scholarly journals Interventions to prevent aspiration in older adults with dysphagia living in nursing homes: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shen Chen ◽  
Bridie Kent ◽  
Yan Cui
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Scoping Review ◽  
Respiratory Infections ◽  
Data Extraction ◽  
Nursing Home Residents ◽  
Final Analysis ◽  
Rehabilitation Program ◽  
Cochrane Library ◽  
Cognitive State

Abstract Background Dysphagia is highly prevalent condition in older adults living in nursing homes. There is also evidence indicating that aspiration is one of the major health risks for these older adults, which is more likely to result in respiratory infections, aspiration pneumonia and sudden bolus death. Evidence syntheses have demonstrated the effectiveness of interventions for prevention of aspiration among hospitalized older people. The aim of this scoping review is to describe the current spread of interventions to prevent or reduce aspiration in older adults with dysphagia with a specific focus on those who reside in nursing homes. Methods The Joanna Briggs Institute methods and PRISMA-ScR guidelines were used to inform this review. MEDLINE, CINAHL, EMBASE, Cochrane Library, Joanna Briggs Institute EBP Database and Web of Science were searched for related articles from 2010 to 2020 as well as Chinese databases (CNKI, WANFANG DATA and VIP) and databases for unpublished material. A three-step search strategy was utilized, including the use of citation software to manage search results and de-duplication, abstract review and full-text review by two reviewers. Details of included studies were then extracted using a prepared data extraction tool. The resulting map was displayed in tabular form along with a narrative summary. Results Although 637 articles were located, 19 papers were included in the final analysis. Interventions to prevent aspiration in older adults with dysphagia living in nursing homes included: more bedside evaluation, modification of dietary, creating an appropriate environment for swallowing, providing appropriate feeding assistance, appropriate posture or maneuver for swallowing, appropriate rehabilitation program, medication treatment, and stimulation treatment. Conclusion Nursing homes, particularly those in developing countries, require more support for staff training and necessary equipment. Professional interventions provided by speech and language therapists are still limited in the setting of nursing homes. Modification of dietary was the most frequently used intervention to prevent or reduce aspiration. Multi-disciplinary interventions had the best results for aspiration management, but for many nursing homes, access to such teams is limited. Nursing home residents respond well to person-centered interventions that have a comprehensive consideration of their degree of aspiration risk, health condition, individual feelings and cognitive state.

scholarly journals Intervention elements to reduce inappropriate prescribing for older adults with multimorbidity receiving outpatient care: a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039543
Author(s):  
Jia Qi Lee ◽  
Kate Ying ◽  
Penny Lun ◽  
Keng Teng Tan ◽  
Wendy Ang ◽  
...  
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Data Extraction ◽  
Adult Population ◽  
Grey Literature ◽  
Inappropriate Prescribing ◽  
Complex Interventions ◽  
Final Analysis ◽  
Outpatient Setting ◽  
Cochrane Library

ObjectivePolypharmacy occurs in approximately 30% of older adults aged 65 years or more, particularly among those with multimorbidity. With polypharmacy, there is an associated risk of potentially inappropriate prescribing (PIP). The aims of this scoping review were to (1) identify the intervention elements that have been adopted to reduce PIP in the outpatient setting and (2) determine the behaviour change wheel (BCW) intervention functions performed by each of the identified intervention elements.DesignScoping reviewData sourcesPubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science and Cochrane Library databases, grey literature sources, six key geriatrics journals and the reference lists of review papers.Study selectionAll studies reporting an intervention or strategy that addressed PIP in the older adult population (age ≥65) with multimorbidity in the outpatient setting and in which the primary prescriber is the physician.Data extractionData extracted from the included studies can be broadly categorised into (1) publication details, (2) intervention details and (3) results. This was followed by data synthesis and analysis based on the BCW framework.ResultsOf 8195 studies yielded, 80 studies were included in the final analysis and 14 intervention elements were identified. An average of two to three elements were adopted in each intervention. The three most frequently adopted intervention elements were medication review (70%), training (26.3%) and tool/instrument(s) (22.5%). Among medication reviews, 70% involved pharmacists. The 14 intervention elements were mapped onto five intervention functions: ‘education’, ‘persuasion’, ‘training’, ‘environmental restructuring’ and ‘enablement’.ConclusionPIP is a multifaceted problem that involves multiple stakeholders. As such, interventions that address PIP require multiple elements to target the behaviour of the various stakeholders. The intervention elements and their corresponding functions identified in this scoping review will serve to inform the design of complex interventions that aim to reduce PIP.

scholarly journals Optimising prescribing practices in older adults with multimorbidity: a scoping review of guidelines

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049072
Author(s):  
Penny Lun ◽  
Felicia Law ◽  
Esther Ho ◽  
Keng Teng Tan ◽  
Wendy Ang ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Scoping Review ◽  
Data Extraction ◽  
Grey Literature ◽  
Cochrane Library ◽  
Prescribing Practices ◽  
Usable Knowledge ◽  
Study Selection ◽  
The Cochrane Library

ObjectiveInappropriate polypharmacy occurs when multiple medications are prescribed without clear indications or where harms outweigh their benefits. The aims of this scoping review are to (1) identify prescribing guidelines that are available for older adults with multimorbidity and (2) to identify cross-cutting themes used in these guidelines.DesignScoping review.Data sourcesPubMed, Embase, Web of Science, the Cochrane Library databases, Cumulative Index to Nursing and Allied Health Literature, grey literature sources, six key geriatrics journals, and reference lists of identified review papers. The search was conducted in November 2018 and updated in September 2019.Study selectionGeneral prescribing guidelines tailored to or for adults including older adults with multimorbidity.Data extractionData for publication description, guideline characteristics, information for users and criteria were extracted. The synthesis contains summarised qualitative descriptions of the studies and guideline characteristics as well as identified cross-cutting themes.ResultsOur search strategy yielded 10 427 unique citations, of which 70 fulfilled the inclusion criteria for synthesis. Among these, there were 61 unique guidelines and tools which used implicit, explicit, mixed or other approaches in the prescriber decision-making process. There are 11 cross-cutting themes identified in the guidelines. Prescriber-related themes are: conduct a comprehensive assessment before prescribing, identify patients’ needs, goals and priorities, adopt shared decision-making, consider evidence-based recommendations, use clinical prescribing tools, incorporate multidisciplinary inputs and embrace technology-enabled prescribing. Wider organisation-related and system-related themes related to education, training and the work environment are also identified.ConclusionsFrom guidelines and tools identified, eleven cross-cutting themes provide a usable knowledge base when seeking to optimise prescribing among older adults with multimorbidity. Incorporating these themes in an approach that uses mixed criteria and implementation information could facilitate greater uptake of published prescribing recommendations.

scholarly journals Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses

2021 ◽  
pp. 155982762110012
Author(s):  
Fei-Chi Yang ◽  
Aishwarya B. Desai ◽  
Pelareh Esfahani ◽  
Tatiana V. Sokolovskaya ◽  
Doreen J. Bartlett
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Health Outcomes ◽  
Scoping Review ◽  
General Health ◽  
Tai Chi ◽  
Well Being ◽  
Cochrane Library ◽  
Care Providers ◽  
Meta Analyses

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

Artificial Intelligence and Ethics in Dentistry: A Scoping Review

2021 ◽  
pp. 002203452110138
Author(s):  
C.M. Mörch ◽  
S. Atsu ◽  
W. Cai ◽  
X. Li ◽  
S.A. Madathil ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Scoping Review ◽  
Ethical Issues ◽  
Data Extraction ◽  
Cochrane Library ◽  
Data Sets ◽  
Ethical Challenges ◽  
Internal Validation ◽  
Neural Learning ◽  
Learning Techniques

Dentistry increasingly integrates artificial intelligence (AI) to help improve the current state of clinical dental practice. However, this revolutionary technological field raises various complex ethical challenges. The objective of this systematic scoping review is to document the current uses of AI in dentistry and the ethical concerns or challenges they imply. Three health care databases (MEDLINE [PubMed], SciVerse Scopus, and Cochrane Library) and 2 computer science databases (ArXiv, IEEE Xplore) were searched. After identifying 1,553 records, the documents were filtered, and a full-text screening was performed. In total, 178 studies were retained and analyzed by 8 researchers specialized in dentistry, AI, and ethics. The team used Covidence for data extraction and Dedoose for the identification of ethics-related information. PRISMA guidelines were followed. Among the included studies, 130 (73.0%) studies were published after 2016, and 93 (52.2%) were published in journals specialized in computer sciences. The technologies used were neural learning techniques for 75 (42.1%), traditional learning techniques for 76 (42.7%), or a combination of several technologies for 20 (11.2%). Overall, 7 countries contributed to 109 (61.2%) studies. A total of 53 different applications of AI in dentistry were identified, involving most dental specialties. The use of initial data sets for internal validation was reported in 152 (85.4%) studies. Forty-five ethical issues (related to the use AI in dentistry) were reported in 22 (12.4%) studies around 6 principles: prudence (10 times), equity (8), privacy (8), responsibility (6), democratic participation (4), and solidarity (4). The ratio of studies mentioning AI-related ethical issues has remained similar in the past years, showing that there is no increasing interest in the field of dentistry on this topic. This study confirms the growing presence of AI in dentistry and highlights a current lack of information on the ethical challenges surrounding its use. In addition, the scarcity of studies sharing their code could prevent future replications. The authors formulate recommendations to contribute to a more responsible use of AI technologies in dentistry.

scholarly journals Addressing barriers to the conduct and application of research in complementary and alternative medicine: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yasamin Veziari ◽  
Saravana Kumar ◽  
Matthew Leach
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Scoping Review ◽  
Data Extraction ◽  
Grey Literature ◽  
Evidence Base ◽  
Cochrane Library ◽  
Educational Strategies ◽  
The Cochrane Library ◽  
Complementary And Alternative

Abstract Background Over the past few decades, the popularity of complementary and alternative medicine (CAM) has grown considerably and along with it, scrutiny regarding its evidence base. While this is to be expected, and is in line with other health disciplines, research in CAM is confronted by numerous obstacles. This scoping review aims to identify and report the strategies implemented to address barriers to the conduct and application of research in CAM. Methods The scoping review was undertaken using the Arksey and O’Malley framework. The search was conducted using MEDLINE, EMBASE, EMCARE, ERIC, Scopus, Web of Science, The Cochrane Library, JBI and the grey literature. Two reviewers independently screened the records, following which data extraction was completed for the included studies. Descriptive synthesis was used to summarise the data. Results Of the 7945 records identified, 15 studies met the inclusion criteria. Using the oBSTACLES instrument as a framework, the included studies reported diverse strategies to address barriers to the conduct and application of research in CAM. All included studies reported the use of educational strategies and collaborative initiatives with CAM stakeholders, including targeted funding, to address a range of barriers. Conclusions While the importance of addressing barriers to the conduct and application of research in CAM has been recognised, to date, much of the focus has been limited to initiatives originating from a handful of jurisdictions, for a small group of CAM disciplines, and addressing few barriers. Myriad barriers continue to persist, which will require concerted effort and collaboration across a range of CAM stakeholders and across multiple sectors. Further research can contribute to the evidence base on how best to address these barriers to promote the conduct and application of research in CAM.

scholarly journals Clinical parameters and biomarkers predicting spontaneous operational tolerance after liver transplantation: a scoping review protocol

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 2059
Author(s):  
Christian Appenzeller-Herzog ◽  
Steffen Hartleif ◽  
Julien Vionnet
Keyword(s):  
Autoimmune Disease ◽  
Viral Hepatitis ◽  
Scoping Review ◽  
Data Extraction ◽  
Clinical Parameter ◽  
Cochrane Library ◽  
Narrative Form ◽  
Clinical Parameters ◽  
Clinical Trial Registries ◽  
Operational Tolerance

Objective: This scoping review aims at systematically mapping reported prognostic factors for spontaneous immunosuppression (IS) free allograft tolerance (operational tolerance, OT) in non-viral hepatitis and non-autoimmune disease liver transplant (LT) recipients who are undergoing immunosuppression withdrawal (ISW). The results may inform the subsequent conduct of a systematic review with a more specific review question. Background: LT is currently the most effective treatment for end-stage liver diseases. Whereas the short-term outcomes after LT have dramatically improved over the last decades, the long-term outcomes remain unsatisfactory, mainly because of side effects of lifelong IS, such as infections, cardiovascular diseases, malignancies, and nephrotoxicity. ISW studies have shown that OT can be achieved by a subset of LT recipients and recent research has identified biomarkers of OT in these patients. However, an evidence-based selection algorithm for patients that can predictably benefit from ISW is not available to date. The planned review will, therefore, map existing knowledge on prognostic clinical parameters and biomarkers for OT. Inclusion criteria: We will consider studies that record any clinical parameter or biomarker before the initiation of ISW in paediatric or adult non-viral hepatitis and non-autoimmune disease LT recipients and analyse their possible association with ISW outcomes (OT or non-tolerance). Studies addressing the effectiveness of OT-inducing treatments will be excluded. Methods: Embase, MEDLINE, and Cochrane Library will be searched for relevant articles or conference abstracts. Full-texts of selected abstracts will be independently screened for inclusion by two reviewers. References and citing articles of included records will be screened for additional relevant records. Clinical trial registries will be searched for ongoing studies, and their investigators contacted for the sharing of unpublished data. Data from included records will be independently extracted by two reviewers using a prespecified data extraction table and presented in both tabular and narrative form.

scholarly journals Functionalized Nanoparticles Activated by Photodynamic Therapy as an Antimicrobial Strategy in Endodontics: A Scoping Review

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1064
Author(s):  
Pablo Betancourt ◽  
Nadia Brocal ◽  
Eulàlia Sans-Serramitjana ◽  
Carlos Zaror
Keyword(s):  
Photodynamic Therapy ◽  
Scoping Review ◽  
Selection Process ◽  
Data Extraction ◽  
Cochrane Library ◽  
Qualitative Synthesis ◽  
Promising Alternative ◽  
Root Canals ◽  
Low Cytotoxicity

The eradication of endodontic pathogens continues to be the focus of the search for new root canal system (RCS) disinfection strategies. This scoping review provides a comprehensive synthesis of antimicrobial photodynamic therapy (aPDT) using nanoparticles (NPs) as an alternative to optimize RCS disinfection. A systematic search up to March 2021 was carried out using the MEDLINE, EMBASE, Scopus, Lilacs, Central Cochrane Library, and BBO databases. We included studies focused on evaluating the activation of NPs by aPDT in inoculated root canals of human or animal teeth or bacterial cultures in the laboratory. The selection process and data extraction were carried out by two researchers independently. A qualitative synthesis of the results was performed. A total of seventeen studies were included, of which twelve showed a substantial antibacterial efficacy, two assessed the substantivity of the disinfection effect, and three showed low cytotoxicity. No adverse effects were reported. The use of functionalized NPs with photosensitizer molecules in aPDT has been shown to be effective in reducing the bacteria count, making it a promising alternative in endodontic disinfection. Further studies are needed to assess the development of this therapy in in vivo conditions, with detailed information about the laser parameters used to allow the development of safe and standardized protocols.

scholarly journals Motivation as a mechanism underpinning exercise-based falls prevention programmes for older adults with cognitive impairment: a realist review

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024982 ◽  
Author(s):  
Vicky Booth ◽  
Rowan Harwood ◽  
Jennie E Hancox ◽  
Victoria Hood-Moore ◽  
Tahir Masud ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Exercise Intervention ◽  
Data Extraction ◽  
Realist Review ◽  
Falls Prevention ◽  
Cochrane Library ◽  
Programme Theory ◽  
Eligibility Criteria ◽  
Prevention Programmes

ObjectivesThis review aimed to identify mechanisms underlying participation in falls prevention interventions, in older adults with cognitive impairment. In particular we studied the role of motivation.DesignA realist review of the literature.Data sourcesEMBASE, MEDLINE, CINAHL, the Cochrane Library, PsycINFO and PEDRO.Eligibility criteriaPublications reporting exercise-based interventions for people with cognitive impairment, including dementia, living in the community.Data extraction and synthesisA ‘rough programme theory’ (a preliminary model of how an intervention works) was developed, tested against findings from the published literature and refined. Data were collected according to elements of the programme theory and not isolated to outcomes. Motivation emerged as a key element, and was prioritised for further study.ResultsAn individual will access mechanisms to support participation when they think that exercise will be beneficial to them. Supportive mechanisms include having a ‘gate-keeper’, such as a carer or therapist, who shares responsibility for the perception of exercise as beneficial. Lack of access to support decreases adherence and participation in exercise. Motivational mechanisms were particularly relevant for older adults with mild-to-moderate dementia, where the exercise intervention was multicomponent, in a preferred setting, at the correct intensity and level of progression, correctly supported and considered, and flexibly delivered.ConclusionMotivation is a key element enabling participation in exercise-based interventions for people with cognitive impairment. Many of the mechanisms identified in this review have parallels in motivational theory. Clinically relevant recommendations were derived and will be used to further develop and test a motivationally considered exercise-based falls intervention for people with mild dementia.PROSPERO registration numberCRD42015030169.

Chronic Disease Self-Management Among Iranian Older Adults: A Scoping Review

2019 ◽  
Vol 39 (8) ◽  
pp. 922-930 ◽  
Author(s):  
Aein Zarrin ◽  
Nima Tourchian ◽  
George A. Heckman
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Disease ◽  
Scoping Review ◽  
Self Management ◽  
Cochrane Library ◽  
Self Monitoring ◽  
Care Models ◽  
Language Objectives ◽  
Main Components

Background: Implementing care models that emphasize chronic disease self-management (CDSM) strategies may be an effective approach to the growing prevalence of chronic conditions in Iran. We, therefore, conducted a scoping review on CDSM among older Iranians to identify existing gaps and opportunities to improve chronic disease care. Method: We conducted a search in CINAHL, EMBASE, MEDLINE/PubMed, and Cochrane library. Selected articles were charted based on year of publication, language, objectives, methods, target chronic disease(s), sample demographics, self-management type, and key findings. Results: We selected 73 articles. The main components of CDSM addressed were social support, education, physical activity, nutrition, self-monitoring, spirituality, and financial support. Older Iranians reported low levels of physical activity. Conclusion: Enhancing the quality of CDSM research and provision of coaching to enhance older adults’ social and mental health are among the main strategies to enhance CDSM among the Iranian older population.

scholarly journals Clinical prediction models to diagnose neonatal sepsis: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039712
Author(s):  
Samuel R Neal ◽  
David Musorowegomo ◽  
Hannah Gannon ◽  
Mario Cortina Borja ◽  
Michelle Heys ◽  
...  
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
Neonatal Sepsis ◽  
Prediction Models ◽  
Data Extraction ◽  
Cochrane Library ◽  
Clinical Prediction ◽  
Clinical Prediction Models ◽  
Scoping Reviews ◽  
Review Protocol

IntroductionNeonatal sepsis is responsible for significant morbidity and mortality worldwide. Diagnosis is often difficult due to non-specific clinical features and the unavailability of laboratory tests in many low-income and middle-income countries (LMICs). Clinical prediction models have the potential to improve diagnostic accuracy and rationalise antibiotic usage in neonatal units, which may result in reduced antimicrobial resistance and improved neonatal outcomes. In this paper, we outline our scoping review protocol to map the literature concerning clinical prediction models to diagnose neonatal sepsis. We aim to provide an overview of existing models and evidence underlying their use and compare prediction models between high-income countries and LMICs.Methods and analysisThe protocol was developed with reference to recommendations by the Joanna Briggs Institute. Searches will include six electronic databases (Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, Global Index Medicus and the Cochrane Library) supplemented by hand searching of reference lists and citation analysis on included studies. No time period restrictions will be applied but only studies published in English or Spanish will be included. Screening and data extraction will be performed independently by two reviewers, with a third reviewer used to resolve conflicts. The results will be reported by narrative synthesis in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and disseminationThe nature of the scoping review methodology means that this study does not require ethical approval. Results will be disseminated through peer-reviewed publications and conference presentations, as well as through engagement with peers and relevant stakeholders.

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