scholarly journals Risk factors for delirium among older adults in the emergency department: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e039175
Author(s):  
Lucas Oliveira J e Silva ◽  
Michelle J Berning ◽  
Jessica A Stanich ◽  
Danielle J Gerberi ◽  
Jin Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Older Adults ◽  
Emergency Department ◽  
Risk Factor ◽  
Random Effect ◽  
Quantitative Relationship ◽  
Original Research ◽  
Eligibility Criteria ◽  
Screening Process

IntroductionDelirium is commonly missed in older adults presenting to the emergency department (ED). Although current recommendations for active screening of delirium in the ED, this might not be feasible or practical. Identifying patients at high risk for prevalent and incident delirium in the ED will help to improve the screening process and to build interventions. There is currently scattered synthesis of evidence on risk factors associated with delirium in the ED. To address this gap, we are conducting a systematic review to describe the risk factors (patient vulnerability factors and precipitating factors) for delirium in the ED.Methods and analysisA literature search was performed from inception to March 2020 in Ovid EBM Reviews, Ovid EMBASE, Ovid MEDLINE, Scopus and Web of Science. We will include original research studies that report a quantitative relationship between at least one risk factor and delirium in the ED setting. Two investigators will use eligibility criteria from this protocol to independently screen titles and abstracts, and select studies based on full-text review of potentially eligible studies. After arriving at a final set of included studies, two investigators will extract data using a standardised data collection form. If appropriate, data regarding each risk factor will be pooled through a random-effect meta-analysis. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to evaluate the overall quality of evidence.Ethics and disseminationTo our knowledge, this will be the first systematic review evaluating risk factors for prevalent and incident delirium specifically related to the ED setting. Results of this study will aid in the identification of older adults at risk for delirium in the ED. We aim to publish the results of this systematic review in a peer-reviewed journal with good visibility for the fields of emergency medicine and geriatrics.PROSPERO registration numberCDR42020175261

scholarly journals Factors Influencing the Association Between Coach and Athlete Rating of Exertion: a Systematic Review and Meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Darren Paul ◽  
Paul Read ◽  
Abdulaziz Farooq ◽  
Luke Jones
Keyword(s):  
Systematic Review ◽  
Perceived Exertion ◽  
Meta Analysis ◽  
Random Effect ◽  
Positive Association ◽  
Rating Of Perceived Exertion ◽  
Original Research ◽  
Eligibility Criteria ◽  
High Association ◽  
The Relationship

Abstract Background Subjective monitoring of rate of perceived exertion is common practice in many sports. Typically, the information is used to understand the training load and at times modify forthcoming sessions. Identifying the relationship between the athlete and coach’s interpretation of training would likely further benefit understanding load management. The aim of this systematic review was to evaluate the relationship between coaches’ rating of intended exertion (RIE) and/or rating of observed exertion (ROE) and athletes’ reported rating of perceived exertion (RPE). Methods The review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of Medline, Google Scholar, Science Direct, SPORTDiscus, and Web of Science databases. We assessed the correlation between coach-reported RIE and/or ROE and RPE. Assessment for risk of bias was undertaken using the Quality Appraisal for Reliability Studies (QAREL) checklist. Inclusion criteria were (1) male and/or female individuals, (2) individual and/or team sport active participants, and (3) original research article published in the English language. Results Data from 19 articles were found to meet the eligibility criteria. A random effect meta-analysis based on 11 studies demonstrated a positive association of player vs. coach rating of RIE (r = 0.62 [95% CI 0.5 to 0.7], p < 0.001). The pooled correlation from 7 studies of player vs. coach rating on ROE was r = 0.64 95% CI (0.5 to 0.7), p < 0.001. Conclusion There was a moderate to high association between coach RIE and/or ROE and athlete-reported RPE and this association seems to be influenced by many factors. The suggestions we present in this review are based on imploring practitioners to consider a multi-modal approach and the implications of monitoring when using RPE. Trial Registration CRD42020193387

Barriers to clinical trial enrollment of older adults with cancer: A systematic review.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18130-e18130
Author(s):  
Mina S. Sedrak ◽  
Arti Hurria ◽  
Daneng Li ◽  
Kevin George ◽  
Simran Padam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Full Text ◽  
Cochrane Library ◽  
Original Research ◽  
Eligibility Criteria ◽  
Oncology Clinical Trials ◽  
Clinical Trial Enrollment

e18130 Background: Despite the disproportionate impact of cancer on older adults, older patients are vastly underrepresented in clinical trials that set the standards for cancer treatment. To better understand the reasons for this disparity, we conducted a systematic review of studies that have specifically examined barriers and interventions to improve clinical trial enrollment of older adults with cancer. Methods: We conducted a comprehensive two-step search strategy. First, we consulted an information specialist to develop an electronic search for the following databases from inception to January 15, 2019: PubMed, Ovid/Medline, Embase, Scopus, PsycINFO, and Cochrane library. Second, references of retrieved key articles were screened for relevant studies. Two authors then independently reviewed all titles and abstracts (N = 10,985) and examined studies for full text eligibility (N = 221). Inclusion criteria were: 1) original research; 2) study assessed barriers and/or interventions to enrollment in oncology clinical trials; 3) included patients ≥ 60 years with cancer. Narrative reviews and abstracts without full text were excluded. Data was extracted by independent raters and summarized using a qualitative analysis software, NVivo v12. Results: 12 observational studies examining barriers and 1 randomized intervention were included. Barriers were assessed at the patient level (N = 5 studies), healthcare professional (HCP) level (N = 5), and both patient and HCP levels (N = 2). Stringent eligibility criteria (N = 7) and oncologists’ concerns for toxicity (N = 7) were the most common barriers cited. Patient barriers included transportation (N = 6), time/burden (N = 6), and awareness (N = 6). Although caregiver barriers (N = 4) were identified, none of the studies examined caregiver perceptions. One study evaluated a physician-directed educational intervention and found no significant impact on accrual of older adults. Conclusions: Although several studies have examined the barriers to accrual of older adults with cancer, only one intervention study has attempted to address these barriers. Given the aging of the cancer population, new strategies for including older adults in cancer clinical trials are critically needed.

Risk Factors for Delirium in Older Adults in the Emergency Department: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Lucas Oliveira J. e Silva ◽  
Michelle J. Berning ◽  
Jessica A. Stanich ◽  
Danielle J. Gerberi ◽  
Mohammad Hassan Murad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Older Adults ◽  
Emergency Department ◽  
Meta Analysis

scholarly journals Biomarkers predictive of treatment response in psoriasis and psoriatic arthritis: a systematic review

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110140
Author(s):  
Conor Magee ◽  
Hannah Jethwa ◽  
Oliver M. FitzGerald ◽  
Deepak R. Jadon
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Treatment Response ◽  
Unmet Need ◽  
Response To Treatment ◽  
Cochrane Library ◽  
Original Research ◽  
Eligibility Criteria ◽  
Psoriatic Disease ◽  
Subsequent Response

Aims: The ability to predict response to treatment remains a key unmet need in psoriatic disease. We conducted a systematic review of studies relating to biomarkers associated with response to treatment in either psoriasis vulgaris (PsV) or psoriatic arthritis (PsA). Methods: A search was conducted in PubMed, Embase and the Cochrane library from their inception to 2 September 2020, and conference proceedings from four major rheumatology conferences. Original research articles studying pre-treatment biomarker levels associated with subsequent response to pharmacologic treatment in either PsV or PsA were included. Results: A total of 765 articles were retrieved and after review, 44 articles (22 relating to PsV and 22 to PsA) met the systematic review’s eligibility criteria. One study examined the response to methotrexate, one the response to tofacitinib and all the other studies to biologic disease-modifying antirheumatic drugs (DMARDs). Whilst several studies examined the HLA-C*06 allele in PsV, the results were conflicting. Interleukin (IL)-12 serum levels and polymorphisms in the IL-12B gene show promise as biomarkers of treatment response in PsV. Most, but not all, studies found that higher baseline levels of C-reactive protein (CRP) were associated with a better clinical response to treatment in patients with PsA. Conclusion: Several studies have identified biomarkers associated with subsequent response to treatment in psoriatic disease. However, due to the different types of biomarkers, treatments and outcome measures used, firm conclusions cannot be drawn. Further validation is needed before any of these biomarkers translate to clinical practice.

scholarly journals A systematic review of the factors associated with the course of borderline personality disorder symptoms in adolescence

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Gabriele Skabeikyte ◽  
Rasa Barkauskiene
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Strong Support ◽  
Borderline Personality ◽  
Developmental Pathways ◽  
Eligibility Criteria ◽  
Factors Associated ◽  
Prospective Longitudinal

Abstract Background Research on personality pathology in adolescence has accelerated during the last decade. Among all of the personality disorders, there is strong support for the validity of borderline personality disorder (BPD) diagnosis in adolescence with comparable stability as seen in adulthood. Researchers have put much effort in the analysis of the developmental pathways and etiology of the disorder and currently are relocating their attention to the identification of the possible risk factors associated with the course of BPD symptoms during adolescence. The risk profile provided in previous systematic reviews did not address the possible development and course of BPD features across time. Having this in mind, the purpose of this systematic review is to identify the factors that are associated with the course of BPD symptoms during adolescence. Methods Electronic databases were systematically searched for prospective longitudinal studies with at least two assessments of BPD as an outcome of the examined risk factors. A total number of 14 articles from the period of almost 40 years were identified as fitting the eligibility criteria. Conclusions Factors associated with the course of BPD symptoms include childhood temperament, comorbid psychopathology, and current interpersonal experiences. The current review adds up to the knowledge base about factors that are associated with the persistence or worsening of BPD symptoms in adolescence, describing the factors congruent to different developmental periods.

scholarly journals Injuries and frequent use of emergency department services: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040272
Author(s):  
Catherine Laferté ◽  
Andréa Dépelteau ◽  
Catherine Hudon
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Cohort Studies ◽  
Eligibility Criteria ◽  
Geriatric Population ◽  
Physical Injuries ◽  
Frequent Use ◽  
Different Types ◽  
Ed Visits ◽  
Return Visits

ObjectiveTo review all studies having examined the association between patients with physical injuries and frequent emergency department (ED) attendance or return visits.DesignSystematic review.Data sourceMedline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched up to and including July 2019.Eligibility criteriaEnglish and French language publications reporting on frequent use of ED services (frequent attendance and return visits), evaluating injured patients and using regression analysis.Data extraction and synthesisTwo independent reviewers screened the search results, and assessed methodological quality using the Joanna Briggs Institute tool for prevalence studies. Results were collated and summarised using a narrative synthesis. A sensitivity analysis was performed to evaluate the repercussions of removing a study that did not meet the quality criteria.ResultsOf the 2184 studies yielded by this search, 1957 remained after the removal of duplicates. Seventy-eight studies underwent full-text screening leaving nine that met the eligibility criteria and were included in this study: five retrospective cohort studies; two prospective cohort studies; one cross-sectional study; and one case-control study. Different types of injuries were represented, including fractures, trauma and physical injuries related to falls, domestic violence or accidents. Sample sizes ranged from 200 to 1 259 809. Six studies included a geriatric population while three addressed a younger population. Of the four studies evaluating the relationship between injuries and frequent ED use, three reported an association. Additionally, of the five studies in which the dependent variable was return ED visits, three articles identified a positive association with injuries.ConclusionsPhysical injuries appear to be associated with frequent use of ED services (frequent ED attendance as well as return ED visits). Further research into factors including relevant youth-related covariates such as substance abuse and different types of traumas should be undertaken to bridge the gap in understanding this association.

scholarly journals Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044564
Author(s):  
Kaizhuang Huang ◽  
Jiaying Lu ◽  
Yaoli Zhu ◽  
Tao Cheng ◽  
Dahao Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Factor ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Cochrane Library ◽  
Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

scholarly journals Apathy Measures in Older Adults and People with Dementia: A Systematic Review of Measurement Properties Using the COSMIN Methodology

2021 ◽  
pp. 1-13
Author(s):  
Clare Burgon ◽  
Sarah Elizabeth Goldberg ◽  
Veronika van der Wardt ◽  
Catherine Brewin ◽  
Rowan H. Harwood
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Rating Scale ◽  
Measurement Properties ◽  
Evaluation Procedure ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Eligibility Criteria ◽  
People With Dementia ◽  
Patient Reported

<b><i>Background:</i></b> Apathy is highly prevalent in dementia and is also seen in mild cognitive impairment and the general population. Apathy contributes to failure to undertake daily activities and can lead to health problems or crises. It is therefore important to assess apathy. However, there is currently no gold standard measure of apathy. A comprehensive systematic review of the measurement properties of apathy scales is required. <b><i>Methods:</i></b> A systematic review was registered with PROSPERO (ID: CRD42018094390). MEDLINE, Embase, PsycINFO, and CINAHL were searched for studies that aimed to develop or assess the validity or reliability of an apathy scale in participants over 65 years, living in the community. A systematic review was conducted in line with the COnsensus-based Standards for the selection of health Measurement INstruments procedure for reviewing patient-reported outcome measures. The studies’ risk of bias was assessed, and all relevant measurement properties were assessed for quality. Results were pooled and rated using a modified Grading of Recommendations Assessment, Development, and Evaluation procedure. <b><i>Results:</i></b> Fifty-seven publications regarding 18 measures and 39 variations met the eligibility criteria. The methodological quality of individual studies ranged from inadequate to very good and measurement properties ranged from insufficient to sufficient. Similarly, the overall evidence for measurement properties ranged from very low to high quality. The Apathy Evaluation Scale (AES) and Lille Apathy Rating Scale (LARS) had sufficient content validity, reliability, construct validity, and where applicable, structural validity and internal consistency. <b><i>Conclusion:</i></b> Numerous scales are available to assess apathy, with varying psychometric properties. The AES and LARS are recommended for measuring apathy in older adults and people living with dementia. The apathy dimension of the commonly used Neuropsychiatric Inventory should be limited to screening for apathy.

scholarly journals An investigation of the effects of environmental and ecologic factors on cutaneous leishmaniasis in the old world: a systematic review study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Abolfazl Mohammadbeigi ◽  
Salman Khazaei ◽  
Hamidreza Heidari ◽  
Azadeh Asgarian ◽  
Shahram Arsangjang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Environmental Factors ◽  
Land Cover ◽  
Cutaneous Leishmaniasis ◽  
Weather Condition ◽  
Weather Conditions ◽  
Eligibility Criteria ◽  
Screening Process ◽  
Old World ◽  
Review Study

AbstractObjectivesLeishmaniasis is a neglected and widespread parasitic disease that can lead to serious health problems. The current review study aimed to synthesize the relationship between ecologic and environmental factors (e.g., weather conditions, climatology, temperature and topology) and the incidence of cutaneous leishmaniasis (CL) in the Old World.ContentA systematic review was conducted based on English, and Persian articles published from 2015 to 2020 in PubMed/Medline, Science Direct, Web of Science and Google Scholar. Keywords used to search articles were leishmaniasis, environmental factors, weather condition, soil, temperature, land cover, ecologic* and topogr*. All articles were selected and assessed for eligibility according to the titles or abstracts. The quality screening process of articles was carried out by two independent authors. The selected articles were checked according to the inclusion and exclusion criteria.Summary and outlookA total of 827 relevant records in 2015–2020 were searched and after evaluating the articles, 23 articles met the eligibility criteria; finally, 14 full-text articles were included in the systematic review. Two different categories of ecologic/environmental factors (weather conditions, temperature, rainfall/precipitation and humidity) and land characteristics (land cover, slope, elevation and altitude, earthquake and cattle sheds) were the most important factors associated with CL incidence.ConclusionsTemperature and rainfall play an important role in the seasonal cycle of CL as many CL cases occurred in arid and semiarid areas in the Old World. Moreover, given the findings of this study regarding the effect of weather conditions on CL, it can be concluded that designing an early warning system is necessary to predict the incidence of CL based on different weather conditions.

scholarly journals Psychological and Behavioral Impact of Lockdown and Quarantine Measures for COVID-19 Pandemic on Children, Adolescents and Caregivers: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Prateek Kumar Panda ◽  
Juhi Gupta ◽  
Sayoni Roy Chowdhury ◽  
Rishi Kumar ◽  
Ankit Kumar Meena ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Disturbance ◽  
Behavioral Problems ◽  
Meta Analysis ◽  
Random Effect ◽  
Psychological Problems ◽  
Psychological State ◽  
Eligibility Criteria ◽  
Behavioral Abnormalities ◽  
Anxiety Depression

Abstract Background During the current ongoing COVID-19 pandemic, psychological problems like anxiety, depression, irritability, mood swings, inattention and sleep disturbance are fairly common among quarantined children in several studies. A systematic review of these publications to provide an accurate burden of these psychiatric/behavioral problems is needed for planning mitigating measures by the health authorities. Methods Different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles describing psychological/behavioral complications in children/adolescents with/without pre-existing behavioral abnormalities and their caregivers related to the COVID-19 pandemic. Only original articles with/without comparator arms and a minimum sample size of 50 were included in the analysis. The pooled estimate of various psychological/behavioral problems was calculated using a random-effect meta-analysis. Results Fifteen studies describing 22 996 children/adolescents fulfilled the eligibility criteria from a total of 219 records. Overall, 34.5%, 41.7%, 42.3% and 30.8% of children were found to be suffering from anxiety, depression, irritability and inattention. Although the behavior/psychological state of a total of 79.4% of children was affected negatively by the pandemic and quarantine, at least 22.5% of children had a significant fear of COVID-19, and 35.2% and 21.3% of children had boredom and sleep disturbance. Similarly, 52.3% and 27.4% of caregivers developed anxiety and depression, respectively, while being in isolation with children. Conclusion Anxiety, depression, irritability, boredom, inattention and fear of COVID-19 are predominant new-onset psychological problems in children during the COVID-19 pandemic. Children with pre-existing behavioral problems like autism and attention deficit hyperactivity disorder have a high probability of worsening of their behavioral symptoms.

Sign in / Sign up

Export Citation Format

Share Document