scholarly journals Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018568 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Luke Testa ◽  
Gina Lamprell ◽  
Jessica Herkes ◽  
Kristiana Ludlow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Health Systems ◽  
Full Text ◽  
English Language ◽  
Secondary Data ◽  
Primary Data ◽  
Change Strategies ◽  
Screening Process ◽  
Sustainable Health

IntroductionThe sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system.Methods and analysisThe protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies.Ethics and disseminationAs no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems.

scholarly journals Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Keely Jordan ◽  
Todd P. Lewis ◽  
Bayard Roberts
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Health Systems ◽  
Point Of Care ◽  
System Level ◽  
System Quality ◽  
High Quality ◽  
Humanitarian Settings ◽  
Quality Health

Abstract Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.

scholarly journals A systematic review of the effects of nicotine replacement therapy on agitation among nicotine-dependent psychiatric inpatients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S296-S296
Author(s):  
Joseph Toms ◽  
Jacob King
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Controlled Trial ◽  
Psychiatric Inpatients ◽  
Cochrane Collaboration ◽  
Search Strategies ◽  
Primary Data ◽  
Psychiatric Admission ◽  
Cross Sectional ◽  
Nicotine Replacement

AimsThis systematic review aims to evaluate the effect of nicotine replacement therapies (NRTs) on measures of agitation amongst nicotine-dependent adult psychiatric inpatients.BackgroundSince the introduction of the smoke-free policy for all psychiatric facilities, a psychiatric admission is likely to upset a nicotine-dependent individual's normal routine of nicotine consumption. In addition to the physiological effects of nicotine withdrawal (NW), the interpersonal dynamic which nurse-led guardianship of nicotine products constructs presents stressors to the nicotine dependent patient.Several systematic reviews evaluating changes in objective measures of agitation amongst smoking patients in medical critical care units have found varied results, with some demonstrating worsening agitation with NRT use. We therefore believe that there is sufficient equipoise in the use of NRT to prompt a review of studies amongst psychiatric inpatients.MethodThis review identified English language studies through developed search strategies in PubMed/MEDLINE, EMBASE, PyschINFO, PSYCHLit, Cochrane databases, and Google scholar. The bibliographies of notable papers were explored. Hand searches of five major psychiatric journals were conducted. Peer reviewed studies of any study design were included if they reported primary data of adult psychiatric inpatients. Studies were extracted from 1990 – present, this was felt appropriate as nicotine replacement patches became available in 1992.Search strategies were informed by MeSH search terms and included multiple conceptions of “agitation”, including variations on; agitation, irritability, and arousal to capture the concept from broad academic constructions. The quality of studies was assessed with the Newcastle-Ottawa and Cochrane Collaboration tools.This review follows PRISMA guidelines, and an application for PROSPERO registration has been submitted pending acceptance.ResultTwo studies were identified which matched inclusion criteria. A double-blinded randomised placebo-controlled trial of 40 nicotine-dependent inpatients from Allen et al. reported a significant 23% reduction in Agitated Behaviour Scores at 24 hours following NRT administration on admission compared to their matched placebo controls. Yet a retrospective cross-sectional analysis from Okoli using scores for NW identified more severe withdrawal symptoms including “restlessness” and “anger/irritability” than nicotine-dependent patients not provided with NRT.ConclusionDespite considerable commentary within literature there is presently only one study providing moderate evidence of a positive benefit to measures of agitated behaviour from the use of NRT amongst nicotine-dependent psychiatric inpatients. There is currently very low evidence whether NRT improves or exacerbates the agitation associated with NW amongst nicotine-dependent psychiatric inpatients.

Care of the Postpartum Patient in the Emergency Department: A Systematic Review with Implications for Maternal Mortality

2021 ◽  
Author(s):  
Kellie A. Mitchell ◽  
Alison J. Haddock ◽  
Hamad Husainy ◽  
Lauren A. Walter ◽  
Indranee Rajapreyar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Maternal Mortality ◽  
Social Services ◽  
Full Text ◽  
Postpartum Period ◽  
English Language ◽  
Case Reports ◽  
Private Insurance ◽  
Maternal Deaths

Objective Approximately one-third of maternal deaths occur postpartum. Little is known about the intersection between the postpartum period, emergency department (ED) use, and opportunities to reduce maternal mortality. The primary objectives of this systematic review are to explore the incidence of postpartum ED use, identify postpartum disease states that are evaluated in the ED, and summarize postpartum ED use by race/ethnicity and payor source. Study Design We searched PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov, Cochrane CENTRAL, Social Services Abstracts, and Scopus from inception to September 19, 2019. Each identified abstract was screened by two authors; the full-text manuscripts of all studies deemed to be potential candidates were then reviewed by the same two authors and included if they were full-text, peer-reviewed articles in the English language with primary patient data reporting care of a female in the ED in the postpartum period, defined as up to 1 year after the end of pregnancy. Results A total of 620 were screened, 354 records were excluded and 266 full-text articles were reviewed. Of the 266 full-text articles, 178 were included in the systematic review; of these, 108 were case reports. Incidence of ED use by postpartum females varied from 4.8 to 12.2% in the general population. Infection was the most common reason for postpartum ED evaluation. Young females of minority race and those with public insurance were more likely than whites and those with private insurance to use the ED. Conclusion As many as 12% of postpartum women seek care in the ED. Young minority women of lower socioeconomic status are more likely to use the ED. Since approximately one-third of maternal deaths occur in the postpartum period, successful efforts to reduce maternal mortality must include ED stakeholders. Systematic Review Registration CRD42020151126. Key Points

scholarly journals The Efficiency of Health Systems in Response to the COVID-19 Pandemic: Evidence from the EU Countries

2022 ◽  
Vol 17 (1) ◽  
pp. 7-15
Author(s):  
Tamara Rađenović ◽  
◽  
Vladimir Radivojević ◽  
Bojan Krstić ◽  
Tanja Stanišić ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
International Health ◽  
Secondary Data ◽  
The European Union ◽  
Health Security ◽  
Eu Countries ◽  
Public Health Emergencies ◽  
Comprehensive Health ◽  
The Eu

The COVID-19 pandemic has revealed the insufficient capacities and capabilities of countries around the world to deal with global infectious diseases and stressed the need to improve the international health security frame-work. An efficient and comprehensive health system that is able to cope with public health emergencies is an essential prerequisite for strengthening health security. The paper analyzes the efficiency of health systems in the European Union (EU) countries and their responsiveness to the COVID-19 pandemic. The research covers 27 EU countries and it is based on the secondary data contained in the 2019 Global Health Security Index Re-port. The aim of the paper is to identify key determinants for improving the efficiency of health systems in the EU, as well as to examine the interdependence between health expenditures and the efficiency of health system in this sample of countries. The research is conducted through descriptive statistics and correlation and regression analysis. The conclusions can be useful for the EU policy makers in formulating a strategy to improve the efficiency of Member States’ health systems and preparedness for possible new pandemics.

scholarly journals Artificial Intelligence Techniques: Analysis, Application, and Outcome in Dentistry—A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Naseer Ahmed ◽  
Maria Shakoor Abbasi ◽  
Filza Zuberi ◽  
Warisha Qamar ◽  
Mohamad Syahrizal Bin Halim ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Full Text ◽  
Patient Management ◽  
English Language ◽  
Clinical Performance ◽  
Research Question ◽  
Time Saving ◽  
Artificial Intelligence Techniques ◽  
Clinical Scenarios

Objective. The objective of this systematic review was to investigate the quality and outcome of studies into artificial intelligence techniques, analysis, and effect in dentistry. Materials and Methods. Using the MeSH keywords: artificial intelligence (AI), dentistry, AI in dentistry, neural networks and dentistry, machine learning, AI dental imaging, and AI treatment recommendations and dentistry. Two investigators performed an electronic search in 5 databases: PubMed/MEDLINE (National Library of Medicine), Scopus (Elsevier), ScienceDirect databases (Elsevier), Web of Science (Clarivate Analytics), and the Cochrane Collaboration (Wiley). The English language articles reporting on AI in different dental specialties were screened for eligibility. Thirty-two full-text articles were selected and systematically analyzed according to a predefined inclusion criterion. These articles were analyzed as per a specific research question, and the relevant data based on article general characteristics, study and control groups, assessment methods, outcomes, and quality assessment were extracted. Results. The initial search identified 175 articles related to AI in dentistry based on the title and abstracts. The full text of 38 articles was assessed for eligibility to exclude studies not fulfilling the inclusion criteria. Six articles not related to AI in dentistry were excluded. Thirty-two articles were included in the systematic review. It was revealed that AI provides accurate patient management, dental diagnosis, prediction, and decision making. Artificial intelligence appeared as a reliable modality to enhance future implications in the various fields of dentistry, i.e., diagnostic dentistry, patient management, head and neck cancer, restorative dentistry, prosthetic dental sciences, orthodontics, radiology, and periodontics. Conclusion. The included studies describe that AI is a reliable tool to make dental care smooth, better, time-saving, and economical for practitioners. AI benefits them in fulfilling patient demand and expectations. The dentists can use AI to ensure quality treatment, better oral health care outcome, and achieve precision. AI can help to predict failures in clinical scenarios and depict reliable solutions. However, AI is increasing the scope of state-of-the-art models in dentistry but is still under development. Further studies are required to assess the clinical performance of AI techniques in dentistry.

scholarly journals Oral Microbiome Response to Powered vs Manual Toothbrush: Protocol for a Systematic Review & Meta-Analysis

2020 ◽  
Author(s):  
Abanoub Riad ◽  
Jitka Klugarova ◽  
Veronika Chuchmova ◽  
Simona Slezakova ◽  
Andrea Pokorna ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Oral Microbiome ◽  
Primary Data ◽  
Cochrane Library ◽  
Process Data ◽  
Post Intervention ◽  
Screening Process ◽  
Study Results

Abstract Background: Subclinical changes in response to different types of toothbrushes represent a challenging knowledge gap in the context of self-administered oral hygiene regimes; therefore, this systematic review will be the first to evaluate the oral microbiome response to powered versus manual toothbrushes.Methods: We will conduct a systematic review using the Cochrane Handbook’s guidelines and will adhere to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy will be conducted in the following databases for published studies: Ovid MEDLINE(R), EMBASE, Cochrane Library, Web of Science, Scopus, ProQuest Central, ProQuest Dissertations Theses Global, Bibliographia Medica Cechoslovaca, and Dentistry Oral Sciences Source. Following a two-level screening process, data including the full reference, objectives, target population, description of the intervention and control intervention, outcome measures, design, length of the post-intervention follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed.Discussion: No primary data collection will be undertaken; therefore, no formal ethical assessment is required. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.Registration: The protocol has been registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42020153557) since April 28th, 2020.

scholarly journals Everywhere is Nowhere: A Systematic Review of Menstrual Health and Hygiene Management (MHHM) as a Human Right

2020 ◽  
Author(s):  
Suruchi Sood ◽  
Sarah Stevens ◽  
Maho Okumura ◽  
Astha Ramaiya ◽  
Michael Hauer
Keyword(s):  
Systematic Review ◽  
Human Rights ◽  
Full Text ◽  
Child Protection ◽  
English Language ◽  
Grey Literature ◽  
Hygiene Management ◽  
Sanitation And Hygiene ◽  
Menstrual Health ◽  
Rights Issue

Abstract Background: In many countries, stigma surrounds menstruation, which impacts several Sustainable Development Goals, including good health, quality education, gender equality, and water and sanitation. Despite its relationship with several development issues, menstrual health and hygiene management among adolescents has until recently been ignored by practitioners and researchers. This paper is a systematic review of existing literature and argues that menstrual health and hygiene management is a human rights issue, cross-cutting through development domains of health, education, nutrition, child protection, and water, sanitation, and hygiene. Methods: Four coders independently screened PubMed, Academic OneFile, and Google Scholar to obtain articles using iterations of the key terms: menstrual health; adolescents; health outcomes; education; nutrition; water, sanitation, and hygiene; and child protection. English language primary studies in peer-reviewed or grey literature articles published after 2000, that mentioned adolescents, health or hygiene, and menstruation or menstrual were included. A 9-item scale was used to rate selected full-text articles as strong, moderate, or weak. Synthesis of the results were narrative and examined the relationships between menstrual health and hygiene management and the cross-cutting domains.Results: In total, 28,745 articles were screened, with 84 articles included in the full-text review and quality assessment. Nine articles were coded as “strong” (10.8%), 46 (55.4%) as “moderate,” and 28 (33.7%) as “weak.” More than 60% of the articles examined the relationship between menstrual health and hygiene management and health (37.3%) or water, sanitation, and hygiene (25.3%). Only 11 manuscripts examined menstrual health and hygiene management as a cross-cutting issue impacting more than one development domain.Conclusions: Access to adequate facilities and menstrual health and hygiene management resources are the most common relationships documented within literature. However, there is little focus on menstrual health and hygiene management in the context of other development domains, highlighting the fact that poor menstrual health and hygiene management has not been studied as a human rights issue, negatively impacting millions of girls. Using a cross-cutting, human rights framework to address inadequate menstrual health and hygiene management is fundamental to promoting menstrual health and hygiene management with dignity among girls and women across the globe.

scholarly journals The “Sustainability Doctrine” in Donor-Driven Maternal Health Programs in Tanzania

2022 ◽  
pp. 73-91
Author(s):  
Meredith G. Marten
Keyword(s):  
Health System ◽  
Health Systems ◽  
Newborn Care ◽  
Health System Strengthening ◽  
Respectful Maternity Care ◽  
Health Issues ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Sustainable Health

AbstractStrengthening health systems to provide equitable, sustainable health care has been identified as essential for improving maternal and reproductive health. Many donors and non-governmental organizations (NGOs) have contributed to undermining health system strengthening, however, through adhering to what Swidler and Watkins call the “sustainability doctrine,” policies that prioritize time-limited, targeted interventions best suited for short-term funding streams, rather than the long-term needs of local populations. This chapter presents ethnographic data from semi-structured and key informant interviews with 16 policymakers and NGO directors in Dar es Salaam, Tanzania from 2011 to 2012. I illustrate how sustainability doctrine policies were put into practice, and how they have persisted, despite their shortcomings, using examples of donor-prioritized maternal healthcare initiatives in Tanzania rolled-out several years apart: prevention of mother-to-child transmission of HIV (PMTCT) and basic emergency obstetric and newborn care (BEmONC) programs in the late 2000s, and more recent efforts to implement respectful maternity care (RMC) programs. I focus on several issues informants identified as crippling efforts to build strong health systems, particularly the internal brain drain of healthcare workers from the public sector to higher-paying NGO jobs, and the prioritization of types of programs donors believed could be sustained after the funding period ended, specifically trainings and workshops. I describe how despite these issues, international organizations still design and implement less effective programs that often fail to account for local circumstances in their efforts to solve some of the more intractable health issues facing Tanzania today, in particular, the country’s stagnating maternal mortality rate. In this chapter, I argue that practices promoted and implemented under the guise of “sustainability” in policy papers and reports generated by donors paradoxically contribute to health system precarity in Tanzania.

scholarly journals Kitab Shahih Bukhari (Kajian Tentang Identitas dan Relevansinya Dengan Fase Kodifikasi Hadis)

2021 ◽  
Vol 14 (2) ◽  
pp. 92-99
Author(s):  
Nurcahaya Nurcahaya
Keyword(s):  
Islamic Law ◽  
Secondary Data ◽  
Data Sources ◽  
Primary Data ◽  
Journal Articles ◽  
Screening Process ◽  
Analysis Techniques ◽  
Library Research ◽  
Data Source ◽  
Secondary Data Sources

This study aims to describe the book of Sahih Bukhari and the background of the codification phase of Hadith. This research uses qualitative research methods based on library research (Library Research). Sources of data in this study consisted of primary data sources and secondary data sources. The primary data source in this study is the Sahih Bukhari book written by Imam al-Bukhari, while the secondary data sources are books and journal articles related to the codification phase of hadith. Data analysis used content analysis techniques, namely by deepening the meaning in the literature quotations used. The results showed that the Sahih Bukhari book was the first book compiled containing the Hadiths of the Prophet Muhammad. This book was written in a period of approximately 16 years through a very strict screening process from 600,000 Hadith which resulted in 7,397 Hadiths contained in the book. With regard to the book, the birth of the Hadith codification movement during the era of Imam Bukhari was the dynamics of Islamic law, particularly the influence of Imam Syafi'i. In the period before Imam Syafi'i formulated a system of law making as contained in the ar-Risalah.

scholarly journals Impact of adult weight management interventions on mental health: a systematic review and meta-analysis protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031857
Author(s):  
Rebecca A Jones ◽  
Emma R Lawlor ◽  
Simon J Griffin ◽  
Esther M F van Sluijs ◽  
Amy L Ahern
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Weight Loss ◽  
Weight Management ◽  
English Language ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Primary Data ◽  
Management Interventions ◽  
The Impact

IntroductionThe effects of interventions targeting weight loss on physical health are well described, yet the evidence for mental health is less clear. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm. We will assess the effect of behavioural weight management interventions on mental health in adults with overweight and obesity.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We will include behavioural weight management interventions with a diet and/or physical activity component focusing on weight loss for adults with a body mass index ≥25 kg/m2. Randomised controlled trials (RCTs) and cluster RCTs will be the only eligible study designs. Outcomes of interest will be related to mental health. The following databases were searched from inception to 07 May 2019: MEDLINE, Embase, Cochrane database (CENTRAL), PsycINFO, ASSIA, AMED and CINAHL. The search strategy was based on four concepts: (1) adults, defined as ≥18 years, with overweight/obesity, defined as BMI ≥25kg/m², (2) weight management interventions, (3) mental health outcomes and (4) study design. The search was restricted to English-language published papers, with no other restrictions applied. Two stage screening for eligibility will be completed by two independent reviewers, with two independent reviewers completing data extraction and risk of bias assessment. Data permitting, a random-effects meta-analysis of outcomes, subgroup analyses and meta-regression will be conducted. If not appropriate, narrative synthesis and ‘levels of evidence’ assessment will be completed.Ethics and disseminationEthical approval is not required as primary data will not be collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences and contribute towards the lead author’s PhD thesis.PROSPERO registration numberCRD42019131659.

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