scholarly journals Effects of medical and non-medical cannabis use in older adults: protocol for a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034301
Author(s):  
Dianna Wolfe ◽  
Kimberly Corace ◽  
Danielle Rice ◽  
Andra Smith ◽  
Salmaan Kanji ◽  
...  

IntroductionWith its legalisation and regulation in Canada in 2018, the proportion of Canadians reporting cannabis use in 2019 increased substantially over the previous year, with half of new users being aged 45+ years. While use in older adults has been low historically, as those born in the 1950s and 1960s continue to age, this demographic will progressively have more liberal attitudes, prior cannabis exposure and higher use rates. However, older adults experience slower metabolism, increased likelihood of polypharmacy, cognitive decline and chronic physical/mental health problems. There is a need to enhance knowledge of the effects of cannabis use in older adults. The following question will be addressed using a scoping review approach: what evidence exists regarding beneficial and harmful effects of medical and non-medical cannabis use in adults >50 years of age? Given that beneficial and harmful effects of cannabis may be mediated by patient-level (eg, age, sex and race) and cannabis-related factors (eg, natural vs synthetic, consumption method), subgroup effects related to these and additional factors will be explored.Methods and analysisMethods for scoping reviews outlined by Arksey & O’Malley and the Joanna Briggs Institute will be used. A librarian designed a systematic search of the literature from database inception to June 2019. Using the OVID platform, Ovid MEDLINE will be searched, including Epub Ahead of Print and In-Process and Other Non-Indexed Citations, Embase Classic+Embase, and PsycINFO for reviews, randomised trials, non-randomised trials and observational studies of cannabis use. The Cochrane Library on Wiley will also be searched. Eligibility criteria will be older adult participants, currently using cannabis (medical or non-medical), with studies required to report a cannabis-related health outcome to be eligible. Two reviewers will screen citations and full texts, with support from artificial intelligence. Two reviewers will chart data. Tables/graphics will be used to map evidence and identify evidence gaps.Ethics and disseminationThis research will enhance awareness of existing evidence addressing the health effects of medical and non-medical cannabis use in older adults. Findings will be disseminated through a peer-reviewed publication, conference presentations and a stakeholder meeting.Trial registration numberDOI 10.17605/OSF.IO/5JTAQ.

2021 ◽  
Vol 4 ◽  
pp. 62
Author(s):  
Lamya Al Shuhaimi ◽  
Martin Henman ◽  
Philip McCallion ◽  
Mary McCarron ◽  
Maire O'Dwyer

Background: Older adults with intellectual disability often take multiple medicines with anticholinergic activity and sedative properties to manage multi-morbidity; the use of medication with anticholinergic activity has been found to be associated with various cognitive and physical impairments. However, there are limited studies that have examined the long-term impact of anticholinergic use among older adults. Therefore, this protocol is designed to conduct a scoping review to examine the available data on the long-term impact of anticholinergic use in older adults with intellectual disability. Aim and objectives:  The aim of this scoping review is to a) map and b) examine the existing research literature to answer the research question: What is the impact on cognitive and physical outcomes of long-term exposure to medications with anticholinergic activity among older adults with intellectual disabilities? Methods and analysis: This scoping review will follow the methodology framework of Arksey and O’Malley and its developed version by Levac. The framework consists of a six-stage process to be conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) reporting guidelines. The search strategy will include the following electronic data bases: Pubmed, Cochrane library, EMBASE, Medline, Science Direct, CINAHL Complete and PsycINFO. The search will include terms related to ‘Anticholinergic burden’, ‘Intellectual disability’, ‘Adverse drug reaction’ and ‘long-term impact’ with Boolean operator ‘and’. The scoping review will include studies with at least 3 months exposure to anticholinergics. The collected data will be mapped as a tabular presentation of the various physical and cognitive adverse effects associated with long-term use of anticholinergics in this group of population.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
M. F. Van den Bosch ◽  
C. M. Wiepjes ◽  
M. Den Heijer ◽  
L. J. Schoonmade ◽  
R. E. G. Jonkman ◽  
...  

Abstract Background Gender-affirming hormone (GAH) therapy aims to support the transition of transgender people to their gender identity. GAHs can induce changes in their secondary sex characteristics such as the development of breasts in transgender females and increased muscle mass in transgender males. The face and its surrounding tissues also have an important role in gender confirmation. The aim of this scoping review is to systematically map the available evidence in order to provide an overview of the effects of GAH therapy on the hard and soft tissues of the craniofacial complex in transgender people. Methods/design The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) extension for Scoping Reviews was consulted for reporting this protocol. The methods were based on the Arksey and O’Malley’s framework and the Reviewer’s Manual of the Joanna Briggs Institute for conducting scoping reviews. Ten transgender people were involved in the development of the primary research question through short interviews. The eligibility criteria were defined for transgender people undergoing GAH therapy and for quantitative and qualitative outcomes on the hard and soft tissues of the craniofacial complex. Eligible sources of evidence include observational, experimental, qualitative, and mixed method studies. No exclusion criteria will be applied for the language of publication and the setting. To identify eligible sources of evidence, we will conduct searches from inception onwards in PubMed, Embase.com, the Cochrane Library, Web of Science Core Collection, Scopus, CINAHL, LIVIVO, and various grey literature sources such as Google Scholar. Two reviewers will independently select eligible studies in these information sources and will subsequently conduct data extraction. The same operators will chart, categorize, and summarize the extracted data. A narrative summary of findings will be conducted. Frequency counts of quantitative and qualitative data on items such as concepts, populations, interventions, and other characteristics of the eligible sources will be given. Where possible, these items will be mapped descriptively. Discussion We chose the scoping review over the systematic review approach, because the research questions are broad-spectrum and the literature is expected to be widely scattered. No systematic review has previously assessed this topic. Identifying knowledge gaps in this area and summarizing and disseminating research findings are important for a wide spectrum of stakeholders, in particular, for transgender people who want to undergo additional interventions such as plastic or orthognathic surgery or orthodontics. Systematic review registration This protocol was registered in the Open Science Framework: https://osf.io/e3qj6


2021 ◽  
pp. 155982762110012
Author(s):  
Fei-Chi Yang ◽  
Aishwarya B. Desai ◽  
Pelareh Esfahani ◽  
Tatiana V. Sokolovskaya ◽  
Doreen J. Bartlett

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.


2021 ◽  
pp. 105413732199581
Author(s):  
Patricia Moyle Wright

A scoping review of parental bereavement in older age was conducted to identify the unique needs of older adults after the loss of an adult child. Inclusion and exclusion criteria were developed in accordance with the stated objectives of this review, which was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). In total, 26 research studies were included. The data were then analyzed using a systematic approach for organizing and synthesizing key data. The results indicated that some consequences and mediators of parental bereavement are similar regardless of age. But, older adults experience greater loneliness, isolation, and stigma than their younger counterparts. Older parents are also at greater risk for physical decline, mortality, and institutionalization following the death of an adult child. Religious and cultural mores also have influence on the bereavement process.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041894
Author(s):  
Joyce Kibaru ◽  
Pinky Kotecha ◽  
Abdulkarim Muhammad Iya ◽  
Beth Russell ◽  
Muzzammil Abdullahi ◽  
...  

IntroductionBladder cancer (BC) is the 10th common cancer worldwide and ranks seventh in Nigeria. This scoping review aims to identify the gaps in clinical care and research of BC in Nigeria as part of the development of a larger national research programme aiming to improve outcomes and care of BC.Methods and analysisThis review will be conducted according to Arksey and O’Malley scoping review methodology framework. The following electronic databases will be searched: Medline (using the PubMed interface), Ovid Gateway (Embase and Ovid), Cochrane library and Open Grey literature. Two independent reviewers will screen titles and abstracts and subsequently screen full-text studies for inclusion, any lack of consensus will be discussed with a third reviewer. Any study providing insight into the epidemiology or treatment pathway of BC (RCTs, observations, case series, policy paper) will be included. A data chart will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A consultation process will be carried out with a multidisciplinary team of Nigerian healthcare professionals, patients and scientists.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. By highlighting the key gaps in the literature, this review can provide direction for future research and clinical guidelines in Nigeria (and other low-income and middle-income countries), where BC is more prevalent due to local risk factors and healthcare settings.


2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i23-i24
Author(s):  
M Murphy ◽  
K Bennett ◽  
S Ryan ◽  
C Hughes ◽  
A Lavan ◽  
...  

Abstract Introduction Older adults with cancer often require multiple medications (polypharmacy) comprising cancer-specific treatments, supportive care medications (e.g. analgesics) and medications for pre-existing conditions. The reported prevalence of polypharmacy in older adults with cancer ranges from 13–92% (1). Increasing numbers of medications pose risks of potentially inappropriate prescribing and medication non-adherence. Aim The aim of this scoping review was to provide an overview of evaluations of interventions to optimise medication prescribing and/or adherence in older adults with cancer, with a particular focus on the interventions, study populations and outcome measures that have been assessed in previous evaluations. Methods Four databases (PubMed, EMBASE, CINAHL, PsycINFO) were searched from inception to 29th November 2019 using relevant search terms (e.g. cancer, older adults, prescribing, adherence). Eligible studies evaluated interventions seeking to improve medication prescribing and/or adherence in older adults (≥65 years) with an active cancer diagnosis using a comparative evaluation (e.g. inclusion of a control group). All outcomes for studies that met inclusion criteria were included in the review. Two reviewers independently screened relevant abstracts for inclusion and performed data extraction. As a scoping review aims to provide a broad overview of existing literature, formal assessments of methodological quality of included studies were not undertaken. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines (2). Results The electronic searches yielded 21,136 citations (Figure 1). Nine studies met inclusion criteria. Included studies consisted of five randomised controlled trials (RCTs), including one cluster RCT, and four before-and-after study designs. Studies were primarily conducted in oncology clinics, ranging from single study sites to 109 oncology clinics. Sample sizes ranged from 33 to 4844 patients. All studies had a sample population with a mean/median age of ≥65 years, however, only two studies focused specifically on older populations. Interventions most commonly involved patient education (n=6), and were delivered by pharmacists or nurses. Five studies referred to the intervention development process and no studies reported any theoretical underpinning. Three studies reported on prescribing-related outcomes and seven studies reported on adherence-related outcomes, using different terminology and a range of assessments. Prescribing-related outcomes comprised assessments of medication appropriateness (using Beers criteria), drug-related problems and drug interactions. Adherence-related outcomes included assessments of self-reported medication adherence and calculation of patients’ medication possession ratio. Conclusion The main strength of this scoping review is that it provides a broad overview of the existing literature on interventions aimed at optimising medication prescribing and adherence in older adults with cancer. The review highlights a lack of robust studies specifically targeting this patient population and limited scope to pool outcome data across included studies. Limitations of the review were that searches were restricted to English language publications and no grey literature was searched. Future research should focus specifically on older patients with cancer, and exercise rigour during intervention development, evaluation and reporting in order to generate findings that could inform future practice. References 1. Maggiore RJ, Gross CP, Hurria A. Polypharmacy in older adults with cancer. The oncologist. 2010;15(5):507–22. 2. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Mona Vestbøstad ◽  
Klas Karlgren ◽  
Nina Rydland Olsen

Abstract Background Today, there are fewer opportunities for health care students and staff for skills training through direct patient contact. The World Health Organization therefore recommends learning about patient safety through hands-on experience and simulation. Simulation has the potential to improve skills through training in a controlled environment, and simulation has a positive effect on knowledge and skills, and even patient-related outcomes. Reviews addressing the use of simulation across the different radiography specialties are lacking. Further knowledge on simulation in radiography education is needed to inform curriculum design and future research. The purpose of this scoping review is to explore, map, and summarize the extent, range, and nature of published research on simulation in radiography education. Methods We will follow the methodological framework for scoping reviews originally described by Arksey and O’Malley. We will search the MEDLINE, Embase, Epistemonikos, The Cochrane Library, ERIC, Scopus, and sources of grey literature. A comprehensive search strategy for Ovid MEDLINE was developed in collaboration with a research librarian. An example of a full electronic search from the Ovid MEDLINE (1641 articles records, January 9, 2020) is provided and will be used to adapt the search strategy to each database. Two independent review authors will screen all abstracts and titles, and full-text publications during a second stage. Next, they will extract data from each included study using a data extraction form informed by the aim of the study. A narrative account of all studies included will be presented. We will present a simple numerical analysis related to the extent, nature, and distribution of studies, and we will use content analysis to map the different simulation interventions and learning design elements reported. Any type of simulation intervention within all types of radiography specializations will be included. Our search strategy is not limited by language or date of publication. Discussion An overview of publications on simulation in radiography education across all radiography specialties will help to inform future research and will be useful for stakeholders within radiography education using simulation, both in the academic and clinical settings. Systematic review registration Open Science Framework (OSF). Submitted on October 18, 2020


2021 ◽  
Vol 10 (16) ◽  
pp. e444101623459
Author(s):  
Fabiana Helena da Conceição ◽  
Viviani Aparecida Fraga ◽  
Cristiane Aparecida Silveira Monteiro ◽  
Melissa Santos Nassif ◽  
Isabelle Cristinne Pinto Costa

Objetivo: Este estudo tem como objetivo descrever o protocolo e a metodologia usados para realizar uma revisão de escopo que irá mapear as evidências científicas sobre a espiritualidade no contexto dos cuidados paliativos pediátricos. Metodologia: Trata-se de uma revisão de escopo que será desenvolvida conforme as recomendações do Instituto Joanna Briggs (JBI). Para a redação do estudo, será utilizado o PRISMA Extension for Scoping Reviews (PRISMA-ScR). Uma pesquisa abrangente será realizada nas bases de dados Web of Science, Scopus, Cochrane Library, PubMed, CINAHL e EMBASE, além da busca de literatura cinzenta nas bases Google Scholar, ProQuest e OpenGrey, sem limitação quanto ao ano de publicação e idioma. Além disso, será realizada busca adicional de artigos por meio da leitura das referências dos estudos incluídos na revisão. Serão incluídos estudos primários e secundários que abordem a espiritualidade no contexto dos cuidados paliativos pediátricos, independentemente do tipo de delineamento. Serão excluídos documentos do tipo cartas, comentários, editoriais e artigos de opinião. A seleção dos estudos por meio da leitura dos títulos, resumos e texto completo será conduzida por dois revisores independentes. A extração de dados será realizada por meio de formulário construído pelos autores com base nas recomendações do JBI. Os dados serão organizados, resumidos e analisados quanto à extensão, natureza, distribuição e padrões recorrentes e os resultados serão comunicados narrativamente e por meio de mapas de rede. Considerações finais: Espera-se que os resultados provenientes da realização desta revisão de escopo possam contribuir para o fortalecimento da utilização do cuidado espiritual às crianças sob os cuidados paliativos, com o escopo de promover uma melhor qualidade de vida para ela e seus familiares. Adicionalmente, pretende-se por meio dessa pesquisa estimular os profissionais de saúde a atender essa dimensão durante o cuidado à crianças sob os cuidados paliativos, com vistas a proporcionar um cuidado humanizado e uma assistência espiritual de qualidade que possam ajudá-los na busca de um significado para a vida, no alívio de dores e que facilitem a lidar com a angústia e o medo que permeiam esse processo.


2019 ◽  
Vol 39 (8) ◽  
pp. 922-930 ◽  
Author(s):  
Aein Zarrin ◽  
Nima Tourchian ◽  
George A. Heckman

Background: Implementing care models that emphasize chronic disease self-management (CDSM) strategies may be an effective approach to the growing prevalence of chronic conditions in Iran. We, therefore, conducted a scoping review on CDSM among older Iranians to identify existing gaps and opportunities to improve chronic disease care. Method: We conducted a search in CINAHL, EMBASE, MEDLINE/PubMed, and Cochrane library. Selected articles were charted based on year of publication, language, objectives, methods, target chronic disease(s), sample demographics, self-management type, and key findings. Results: We selected 73 articles. The main components of CDSM addressed were social support, education, physical activity, nutrition, self-monitoring, spirituality, and financial support. Older Iranians reported low levels of physical activity. Conclusion: Enhancing the quality of CDSM research and provision of coaching to enhance older adults’ social and mental health are among the main strategies to enhance CDSM among the Iranian older population.


BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e036203
Author(s):  
Aislinn Conway ◽  
Jessica Reszel ◽  
Mark C Walker ◽  
Jeremy M Grimshaw ◽  
Sandra I Dunn

IntroductionOptimising the safety of obstetric patient care is a primary concern for many hospitals. Performance indicators measuring aspects of patient care processes can lead to improvements in health systems and the prevention of harm to the patient. We present our protocol for a scoping review to identify indicators for obstetric safety in low risk births. We aim to identify indicators addressing preventable hospital harms, to summarise the data and synthesise results.Methods and analysisWe will use methods described by Arksey and O’Malley and further expanded by Levacet al. We will search electronic databases such as Medline, Embase, CINAHL and the Cochrane Library, and websites from professional bodies and other organisations, using an iterative search strategy.Two reviewers will independently screen titles and abstracts of search results to determine eligibility for inclusion. If eligibility is not clear, the reviewers will screen the full text version. If reviewers’ decisions regarding eligibility differ, a third reviewer will review the record. Two reviewers will independently extract data from records that meet our inclusion criteria using a standardised data collection form. We will narratively describe quantitative data, such as the frequency with which indicators are identified, and conduct a thematic analysis of the qualitative data. We will compile a comprehensive list of patient safety indicators and organise them according to concepts that best suit the data such as the Donabedian model or the Hospital Harm Framework. We will discuss the implications for future research, clinical practice and policy-making. We will report the conduct of the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist.Ethics and disseminationThe sources of information included in this scoping review will be available to the public. Therefore, ethics approval is not warranted. We will disseminate results in a peer-reviewed publication, conference/event presentation(s) and stakeholder communications.


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