Implementation strategies to improve preconception and antenatal care for tobacco smoking, alcohol consumption and weight management: a systematic review protocol

Abstract Background Despite existing best practice care recommendations for addressing tobacco smoking, alcohol consumption and weight management in preconception and antenatal care, such recommendations are often not implemented into routine practice. Effective strategies that target known barriers to implementation are key to reducing this evidence to practice gap. The aim of this review is to synthesise the evidence on the effectiveness of implementation strategies in improving the provision of preconception and antenatal care for these modifiable risk factors. Methods Randomised and non-randomised study designs will be eligible for inclusion if they have a parallel control group. We will include studies that either compare an implementation strategy to usual practice or compare two or more strategies. Participants may include any health service providing preconception or antenatal care to women and/or the health professionals working within such a service. The primary outcome will be any measure of the effectiveness of implementation strategies to improve preconception and/or antenatal care for tobacco smoking, alcohol consumption and/or weight management (including care to improve nutrition and/or physical activity). Secondary outcomes will include the effect of the implementation strategy on women’s modifiable risk factors, estimates of absolute costs or cost-effectiveness and any reported unintentional consequences. Eligible studies will be identified via searching Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, ProQuest Dissertations and Theses and other sources (e.g. contacting experts in the field). Study selection, data extraction and risk of bias will be assessed independently by two review authors and differences resolved by a third reviewer. If data permits, we will conduct fixed-effects or random-effects meta-analysis where appropriate. If studies do not report the same outcome or there is significant heterogeneity, results will be summarised narratively. Discussion This review will identify which implementation strategies are effective in improving the routine provision of preconception and antenatal care for tobacco smoking, alcohol consumption and weight management. Such a review will be of interest to service providers, policy makers and implementation researchers seeking to improve women’s modifiable risk factors in preconception and antenatal care settings. Systematic review registration PROSPERO CRD42019131691

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Risk factors for new-onset atrial fibrillation on the general adult ICU: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-024640 ◽

2018 ◽

Vol 8 (9) ◽

pp. e024640 ◽

Cited By ~ 2

Author(s):

Jonathan Bedford ◽

Mirae Harford ◽

Tatjana Petrinic ◽

J Duncan Young ◽

Peter J Watkinson

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Systematic Review ◽

Systematic Reviews ◽

Cochrane Library ◽

Future Research ◽

Published Data ◽

Modifiable Risk Factors ◽

Cochrane Central Register ◽

New Onset

IntroductionAtrial fibrillation (AF) is a common arrhythmia in the critical care environment. New-onset AF is associated with increased mortality and intensive care unit (ICU) length of stay. Observational studies have identified several epidemiological and disease severity-related factors associated with developing new-onset AF on the ICU. However, there are limited data on the modifiable risk factors in the general adult ICU population.We describe a protocol for a systematic review of modifiable and non-modifiable risk factors for new-onset AF in the general adult ICU population. The results of this review will aid the development of risk prediction tools and inform future research into AF prevention on the ICU.Methods and analysisMedical Literature Analysis and Retrieval System Online, Excerpta Medica database and the Cochrane Library, including Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials will be searched for studies that assess the association of patient variables, investigation results, interventions and diagnoses associated with subsequent new-onset AF on the ICU.Only studies involving adult patients admitted to non-service-specific ICUs will be included. We will extract data relating to the statistical association between reversible and non-reversible factors and AF, the quality of the studies and the generalisability of the results. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review will be based on published data, and therefore ethical approval is not required. The findings of this study will be disseminated through publication in a peer reviewed journal and will be presented at conferences.PROSPERO registration numberCRD42017074221.

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Modifiable risk factors for cognitive impairment in Parkinson's disease: A systematic review and meta‐analysis of prospective cohort studies

Movement Disorders ◽

10.1002/mds.27665 ◽

2019 ◽

Vol 34 (6) ◽

pp. 876-883 ◽

Cited By ~ 11

Author(s):

Yu Guo ◽

Wei Xu ◽

Feng‐Tao Liu ◽

Jie‐Qiong Li ◽

Xi‐Peng Cao ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Modifiable Risk Factors ◽

Prospective Cohort Studies

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Effectiveness and meaningful use of paediatric surgical safety checklists and their implementation strategies: a systematic review with narrative synthesis

BMJ Open ◽

10.1136/bmjopen-2017-016298 ◽

2017 ◽

Vol 7 (10) ◽

pp. e016298 ◽

Cited By ~ 10

Author(s):

Janaka Lagoo ◽

Steven R Lopushinsky ◽

Alex B Haynes ◽

Paul Bain ◽

Helene Flageole ◽

...

Keyword(s):

Systematic Review ◽

High Risk ◽

Implementation Strategy ◽

Citation Index ◽

Improve Patient Safety ◽

Implementation Strategies ◽

Meaningful Use ◽

Narrative Synthesis ◽

Surgical Safety ◽

Full Text Review

ObjectiveTo examine the effectiveness and meaningful use of paediatric surgical safety checklists (SSCs) and their implementation strategies through a systematic review with narrative synthesis.Summary background dataSince the launch of the WHO SSC, checklists have been integrated into surgical systems worldwide. Information is sparse on how SSCs have been integrated into the paediatric surgical environment.MethodsA broad search strategy was created using Pubmed, Embase, CINAHL, Cochrane Central, Web of Science, Science Citation Index and Conference Proceedings Citation Index. Abstracts and full texts were screened independently, in duplicate for inclusion. Extracted study characteristic and outcomes generated themes explored through subgroup analyses and idea webbing.Results1826 of 1921 studies were excluded after title and abstract review (kappa 0.77) and 47 after full-text review (kappa 0.86). 20 studies were of sufficient quality for narrative synthesis. Clinical outcomes were not affected by SSC introduction in studies without implementation strategies. A comprehensive SSC implementation strategy in developing countries demonstrated improved outcomes in high-risk surgeries. Narrative synthesis suggests that meaningful compliance is inconsistently measured and rarely achieved. Strategies involving feedback improved compliance. Stakeholder-developed implementation strategies, including team-based education, achieved greater acceptance. Three studies suggest that parental involvement in the SSC is valued by parents, nurses and physicians and may improve patient safety.ConclusionsA SSC implementation strategy focused on paediatric patients and their families can achieve high acceptability and good compliance. SSCs’ role in improving measures of paediatric surgical outcome is not well established, but they may be effective when used within a comprehensive implementation strategy especially for high-risk patients in low-resource settings.

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Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review

Annals of Translational Medicine ◽

10.21037/atm.2019.10.115 ◽

2019 ◽

Vol 7 (22) ◽

pp. 632-632 ◽

Cited By ~ 1

Author(s):

Xi Ji ◽

Xin-Yi Leng ◽

Yi Dong ◽

Ya-Hui Ma ◽

Wei Xu ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Carotid Atherosclerosis ◽

Meta Analysis ◽

Modifiable Risk Factors

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Tobacco smoking and alcohol consumption as risk factors for thymoma – A European case-control study

Cancer Epidemiology ◽

10.1016/j.canep.2019.06.008 ◽

2019 ◽

Vol 61 ◽

pp. 133-138 ◽

Cited By ~ 3

Author(s):

Mikael Eriksson ◽

Linda Kaerlev ◽

Preben Johansen ◽

Noemia Afonso ◽

Wolfgang Ahrens ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Consumption ◽

Tobacco Smoking ◽

Case Control Study ◽

Case Control ◽

Control Study

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Global risk factors of contrast-induced acute kidney injury: systematic review and meta-analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.2448 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Liu ◽

Y Liu ◽

S Chen ◽

E.Y.M Chung ◽

L Lei ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Left Ventricular ◽

Public Institution ◽

Left Ventricular Ejection ◽

Modifiable Risk Factors ◽

Funding Source

Abstract Background Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors. Methods We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region. Findings We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences. Bubble chart of the 12 risk factors Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China

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P62 RISK FACTORS AND OUTCOMES ASSOCIATED WITH ANASTOMOTIC LEAKS (AL) FOLLOWING OESOPHAGECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Diseases of the Esophagus ◽

10.1093/dote/doz092.62 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

K Kamarajah Sivesh ◽

Lin Aaron ◽

Tharmaraja Thahesh ◽

Bharwada Yashvi ◽

R Bundred James ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Major Complication ◽

Adverse Outcomes ◽

Cardiac Complications ◽

Modifiable Risk Factors ◽

Anastomotic Leaks ◽

Patient Counselling ◽

Prolonged Hospital

Abstract Introduction Anastomotic leaks (AL) are a major complication after oesophagectomy. This meta-analysis aimed to determine identify risks factors for AL (pre-operative, intra-operative and post-operative factors) and assess the consequences to outcome on patients who developed an AL. Methods This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 31st December 2018. A meta-analysis was conducted with the use of random-effects modelling and prospectively registered with the PROSPERO database (Registration CRD42018130732). Results This review identified 174 studies reporting outcomes of 74,226 patients undergoing oesophagectomy. The overall pooled AL rates were 11%, ranging from 0 - 49% in individual studies. Majority of studies were from Asia (n=79). In pooled analyses, 23 factors were associated with AL (17 preoperative and six intraoperative). AL were associated with adverse outcomes including pulmonary (OR: 4.54, CI95%: 2.99 - 6.89, p<0.001) and cardiac complications (OR: 2.44, CI95%: 1.77 - 3.37, p<0.001), prolonged hospital stay (mean difference: 15 days, CI95%: 10 - 21 days, p<0.001 and in-hospital mortality (OR: 5.91, CI95%: 1.41 - 24.79, p=0.015). Conclusion AL are a major complication following oesophagectomy accounting for major morbidity and mortality. This meta-analysis identified modifiable risk factors for AL which can be a target for interventions to reduce anastomotic leak rates. Furthermore, identification of both modifiable and non-modifiable risk factors will facilitate risk stratification and prediction of AL enabling better perioperative planning, patient counselling and informed consent.

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