Non-accidental harms (‘abuse’) in athletes with impairment (‘para athletes’): a state-of-the-art review

ObjectivePara athletes reap significant health benefits from sport but are vulnerable to non-accidental harms. Little is known about the types and impacts of non-accidental harms Para athletes face. In this literature review, we summarise current knowledge and suggest priorities for future research related to non-accidental harms in Para athletes.DesignSix electronic databases were searched between August and September 2017. 2245 articles were identified in the initial title/abstract review, and 202 records were selected for full-text review following preliminary screening. Two independent examiners evaluated each full text, and eight citations were selected based on inclusion/exclusion criteria.Data sourcesMEDLINE, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Scopus and Academic Search Premier.Eligibility criteria for selecting studiesInclusion criteria: (A) human participants; (B) written in English; (C) descriptive, cohort and case series, case–control, qualitative, mixed methods studies and all clinical trials; and (D) data pertain to harassment/abuse of youth, recreational, collegiate, national-level and/or elite-level athletes with a physical and/or intellectual impairment.ResultsMost studies focused on young, visually impaired athletes and approximately half of all studies described high rates of bullying and its social implications. One study confirmed remarkably high rates of psychological, physical and sexual harms in Para athletes, compared with able-bodied peers.ConclusionsBullying in young, visually impaired athletes is described most commonly in the available literature. Due to the limited amount of data, the prevalence of non-accidental harms in Para athletes remains unclear and information on trends over time is similarly unavailable.

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Comprehensive Researcher Achievement Model (CRAM): a framework for measuring researcher achievement, impact and influence derived from a systematic literature review of metrics and models

BMJ Open ◽

10.1136/bmjopen-2018-025320 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025320 ◽

Cited By ~ 4

Author(s):

Jeffrey Braithwaite ◽

Jessica Herkes ◽

Kate Churruca ◽

Janet C Long ◽

Chiara Pomare ◽

...

Keyword(s):

Full Text ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Assessment Method ◽

Assessment Model ◽

Eligibility Criteria ◽

Promotion And Tenure ◽

Full Text Review ◽

Q Statistic

ObjectivesEffective researcher assessment is key to decisions about funding allocations, promotion and tenure. We aimed to identify what is known about methods for assessing researcher achievements, leading to a new composite assessment model.DesignWe systematically reviewed the literature via the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols framework.Data sourcesAll Web of Science databases (including Core Collection, MEDLINE and BIOSIS Citation Index) to the end of 2017.Eligibility criteria(1) English language, (2) published in the last 10 years (2007–2017), (3) full text was available and (4) the article discussed an approach to the assessment of an individual researcher’s achievements.Data extraction and synthesisArticles were allocated among four pairs of reviewers for screening, with each pair randomly assigned 5% of their allocation to review concurrently against inclusion criteria. Inter-rater reliability was assessed using Cohen’s Kappa (ĸ). The ĸ statistic showed agreement ranging from moderate to almost perfect (0.4848–0.9039). Following screening, selected articles underwent full-text review and bias was assessed.ResultsFour hundred and seventy-eight articles were included in the final review. Established approaches developed prior to our inclusion period (eg, citations and outputs, h-index and journal impact factor) remained dominant in the literature and in practice. New bibliometric methods and models emerged in the last 10 years including: measures based on PageRank algorithms or ‘altmetric’ data, methods to apply peer judgement and techniques to assign values to publication quantity and quality. Each assessment method tended to prioritise certain aspects of achievement over others.ConclusionsAll metrics and models focus on an element or elements at the expense of others. A new composite design, the Comprehensive Researcher Achievement Model (CRAM), is presented, which supersedes past anachronistic models. The CRAM is modifiable to a range of applications.

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Factors that influence performance in Olympic air-rifle and small-bore shooting: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0247353 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247353

Author(s):

Sina Spancken ◽

Hannah Steingrebe ◽

Thorsten Stein

Keyword(s):

National Level ◽

Body Sway ◽

Future Research ◽

Skill Levels ◽

Performance Requirements ◽

Accuracy And Precision ◽

Elite Level ◽

Performance Determinants ◽

Air Rifle

Background Air-rifle and small-bore shooting are fascinating Olympic sports due to their unique performance requirements for accuracy and precision. Objective The purpose of our study was to systematically research the literature to determine and summarize performance determinants in both air-rifle and small-bore shooting. Since some athletes participate internationally in both disciplines in competition, the disciplines must have some similarity in the performance structure. Therefore, we further investigated whether performance in air-rifle and small-bore shooting can be explained by the same performance determinants. Methods We systematically searched in four databases using combined keywords relevant to performance in air-rifle and small-bore shooting. The articles included had undergone peer-review and had a) a direct relation to shooting performance, b) an indirect relation by comparing the performance of shooters of different skill levels, and c) a practical relevance (directly controllable through training). After the quality of each article was assessed, the key data were extracted and summarized. Results The fourteen articles included achieved an average of 60 ± 14% (range 30–80%) in quality assessment. Altogether, articles covered 268 subjects (32% female), of which 19% were elite- and 28% were national-level athletes. Sixteen performance determinants were investigated, which were divided into anthropometric, technical-coordinative, physiological and psychological categories. Both in air-rifle and small-bore shooting, rifle stability and body sway were found to differ between elite- and national-level athletes. In both disciplines, body sway seemed to have no influence on shot score in elite- and national-level athletes. Similarly, heart rate did not correlate with shot score at nearly all performance levels in both disciplines. In national-level air-rifle athletes, horizontal rifle stability, aiming accuracy and aiming time were found to affect shot score. Conclusions To be competitive at a national-level in air-rifle shooting, a highly developed aiming process is needed to achieve a high shot score. Lack of data prevented us from drawing evidence-based conclusions in elite-level air-rifle athletes and in small-bore shooting. Future research should investigate possible performance determinants both in air-rifle and in small-bore shooting, especially with elite-level athletes, to confirm or disprove existing findings. Further research should use more complex analyses to investigate the multifaceted processes associated with different performance determinants.

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Outsourcing Microbiology Services in Medical Centers: Is It Worth It?

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piz019 ◽

2019 ◽

Vol 9 (3) ◽

pp. 293-297

Author(s):

Manuel E Penton ◽

Caitlin Otto ◽

Margaret R Hammerschlag

Keyword(s):

Medical Education ◽

Blood Culture ◽

Patient Care ◽

Full Text ◽

Case Series ◽

Microbiology Laboratory ◽

Medical Centers ◽

Full Text Review ◽

Potential Benefits ◽

Key Questions

Abstract Background Outsourcing of microbiology laboratory services is a growing trend in US medical centers. Data on the actual impact of outsourcing on patient care, safety, and medical education, including costs, are limited. The objective of this study was to examine the published literature on the potential benefits and harms when medical centers outsource common microbiology services. Methods We conducted a 16-step literature search of PubMed and Embase. Articles were selected for full-text review if their content matched our key questions: (1) What are the potential benefits of outsourcing core microbiology laboratory testing? (2) What are the potential harms to patient care and medical education when medical centers outsource essential microbiology services? Results The initial search yielded 6111 unique published articles; 36 were selected for full-text review, which resulted in the identification of 8 articles that addressed our key questions (2 editorials, 3 editorials with observational data, 1 survey, 1 case series, and 1 study of blood culture transport). These articles described a variety of issues, including longer turnaround times for blood cultures that resulted in delays in diagnosis and treatment, errors that resulted in patient morbidity, limited cost savings, and communication barriers. Conclusions In this study, with the exception of the blood culture transport study, we found no published prospective studies that quantified the effects of outsourcing microbiology services on patient care, patient safety, or medical education. However, these largely anecdotal reports suggest that outsourcing microbiology services may have a detrimental impact on medical education, especially infectious disease training programs.

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A Comparison of Antifungal Drugs and Traditional Antiseptic Medication for Otomycosis Treatment: A Systematic Review and Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.739360 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shunyu Wu ◽

Yin Cheng ◽

Shunzhang Lin ◽

Huanhai Liu

Keyword(s):

Systematic Review ◽

Literature Review ◽

Meta Analysis ◽

Case Series ◽

Antifungal Drugs ◽

Cochrane Library ◽

Future Research ◽

Research Subjects ◽

Full Text Review ◽

Meta Analyses

Objectives/Hypothesis: To perform a systematic review and meta-analysis to compare the efficacy of and complications associated with antifungal drugs and traditional antiseptic medication for the treatment of otomycosis.Data Sources: The PubMed, EMBASE, GeenMedical, Cochrane Library, CBM, CNKI, VIP and other databases were searched from January 1991 to January 2021.Methods: The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) and non-randomized studies (case-control, cohort, and case series) were included to assess the topical use of antifungal drugs and traditional antiseptic medication in patients with otomycosis. The research subjects were patients who were clinically diagnosed with otomycosis and whose external auditory canal secretions were positive for fungi. Funnel plots were used to detect bias, and the Q test was used to assess heterogeneity. The random-effects model was used for meta-analysis. The t-test was used to assess significance.Results: Of the 324 non-duplicate studies screened, 16 studies met the criteria for full-text review, and 7 were included in the meta-analysis. Four studies reported recovery conditions (P = 0.01). Six common complications after medication use were compared, and there were no significant differences. The authors further conducted subgroup analysis according to complications. The differences in the rates of ear distension (P = 0.007), earache (P = 0.03) and tinnitus (P = 0.003) were statistically significant.Conclusion: The results of this meta-analysis and literature review showed that antifungal drugs and traditional antiseptic medication were effective in relieving symptoms in patients with otomycosis, and the two treatments were associated with different complications. Otolaryngologists have the option to use one medication or a combination of two drugs on the basis of the condition. Future research in this area should include RCTs with long-term follow-up to guide the development of otomycosis guidelines to overcome some of the weaknesses found in the literature.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#myprospero.

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Talent transfer: A systematic review

Current Issues in Sport Science (CISS) ◽

10.36950/2021ciss006 ◽

2021 ◽

Vol 6 ◽

pp. 006

Author(s):

Karlijn Van Harten ◽

Kayan Bool ◽

Janiek Van Vlijmen ◽

Marije Elferink-Gemser

Keyword(s):

Systematic Review ◽

Psychological Factors ◽

High Performance ◽

Fast Track ◽

Alternative Pathway ◽

Future Research ◽

Determining Factors ◽

Full Text Review ◽

Elite Level ◽

Meta Analyses

Background: The effectiveness of traditional talent development (TD) programs can be questioned. Meanwhile, an extra pathway to the top has made its appearance: Talent transfer (TT). The aim of TT is to fast-track talented athletes into the high-performance environment. The first TT initiatives and studies exploring the TT process have been carried out. Objective: This systematic review gives an overview of studies examining TT, by situating TT within the developmental framework, comparing formal and informal TT and investigating the similarities between donor and transfer sports in TT from elite and non-elite level. Methods: A search was conducted on the PubMed and PsychINFO databases. The analysis was done according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) statement. Results: After screening on title and abstract and full-text review, five studies remained for inclusion. Although literature is still scarce, results show that TT can serve as an alternative pathway in addition to the traditional TD programs. Literature suggests that similarities between donor and transfer sports are helpful, but this is not a prerequisite for TT. Besides, psychological factors are perceived to play an important role. Results regarding other determining factors of TT are still lacking. Athletes, national governing bodies and TD programs might benefit from this additional pathway, but the effectiveness of formal and informal TT remains unclear. Conclusion: A lot remains unknown about TT, hence future research is needed to increase our understanding of TT and its contribution as an extra pathway to the top.

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Computerized Clinical Decision Support Systems for Early Detection of Sepsis Among Adult Inpatients: a Scoping Review (Preprint)

10.2196/preprints.31083 ◽

2021 ◽

Author(s):

Khalia Ackermann ◽

Jannah Baker ◽

Malcolm Green ◽

Mary Fullick ◽

Hilal Varinli ◽

...

Keyword(s):

Decision Support ◽

Early Detection ◽

Patient Outcomes ◽

Clinical Decision Support ◽

Scoping Review ◽

Full Text ◽

Clinical Decision ◽

Future Research ◽

Eligibility Criteria ◽

Full Text Screening

BACKGROUND Sepsis is a significant cause of morbidity and mortality worldwide. Early detection of septic patients followed by rapid treatment initiation improves patient outcomes and saves lives. Hospitals are increasingly utilizing computerized clinical decision support (CCDS) systems for the rapid identification of adult septic patients. OBJECTIVE This scoping review aimed to systematically describe studies reporting on the use and evaluation of CCDS systems for early detection of adult sepsis inpatients. METHODS The protocol for this scoping review has been previously published. Ten electronic databases (MEDLINE, Embase, CINAHL, The Cochrane database, LILACS, Scopus, Web of Science, OpenGrey, clinicaltrials.gov, and PQDT) were comprehensively searched to identify relevant studies. Title, abstract, and full-text screening were performed by two independent reviewers using predefined eligibility criteria. Data charting was performed by one reviewer with a second reviewer double checking a random sample of studies. Any disagreements were discussed with input from a third reviewer. In this review we present the results for adult inpatients, including studies that do not specify patient age. RESULTS A search of the electronic databases retrieved 12139 studies following duplicate removal. We identified 124 studies for inclusion after title, abstract, full-text screening, and hand-searching were complete. Nearly all studies (n=121, 97.6%) were published after 2009. Half the studies were journal articles (n=65), and the remainder were conference abstracts and theses (n=54 and 5 respectively). Most studies used a single cohort (n=54; 43.5%) or before-after (n=42; 33.9%) approach. Of all 124 included studies, patient outcomes were the most frequently reported outcomes (n=107; 86.3%), followed by sepsis treatment and management (n=75; 60.5%), CCDS usability (n=14; 11.3%), and cost outcomes (n=9; 7.3%). For sepsis identification, the systemic inflammatory response syndrome (SIRS) criteria were the most commonly used, either alone (n=50; 40.3%), combined with organ dysfunction (n=28; 22.6%) or combined with other criteria (n=23; 18.5%). Over half of the CCDS systems (n=68; 54.8%) were implemented alongside other sepsis-related interventions. CONCLUSIONS The current body of literature investigating the implementation of CCDS systems for the early detection of adult sepsis inpatients is extremely diverse. There is substantial variability in study design, CCDS criteria and characteristics, and outcomes measured across the identified literature. Future research on CCDS system usability, cost, and impact on sepsis morbidity is needed. INTERNATIONAL REGISTERED REPORT RR2-10.2196/24899

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P093: Quality assurance programs for tests pending at discharge from emergency departments: a systematic review

CJEM ◽

10.1017/cem.2019.284 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S97

Author(s):

J. Mikhaeil ◽

H. Jalali ◽

A. Orchanian-Cheff ◽

L. Chartier

Keyword(s):

Systematic Review ◽

Quality Assurance ◽

Full Text ◽

Safety Concern ◽

Rapid Assessment ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Full Text Review ◽

Medical Librarian

Introduction: Emergency department (ED) care allows for the rapid assessment of patient concerns, but often leads to tests being performed that are not finalized or reviewed prior to patients leaving the ED. The follow-up for these tests pending at discharge (TPADs), most commonly final diagnostic imaging (DI) reports and microbiology cultures, is a major medico-legal concern for ED providers and significant safety concern for patients. We therefore performed a systematic review of the literature to identify existing ED quality assurance (QA) processes to address TPADs relating to final DI reports and microbiology cultures. Methods: Comprehensive literature searches were developed with a medical librarian and conducted in Ovid Medline, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL from inception through May 8, 2018. Studies were included if they described an intervention or program designed to follow-up relevant ED TPADs, and excluded if they pertained to communication between departments or clinicians only rather than with patients. Study selection was performed independently by two reviewers in two steps (title and abstract review, then full-text review), with all discrepancies resolved by consensus with a senior reviewer. The primary outcome was the description of any QA process to follow-up on TPADs and secondary outcomes included quantifiable results of successful interventions or programs. Results: From the 11,685 articles identified, 58 were selected for full-text review, and 12 met eligibility criteria. In the included studies, the responsibility for following up on TPADs was owned by different members of the care team (e.g., ED physicians, nurses or radiologists) and recorded in a variety of ways (e.g., electronic medical record, paper chart, system designed for TPADs). Follow-up pathways with variable standardization were described, ranging from dedicated assignment for TPAD duties with protected/remunerated time to do so, to follow-up completion done by the first clinician to receive the TPAD result. Studies that evaluated their QA process implementation found that more patients were notified of abnormal test results, follow-up times decreased, and fewer unnecessary antibiotics were used. Conclusion: A variety of QA processes have been implemented to follow up on ED TPADs in terms of personnel involved, charting and logistics, and when evaluated, they have improved patient care.

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The Impact of Bisphenol A on Thyroid Function in Neonates and Children: A Systematic Review of the Literature

Nutrients ◽

10.3390/nu14010168 ◽

2021 ◽

Vol 14 (1) ◽

pp. 168

Author(s):

Diamanto Koutaki ◽

George Paltoglou ◽

Aikaterini Vourdoumpa ◽

Evangelia Charmandari

Keyword(s):

Systematic Review ◽

Bisphenol A ◽

Thyroid Function ◽

Full Text ◽

Current Knowledge ◽

Thyroid Autoimmunity ◽

Future Research ◽

Cochrane Central Register ◽

Cross Sectional ◽

The Impact

Background: Bisphenol A (BPA) is an endocrine-disrupting chemical widely used in plastic products that may have an adverse effect on several physiologic functions in children. The aim of this systematic review is to summarize the current knowledge of the impact of BPA concentrations on thyroid function in neonates, children, and adolescents. Methods: A systematic search of Medline, Scopus, Clinical Trials.gov, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases according to PRISMA guidelines was performed. Only case–control, cross-sectional, and cohort studies that assessed the relationship between Bisphenol A and thyroid function in neonates and children aged <18 years were included. Initially, 102 articles were assessed, which were restricted to 73 articles after exclusion of duplicates. A total of 73 articles were assessed by two independent researchers based on the title/abstract and the predetermined inclusion and exclusion criteria. According to the eligibility criteria, 18 full-text articles were selected for further assessment. Finally, 12 full-text articles were included in the present systematic review. Results: The presented studies offer data that suggest a negative correlation of BPA concentrations with TSH in children, a gender-specific manner of action, and a potential effect on proper neurodevelopment. However, the results are inconclusive with respect to specific thyroid hormone concentrations and the effect on thyroid autoimmunity. Conclusion: The potential negative effect of BPA in the developing thyroid gland of children that may affect proper neurodevelopment, suggesting the need to focus future research on designing studies that elucidate the underlying mechanisms and the effects of BPA in thyroid function in early life.

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TBE in Italy

Tick-borne encephalitis - The Book ◽

10.33442/26613980_12b15-3 ◽

2020 ◽

Keyword(s):

Surveillance System ◽

Ad Hoc ◽

National Level ◽

Case Series ◽

Incidence Rates ◽

Mountainous Regions ◽

North East ◽

The North ◽

Tick Borne Encephalitis ◽

Low Incidence

Italy is considered a low-incidence country for tick-borne encephalitis (TBE) in Europe.1 Areas at higher risk for TBE in Italy are geographically clustered in the forested and mountainous regions and provinces in the north east part of the country, as suggested by TBE case series published over the last decade.2-5 A national enhanced surveillance system for TBE has been established since 2017.6 Before this, information on the occurrence of TBE cases at the national level in Italy was lacking. Both incidence rates and the geographical distribution of the disease were mostly inferred from endemic areas where surveillance was already in place, ad hoc studies and international literature.1

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Chasing the Anchor: A Systematic Review and Meta-analysis of Perceptual Anchoring Deficits in Developmental Dyslexia

10.31234/osf.io/amzpj ◽

2020 ◽

Author(s):

Kurt D Shulver ◽

Nicholas A Badcock

Keyword(s):

Systematic Review ◽

Reading Ability ◽

English Language ◽

Prediction Interval ◽

Meta Analysis ◽

Visual Assessment ◽

Individual Performance ◽

Future Research ◽

Significant Heterogeneity ◽

Eligibility Criteria

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.

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