Advanced Practice Registered Nurses Using Synchronous Telepsychiatry: An Integrative Systematic Review

2020 ◽  
pp. 107839032093915
Author(s):  
Brooke A. Finley ◽  
Kimberly D. Shea ◽  
Roberta Maixner ◽  
Maribeth Slebodnik
Keyword(s):  
Nurse Practitioners ◽  
Assessment Tool ◽  
Cochrane Library ◽  
Publication Date ◽  
Advanced Practice ◽  
Assessment Development ◽  
Wide Range ◽  
Medical Librarian ◽  
Medium Quality ◽  
The Cochrane Library

BACKGROUND: Despite wide-spread use, telepsychiatry use among psychiatric mental health advanced practice nurse practitioners (PMH APRNs) has not been systematically explored in the literature. OBJECTIVE: Systematically review the PMH APRN usage of live-time, synchronous telepsychiatry including audiovisual teleconferencing technology. METHOD: A comprehensive, systematic search was performed with no publication date restriction across CINAHL, the Cochrane Library, Embase, Google Scholar, PsycINFO, PubMed, Scopus, and Web of Science on July 30, 2019, by a medical librarian. Each citation was blinded and independently reviewed by three reviewers, and consensus was reached for inclusion. Eligible articles were peer-reviewed research or quality improvement articles available in full-text, written in English, including real-time, synchronous, audiovisual telepsychiatry services with PMH APRN providers. Discussion articles and literature reviews were excluded. Article quality and bias were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment tool. RESULTS: The search yielded a total of 342 articles, and only nine articles met full inclusion criteria. Overall, risk of bias was high in all studies, and the GRADE rating consisted of three “very low,” five “low,” and one “medium” quality article. However, considering the collectively positive outcomes from PMH APRN telepsychiatry use, the overall GRADE recommendation was to “probably do it” for seven studies and “do it” for two studies. DISCUSSION: Though existent literature is low quality and sparse, evidence supports that PMH APRNs can feasibly and successfully provide telepsychiatry services across a wide range of demographic patients and locations. CONCLUSION: PMH APRNs should contribute more original evidence to guide telepsychiatry implementation and adoption as the service expands.

scholarly journals Scoping review protocol: the use of telemedicine in providing opioid agonist treatment and related psychosocial supports

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040556
Author(s):  
Des Crowley ◽  
Robyn Homeniuk ◽  
Ide Delargy
Keyword(s):  
Scoping Review ◽  
Psychosocial Support ◽  
Descriptive Analysis ◽  
Cochrane Library ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Search Terms ◽  
Medical Librarian ◽  
The Cochrane Library

IntroductionThe global opioid-related disease burden is significant. Opioid agonist treatment (OAT) can be effective in reducing illicit opioid use and fatal overdose, and improving multiple health and social outcomes. Despite evidence for its effectiveness, there are significant deficits in OAT globally. COVID-19 has required rapid adaptation of remote models of healthcare. Telemedicine is not used routinely in OAT, and little is known about the current levels of use and effectiveness. The objective of this review is to describe models of telemedicine and their efficacy.Methods and analysisThis scoping review uses the review methodology described by Arksey and O’Malley and adapted by Levac et al. The search strategy developed by the medical librarian at the Irish College of General Practitioners in conjunction with the research team will involve five databases (PubMed, EMBASE, the Cochrane Library, PsycInfo and OpenGrey) and the hand searching of reference lists. A limited initial search of two databases will be completed to refine search terms, followed by a second comprehensive search using newly refined search terms of all databases and finally hand searching references of included studies. To be included, studies must report on remote ways of providing OAT (including assessment, induction and monitoring) or related psychosocial support; be published in English after 2010. Two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Data will be extracted onto an agreed template and will undergo a descriptive analysis of the contextual or process-oriented data and simple quantitative analysis using descriptive statistics.Ethics and disseminationResearch ethics approval is not required for this scoping review. The results of this scoping review will inform the development of a national remote model of OAT. The results will be published in peer-reviewed journals and presented at relevant conferences.

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.

scholarly journals Over-the-Counter Tooth Whitening Agents: A Review of Literature

2020 ◽  
Vol 31 (3) ◽  
pp. 221-235 ◽  
Author(s):  
Arti. S. Naidu ◽  
Vincent Bennani ◽  
John M. Aarts Paul Brunton ◽  
Paul Brunton
Keyword(s):  
Cochrane Library ◽  
Cochrane Central Register ◽  
Short Term ◽  
Tooth Whitening ◽  
Over The Counter ◽  
Assessment Development ◽  
Ranking Criteria ◽  
Central Register ◽  
The Cochrane Library

Abstract There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth “by removing extrinsic stains” when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.

scholarly journals The Value of Pepsinogen in GC Screening: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Ling Liu ◽  
Junjie Lang ◽  
Yuelong Jin ◽  
Yan Chen ◽  
Weiwei Chang ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Barium Meal ◽  
Cochrane Library ◽  
Likelihood Ratios ◽  
Exclusion Criteria ◽  
High Quality Research ◽  
Wide Range ◽  
The Cochrane Library

Background. The current gold standard for gastric cancer (GC) screening is pathology or a barium meal followed by X-ray. This is not applicable to a wide range of screening capabilities due to the lack of operability. This article used a meta-analysis to evaluate the value of pepsinogen (PG) screening for GC.Methods. PubMed, EMbase, the Cochrane Library, CNKI, WanFang, VIP, and CBM databases were systematically searched for published studies that used serum PG to diagnose GC. Articles were searched from January 2003 to January 2018. Two reviewers independently screened the literature according to specified inclusion and exclusion criteria. The data were extracted and evaluated, and the quality of the methodologies evaluated using the QUADAS entry. The meta-analysis (MA) was performed using Meta-DiSc 1.4 software. Stata 12.0 software was used to assess publication bias.Results. A total of 19 studies were finally included from a total of 169,009 cases. The MA showed a combined sensitivity and specificity of 0.56 (95% CI (0.53–0.59),P<0.01) and 0.71 (95% CI (0.70-0.71),P<0.01), respectively. The combined likelihood ratios were +LR = 2.82 (95% CI (2.06–3.86),P<0.01) and −LR = 0.56 (95% CI (0.45–0.68),P<0.01). The combined DOR was 5.41 (95% CI (3.64~ 8.06),P<0.01), and the area under the SROC curve was 0.7468.Conclusions. Serum PG provides medium levels of sensitivity and specificity for GC assessment. To be used in a clinical setting, further high-quality research must be performed and verified.

scholarly journals Diagnostic, preventive and therapeutic evidence in obstetrics for the implementation of patient blood management: a systematic review protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021322 ◽  
Author(s):  
Iosief Abraha ◽  
Alessandro Montedori ◽  
Gian Carlo Di Renzo ◽  
Patrizio Angelozzi ◽  
Marta Micheli ◽  
...  
Keyword(s):  
Evaluation Method ◽  
Haemoglobin Concentration ◽  
Cochrane Library ◽  
Measurement Tool ◽  
Therapeutic Approaches ◽  
Assessment Development ◽  
Ethical Approval ◽  
Therapeutic Tools ◽  
The Cochrane Library

IntroductionPatientblood management (PBM) is defined as the application of evidence-based diagnostic, preventive and therapeutic approaches designed to maintain haemoglobin concentration, optimise haemostasis and minimise blood loss in an effort to improve patient outcome. We propose a protocol for the assessment of the evidence of diagnostic, preventive and therapeutic approaches for the management of relevant outcomes in obstetrics with the aim to create a framework for PBM implementation.Methods and analysisDiagnostic, preventive and therapeutic tools will be considered in the gynaecological conditions and obstetrics setting (antenatal care, peripartum care and maternity care). For each condition, (1) clinical questions based on prioritised outcomes will be developed; (2) evidence will be retrieved systematically from electronic medical literature (MEDLINE, EMBASE, the Cochrane Library, Web of Science, and CINAHL); (3) quality of the reviews will be assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist; quality of primary intervention studies will be assessed using the risk of bias tool (Cochrane method); quality of diagnostic primary studies will be assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies); (4) the Grading of Recommendations Assessment, Development and Evaluation method will be applied to rate the quality of the evidence and to develop recommendations.Ethics and disseminationFor each diagnostic, preventive or therapeutic intervention evaluated, a manuscript comprising the evidence retrieved and the recommendation produced will be provided and published in peer-reviewed journals. Ethical approval is not required.

Calprotectin as a Biomarker for Rheumatoid Arthritis: A Systematic Review

2015 ◽  
Vol 42 (5) ◽  
pp. 760-770 ◽  
Author(s):  
Mads Abildtrup ◽  
Gabrielle H. Kingsley ◽  
David L. Scott
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Longitudinal Data ◽  
Calcium Binding ◽  
Therapeutic Response ◽  
Original Data ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Wide Range ◽  
The Cochrane Library

Objective.Calprotectin (myeloid-related protein 8/14), a heterodimeric complex of calcium-binding proteins, is expressed in granulocytes and monocytes. Calprotectin levels are high in synovial tissue, particularly in activated cells adjacent to the cartilage-pannus junction. This systematic review evaluates the use of calprotectin as an indicator of disease activity, therapeutic response, and prognosis in rheumatoid arthritis (RA).Methods.Medline, Scopus, and the Cochrane Library (1970–2013) were searched for studies containing original data from patients with RA in whom calprotectin levels were measured in plasma/serum and/or synovial fluid (SF). We included studies examining associations between calprotectin levels and clinical and laboratory assessments, disease progression, and therapeutic response. There were no restrictions for sample size, disease duration, or length of followup.Results.We evaluated 17 studies (1988–2013) with 1065 patients enrolled; 11 were cross-sectional and 8 had longitudinal designs with 2 studies reporting cross-sectional and longitudinal data. Systemic and SF levels of calprotectin were raised in RA. There was a wide range of levels and marked interstudy and intrastudy variability. Calprotectin levels were high in active disease and were particularly high in rheumatoid factor (RF)-positive patients. Levels fell with effective treatment. Longitudinal data showed that calprotectin was a significant and independent predictor of erosive progression and therapeutic responses, particularly in patients who received effective biological treatments.Conclusion.SF calprotectin levels are high, suggesting there is substantial local production by inflamed synovium. Blood calprotectin levels, though highly variable, are elevated in active RA and fall with effective therapy. High baseline calprotectin levels predict future erosive damage.

scholarly journals Clinical practice recommendations on the management of perioperative cardiac arrest: A report from the PERIOPCA Consortium

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Athanasios Chalkias ◽  
Nicolas Mongardon ◽  
Vladimir Boboshko ◽  
Vladimir Cerny ◽  
Anne-Laure Constant ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Task Force ◽  
Rare Complication ◽  
Healthcare Providers ◽  
Cochrane Library ◽  
Future Research ◽  
Delphi Consensus ◽  
Assessment Development ◽  
Modified Delphi ◽  
The Cochrane Library

Abstract Background Perioperative cardiac arrest is a rare complication with an incidence of around 1 in 1400 cases, but it carries a high burden of mortality reaching up to 70% at 30 days. Despite its specificities, guidelines for treatment of perioperative cardiac arrest are lacking. Gathering the available literature may improve quality of care and outcome of patients. Methods The PERIOPCA Task Force identified major clinical questions about the management of perioperative cardiac arrest and framed them into the therapy population [P], intervention [I], comparator [C], and outcome [O] (PICO) format. Systematic searches of PubMed, Embase, and the Cochrane Library for articles published until September 2020 were performed. Consensus-based treatment recommendations were created using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The strength of consensus among the Task Force members about the recommendations was assessed through a modified Delphi consensus process. Results Twenty-two PICO questions were addressed, and the recommendations were validated in two Delphi rounds. A summary of evidence for each outcome is reported and accompanied by an overall assessment of the evidence to guide healthcare providers. Conclusions The main limitations of our work lie in the scarcity of good quality evidence on this topic. Still, these recommendations provide a basis for decision making, as well as a guide for future research on perioperative cardiac arrest.

scholarly journals Referral in a routine Italian optometric examination: towards an evidence-based model.

2021 ◽  
Vol 14 (1) ◽  
pp. 1-11
Author(s):  
Riccardo Cheloni ◽  
Alexander G Swystun ◽  
Mauro Frisani ◽  
Christopher J Davey
Keyword(s):  
Visual Impairment ◽  
Meta Analysis ◽  
Health Assessment ◽  
Preliminary Evidence ◽  
Cochrane Library ◽  
Optimal Time ◽  
Evidence Based ◽  
Wide Range ◽  
The Cochrane Library ◽  
Ocular Health

Italian optometrists refract patients and prescribe optical appliances. The routine optometric examination that is currently conducted in Italy, however, does not include a comprehensive ocular health assessment. Like many other countries, in Italy ophthalmologists are solely responsible for the diagnosis and treatment of ocular pathologies, yet, the care an optometrist provides must be done with the aim of promoting the general and ocular health of patients seen in practice. Such scope has to be pursued using a close collaboration with ophthalmologists, ultimately facilitating the earliest medical diagnosis and minimisation of visual impairment. Referral represents the basis of optometrist-ophthalmologist collaboration, yet, no guidance is available to Italian optometrists indicating when referral is warranted. The purpose of this study was to identify the circumstances deserving a referral in a routine Italian optometric examination in adults, ultimately constituting preliminary evidence-based indications of a referral model oriented to enhance the ocular and general health of patients. A literature review was conducted on Pubmed and the Cochrane Library, mainly targeting high quality secondary literature such as systematic reviews, meta-analysis and clinical guidelines. Several reasons for referral were identified. Further, while a wide range of anomalies of the visual system are likely to be discovered by the Italian optometric examination, up to 20% of patients could suffer an underlying condition undetected by the current assessment. This results in the need to refer seemingly healthy patients if they have not attended routine ophthalmological examinations within optimal time frames. In Italy, and countries with similar settings, the referral is an essential instrument that optometrists must largely use to ensure early diagnosis of ocular conditions by ophthalmologists and minimisation of avoidable visual impairment.

Tongue-tie and frenotomy in infants with breastfeeding difficulties: achieving a balance

2014 ◽  
Vol 100 (5) ◽  
pp. 489-494 ◽  
Author(s):  
R F Power ◽  
J F Murphy
Keyword(s):  
Additional Data ◽  
Assessment Tool ◽  
Neuromuscular Disorders ◽  
Cochrane Library ◽  
Feeding Problems ◽  
Exclusion Criteria ◽  
Young Infants ◽  
The Cochrane Library ◽  
Breastfeeding Problems ◽  
Oral Anomalies

AimsCurrently there is debate on how best to manage young infants with tongue-tie who have breastfeeding problems. One of the challenges is the subjectivity of the outcome variables used to assess efficacy of tongue-tie division. This structured review documents how the argument has evolved. It proposes how best to assess, inform and manage mothers and their babies who present with tongue-tie related breastfeeding problems.MethodsDatabases were searched for relevant papers including Pubmed, Medline, and the Cochrane Library. Professionals in the field were personally contacted regarding the provision of additional data. Inclusion criteria were: infants less than 3 months old with tongue-tie and/or feeding problems. The exclusion criteria were infants with oral anomalies and neuromuscular disorders.ResultsThere is wide variation in prevalence rates reported in different series, from 0.02 to 10.7%. The most comprehensive clinical assessment is the Hazelbaker Assessment Tool for lingual frenulum function. The most recently published systematic review of the effect of tongue-tie release on breastfeeding concludes that there were a limited number of studies with quality evidence. There have been 316 infants enrolled in frenotomy RCTs across five studies. No major complications from surgical division were reported. The complications of frenotomy may be minimised with a check list before embarking on the procedure.ConclusionsGood assessment and selection are important because 50% of breastfeeding babies with ankyloglossia will not encounter any problems. We recommend 2 to 3 weeks as reasonable timing for intervention. Frenotomy appears to improve breastfeeding in infants with tongue-tie, but the placebo effect is difficult to quantify. Complications are rare, but it is important that it is carried out by a trained professional.

The serratus plane block for postoperative analgesia in breast and thoracic surgery: a systematic review and meta-analysis

2019 ◽  
pp. rapm-2019-100982 ◽  
Author(s):  
Matthew Chong ◽  
Nicolas Berbenetz ◽  
Kamal Kumar ◽  
Cheng Lin
Keyword(s):  
Thoracic Surgery ◽  
Postoperative Analgesia ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Postoperative Nausea And Vomiting ◽  
Cochrane Library ◽  
Assessment Development ◽  
Pain Scores ◽  
Language Restriction ◽  
The Cochrane Library

Background and objectivesThe serratus plane block (SPB) is a novel chest wall interfascial plane block. Its analgesic efficacy compared with non-block care and paravertebral block (PVB) is unestablished.MethodsWe conducted a random-effects meta-analysis of randomized controlled trials (RCTs) recruiting adult surgical patients that compared a SPB to non-block care or PVB for postoperative analgesia. Visual analog scale pain scores were the primary outcome. Database sources were Medline, Embase, the Cochrane Library, and Google Scholar searched up to July 29, 2019 without language restriction. Risk of bias was assessed using Cochrane methodology.ResultsNineteen RCTs that comprised 1260 patients were included. Six trials involved thoracic surgery patients and 13 studied breast surgery patients. SPB reduced pain scores 0 hour postoperatively (−1.62 cm; 99% CI −2.43 to −0.81; p<0.001; I2=92%), at 2–4 hours (−1.29 cm; 99% CI −2.08 to −0.49; p<0.001; I2=92%), at 6 hours (−1.69 cm; 99% CI −3.19 to −0.20; p=0.004; I2=99%), and up to 24 hours compared with non-block care. SPB also prolonged the time to first analgesic request (193.2 min; 95% CI 7.2 to 379.2 min; p=0.04; I2=99%), reduced 24-hour postoperative opioid consumption (−11.27 mg of IV morphine equivalent; −17.36 to −5.18 mg; p<0.001), and reduced postoperative nausea and vomiting (RR 0.51; 95% CI 0.38 to 0.68; p<0.001; I2=12%). In contrast, no meaningful differences were detected in any of the outcomes for the SPB versus PVB data.ConclusionsSPB reduced postoperative pain scores (Grading of Recommendations Assessment, Development, and Evaluation rating: low; due to heterogeneity and deficiencies in blinding) in breast and thoracic surgery patients compared with non-block care. Based on five trials only, SPB was not appreciably different from PVB.

Sign in / Sign up

Export Citation Format

Share Document