scholarly journals Inclusion, characteristics and outcomes of people requiring palliative care in studies of non-pharmacological interventions for delirium: A systematic review

2019 ◽  
Vol 33 (8) ◽  
pp. 878-899 ◽  
Author(s):  
Annmarie Hosie ◽  
Najma Siddiqi ◽  
Imogen Featherstone ◽  
Miriam Johnson ◽  
Peter G Lawlor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Subjective Experience ◽  
Intervention Studies ◽  
Search Terms ◽  
Study Heterogeneity ◽  
Inpatient Settings ◽  
Almost All ◽  
Multicomponent Interventions

Background: Delirium is common, distressing, serious and under-researched in specialist palliative care settings. Objectives: To examine whether people requiring palliative care were included in non-pharmacological delirium intervention studies in inpatient settings, how they were characterised and what their outcomes were. Design: Systematic review (PROSPERO 2017 CRD42017062178). Data sources: Systematic search in March 2017 for non-pharmacological delirium intervention studies in adult inpatients. Database search terms were ‘delirium’, ‘hospitalisation’, ‘inpatient’, ‘palliative care’, ‘hospice’, ‘critical care’ and ‘geriatrics’. Scottish Intercollegiate Guidelines Network methodological checklists guided risk of bias assessment. Results: The 29 included studies were conducted between 1994 and 2015 in diverse settings in 15 countries (9136 participants, mean age = 76.5 years ( SD = 8.1), 56% women). Most studies tested multicomponent interventions ( n = 26) to prevent delirium ( n = 19). Three-quarters of the 29 included studies ( n = 22) excluded various groups of people requiring palliative care; however, inclusion criteria, participant diagnoses, illness severity and mortality indicated their presence in almost all studies ( n = 26). Of these, 21 studies did not characterise participants requiring palliative care or report their specific outcomes (72%), four reported outcomes for older people with frailty, dementia, cancer and comorbidities, and one was explicitly focused on people receiving palliative care. Study heterogeneity and limitations precluded definitive determination of intervention effectiveness and only allowed interpretations of feasibility for people requiring palliative care. Acceptability outcomes (intervention adverse events and patients’ subjective experience) were rarely reported overall. Conclusion: Non-pharmacological delirium interventions have frequently excluded and under-characterised people requiring palliative care and infrequently reported their outcomes.

A Systematic Review of Replicative Self-Determination Intervention Studies

2019 ◽  
Vol 54 (1) ◽  
pp. 29-39
Author(s):  
John L. Luckner ◽  
Rashida Banerjee ◽  
Sara Movahedazarhouligh ◽  
Kaitlyn Millen
Keyword(s):  
Systematic Review ◽  
Intervention Studies ◽  
Self Determination ◽  
Future Research ◽  
Replication Studies ◽  
Research Designs ◽  
Replication Research ◽  
Quality Of Research

Current federal legislation emphasizes the use of programs, interventions, strategies, and activities that have been demonstrated through research to be effective. One way to increase the quantity and quality of research that guides practice is to conduct replication research. The purpose of this study was to undertake a systematic review of the replication research focused on self-determination conducted between 2007 and 2017. Using methods used by Cook and colleagues, we identified 80 intervention studies on topics related to self-determination, of which 31 were coded as replications. Intervention study trends, rate of replication studies, percentage of agreements between findings of original and replication studies, amount of author overlap, and types of research designs used are reported along with recommendations for future research.

scholarly journals The incidence and prevalence of delirium across palliative care settings: A systematic review

2019 ◽  
Vol 33 (8) ◽  
pp. 865-877 ◽  
Author(s):  
Christine L Watt ◽  
Franco Momoli ◽  
Mohammed T Ansari ◽  
Lindsey Sikora ◽  
Shirley H Bush ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Data Extraction ◽  
Risk Of Bias ◽  
Point Prevalence ◽  
Assessment Tools ◽  
Included Patient ◽  
Study Heterogeneity ◽  
Palliative Care Units ◽  
Meta Analyses

Background: Delirium is a common and distressing neurocognitive condition that frequently affects patients in palliative care settings and is often underdiagnosed. Aim: Expanding on a 2013 review, this systematic review examines the incidence and prevalence of delirium across all palliative care settings. Design: This systematic review and meta-analyses were prospectively registered with PROSPERO and included a risk of bias assessment. Data sources: Five electronic databases were examined for primary research studies published between 1980 and 2018. Studies on adult, non-intensive care and non-postoperative populations, either receiving or eligible to receive palliative care, underwent dual reviewer screening and data extraction. Studies using standardized delirium diagnostic criteria or valid assessment tools were included. Results: Following initial screening of 2596 records, and full-text screening of 153 papers, 42 studies were included. Patient populations diagnosed with predominantly cancer ( n = 34) and mixed diagnoses ( n = 8) were represented. Delirium point prevalence estimates were 4%–12% in the community, 9%–57% across hospital palliative care consultative services, and 6%–74% in inpatient palliative care units. The prevalence of delirium prior to death across all palliative care settings ( n = 8) was 42%–88%. Pooled point prevalence on admission to inpatient palliative care units was 35% (confidence interval = 0.29–0.40, n = 14). Only one study had an overall low risk of bias. Varying delirium screening and diagnostic practices were used. Conclusion: Delirium is prevalent across all palliative care settings, with one-third of patients delirious at the time of admission to inpatient palliative care. Study heterogeneity limits meta-analyses and highlights the future need for rigorous studies.

scholarly journals Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

2012 ◽  
Vol 27 (6) ◽  
pp. 486-498 ◽  
Author(s):  
Annmarie Hosie ◽  
Patricia M Davidson ◽  
Meera Agar ◽  
Christine R Sanderson ◽  
Jane Phillips
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Specialist Palliative Care ◽  
Inpatient Settings

scholarly journals Components of palliative care interventions addressing the needs of people with dementia living in long-term care: A systematic review

2020 ◽  
Vol 34 (4) ◽  
pp. 454-492
Author(s):  
Slavica Kochovska ◽  
Maja V Garcia ◽  
Frances Bunn ◽  
Claire Goodman ◽  
Tim Luckett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
European Association ◽  
Long Term Care ◽  
White Paper ◽  
Future Research ◽  
Term Care ◽  
People With Dementia ◽  
Almost All

Background: People with dementia requiring palliative care have multiple needs, which are amplified in long-term care settings. The European Association for Palliative Care White Paper offers recommendations for optimal palliative care in dementia integral for this population, providing useful guidance to inform interventions addressing their specific needs. Aim: The aim of this study is to describe the components of palliative care interventions for people with dementia in long-term care focusing on shared decision-making and examine their alignment to the European Association for Palliative Care domains of care. Design: Systematic review with narrative synthesis (PROSPERO ID: CRD42018095649). Data sources: Four databases (MEDLINE, CINAHL, PsycINFO and CENTRAL) were searched (earliest records – July 2019) for peer-reviewed articles and protocols in English, reporting on palliative care interventions for people with dementia in long-term care, addressing European Association for Palliative Care Domains 2 (person-centred) or 3 (setting care goals) and ⩾1 other domain. Results: Fifty-one papers were included, reporting on 32 studies. For each domain (1–10), there were interventions found aiming to address its goal, although no single intervention addressed all domains. Domain 7 (symptom management; n = 19), 6 (avoiding overly aggressive treatment; n = 18) and 10 (education; n = 17) were the most commonly addressed; Domain 5 (prognostication; n = 7) and 4 (continuity of care; n = 2) were the least addressed. Conclusion: Almost all domains were addressed across all interventions currently offered for this population to various degrees, but not within a singular intervention. Future research optimally needs to be theory driven when developing dementia-specific interventions at the end of life, with the European Association for Palliative Care domains serving as a foundation to inform the best care for this population.

scholarly journals Any Effective Intervention to Improve CPAP Adherence in Children with Obstructive Sleep Apnea: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110198
Author(s):  
Bundit Sawunyavisuth ◽  
Chetta Ngamjarus ◽  
Kittisak Sawanyawisuth
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Intervention Studies ◽  
Pediatric Patients ◽  
Adherence Rate ◽  
Caregiver Support ◽  
Cpap Adherence ◽  
Search Terms ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) in children is leading to several consequences as reported in adults. A continuous positive airway pressure (CPAP) machine is one of the effective treatments in pediatric OSA. However, the CPAP adherence rate is approximately 50%. This study aimed to evaluate if any interventions that improve CPAP adherence in pediatric patients with OSA using a systematic review. We included intervention studies on CPAP adherence in pediatric patients with OSA regardless of machine types. Five databases were used for article searching. Search terms included OSA, adherence, compliance, and CPAP. The outcomes of this study were adherence rate and usage hours/minutes. The outcomes were compared between the intervention and comparator groups with descriptive statistics. There were 2931 articles from 5-database searching. There were 41 articles related with children. There were 7 articles conducted with any intervention on CPAP compliance. Of those, 4 studies included in the analysis. There were 3 significant differences between both groups in 2 studies. Those with caregiver support had significantly longer CPAP use/night by 86.60 minutes (95% CI 10.90, 162.30) and percentage of CPAP usage more than 4 hours/night by 18.10% (95% CI 3.87, 32.33) than those without caregiver support. Those who received BPAP therapy had higher chance of good PAP adherence than those who received CPAP by 18.17 times (95% CI 5.19, 63.70). Caregiver support and BPAP therapy significantly improved CPAP adherence in children with OSA. Further studies are required to add additional comparisons and also other interventions.

scholarly journals Effect of statin treatment on circulating malondialdehyde concentrations: a systematic review and meta-analysis

2019 ◽  
Vol 10 ◽  
pp. 204062231986271 ◽  
Author(s):  
Angelo Zinellu ◽  
Panagiotis Paliogiannis ◽  
Maria Franca Usai ◽  
Ciriaco Carru ◽  
Arduino A. Mangoni
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Intervention Studies ◽  
Meta Analysis ◽  
Statin Treatment ◽  
Published Data ◽  
Random Effects Model ◽  
Stress Markers ◽  
Before And After ◽  
Study Heterogeneity

Background: The effect of statins on oxidative stress markers, such as malondialdehyde (MDA), is still a matter of debate. We sought to address this issue by conducting a systematic review and meta-analysis of published data on the effect of statin treatment on systemic MDA concentrations. Methods: A literature search was conducted on MEDLINE/ PubMed, ISI Web of Sciences and Scopus. Data were pooled using a random-effects model. Results: A total of 35 studies assessing MDA concentrations before and after statin treatment in 1512 participants (mean age 53.6 years, 48.7% males) were identified. Extreme between-study heterogeneity was observed (I2 = 96.0%, p < 0.001). Pooled standardized mean difference (SMD) showed a significant reduction in plasma MDA concentrations after treatment (SMD = −1.47 µmol/l, 95% confidence interval = −1.89 to −1.05 μmol/l; p < 0.001). Similarly, a subgroup analysis of 10 studies that also included a placebo group showed a significant reduction in plasma MDA concentrations with statins (−1.03 μmol/l, 95% confidence interval = −1.52 to −0.29 μmol/l; p = 0.036). Conclusions: This systematic review and meta-analysis showed that statin treatment significantly reduces systemic MDA concentrations. However, the results should be interpreted with caution because of extreme between-study heterogeneity, which warrants further intervention studies.

Non-invasive ventilation in palliative care: a systematic review

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Teresa Diaz de Teran ◽  
Elena Barbagelata ◽  
Catia Cilloniz ◽  
Antonello Nicolini ◽  
Tommaso Perazzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Population Change, Modernization and Welfare. By Joseph Spengler. Prentice-Hall Inc., Englewood Cliffs, N.J. 1974.

1977 ◽  
Vol 16 (2) ◽  
pp. 220-222
Author(s):  
Zeba A. Sathar
Keyword(s):  
Population Growth ◽  
Population Change ◽  
Population Control ◽  
Stable Condition ◽  
Developed Countries ◽  
Wide Field ◽  
Wide Scale ◽  
Socio Economic Variables ◽  
Almost All

The book covers a wide field, touching on almost all aspects of popula¬tion change on a world-wide scale. It discusses, using world and country data, the relationships between demographic and socio-economic variables, and elaborates on" their relative importance in the determination of population problems which confront the world as a whole and nations individually. Policies designed to alleviate these problems are discussed with an emphasis on those related to population control. The first chapter is entitled "Population Growth: Past and Prospective" and reviews the various parameters associated with population change in the past and in the future. It touches upon the concept of a stable population in order to show the elements which cause a population to change (i.e. remove it from its stable condition). The main elements of change, population growth, migration, mortality and natality are discussed individually. The chapter is concluded by a description of the main differences in these elements and other socio-economic conditions as they exist in the less-developed and developed countries.

INTERVENTION OF THIRSTY IN CONGESTIVE HEART FAILURE (CHF) PATIENTS TO INCREASED ADHERENCE OF FLUID RESTRICTION: A SYSTEMATIC REVIEW

2017 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
DIAN HUDIYAWATI
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Congestive Heart Failure ◽  
Intervention Studies ◽  
Cold Water ◽  
Fluid Restriction ◽  
Common Symptom ◽  
Oral Swab ◽  
Hand Search ◽  
Effective Interventions

Introduction. Thirst is a common symptom of chronic heart failure (CHF) patients. Difficulties to adherence with fluid restrictions are among the effects of thirst in HF patients and therefore have an impact on worsening condition, but intervention studies aimed specifically at reducing thirst in CHF are lacking.Purpose. Purpose of this manuscript is to assess the effective intervention to reduce thirst intensity in CHF patients.Methods. Medline, Pubmed, EBSCO and hand search were searched using the key words thirst, intervention, heart failure, CHF, fluis restriction, therapy.Result.� Eighteen articles were found, six studies were inluded. Any kind of interventions in each articles, include: drink cold water 5oC, chewing gum, saliva substitute, sucking ice cubes and three bundle of interventions (oral swab, water sprays and menthol moisturizer).Conclusions. The most effective interventions to alleviate thirst was sucking ice cubes. But, no intervention studies were found in congestive heart failure patients. So investigations in people with heart failure is needed.�Keywords: thirst, intervention, heart failure, systematic review

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