scholarly journals The microbiology of pleural infection in adults: a systematic review

2019 ◽  
Vol 54 (3) ◽  
pp. 1900542 ◽  
Author(s):  
Maged Hassan ◽  
Tamsin Cargill ◽  
Elinor Harriss ◽  
Rachelle Asciak ◽  
Rachel M. Mercer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Geographical Location ◽  
Paediatric Population ◽  
Antimicrobial Treatment ◽  
Synthesis Methods ◽  
Viridans Streptococci ◽  
Eligibility Criteria ◽  
Hospital Acquired Infections ◽  
Pleural Infection ◽  
Hospital Acquired

Background and objectivesPleural infection is a major cause of morbidity and mortality among adults. Identification of the offending organism is key to appropriate antimicrobial therapy. It is not known whether the microbiological pattern of pleural infection is variable temporally or geographically. This systematic review aimed to investigate available literature to understand the worldwide pattern of microbiology and the factors that might affect such pattern.Data sources and eligibility criteriaOvid MEDLINE and Embase were searched between 2000 and 2018 for publications that reported on the microbiology of pleural infection in adults. Both observational and interventional studies were included. Studies were excluded if the main focus of the report was paediatric population, tuberculous empyema or post-operative empyema.Study appraisal and synthesis methodsStudies of ≥20 patients with clear reporting of microbial isolates were included. The numbers of isolates of each specific organism/group were collated from the included studies. Besides the overall presentation of data, subgroup analyses by geographical distribution, infection setting (community versus hospital) and time of the report were performed.ResultsFrom 20 980 reports returned by the initial search, 75 articles reporting on 10 241 patients were included in the data synthesis. The most common organism reported worldwide was Staphylococcus aureus. Geographically, pneumococci and viridans streptococci were the most commonly reported isolates from tropical and temperate regions, respectively. The microbiological pattern was considerably different between community- and hospital-acquired infections, where more Gram-negative and drug-resistant isolates were reported in the hospital-acquired infections. The main limitations of this systematic review were the heterogeneity in the method of reporting of certain bacteria and the predominance of reports from Europe and South East Asia.ConclusionsIn pleural infection, the geographical location and the setting of infection have considerable bearing on the expected causative organisms. This should be reflected in the choice of empirical antimicrobial treatment.

scholarly journals Effectiveness of return to activity and return to school protocols for children postconcussion: a systematic review

2020 ◽  
Vol 6 (1) ◽  
pp. e000667 ◽  
Author(s):  
Carol DeMatteo ◽  
E Dimitra Bednar ◽  
Sarah Randall ◽  
Katie Falla
Keyword(s):  
Systematic Review ◽  
Paediatric Population ◽  
Acute Stage ◽  
Current Data ◽  
Return To School ◽  
Original Research ◽  
Reference List ◽  
Eligibility Criteria ◽  
Outcomes For Children ◽  
Return To Activity

ObjectiveTo determine the effects of following return to activity (RTA) and return to school (RTS) protocols on clinical outcomes for children with concussion. The 12 subquestions of this review focus on the effectiveness of protocols, guidelines and recommendations, and the evidence supporting content of the protocols including rest, exercise and school accommodations.DesignSystematic review.Data sourcesPubMed, MEDLINE, EMBASE, CINAHL, ERIC and manual reference list check.Eligibility criteria for selecting studiesStudies were included if they evaluated RTA or RTS protocols in children aged 5–18 years with a concussion or if they reported a rigorous study design that provided evidence for the recommendations. Included studies were original research or systematic reviews. Articles were excluded if they did not report on their methodology or included participants with significant neurological comorbidities.ResultsThe literature search retrieved 198 non-duplicate articles and a total of 13 articles were included in this review. Despite the adoption of several RTS and RTA protocols in clinical practice there is little evidence to determine their efficacy in the paediatric population.SummaryThe current data support the recommendation that children in the acute stage postconcussion should undergo 1–2 days physical and cognitive rest as they initiate graduated RTA/RTS protocols. Prolonged rest may increase reported symptoms and time to recovery. Further interventional studies are needed to evaluate the effectiveness of RTA/RTS protocols in youth with concussion.

scholarly journals Landscapes of becoming social: A systematic review of evidence for associations and pathways between interactions with nature and socioemotional development in children

2020 ◽  
Author(s):  
Lærke Mygind ◽  
Mette Kurtzhals ◽  
Clare Nowell ◽  
Paulina S. Melby ◽  
Matt P. Stevenson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Green Space ◽  
Internal Validity ◽  
Later Life ◽  
Risk Of Bias ◽  
Observational Research ◽  
Synthesis Methods ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Socioemotional Outcomes

Background. Existing research indicates that spending time in nature is associated with diverse aspects of children’s health and wellbeing. Although fundamental to later life chances and health, no systematic reviews, to our knowledge, have focused specifically on the effects of interaction with nature on socioemotional functioning in childhood. Objectives. Amongst children, what is the consistency of associations between the availability of or spending time in nature on socioemotional function and development? Furthermore, which child behaviours and states independently associate with socioemotional function and availability of or spending time in nature, and what is the consistency of associations between these behaviours and states and contact with nature?Data sources. Embase, Environment Complete, MEDLINE, and APA PsycINFO. Eligible studies were backward and forward snowball-searched. Study eligibility criteria. Studies investigating effects of, or associations between, availability of or interaction with nature on socioemotional or proximal outcomes in children under the age of 12 years were included in this review. Study appraisal and synthesis methods. The internal validity of studies investigating socioemotional outcomes were based on assessments of elements of study design, conduct, and reporting to identify potential issues related to confounding or other biases. The number of analyses indicating positive, negative, and non-significant associations between availability or interaction with green space and the outcomes were summed.Results. A total of 223 eligible full-texts, of which 43 pertained to socioemotional outcomes and 180 to proximal outcomes, met eligibility criteria. Positive associations between availability of and spending time in green space were found with children’s intra- and interpersonal socioemotional function and development. Proportions of positive findings ranged from 13.9% to 55% across experimental and observational research, exposures, populations, and contexts. Modifying and mediating factors were identified. We found consistent evidence for improved aspects of cognition and, for children over six years, reduced risk of obesity and overweight in association with green space; consistent links between movement behaviours in the experimental, but not observational research; tentative trends suggesting associations with play, motor skills, language, screen time, and communication skills; little evidence for positive associations between green space and mood, physical wellbeing, and stress; some evidence for associations with healthy birth outcomes, and little evidence for direct associations between availability of green space and asthma and allergy prevalence, however, mediation via, for example, air pollution was likely.Limitations. We identified few studies without either probable or severe risk of bias in at least one item. Improved study quality may therefore result in different results. Restricting analyses to include only studies considered at low risk of bias indicated similar or slightly lower proportions of positive findings. Risk of bias in proximal outcomes was not assessed.Conclusions. The empirical evidence for benefits of availability of and interaction green space for child socioemotional function and development must currently be considered limited. A number of proximal indicators were identified. Systematic review registration number. PROSPERO ID: CRD42019135016.

scholarly journals PIWI proteins as prognostic markers in cancer: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Alexios-Fotios A. Mentis ◽  
Efthimios Dardiotis ◽  
Athanassios G. Papavassiliou
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cancer Site ◽  
Synthesis Methods ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Protein Levels ◽  
Low Expression

ABSTRACTBackgroundPIWI proteins, which interact with piRNAs, are implicated in stem cell and germ cell regulation, but have been detected in various cancers, as well.ObjectivesIn this systematic review, we explored, for the first time in the literature (to our knowledge), the association between prognosis in patients with cancer and intratumoral expression of PIWI proteins.Data sourcesPubMed, Embase and Web of Knowledge databases were searched for the relevant cohort studies.Study eligibility criteriaProspective or retrospective cohort studies investigating the association of intratumoral mRNA or protein expression of different types of PIWI proteins with survival, metastasis or recurrence of various types of cancers in the systematic review. Exclusion of cross-sectional studies, of studies on the prognostic value of genetic polymorphism of PIWI genes, of studies re-analyzed previously published databases, and of conference abstracts and non-English articles.ParticipantsTwenty-six studies with 4,299 participants were included in the systematic review.InterventionsPooled Hazard Ratios (HRs) and their 95% Confidence Intervals (CIs) were calculated for different PIWI proteins separately, by pooling of log of the calculated HRs using the random-effects model.Study appraisal and synthesis methodsData extraction was performed using a pre-designed form and quality of the studies was assessed using REMARK criteria. Heterogeneity assessed using the I2 index and the Cochran Q test. Publication bias assessed using funnel plots and Egger’s regression.ResultsThe pooled HR of mortality in high compared to low expression of HIWI, HILI and PIWIL4 was 1.87 (CI95%: 1.31-2.66, p < 0.05), 1.09 (CI95%: 0.58-2.07, p = 0.79) and 0.44 (CI95%: 0.25-0.76, p < 0.05), respectively. The pooled HR of recurrence in in high compared to low expression of HIWI and HILI was 1.72 (CI95%: 1.20-2.49, p < 0.05) and 1.98 (CI95%: 0.65-5.98, p = 0.23), respectively.LimitationsExclusion of studies not in English; Discrepancy between mRNA and protein levels, and the respective analytical methods; Only one cancer site – PIWI protein pair investigated in three or more studies.Conclusions and Implications of Key FindingsThe prognosis of cancer patients is worse with higher HIWI and lower PIWIL4 expression, although the results are highly variable for different cancers. The expression of these proteins can be used for personalized prognostication and treatment of individual patients.Systematic review registration numberNot registered.

scholarly journals Communicating with patients and families about difficult matters: A rapid review in the context of the COVID-19 pandemic

2020 ◽  
Author(s):  
Stuart Ekberg ◽  
Ruth Parry ◽  
Victoria Land ◽  
Katie Ekberg ◽  
Marco Pino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
End Of Life ◽  
Rapid Review ◽  
Synthesis Methods ◽  
Eligibility Criteria ◽  
Previous Systematic Review ◽  
The Future ◽  
Communication Practices ◽  
Illness Progression

BackgroundPandemics pose significant challenges for healthcare systems, including an increase in difficult discussions about future illness progression and end of life.ObjectivesTo synthesise existing evidence about communication practices used to discuss difficult matters, including prognosis and end of life, and to use this evidence to make recommendations for clinical practice. The aim of this study was to use rapid review methods to update findings from a previous systematic review published in 2014.Data sourcesMEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, Web of Science, Scopus, ASSIA and Amed.Study eligibility criteriaStudies using conversation analysis or discourse analysis to examine recordings of actual conversations about difficult matters relating to future illness progression and end of life.Study appraisal and synthesis methodsData appraisal and extraction procedures used in the 2014 review were modified for this rapid review.ResultsFollowing screening, 18 sources were deemed to meet eligibility criteria, which were added to the 19 sources included in the 2014 systematic review. Synthesis of study findings identified 11 communication practices: providing opportunities for patient or family members to propose matters to discuss (7 out of 37 included sources); seeking a patient or family member’s perspective (6/37); discussing the future indirectly (11/37); discussing the future explicitly (7/37) linking to something previously said or done (11/37); using hypothetical scenarios (13/37); framing a difficult matter as universal (5/37); acknowledging uncertainty (3/37); exploring options (2/37); displaying sensitivity (7/37); emphasising the positive (7/37).LimitationsDividing work amongst the study authors to enable rapid review may have created inconsistencies.Conclusions and implications of key findingsThis synthesis of high-quality evidence from actual clinical practice supports a series of recommendations for communicating about difficult matters during and beyond the COVID-19 pandemic.

scholarly journals Is mindfulness research methodology improving over time? A systematic review

2018 ◽  
Author(s):  
Simon Goldberg ◽  
Raymond P. Tucker ◽  
Preston A. Greene ◽  
Tracy L. Simpson ◽  
David Kearney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Treatment Fidelity ◽  
The Body ◽  
Synthesis Methods ◽  
Eligibility Criteria ◽  
Clinical Disorder ◽  
Fidelity Assessment ◽  
Methodological Improvement

Background: Despite an exponential growth in research on mindfulness-based interventions, the body of scientific evidence supporting these treatments has been criticized for being of poor methodological quality. Objectives: The current systematic review examined the extent to which mindfulness research demonstrated increased rigor over the past 16 years regarding six methodological features that have been highlighted as areas for improvement. These feature included using active control conditions, larger sample sizes, longer follow-up assessment, treatment fidelity assessment, and reporting of instructor training and intent-to-treat (ITT) analyses. Data sources: We searched PubMed, PsychInfo, Scopus, and Web of Science in addition to a publically available repository of mindfulness studies. Study eligibility criteria: Randomized clinical trials of mindfulness-based interventions for samples with a clinical disorder or elevated symptoms of a clinical disorder listed on the American Psychological Association’s list of disorders with recognized evidence-based treatment. Study appraisal and synthesis methods: Independent raters screened 9,067 titles and abstracts, with 303 full text reviews. Of these, 171 were included, representing 142 non-overlapping samples. Results: Across the 142 studies published between 2000 and 2016, there was no evidence for increases in any study quality indicator, although changes were generally in the direction of improved quality. When restricting the sample to those conducted in Europe and North America (continents with the longest history of scientific research in this area), an increase in reporting of ITT analyses was found. When excluding an early, high-quality study, improvements were seen in sample size, treatment fidelity assessment, and reporting of ITT analyses. Conclusions and implications of key findings: Taken together, the findings suggest modest adoption of the recommendations for methodological improvement voiced repeatedly in the literature. Possible explanations for this and implications for interpreting this body of research and conducting future studies are discussed.

Sign in / Sign up

Export Citation Format

Share Document