‘I can see clearly now’: clarifying the role of psychiatry in global disaster

2021 ◽  
pp. 103985622098672
Author(s):  
William Pridmore
Keyword(s):  
Disaster Response ◽  
Best Practice ◽  
Reference Lists ◽  
Cochrane Library ◽  
Positive Outcomes ◽  
Front Line ◽  
Specific Knowledge ◽  
Global Events ◽  
The Cochrane Library

Objective: First, to review the principles and practice of disaster psychiatry, in light of recent global events. Second, to identify opportunities for research. Method: A literature review of the MEDLINE database, UpToDate and the Cochrane Library was conducted. Reference lists were also reviewed. Results: Psychiatrists are well-positioned to contribute to positive outcomes at all stages of the disaster response. These contributions derive from their roles as doctors, mental illness specialists and clinical leaders. Conclusion: A novel framework for the psychiatrist’s contributions was proposed. Specific knowledge of disaster psychiatry may be worthwhile, and establishment of a public disaster psychiatry centre is reasonable. Research should further examine the role of tele-psychiatry and pursue a best practice for community and front-line employee psychological preparedness.

Nitric Oxide and Immune Responses in Cancer: Searching for New Therapeutic Strategies

2021 ◽  
Vol 28 ◽  
Author(s):  
Adeleh Sahebnasagh ◽  
Fatemeh Saghafi ◽  
Sina Negintaji ◽  
Tingyan Hu ◽  
Mojtaba Shabani-Boroujeni ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Immune Responses ◽  
Therapeutic Potential ◽  
Relevant Literature ◽  
Cochrane Library ◽  
Signaling Molecule ◽  
No Donors ◽  
The Cochrane Library ◽  
Oxide Synthase

: In recent years, there has been an increasing interest in understanding the mysterious functions of nitric oxide (NO) and how this pleiotropic signaling molecule contributes to tumorigenesis. This review attempts to expose and discuss the information available on the immunomodulatory role of NO in cancer and recent approaches to the role of NO donors in the area of immunotherapy. To address the goal, the following databases were searched to identify relevant literature concerning empirical evidence: The Cochrane Library, Pubmed, Medline, EMBASE from 1980 through March 2020. Valuable attempts have been made to develop distinctive NO-based cancer therapy. Although the data do not allow generalization, the evidence seems to indicate that low / moderate levels may favor tumorigenesis while higher levels would exert anti-tumor effects. In this sense, the use of NO donors could have an important therapeutic potential within immunotherapy, although there are still no clinical trials. The emerging understanding of NO-regulated immune responses in cancer may help unravel the recent features of this “double-edged sword” in cancer physiological and pathologic processes and its potential use as a therapeutic agent for cancer treatment. In short, in this review, we discuss the complex cellular mechanism in which NO, as a pleiotropic signaling molecule, participates in cancer pathophysiology. We also debate the dual role of NO in cancer and tumor progression, and clinical approaches for inducible nitric oxide synthase (iNOS) based therapy against cancer.

scholarly journals Factors determining eligibility and access to subacute rehabilitation for elderly people with dementia and hip fracture

Dementia ◽  
2015 ◽  
Vol 16 (4) ◽  
pp. 413-423 ◽  
Author(s):  
Rosemary A McFarlane ◽  
Stephen T Isbel ◽  
Maggie I Jamieson
Keyword(s):  
Hip Fracture ◽  
Best Practice ◽  
Inpatient Rehabilitation ◽  
Models Of Care ◽  
Cochrane Library ◽  
Ageing Population ◽  
Barriers To Access ◽  
People With Dementia ◽  
Vulnerable Patients ◽  
The Cochrane Library

With hip fracture and dementia increasing in incidence in the global ageing population, there is a need for the development of specific procedures targeting optimal treatment outcomes for these patients. This paper looks primarily at the factors that limit access to subacute rehabilitation services as a growing body of evidence suggests that access to timely inpatient rehabilitation increases functional outcomes for patients both with dementia and without. Information was gathered by searching electronic data bases (SCOPUS, Medline, CINAHL, Health Source Nursing/Academic Addition, Psychinfo and the Cochrane Library) for relevant articles using the search terms dementia OR Alzheimer* AND hip fracture AND subacute rehabilitation OR convalescence for the period 2005–2015. Abstracts were scanned to identify articles discussing eligibility and access. A total of nine papers were identified that directly addressed this topic. Other papers discussing success or failure of rehabilitation and improved models of care were also reviewed. Barriers to access discussed in the literature include information management, management of comorbidities, attitudes, resource availability, and the quality of evidence and education. By identifying these factors we can identify strategic points of intervention across the trajectory of prevention, treatment and rehabilitation that may improve outcomes for this growing group of vulnerable patients. Emerging best practice for these patients is also discussed.

Facilitators of Attendance and Adherence to Group-Based Physical Activity for Older Adults: A Literature Synthesis

2018 ◽  
Vol 26 (1) ◽  
pp. 155-167 ◽  
Author(s):  
Cassandra J. de Lacy-Vawdon ◽  
Ruth Klein ◽  
Joanna Schwarzman ◽  
Genevieve Nolan ◽  
Renee de Silva ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Factors ◽  
Best Practice ◽  
Qualitative Studies ◽  
Cochrane Library ◽  
Future Research ◽  
Literature Synthesis ◽  
Instructor Characteristics ◽  
The Cochrane Library

This review examines program features that influence attendance and adherence to group-based physical activity (PA) by older adults. Medline, PubMed, CINAHL plus, PsycINFO, and the Cochrane Library were searched for studies published from 1995–2016. Quantitative and qualitative studies investigating factors related to PA group attendance or adherence by persons aged 55 years and over were included. Searching yielded eight quantitative and 13 qualitative studies, from 2,044 titles. Quantitative findings identified social factors, instructor characteristics, PA types, class duration and frequency, and perceived PA outcomes as important for attendance and adherence, whilst qualitative studies identified settings, leadership, PA types, observable benefits, and social support factors. Studies were predominantly low- to moderate-quality. This review identified design and delivery considerations for group-based PA programs to inform best-practice frameworks and industry capacity building. Future research should use longitudinal and mixed-methods designs to strengthen evidence about facilitators of program reach and engagement.

scholarly journals The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis

2019 ◽  
Vol 49 (6) ◽  
pp. 497-506 ◽  
Author(s):  
Johanna Kuipers ◽  
Loes M. Verboom ◽  
Karin J.R. Ipema ◽  
Wolter Paans ◽  
Wim P. Krijnen ◽  
...  
Keyword(s):  
Best Practice ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Female Gender ◽  
Cochrane Library ◽  
Intradialytic Hypotension ◽  
Interdialytic Weight Gain ◽  
Lower Body Weight ◽  
Wide Range ◽  
The Cochrane Library

Background: Intradialytic hypotension (IDH) is considered to be a frequent complication of hemodialysis (HD) and is associated with symptom burden, increased incidence of access failure, cardiovascular events, and higher mortality. This systematic literature review aims to analyse studies that investigated the prevalence of IDH. A complicating factor herein is that many different definitions of IDH are used in literature. Methods: A systematic literature search from databases, Medline, Cinahl, EMBASE, and the Cochrane library to identify studies reporting on the actual prevalence of IDH was conducted. Studies were categorized by the type of definition used for the prevalence of IDH. A meta-analysis of the prevalence of IDH was performed. Results: In a meta-analysis comprising 4 studies including 1,694 patients and 4 studies including 13,189 patients, the prevalence of HD sessions complicated by IDH was 10.1 and 11.6% for the European Best Practice Guideline (EBPG) definition and the Nadir <90 definition, respectively. The proportion of patients with frequent IDH could not reliably be established because of the wide range in cutoff values that were used to identify patients with frequent IDH. There was a large variety in the prevalence of symptoms and interventions. Major risk factors associated with IDH across studies were diabetes, a higher interdialytic weight gain, female gender, and lower body weight. Conclusion: Our meta-analysis suggests that the prevalence of IDH is lower than 12% for both the EBPG and the Nadir <90 definition which is much lower than stated in most reviews.

Oral Flora and Perioperative Antimicrobial Interventions in Cleft Palate Surgery: A Review of the Literature

2020 ◽  
pp. 105566562097736
Author(s):  
Miles J. Pfaff ◽  
Leila Musavi ◽  
Maxwell M. Wang ◽  
Christos S. Haveles ◽  
Claire Liu ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Antibiotic Use ◽  
Fistula Formation ◽  
Cochrane Library ◽  
Oral Flora ◽  
Oronasal Fistula ◽  
Perioperative Antibiotics ◽  
Antimicrobial Interventions ◽  
The Cochrane Library

Background: The role of perioperative antibiotics in cleft palate remains a topic of debate. Advocates stress their importance in preventing local and systemic infections and decreasing the incidence of oronasal fistula formation. However, few studies to date have directly evaluated the role of antibiotics and other antimicrobial measures in cleft palate surgery. Objective: The aim of this review is to evaluate the evidence surrounding the use of perioperative antibiotics and other antimicrobial interventions in cleft palate surgery. Additionally, we review the literature on the oral flora unique to the cleft palate patient population. Methods: This was accomplished utilizing PubMed, Medline, and the Cochrane Library with MeSH and generic terms. Articles were selected based on predefined inclusion and exclusion criteria. Results: This review highlights the lack of higher level evidence on perioperative antibiotic use and other antimicrobial interventions in cleft palatoplasty and calls for further research on the matter. Conclusions: The literature appears to support the use of preoperative antibiotics for cleft palatoplasty, but the benefits of prolonged postoperative antibiotic use remain questionable.

scholarly journals Awareness and the use of evidence-based medicine resources among physicians

2019 ◽  
Vol 6 (10) ◽  
pp. 4612-4614
Author(s):  
Amjad Alhelo ◽  
Bashar Samara
Keyword(s):  
Evidence Based Medicine ◽  
Best Practice ◽  
Response Rate ◽  
Cross Sectional Study ◽  
Cochrane Library ◽  
Evidence Based ◽  
Cross Sectional ◽  
Evidenced Based ◽  
The Cochrane Library ◽  
Based Medicine

Aim: to evaluate awareness and the use of evidence-based medicine resources among physicians in Jordan.  Method: A cross-sectional study by internet was performed among 517 doctors who were responsive from a total of 717 doctors, a total of 72.1% response rate. Doctors from all specialties were contacted from a Facebook group called doctors café in Jordan. A questionnaire was given to each one of them to measure their awareness and use of Evidence based database.   Result: From 517 physicians 377 they are using evidenced based resources frequently, and 91 using resources but not frequently and 49 not using evidence-based resources. The resource that was mostly used by the doctors was PubMed, followed by other resources such as Up to date, National Guideline Clearinghouse, Medscape, BMJ best practice, e-books and other online journals for published papers. The Cochrane Library was surprisingly not so familiar amongst physicians. Conclusion: There is good awareness about EBM among physicians in Jordan, and that benefits health care in Jordan.

scholarly journals The Accuracy of Near Infrared Autofluorescence in Identifying Parathyroid Gland During Thyroid and Parathyroid Surgery: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Bin Wang ◽  
Chun-Rong Zhu ◽  
Hong Liu ◽  
Xin-Min Yao ◽  
Jian Wu
Keyword(s):  
Parathyroid Gland ◽  
Sensitivity And Specificity ◽  
Area Under Curve ◽  
Near Infrared ◽  
Reference Lists ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Parathyroid Surgery ◽  
Funnel Plots ◽  
The Cochrane Library

ObjectiveWe aim to assess the accuracy of near infrared autofluorescence in identifying parathyroid gland during thyroid and parathyroid surgery.MethodA systematic literature search was conducted by using PubMed, Embase, and the Cochrane Library electronic databases for studies that were published up to February 2021. The reference lists of the retrieved articles were also reviewed. Two authors independently assessed the methodological quality and extracted the data. A random-effects model was used to calculate the combined variable. Publication bias in these studies was evaluated with the Deeks’ funnel plots.ResultA total of 24 studies involving 2,062 patients and 6,680 specimens were included for the meta-analysis. The overall combined sensitivity and specificity, and the area under curve of near infrared autofluorescence were 0.96, 0.96, and 0.99, respectively. Significant heterogeneities were presented (Sen: I2 = 87.97%, Spe: I2 = 65.38%). In the subgroup of thyroid surgery, the combined sensitivity and specificity, and the area under curve of near infrared autofluorescence was 0.98, 0.99, and 0.99, respectively, and the heterogeneities were moderate (Sen: I2 = 59.71%, Spe: I2 = 67.65%).ConclusionNear infrared autofluorescence is an excellent indicator for identifying parathyroid gland during thyroid and parathyroid surgery.

scholarly journals Probiotics for the Prophylaxis of Migraine: A Systematic Review of Randomized Placebo Controlled Trials

2019 ◽  
Vol 8 (9) ◽  
pp. 1441 ◽  
Author(s):  
Malwina M. Naghibi ◽  
Richard Day ◽  
Samantha Stone ◽  
Ashton Harper
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Gut Microbiome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Qualitative Comparison ◽  
Microbiome Research ◽  
The Cochrane Library

Migraine is a common and disabling neurological condition with a complex etiology. Recent advances in the understanding of the gut microbiome have shown the role of gut micro-organisms in disease outcomes for distant organs—including the brain. Interventions targeting the gut microbiome have been shown to be effective in multiple neurological diagnoses, but there is little research into the role of the microbiome in migraine. This systematic review seeks to assess the current research landscape of randomized placebo controlled trials utilizing probiotic interventions as migraine prophylaxis. Searches were conducted of scientific databases including PubMed, MEDLINE, and the Cochrane Library, following PRISMA guidelines. Of 68 screened studies, 2 were eligible for analysis. Due to methodological differences, meta-analysis was not possible. Qualitative comparison of the studies demonstrated a dichotomy of results—one trial reported no significant change in migraine frequency and intensity, while the second trial reported highly significant improvements. No clear ‘gold standard’ currently exists for microbiome research, let alone for migraine-related microbiome research. The heterogeneity of outcome measures used in the two trials included in this systematic review shows the need for a standardization of outcome measures, therefore a series of recommendations for future probiotic–migraine research are included.

Interventions for Alleviating Cancer-Related Dyspnea: A Systematic Review

2008 ◽  
Vol 26 (14) ◽  
pp. 2396-2404 ◽  
Author(s):  
Irit Ben-Aharon ◽  
Anat Gafter-Gvili ◽  
Mical Paul ◽  
Leonard Leibovici ◽  
Salomon M. Stemmer
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Supplemental Oxygen ◽  
Cochrane Library ◽  
Analog Scale ◽  
Terminally Ill Cancer Patients ◽  
Randomized Controlled ◽  
The Cochrane Library

Purpose Dyspnea is one of the most distressing symptoms experienced by terminally ill cancer patients. This study aimed to evaluate the role of interventions for the palliation of dyspnea. Methods We conducted a systematic review of randomized controlled trials assessing all pharmacologic and nonpharmacologic interventions for dyspnea palliation in cancer patients, and searched the Cochrane Library, MEDLINE, conference proceedings, and references. Two reviewers independently appraised the quality of trials and extracted data. Results Our search yielded 18 trials. Fourteen evaluated pharmacologic interventions: seven assessing opioids (a total of 256 patients), five assessing oxygen (137 patients), one assessing helium-enriched air, and one assessing furosemide. Four trials evaluated nonpharmacologic interventions (403 patients). The administration of subcutaneous morphine resulted in a significant reduction in dyspnea Visual Analog Scale (VAS) compared with placebo. No difference was observed in dyspnea VAS score when nebulized morphine was compared with subcutaneous morphine, although patients preferred the nebulized route. The addition of benzodiazepines to morphine was significantly more effective than morphine alone, without additional adverse effects. Oxygen was not superior to air for alleviating dyspnea, except for patients with hypoxemia. Nursing-led interventions improved breathlessness. Acupuncture was not beneficial. Conclusion Our review supports the use of opioids for dyspnea relief in cancer patients. The use of supplemental oxygen to alleviate dyspnea can be recommended only in patients with hypoxemia. Nursing-led nonpharmacologic interventions seem valuable. Only a few studies addressing this question were performed. Thus, further studies evaluating interventions for alleviating dyspnea are warranted.

scholarly journals The role of UGT1A1 (c.-3279 T > G) gene polymorphisms in neonatal hyperbilirubinemia susceptibility

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zijin Li ◽  
Li Song ◽  
Lihong Hao
Keyword(s):  
Meta Analysis ◽  
Neonatal Hyperbilirubinemia ◽  
Cochrane Library ◽  
Common Disease ◽  
Homozygous State ◽  
Ugt1a1 Gene ◽  
The Cochrane Library ◽  
Allele Model ◽  
Increased Susceptibility

Abstract Background Neonatal hyperbilirubinemia (NNH) is a common disease in newborns. This research study aimed to assess the associations between uridine diphospho-glucuronate-glucuronosyltransferase 1A1 (UGT1A1, c.-3279 T > G) polymorphisms and NNH risk. Methods We searched PubMed, the Cochrane Library, and the Embase electronic databases. All published eligible studies before July 1, 2019, were searched for this meta-analysis. Results We identified 7 independent studies including 1560 cases. The data showed that in the general population, compared with the GT + GG vs TT and GG vs TT, c.-3279 T > G (rs4124874) was significantly related to a higher NNH risk (GG vs TT: OR = 1.865, 95% CI: 1.031–3.373, P = 0.039; GT + GG vs TT: OR = 1.331, 95% CI: 1.055–1.679, P = 0.016). Although not statistically significant, the data showed that c.3279 T > G had a tendency to be associated with NNH under the allele model and GG vs GT + TT in the overall population (G vs T: OR = 1.288, 95% CI: 0.982–1.689, P = 0.067; GG vs TT + GT: OR = 1.583, 95% CI: 0.947–2.647, P = 0.080). Conclusion The UGT1A1 gene c.-3279 T > G (rs4124874) polymorphism increased susceptibility to NNH, especially for the comparison of GT + GG vs TT and GG vs TT. In the future, we can use homozygous state of the UGT1A1 gene c.-3279 T > G (rs4124874) polymorphism for the diagnosis and screening of molecular biomarkers in NNH patients.

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