Reducing repeat paediatric emergency department attendance for non-urgent care: a systematic review of the effectiveness of interventions

ObjectiveNon-urgent paediatric ED (PED) visits appear to contribute a large portion to the growing use of EDs globally. Several interventions have tried to curb repeated non-urgent attendances, but no systematic review of their effectiveness exists. This review examines the effectiveness of interventions designed to reduce subsequent non-urgent PED visits after a non-urgent attendance.MethodA systematic review design. A systematic search of four databases and key journals was conducted from their inception to November 2018. Experimental studies, involving children aged 0–18 years presenting to an ED for non-urgent care, which assessed the effectiveness of interventions on subsequent non-urgent attendance were considered.Results2120 studies were identified. Six studies, including four randomised controlled trials (RCTs) and two quasi-experimental, were included. Studies were of moderate quality methodologically. All studies originated from the USA and involved informational and/or follow-up support interventions. Only two RCTs demonstrated the longest duration of intervention effects on reducing subsequent non-urgent PED attendance. These studies identified participants retrospectively after ED evaluation. The RCT with the largest number of participants involved follow-up support by primary physicians. Meta-analysis was impractical due to wide heterogeneity of the interventions.ConclusionsThere is inconclusive evidence to support any intervention aimed at reducing subsequent non-urgent PED visits following a non-urgent attendance. The long-term impact of interventions is limited, although the effect may be maximised if delivered by primary care providers in children identified after their ED attendance. However, further research is required to evaluate the impact of any such strategies in settings outside the USA.

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Effects of Educational Interventions on Oral Hygiene: A Systematic Review and Meta-Analysis

10.21203/rs.2.15898/v1 ◽

2019 ◽

Author(s):

Sakineh Dadipoor ◽

Mohtasham Ghaffari ◽

Abbas Alipour ◽

Ali Safari-Moradabadi

Keyword(s):

Systematic Review ◽

Oral Hygiene ◽

Meta Analysis ◽

Experimental Studies ◽

Educational Interventions ◽

Short Term ◽

Standard Data ◽

Significant Difference ◽

Quasi Experimental ◽

The Impact

Abstract Background: This study assesses the impact of school based educational interventions on oral hygiene of students conducted worldwide. This is a systematic review and Meta-Analysis. Methods: Our investigation was conducted in electronic databases including MEDLINE Ovid), Embase Ovid, Scopus), Web of Science from 2000 to march 2018. The data were extracted based on a standard data collection form specific to observational studies, and entered into RevMan2014. Twelve studies of students in this review finally entered the study including five individual RCTs, four cluster-RCTs, and three quasi-experimental studies. Results: Meta-analyses showed a significant difference in knowledge (SMD 3.31, 95% CI 2.52 to 4.11; P < 0.001), attitude (SMD 1. 99, 95% CI 0. 43 to 3.54; P < 0.01), behavior (SMD 4.74, 95% CI 3.70 to 5.77; P < 0.001), plaque index (SMD -1. 01, 95% CI -1.50 to -0. 51; P < 0. 001) and Gingival index (SMD 0.33, 95% CI -0. 36 to 1.02; P = 0.34) for students receiving educational interventions compared to those receiving usual care . Discussion: The focus of the present study is the efficacy of all oral health education and promotion interventions, especially in terms of short-term outcomes. Since long-term and short-term results are of tremendous importance for oral and dental education programs, it will be possible to make these interventions in the future with several target groups, including families and teachers.

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The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040666 ◽

2021 ◽

Vol 10 (4) ◽

pp. 666

Author(s):

Fahimeh Ramezani Tehrani ◽

Marzieh Saei Ghare Naz ◽

Razieh Bidhendi Yarandi ◽

Samira Behboudi-Gandevani

Keyword(s):

Systematic Review ◽

Gestational Diabetes ◽

Pregnant Women ◽

Diagnostic Criteria ◽

Meta Analysis ◽

Population Based ◽

Maternal Outcomes ◽

Care Providers ◽

Iadpsg Criteria ◽

The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

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Between Level Up and Game Over: A Systematic Literature Review of Gamification in Education

Sustainability ◽

10.3390/su13042247 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2247 ◽

Cited By ~ 1

Author(s):

Ana Manzano-León ◽

Pablo Camacho-Lazarraga ◽

Miguel A. Guerrero ◽

Laura Guerrero-Puerta ◽

José M. Aguilar-Parra ◽

...

Keyword(s):

Systematic Review ◽

Academic Performance ◽

Game Design ◽

Learning Strategy ◽

Experimental Studies ◽

Quasi Experimental ◽

Current Lines ◽

Meta Analyses ◽

Game Elements ◽

The Impact

Educational gamification consists of the use of game elements and game design techniques in the educational context. The objective of this study is to examine the existing evidence on the impact of educational gamification on student motivation and academic performance in the last five years in order to analyze its distribution over time, educational level, variables, and most used game elements, and know the advantages of its implementation in the classroom. For this, a systematic review is proposed through the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) methodology in three multidisciplinary databases, through an exhaustive search with inclusion and exclusion criteria on quantitative experimental studies that explore gamification in educational centers, which provide information about the most current lines of research. Fourteen studies were included in this review. These used experimental or quasi-experimental designs. Most of them report gamification as a valid learning strategy. The results support the conclusion that educational gamification has a potential impact on the academic performance, commitment, and motivation of students. Therefore, this study implies the need to expand research on the needs and challenges of students when learning with gamified techniques.

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Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol

Journal of Eating Disorders ◽

10.1186/s40337-021-00525-2 ◽

2022 ◽

Vol 10 (1) ◽

Author(s):

Fatima Safi ◽

Anna M. Aniserowicz ◽

Heather Colquhoun ◽

Jill Stier ◽

Behdin Nowrouzi-Kia

Keyword(s):

Systematic Review ◽

Eating Disorders ◽

Meta Analysis ◽

Experimental Studies ◽

Work Participation ◽

Unpaid Work ◽

Cochrane Library ◽

And Performance ◽

The Impact

Abstract Background Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. Methods Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. Discussion This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. Trial registration The registration number for this systematic review on PROSPERO is CRD42021255055.

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Impact of antenatal care on neonatal mortality among neonates in Ethiopia: a systematic review and meta-analysis

Archives of Public Health ◽

10.1186/s13690-020-00499-8 ◽

2020 ◽

Vol 78 (1) ◽

Author(s):

Tadesse Tolossa ◽

Ginenus Fekadu ◽

Belayneh Mengist ◽

Diriba Mulisa ◽

Getahun Fetensa ◽

...

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Neonatal Mortality ◽

Neonatal Death ◽

Statistical Tests ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Cochrane Library ◽

The Impact

Abstract Background As compared to other regions of the world, Sub Saharan Africa (SSA) is the region with the highest neonatal mortality and is the region showing the least progress in the reduction of newborn death. Despite better progress made in reducing neonatal mortality, Ethiopia contributes the highest rate of neonatal death in Africa. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the impact of antenatal care on neonatal mortality among mother-neonate pairs in Ethiopia. Methods Published articles from various electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science, and Google Scholar were accessed. Also, unpublished studies from library catalogs were identified. All observational studies that were conducted on the association between antenatal care follow-up and neonatal mortality among neonates in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled impact on antenatal care on neonatal mortality. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Results Initially, a total of 345 studies were accessed. Finally, 28 full-text studies were reviewed and fourteen studies fulfilled inclusion criteria and included in the final meta-analysis. The overall pooled estimate indicates the odds of neonatal death among neonates from women with antenatal care were 65% lower than those neonates from women who had no antenatal care follow-up (OR: 0.35, 95% CI: 0.24, 0.51). Conclusions In this systematic review and meta-analysis, lack of ANC follow-up increase the probability of neonatal mortality as compared to having ANC follow-up. Thus, we will recommend for more coverages of appropriate antenatal care where risk groups can best be identified and managed.

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The Effectiveness of Digital Interventions for Psychological Well-Being in the Workplace: A Systematic Review Protocol

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010255 ◽

2019 ◽

Vol 17 (1) ◽

pp. 255 ◽

Cited By ~ 1

Author(s):

Maria Armaou ◽

Stathis Konstantinidis ◽

Holly Blake

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Experimental Studies ◽

Well Being ◽

Psychological Well Being ◽

Scientific Databases ◽

Digital Interventions ◽

Quasi Experimental ◽

Review Protocol ◽

Mental Well Being

Objective: Psychological well-being has been associated with desirable individual and organisational outcomes. This systematic review aims to assess the effectiveness of digital interventions for the improvement of psychological well-being and/or the prevention/management of poor mental well-being in the workplace. Methods: This review protocol is registered in PROSPERO (CRD42019142428). Scientific databases including MEDLINE, Web of Science, CINAHL, PsycINFO, Cochrane Register of Controlled Trials (CENTRAL) and EMBASE will be searched for relevant studies published between January 1990 and July 2019. Studies will be included if they report specific primary and secondary outcomes of digital interventions delivered to adults in the workplace for the improvement of their psychological wellbeing and/or the prevention/management of poor mental well-being and were published in English. Following screening of titles and abstracts, full texts of potentially eligible papers will be screened in duplicate to identify studies that assess the effectiveness of those digital interventions. Discrepancies will be resolved through consensus or by consulting a third reviewer. An integrated narrative synthesis will assess included studies’ findings, and a meta-analysis will be performed if included studies appear to be homogeneous. The “Cochrane Collaboration’s Risk of Bias” tool and the JBI (Joanna Briggs Institute) Critical Appraisal Checklist for Quasi-Experimental Studies will be used to appraise included studies. Conclusion: The results of this work will provide recommendations on the use of digital interventions for the promotion of psychological well-being at work. It will also guide the development of future workplace digital interventions and subsequent primary research in this field.

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Retrospective assessment of adherence to ASCO Surveillance Guidelines following treatment for stage II and III colorectal cancer (CRC)

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e17517 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e17517-e17517

Author(s):

J. M. Davies ◽

S. Lupichuk ◽

E. Batuyong ◽

R. J. Hilsden ◽

J. Easaw

Keyword(s):

Ct Scan ◽

Adjuvant Treatment ◽

Laboratory Data ◽

Primary Care Providers ◽

Stage Ii ◽

Stage Iii ◽

Care Providers ◽

Cancer Centre ◽

The Impact

e17517 Background: The 2005 ASCO guidelines for surveillance following adjuvant therapy for CRC outlined recommended surveillance tests and their frequencies including history and physical examination, CEA testing, CT scan and colonoscopy. The purpose of this study was to assess the impact of these guidelines post treatment of stage II and III CRC in the Calgary Health Region (CHR) before and after implementation of a computer generated, personalized discharge letter (DL). Methods: Cohort 1 patients completed adjuvant chemotherapy or radiotherapy for stage II and III CRC between September 1, 2006, and November 30, 2007, prior to implementation of the DL. Cohort 1 was retrospectively identified from the Alberta Cancer Registry. Registry data was collated with laboratory data and diagnostic imaging data is forthcoming. Adherence to the guidelines at 1-year follow-up in cohort 1 was measured. Prospective data collection on patients who completed adjuvant treatment after implementation of the DL (cohort 2) is ongoing. Comparison of adherence rates to surveillance testing between the two cohorts will be reported upon study completion. Results: For cohort 1, 209 of 238 patients referred to the cancer centre were from the CHR and hence included in the analysis. The average age was 65 and 53% were male. Most patients (136/209) had stage III CRC. 1/209 had a local recurrence only. 27/209 progressed to metastatic disease during the 1-year follow-up period, of which 23 of these patients were initially diagnosed with stage III CRC. CEA adherence (≥4 tests taken within 1-year follow-up period) was 38.3% (95% CI 31.7–44.9). CT scan adherence and use of “inappropriate” surveillance testing for cohort 1 will be available at the meeting. Conclusions: This study assesses compliance with the 2005 ASCO CRC surveillance guidelines at 1-year follow-up post adjuvant treatment at a tertiary cancer centre. Analysis of cohort 1 reveals that adherence to CEA testing is suboptimal. The next phase of this study will assess the impact of a DL, sent to patients and primary care providers outlining recommended surveillance tests and dates, on adherence rates. No significant financial relationships to disclose.

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Long-term outcomes of psychological interventions on children and young people’s mental health: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0236525 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0236525

Author(s):

Stephen Pilling ◽

Peter Fonagy ◽

Elizabeth Allison ◽

Phoebe Barnett ◽

Chloe Campbell ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Publication Bias ◽

Meta Analysis ◽

Psychosocial Interventions ◽

Long Term Outcomes ◽

Self Harm ◽

The Impact

Background Over 600 RCTs have demonstrated the effectiveness of psychosocial interventions for children and young people’s mental health, but little is known about the long-term outcomes. This systematic review sought to establish whether the effects of selective and indicated interventions were sustained at 12 months. Method We conducted a systematic review and meta-analysis focusing on studies reporting medium term outcomes (12 months after end of intervention). Findings We identified 138 trials with 12-month follow-up data, yielding 165 comparisons, 99 of which also reported outcomes at end of intervention, yielding 117 comparisons. We found evidence of effect relative to control at end of intervention (K = 115, g = 0.39; 95% CI: 0.30–0.47 I2 = 84.19%, N = 13,982) which was maintained at 12 months (K = 165, g = 0.31, CI: 0.25–0.37, I2 = 77.35%, N = 25,652) across a range of diagnostic groups. We explored the impact of potential moderators on outcome, including modality, format and intensity of intervention, selective or indicated intervention, site of delivery, professional/para-professional and fidelity of delivery. We assessed both risk of study bias and publication bias. Conclusions Psychosocial interventions provided in a range of settings by professionals and paraprofessionals can deliver lasting benefits. High levels of heterogeneity, moderate to high risk of bias for most studies and evidence of publication bias require caution in interpreting the results. Lack of studies in diagnostic groups such as ADHD and self-harm limit the conclusions that can be drawn. Programmes that increase such interventions’ availability are justified by the benefits to children and young people and the decreased likelihood of disorder in adulthood.

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The Impact of Stratified Teaching on the Academic Performance of Chinese Middle School Students: A Meta-Analysis

Science Insights Education Frontiers ◽

10.15354/sief.20.re012 ◽

2020 ◽

Vol 7 (1) ◽

pp. 735-760

Author(s):

Hui Shi ◽

Alan C.K. Cheung ◽

Elizabeth S.T. Cheung

Keyword(s):

Information Technology ◽

Academic Performance ◽

Meta Analysis ◽

Experimental Studies ◽

Chinese Students ◽

Learning System ◽

School Students ◽

Quasi Experimental ◽

The Impact ◽

Positive Effect

Stratified teaching is an effective method and means to implement teaching students per their aptitude. Domestic and foreign scholars have carried out many experimental and quasi-experimental studies to observe the impact of stratified teaching on students’ academic performance, but the results are quite different. So, can stratified teaching effectively help Chinese students improve their academic performance? How big is its impact? Which model is more suitable for Chinese students? To answer these questions, this article uses meta-analysis to quantitatively analyze 22 Chinese studies on the impact of Stratified teaching on student academic performance. We found that (i) stratified teaching has a positive effect on students’ academic performance, and the overall combined effect size is 0.53; (ii) among the seven subjects of mathematics, English, physics, chemistry, biology, geography, and information technology, stratified teaching has had a positive effect on their learning. Stratified teaching’s order of effect on different subjects was English > Physics > Geography > Information Technology > Mathematics > Biology > Chemistry; (iii) stratified teaching is suitable for students of different sizes of classrooms. However, the smaller the number of students in the classroom, the better the learning effect, and (iv) stratified teaching is more suitable for improving their learning in the mobile learning system.

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Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

10.1101/2020.08.27.20183012 ◽

2020 ◽

Cited By ~ 1

Author(s):

Syed Ghulam Sarwar Shah ◽

David Nogueras ◽

Hugo Cornelis van Woerden ◽

Vasiliki Kiparoglou

Keyword(s):

Systematic Review ◽

Older Adults ◽

Clinical Trials ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Future Research ◽

Before And After ◽

Quasi Experimental

Objective: To review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data Sources: Electronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. Subjects: Adult men and women Design: Systematic review and meta-analysis Main Outcome Measure: Loneliness. Study Selection: Primary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and Synthesis: Two researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. Results: Six studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= -0.36, 0.40; P=0.92), four months (SMDs= -1.11, 95% CI= -2.60, 0.38; P=0.14) and six months (SMD= -0.11, 95% CI= -0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. Conclusions: There is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.

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