouts of the day, reflected in substantial muscle fatigue and damage. Dietary and supplementation studies provided an unclear insight into effective strategies to improve performance and enhance adaptations and recovery due to methodological shortcomings across studies. This systematic review showed that CrossFit® is a high-intensity sport with fairly homogenous anaerobic and aerobic characteristics, resulting in substantial metabolic stress, leading to metabolite accumulation (e.g., lactate and hydrogen ions) and increased markers of muscle damage and muscle fatigue. Limited interventional data exist on dietary and supplementation strategies to optimize CrossFit® performance, and most are moderate to very low quality with some critical methodological limitations, precluding solid conclusions on their efficacy. High-quality work is needed to confirm the ideal dietary and supplemental strategies for optimal performance and recovery for CrossFit® athletes and is an exciting avenue for further research.

scholarly journals Clinical indicators for reporting the effectiveness of patient quality and safety-related interventions: a protocol of a systematic review and Delphi consensus process as part of the international Standardised Endpoints for Perioperative Medicine initiative (StEP)

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023427
Author(s):  
Sohail Bampoe ◽  
Tim Cook ◽  
Lee Fleisher ◽  
Michael P W Grocott ◽  
Mark Neuman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Academic Community ◽  
Delphi Process ◽  
Ease Of Use ◽  
Perioperative Medicine ◽  
Cochrane Library ◽  
Quality And Safety ◽  
Delphi Consensus ◽  
Clinical Indicators ◽  
Safety Interventions

IntroductionClinical indicators are used to measure and quantify the safety and quality of patient care. They are also often used as endpoints in clinical trials. Definitions of clinical indicators in common use are extremely heterogeneous, limiting their applicability. As part of the international Standardised Endpoints in Perioperative Medicine initiative, this study will identify clinical indicators by systematically reviewing the anaesthesia and perioperative medicine literature, and will provide consensus, clinically useful definitions for those indicators using a Delphi process.Methods and analysisAn electronic database search will be conducted of Medline (PubMed/OVID), EMBASE and the Cochrane Library in order to meet this review’s objectives that are: (1) To identify clinical indicators and their definitions used in randomised controlled trials that assess patient-related quality and safety interventions in perioperative medicine; (2) To select a shortlist of recommended indicators and definitions that are the most suitable for evaluation of quality and safety interventions following an expert-based consensus-gaining process (Delphi method) and (3) To provide a classification scale for each indicator related to its clarity of definition, validity (strength), reliability, feasibility (ease of use) and frequency of use. This systematic review protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidance.Ethics and disseminationEthical approval is not required for this systematic review and Delphi process. The results of this study will be disseminated to the anaesthesia and perioperative medicine clinical and academic community through national and international presentations and through publication in a peer reviewed journal.PROSPERO registration numberCRD42016042102.

Female Olympians’ voices: Female sports categories and International Olympic Committee Transgender guidelines

2021 ◽  
pp. 101269022110215
Author(s):  
Cathy Devine
Keyword(s):  
Female Athletes ◽  
Scientific Evidence ◽  
Policy Formulation ◽  
International Olympic Committee ◽  
Political Discourses ◽  
Fair Competition ◽  
Fair Inclusion ◽  
Female Sports ◽  
And Performance ◽  
Unanimous Agreement

The fair inclusion of female athletes at elite and Olympic levels is secured in most sports by way of female categories because of the extensively documented biological and performance-related differences between the sexes. International policy for transgender inclusion is framed by the definitive International Olympic Committee transgender guidelines in which the International Olympic Committee confirms the ‘overriding sporting objective is and remains the guarantee of fair competition’ and transwomen can be excluded from female categories if, in the interests of fairness, this is necessary and proportionate. Feminist theorists argue justice requires that women have equal moral standing in the sociocultural–political structures of society including sport. As such their voices should carry equal democratic weight. However, female elite and Olympic athletes are rarely heard in the sociocultural–political discourses of academic literature or policy formulation for transgender inclusion in female categories by the International Olympic Committee and governing bodies of sport. This empirical study investigated the views and presents the ‘voices’ of 19 female Olympians. The main findings include (1) these athletes thought both female and transgender athletes should be fairly included in elite sport, (2) unanimous agreement there is not enough scientific evidence to show no competitive advantage for transwomen, (3) unanimous agreement that the International Olympic Committee should revisit the rules and scientific evidence for transgender inclusion in female categories, and (4) the majority of athletes felt that they could not ask questions or discuss this issue without being accused of transphobia.

scholarly journals Successful incorporation of single reviewer assessments during systematic review screening: development and validation of sensitivity and work-saved of an algorithm that considers exclusion criteria and count

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Nassr Nama ◽  
Mirna Hennawy ◽  
Nick Barrowman ◽  
Katie O’Hearn ◽  
Margaret Sampson ◽  
...  
Keyword(s):  
Systematic Review ◽  
A Priori ◽  
Research Centre ◽  
Exclusion Criteria ◽  
Conference Abstract ◽  
Pediatric Health Care ◽  
Average Loss ◽  
Validation Set ◽  
Abstract Screening ◽  
Development And Validation

Abstract Background Accepted systematic review (SR) methodology requires citation screening by two reviewers to maximise retrieval of eligible studies. We hypothesized that records could be excluded by a single reviewer without loss of sensitivity in two conditions; the record was ineligible for multiple reasons, or the record was ineligible for one or more specific reasons that could be reliably assessed. Methods Twenty-four SRs performed at CHEO, a pediatric health care and research centre in Ottawa, Canada, were divided into derivation and validation sets. Exclusion criteria during abstract screening were sorted into 11 specific categories, with loss in sensitivity determined by individual category and by number of exclusion criteria endorsed. Five single reviewer algorithms that combined individual categories and multiple exclusion criteria were then tested on the derivation and validation sets, with success defined a priori as less than 5% loss of sensitivity. Results The 24 SRs included 930 eligible and 27390 ineligible citations. The reviews were mostly focused on pediatrics (70.8%, N=17/24), but covered various specialties. Using a single reviewer to exclude any citation led to an average loss of sensitivity of 8.6% (95%CI, 6.0–12.1%). Excluding citations with ≥2 exclusion criteria led to 1.2% average loss of sensitivity (95%CI, 0.5–3.1%). Five specific exclusion criteria performed with perfect sensitivity: conference abstract, ineligible age group, case report/series, not human research, and review article. In the derivation set, the five algorithms achieved a loss of sensitivity ranging from 0.0 to 1.9% and work-saved ranging from 14.8 to 39.1%. In the validation set, the loss of sensitivity for all 5 algorithms remained below 2.6%, with work-saved between 10.5% and 48.2%. Conclusions Findings suggest that targeted application of single-reviewer screening, considering both type and number of exclusion criteria, could retain sensitivity and significantly decrease workload. Further research is required to investigate the potential for combining this approach with crowdsourcing or machine learning methodologies.

scholarly journals Can Transcranial Direct Current Stimulation Enhance Functionality in Older Adults? A Systematic Review

2021 ◽  
Vol 10 (13) ◽  
pp. 2981
Author(s):  
Andrés Pino-Esteban ◽  
Álvaro Megía-García ◽  
David Martín-Caro Álvarez ◽  
Hector Beltran-Alacreu ◽  
Juan Avendaño-Coy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Healthy Older Adults ◽  
Sham Stimulation ◽  
Direct Current Stimulation ◽  
Potential Benefits

Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This systematic review aimed at compiling and summarizing the currently available scientific evidence about the effect of tDCS on functionality in older adults over 60 years of age. A search of databases was conducted to find randomized clinical trials that applied tDCS versus sham stimulation in the above-mentioned population. No limits were established in terms of date of publication. A total of 237 trials were found, of which 24 met the inclusion criteria. Finally, nine studies were analyzed, including 260 healthy subjects with average age between 61.0 and 85.8 years. Seven of the nine included studies reported superior improvements in functionality variables following the application of tDCS compared to sham stimulation. Anodal tDCS applied over the motor cortex may be an effective technique for improving balance and posture control in healthy older adults. However, further high-quality randomized controlled trials are required to determine the most effective protocols and to clarify potential benefits for older adults.

scholarly journals Effects of Sport-Based Interventions on Children’s Executive Function: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 755
Author(s):  
Falonn Contreras-Osorio ◽  
Christian Campos-Jara ◽  
Cristian Martínez-Salazar ◽  
Luis Chirosa-Ríos ◽  
Darío Martínez-García
Keyword(s):  
Systematic Review ◽  
Working Memory ◽  
Executive Function ◽  
Inhibitory Control ◽  
Cognitive Flexibility ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Healthy Children ◽  
Meta Analyses ◽  
The Impact

One of the most studied aspects of children’s cognitive development is that of the development of the executive function, and research has shown that physical activity has been demonstrated as a key factor in its enhancement. This meta-analysis aims to assess the impact of specific sports interventions on the executive function of children and teenagers. A systematic review was carried out on 1 November 2020 to search for published scientific evidence that analysed different sports programs that possibly affected executive function in students. Longitudinal studies, which assessed the effects of sports interventions on subjects between 6 and 18 years old, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of eight studies, with 424 subjects overall, met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibitory control, and cognitive flexibility. The random-effects model for meta-analyses was performed with RevMan version 5.3 to facilitate the analysis of the studies. Large effect sizes were found in all categories: working memory (ES −1.25; 95% CI −1.70; −0.79; p < 0.0001); inhibitory control (ES −1.30; 95% CI −1.98; −0.63; p < 0.00001); and cognitive flexibility (ES −1.52; 95% CI −2.20; −0.83; p < 0.00001). Our analysis concluded that healthy children and teenagers should be encouraged to practice sports in order to improve their executive function at every stage of their development.

Development and Validation of a Cognitive Reserve Index in HIV

2021 ◽  
pp. 1-9
Author(s):  
Navaldeep Kaur ◽  
Lesley K. Fellows ◽  
Marie-Josée Brouillette ◽  
Nancy Mayo
Keyword(s):  
Cognitive Reserve ◽  
Study Entry ◽  
Video Gaming ◽  
Everyday Functioning ◽  
Data Set ◽  
Multiple Indicators ◽  
And Performance ◽  
Competitive Games ◽  
Development And Validation

Abstract Objectives: In the neuroHIV literature, cognitive reserve has most often been operationalized using education, occupation, and IQ. The effects of other cognitively stimulating activities that might be more amenable to interventions have been little studied. The purpose of this study was to develop an index of cognitive reserve in people with HIV, combining multiple indicators of cognitively stimulating lifetime experiences into a single value. Methods: The data set was obtained from a Canadian longitudinal study (N = 856). Potential indicators of cognitive reserve captured at the study entry included education, occupation, engagement in six cognitively stimulating activities, number of languages spoken, and social resources. Cognitive performance was measured using a computerized test battery. A cognitive reserve index was formulated using logistic regression weights. For the evidence on concurrent and predictive validity of the index, the measures of cognition and self-reported everyday functioning were each regressed on the index scores at study entry and at the last follow-up [mean duration: 25.9 months (SD 7.2)], respectively. Corresponding regression coefficients and 95% confidence intervals (CIs) were computed. Results: Professional sports [odds ratio (OR): 2.9; 95% CI 0.59–14.7], visual and performance arts (any level of engagement), professional/amateur music, complex video gaming and competitive games, and travel outside North America were associated with higher cognitive functioning. The effects of cognitive reserve on the outcomes at the last follow-up visit were closely similar to those at study entry. Conclusion: This work contributes evidence toward the relative benefit of engaging in specific cognitively stimulating life experiences in HIV.

scholarly journals A systematic review of definitions of motor vehicle headways in driver behaviour and performance studies

2021 ◽  
Vol 77 ◽  
pp. 38-54
Author(s):  
Raaj Kishore Biswas ◽  
Rena Friswell ◽  
Jake Olivier ◽  
Ann Williamson ◽  
Teresa Senserrick
Keyword(s):  
Systematic Review ◽  
Performance Studies ◽  
Motor Vehicle ◽  
Driver Behaviour ◽  
And Performance

Efficacy of Benson’s Relaxation Technique on Anxiety and Depression among Patients Undergoing Hemodialysis: A Systematic Review

2021 ◽  
pp. 105477382110247
Author(s):  
Haya Ibrahim Ali Abu Maloh ◽  
Kim Lam Soh ◽  
Mohannad Eid AbuRuz ◽  
Seng Choi Chong ◽  
Siti Irma Fadhilah Ismail ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Scientific Evidence ◽  
Relaxation Technique ◽  
Anxiety And Depression ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Depression Level ◽  
Ebsco Host

This study aimed to evaluate the efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis. A systematic review of randomized controlled trials was conducted. Searching databases included EBSCO Host, PubMed, ProQuest, Science Direct, Sage Journals, Ovid, and Google Scholar from January 2000 to September 2020. Five randomized controlled trials were identified. Findings revealed a statistically significant decrease in anxiety score. Concerning depression; one RCT showed a statistically significant decrease and two RCTs revealed a non-significant difference in depression level. The overall quality of the RCTs was not high. Despite that the RCTs showed benefits of BRT in managing anxiety. However, this is not the same for depression. The lack of high-quality scientific evidence supporting its retinue use indicates that additional well designed randomized controlled trials in multiple countries are warranted to support the efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis.

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