scholarly journals Evaluating the Tactical Combat Casualty Care principles in civilian and military settings: systematic review, knowledge gap analysis and recommendations for future research

2021 ◽  
Vol 6 (1) ◽  
pp. e000773
Author(s):  
Rachel Strauss ◽  
Isabella Menchetti ◽  
Laure Perrier ◽  
Erik Blondal ◽  
Henry Peng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Of Bias ◽  
Future Research ◽  
Cochrane Central Register ◽  
Knowledge Gaps ◽  
Tactical Combat Casualty Care ◽  
Combat Casualty ◽  
Improved Outcomes ◽  
Combat Casualty Care

ObjectivesThe Tactical Combat Casualty Care (TCCC) guidelines detail resuscitation practices in prehospital and austere environments. We sought to review the content and quality of the current TCCC and civilian prehospital literature and characterize knowledge gaps to offer recommendations for future research.MethodsMEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials were searched for studies assessing intervention techniques and devices used in civilian and military prehospital settings that could be applied to TCCC guidelines. Screening and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal was conducted using appropriate tools.ResultsNinety-two percent (n=57) of studies were observational. Most randomized trials had low risk of bias, whereas observational studies had higher risk of bias. Interventions of massive hemorrhage control (n=17) were wound dressings and tourniquets, suggesting effective hemodynamic control. Airway management interventions (n=7) had high success rates with improved outcomes. Interventions of respiratory management (n=12) reported low success with needle decompression. Studies assessing circulation (n=18) had higher quality of evidence and suggested improved outcomes with component hemostatic therapy. Hypothermia prevention interventions (n=2) were generally effective. Other studies identified assessed the use of extended focused assessment with sonography in trauma (n=3) and mixed interventions (n=2).ConclusionsThe evidence was largely non-randomized with heterogeneous populations, interventions, and outcomes, precluding robust conclusions in most subjects addressed in the review. Knowledge gaps identified included the use of blood products and concentrate of clotting factors in the prehospital setting.Level of evidenceSystematic review, level III.

scholarly journals Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matt X. Richardson ◽  
Maria Ehn ◽  
Sara Landerdahl Stridsberg ◽  
Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Systematic Review ◽  
Standard Care ◽  
Social Care ◽  
Grey Literature ◽  
Care Quality ◽  
Risk Of Bias ◽  
Future Research ◽  
Care Provision ◽  
Digital Surveillance

Abstract Background Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care. Method Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies. Result Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias. Conclusions We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

scholarly journals Relationship between hormonal contraceptives and sleep among women of reproductive age: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045819
Author(s):  
Jinhui Ma ◽  
Megan Cheng ◽  
Lehana Thabane ◽  
Caihong Ma ◽  
Ning Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Research Question ◽  
Risk Of Bias ◽  
Reproductive Age ◽  
Hormonal Contraceptives ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Women Of Reproductive Age

IntroductionThe aetiology of sleep disruptions is unknown, but hormonal fluctuations during the menstrual cycle, pregnancy and menopause have been shown to potentially affect how well a woman sleeps. The aim of this systematic review was to investigate whether hormonal contraceptives are associated with a decreased quality of sleep and increased sleep duration in women of reproductive age.MethodsThis review will analyse data from randomised controlled trials or non-randomised comparative studies investigating the association between hormonal contraceptives and sleep outcomes among women of reproductive age. Reviews addressing the same research question with similar eligibility criteria will be included. A literature search will be performed using the MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases from inception to 7 March 2021. The Cochrane Collaboration’s Risk of Bias for Randomised Trials V.2.0 and The Risk of Bias for Non-randomised Studies of Interventions tool will be used to assess risk of bias for each outcome in eligible studies. Two reviewers will independently assess eligibility of studies and risk of bias and extract the data. All extracted data will be presented in tables and narrative form. For sleep measures investigated by two or more studies with low heterogeneity, we will conduct random-effects meta-analysis to estimate the magnitude of the overall effect of hormonal contraceptives. If studies included in this systematic review form a connected network, a network meta-analysis will be conducted to estimate the comparative effect of different contraceptives. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to summarise the quality of evidence. Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 guidelines.Ethics and disseminationEthics approval is not required as data were sourced from previously reported studies. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42020199958.

scholarly journals Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brett Williams ◽  
Bronwyn Beovich
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Methodological Quality ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Measurement Properties ◽  
Future Research ◽  
Health Measurement ◽  
Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

scholarly journals Effectiveness of Exergaming in Improving Cognitive and Physical Function in People With Mild Cognitive Impairment or Dementia: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Yinan Zhao ◽  
Hui Feng ◽  
Xinyin Wu ◽  
Yan Du ◽  
Xiufen Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Functions ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Gaming Environment

BACKGROUND Individuals with mild cognitive impairment and dementia have impaired physical and cognitive functions, leading to a reduced quality of life compared with those without such impairment. Exergaming, which is defined as a combination of exercise and gaming, is an innovative, fun, and relatively safe way to exercise in a virtual reality or gaming environment. Therefore, exergaming may help people living with mild cognitive impairment or dementia to overcome obstacles that they may experience regarding regular exercise and activities. OBJECTIVE The aim of this systematic review was to review studies on exergaming interventions administered to elderly individuals with mild cognitive impairment and dementia, and to summarize the results related to physical and cognitive functions such as balance, gait, executive function, and episodic memory. METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, PsycINFO, Amed, and Nursing Database for articles published from the inception of the respective databases to January 2019. We included all clinical trials of exergaming interventions in individuals with mild cognitive impairment and dementia for review. The risk of bias was independently evaluated by two reviewers using the Cochrane Collaboration and Risk of Bias in Non-randomized Studies of Interventions tools. RESULTS Ten studies involving 702 participants were included for review. There was consistent evidence from 7 studies with a low risk of bias showing statistically significant effects of exergaming on cognitive functioning in people with mild cognitive impairment and dementia. With respect to physical function, 3 of 5 full-scale studies found positive results, and the intensity of most games was classified as moderate. CONCLUSIONS Overall, exergaming is an innovative tool for improving physical and cognitive function in people with mild cognitive impairment or dementia, although there is high heterogeneity among studies in terms of the duration, frequency, and gaming platform used. The quality of the included articles was moderate to high. More high-quality studies with more accurate outcome indicators are needed for further exploration and validation of the benefits of exergaming for this population.

scholarly journals Effectiveness of eccentric-biased exercise interventions in reducing the incidence of falls and improving functional performance in older adults: a systematic review

2021 ◽  
Author(s):  
Durga Kulkarni ◽  
Sarah Gregory ◽  
Michelle Evans
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Eccentric Exercise ◽  
Functional Performance ◽  
Risk Of Bias ◽  
Walking Distance ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Exercise Interventions

Abstract Background Exercise has been known to preserve and enhance functional performance in older adults. Eccentric exercise involves muscle contractions characterised by unique features such as lengthening of the muscle–tendon complex by a greater opposing force. Aims To systematically review randomised-controlled trials (RCTs) investigating the effectiveness of eccentric exercises in reducing the incidence of falls and improving the functional performance in older adults. Key methods We conducted a systematic review of RCTs following the PRISMA-P guidelines. Searches were completed in the Cochrane Central Register of Controlled Trials, Embase, CINAHL, Medline, and Global Health CABI. We included RCTs reporting at least one of the following outcomes—falls, Berg balance scale, timed-up and go test, chair stand test, stair climb test, maximal walking speed, and minute walking distance. Two reviewers screened papers for eligibility and assessed the quality of included papers using the Cochrane Collaborative risk-of-bias tool for randomised trials. Data were extracted by a single reviewer and cross-checked by the second reviewer. A narrative synthesis was undertaken, given the high level of heterogeneity across studies. Results Ten studies were assessed as eligible for inclusion in the review. Overall, eccentric exercises were as effective as conventional resistance exercises in improving the selected outcomes by most studies. Additionally, when pre-exercise and post-eccentric exercise functional performance measures were compared, there was a statistically significant improvement in nearly all measures. The quality of trials was mixed (one high, four moderate, two low–moderate, and three low risk of bias). Conclusions Our systematic review suggests that eccentric exercises can be as effective as conventional exercises in older adults. Evidence suggests that such exercise interventions can lead to an improvement in geriatric function.

scholarly journals Effectiveness of Exergaming in Improving Cognitive and Physical Function in People With Mild Cognitive Impairment or Dementia: Systematic Review

10.2196/16841 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16841
Author(s):  
Yinan Zhao ◽  
Hui Feng ◽  
Xinyin Wu ◽  
Yan Du ◽  
Xiufen Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Functions ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Gaming Environment

Background Individuals with mild cognitive impairment and dementia have impaired physical and cognitive functions, leading to a reduced quality of life compared with those without such impairment. Exergaming, which is defined as a combination of exercise and gaming, is an innovative, fun, and relatively safe way to exercise in a virtual reality or gaming environment. Therefore, exergaming may help people living with mild cognitive impairment or dementia to overcome obstacles that they may experience regarding regular exercise and activities. Objective The aim of this systematic review was to review studies on exergaming interventions administered to elderly individuals with mild cognitive impairment and dementia, and to summarize the results related to physical and cognitive functions such as balance, gait, executive function, and episodic memory. Methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, PsycINFO, Amed, and Nursing Database for articles published from the inception of the respective databases to January 2019. We included all clinical trials of exergaming interventions in individuals with mild cognitive impairment and dementia for review. The risk of bias was independently evaluated by two reviewers using the Cochrane Collaboration and Risk of Bias in Non-randomized Studies of Interventions tools. Results Ten studies involving 702 participants were included for review. There was consistent evidence from 7 studies with a low risk of bias showing statistically significant effects of exergaming on cognitive functioning in people with mild cognitive impairment and dementia. With respect to physical function, 3 of 5 full-scale studies found positive results, and the intensity of most games was classified as moderate. Conclusions Overall, exergaming is an innovative tool for improving physical and cognitive function in people with mild cognitive impairment or dementia, although there is high heterogeneity among studies in terms of the duration, frequency, and gaming platform used. The quality of the included articles was moderate to high. More high-quality studies with more accurate outcome indicators are needed for further exploration and validation of the benefits of exergaming for this population.

scholarly journals Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

2021 ◽  
Author(s):  
Matt X. Richardson ◽  
Maria Ehn ◽  
Sara Landerdahl Stridsberg ◽  
Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Systematic Review ◽  
Standard Care ◽  
Social Care ◽  
Grey Literature ◽  
Care Quality ◽  
Risk Of Bias ◽  
Future Research ◽  
Care Provision ◽  
Digital Surveillance

Abstract BackgroundThis systematic review summarized the effects of nocturnal digital surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care.Primary studies published 2005-2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Five publications out of 629 met inclusion criteria. The Risk of Bias 2.0 and ROBINS-I tools were used for quality assessment. ResultHealth-related outcomes (e.g. injuries, unexplained absences) and social care outcomes (e.g. staff burden) did not differ between interventions and standard care. Quality of life and affect showed improvement with some interventions, as did economic outcomes in one setting. The quality of studies was low however, with a serious to critical risk of bias. ConclusionWe found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

scholarly journals Correction of Thumb Duplication: A Systematic Review of Surgical Techniques

2019 ◽  
Vol 12 (02) ◽  
pp. 074-084
Author(s):  
Robert Miller ◽  
Alexandre Kaempfen ◽  
Jamil Moledina ◽  
Bran Sivakumar ◽  
Gill Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Functional Outcomes ◽  
Surgical Techniques ◽  
Spare Parts ◽  
Risk Of Bias ◽  
Future Research ◽  
Level Of Evidence ◽  
Thumb Duplication ◽  
Patient Reported

AbstractSurgical intervention for thumb duplication can be divided into three categories: simple excision of the accessory thumb, excision of the accessory thumb with reconstruction from available “spare parts,” and combining the two thumbs into one, as described by Bilhaut. This prospectively PROSPERO registered systematic review evaluates the overall, aesthetic and functional outcomes for the latter two options (reconstruction from spare parts vs. combining two thumbs into one), aiming to facilitate evidence-based decision making when addressing thumb duplication and direct future research. The review was performed in accordance with the Cochrane Handbook of Systematic Reviews and PRISMA statement. Embase, PubMed, Medline, and Cochrane databases were systematically searched. Studies offering comparisons of techniques were included. Risk of bias was assessed using the Risk of Bias In Non-randomized Studies—of Intervention tool. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. Ten retrospective observational studies were included. Data did not consistently allow analysis by procedure type. Four studies reported similar overall outcomes between techniques, while two specifically reported poor overall outcomes for the Bilhaut procedure. Two studies reported comparatively worse aesthetic outcomes for the Bilhaut procedure with four studies reporting comparatively improved functional outcomes for this procedure. Overall, interpretation of outcomes was challenging with no patient-reported outcome measures used. The quality of the evidence was universally “very low” due to all studies being at risk of methodological bias. Based on the available evidence, surgical techniques for thumb duplication correction appear comparable regarding overall outcome. There is limited evidence suggesting reconstruction with spare parts offers superior aesthetic outcomes at the expense of stability. The level of evidence is III.

scholarly journals Probiotics, prebiotics and synbiotics for chronic kidney disease: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020863 ◽  
Author(s):  
Ming Pei ◽  
Lijuan Wei ◽  
Shouci Hu ◽  
Bo Yang ◽  
Jinhua Si ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Risk Of Bias ◽  
Primary Data ◽  
Controlled Trials ◽  
Extensive Literature ◽  
Cochrane Central Register ◽  
Data Set

IntroductionThere is a growing interest in probiotic, prebiotic and synbiotic supplements for patients with chronic kidney disease (CKD). However, a systematic review and evaluation is lacking. The purpose of the present study is to assess the efficacy and safety of probiotics, prebiotics and synbiotics for non-dialysis or non-renal transplant patients with CKD.Methods and analysisAn extensive literature search will be undertaken to identify potentially eligible studies from electronic databases including PubMed (1946 to present), EMBASE (1974 to present), Web of Science (1900 to present) and the Cochrane Central Register of Controlled Trials (CENTRAL, all years). No language restriction will be applied to the search. Both parallel and crossover randomised controlled trials will be included. The risk of bias of each included study will be assessed using the Cochrane Risk of Bias Tool. The primary outcome measures are uraemic toxins. Secondary outcomes include kidney function, adverse cardiovascular events, all-cause mortality, cause-specific death, progression to end-stage kidney disease, quality of life, gastrointestinal function and adverse events. Data will be synthesised using appropriate statistical methods. The quality of evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationNo ethical approval is required as no primary data will be collected. We will publish findings from this systematic review in a peer-reviewed scientific journal, and the data set will be made freely available.PROSPERO registration numberCRD42017079177.

scholarly journals Early warning scores for detecting deterioration in adult hospital patients: a systematic review protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019268 ◽  
Author(s):  
Stephen Gerry ◽  
Jacqueline Birks ◽  
Timothy Bonnici ◽  
Peter J Watkinson ◽  
Shona Kirtley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Early Warning ◽  
Assessment Tool ◽  
External Validation ◽  
Risk Of Bias ◽  
Future Research ◽  
Early Warning Scores ◽  
Patients At Risk ◽  
Adult Hospital

IntroductionEarly warning scores (EWSs) are used extensively to identify patients at risk of deterioration in hospital. Previous systematic reviews suggest that studies which develop EWSs suffer methodological shortcomings and consequently may fail to perform well. The reviews have also identified that few validation studies exist to test whether the scores work in other settings. We will aim to systematically review papers describing the development or validation of EWSs, focusing on methodology, generalisability and reporting.MethodsWe will identify studies that describe the development or validation of EWSs for adult hospital inpatients. Each study will be assessed for risk of bias using the Prediction model Risk of Bias ASsessment Tool (PROBAST). Two reviewers will independently extract information. A narrative synthesis and descriptive statistics will be used to answer the main aims of the study which are to assess and critically appraise the methodological quality of the EWS, to describe the predictors included in the EWSs and to describe the reported performance of EWSs in external validation.Ethics and disseminationThis systematic review will only investigate published studies and therefore will not directly involve patient data. The review will help to establish whether EWSs are fit for purpose and make recommendations to improve the quality of future research in this area.PROSPERO registration numberCRD42017053324.

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