Paramedics working in general practice: a scoping review

Background: The term ‘paramedic’ has traditionally related to a healthcare professional trained to provide pre-hospital emergency care; however, paramedics are increasingly taking on novel additional non-emergency roles. General practice is facing unprecedented demand for its services related to rising expectations, an aging society and increased prevalence of chronic disease. Paramedics may be recruited to work in general practice to meet some of these demands. We undertook a scoping review to map the current literature considering paramedics working in general practice and inform follow-on research. Methods: We employed the six-stage scoping review framework developed by Arksey and O’Malley. Our research question was ‘to identify the scope of practice, nature of training/qualifications, challenges faced, and impacts of paramedics working in general practice’. Results: After searching PUBMED (Medline, n = 487), EMBASE (n = 536) and the Cochrane Library (n = 0) in June 2020, we identified eleven full-text articles that met our inclusion criteria. The literature suggests that paramedics have diverse skills that enable roles within general practice, some of which are context specific. Additional training is considered necessary to facilitate the transition from emergency care to general practice. We found no research that quantitatively assessed the impact of paramedics working in general practice on healthcare expenditure or patient health outcomes. Conclusions: There is a paucity of empiric scientific literature considering paramedic working in general practice. Further research is needed to inform training pathways, the structure of clinical practice and to measure outcomes.

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COVID-19 and frontline health workers in West Africa: a scoping review

10.1101/2020.10.15.20213249 ◽

2020 ◽

Author(s):

Kingsley K. A. Pereko ◽

Edward Kwabena Ameyaw ◽

Shaibu Bukari ◽

Victoria Acquaye ◽

Alfred Dickson Dai-Kosi

Keyword(s):

West Africa ◽

Scoping Review ◽

Health Workers ◽

Research Question ◽

Cost Effective ◽

West African ◽

Cochrane Library ◽

African Countries ◽

Frontline Health Workers ◽

The Impact

AbstractIntroductionThe novel Coronavirus 2019 (COVID-19) has become a severe global health threat since its emergence. Overcoming the virus is partly dependent on the holistic wellbeing of frontline health workers. Implications of COVID-19 on frontline health workers in West Africa could be substantial given the limited resources and logistics. This scoping review maps available literature on the impact of COVID-19 on frontline health workers in West Africa.Materials and methodsLiterature on the impact of COVID-19 on frontline health workers in West Africa were searched in six databases namely Cochrane Library, PubMed, EMBASE, Google Scholar, Africa Journals Online (AJOL) and CINAHL. Further search was done across websites of the ministries of health of West African countries and notable organisations. We conducted a narrative synthesis of the findings taking cognisance of the overarching purpose of the study and the research question.ResultsOf the 67 studies identified, 19 were included in the final synthesis. Three main themes emerged and these are impact of COVID-19 on frontline health workers, drivers of susceptibility to COVID-19 and government/donor support. A greater number of the studies originated from Nigeria. Each study reported at least one impact of COVID-19 on frontline health workers in West Africa. The impacts included death, fear, unwillingness to attend to COVID-19 patients and stigmatisation. Some health workers were not adhering to the safety protocols coupled with periodic shortage of personal protective equipment (PPE) and thereby had an increased susceptibility.ConclusionBeing the first scoping review on the impact of COVID-19 on frontline health workers in West Africa, the study has illustrated the urgent need for West African governments to enact laws/rules that would compel all frontline health workers to adhere to all the COVID-19 protocols at the workplace. To end intermittent shortage or issue of inadequate PPEs, governments ought to liaise with local industries by empowering them, providing financial support and creating a conducive atmosphere for them to produce cost effective PPEs using available local resources.Scoping review registrationDOI 10.17605/OSF.IO/B9NXZ (Open Science Framework)

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Barriers and facilitators to conducting research by early career psychiatrists: a literature review

Global Psychiatry ◽

10.2478/gp-2019-0018 ◽

2019 ◽

Vol 2 (2) ◽

pp. 135-154

Author(s):

Katja Koelkebeck ◽

Maja Pantovic Stefanovic ◽

Dorota Frydecka ◽

Claudia Palumbo ◽

Olivier Andlauer ◽

...

Keyword(s):

Research Participation ◽

Early Career ◽

Cochrane Library ◽

Inclusion Criteria ◽

Research Career ◽

Hand Search ◽

Electronic Search ◽

Conducting Research ◽

The Cochrane Library ◽

To Receive

AbstractObjectivesTo understand and identify factors that promote and prevent research participation among early career psychiatrists (ECPs), in order to understand what would encourage more ECPs to pursue a research career.MethodsWe conducted an electronic search of databases (PubMed and the Cochrane library) using the keywords ‘doctors’, ‘trainees’, ‘residents’, ‘physicians’ and ‘psychiatric trainees’ as well as ‘research’ (MeSH) and ‘publishing’ (MeSH). This search was complemented by a secondary hand search.ResultsWe identified 524 articles, of which 16 fulfilled inclusion criteria for this review. The main barriers included lack of dedicated time for research, lack of mentoring and lack of funding. The main facilitators were opportunities to receive mentorship and access to research funding.ConclusionsAction is needed to counteract the lack of ECPs interested in a career in research. Specific programs encouraging ECPs to pursue research careers and having access to mentors could help increase the current numbers of researching clinicians in the field.

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Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

The American Surgeon ◽

10.1177/0003134821989034 ◽

2021 ◽

pp. 000313482198903

Author(s):

Mitsuru Ishizuka ◽

Norisuke Shibuya ◽

Kazutoshi Takagi ◽

Hiroyuki Hachiya ◽

Kazuma Tago ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Significant Difference ◽

The Cochrane Library ◽

The Impact ◽

The Relationship ◽

Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

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Association between serum visfatin levels and psoriasis and their correlation with disease severity: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211002381 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052110023

Author(s):

Qian Zou ◽

Jiawei Si ◽

Yatao Guo ◽

Jiayu Yu ◽

Huijuan Shi

Keyword(s):

Body Mass Index ◽

Meta Analysis ◽

Severity Index ◽

Cochrane Library ◽

Control Group ◽

Inclusion Criteria ◽

Subgroup Analyses ◽

Mean Differences ◽

The Cochrane Library ◽

Psoriasis Severity

Objective To determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis. Methods The electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates. Results A total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI ( r = 0.51, 95% CI 0.14, 0.75). Conclusions This meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.

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

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03371-6 ◽

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.

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Relative infectiousness of asymptomatic SARS-CoV-2 infected persons compared with symptomatic individuals: a rapid scoping review

BMJ Open ◽

10.1136/bmjopen-2020-042354 ◽

2021 ◽

Vol 11 (5) ◽

pp. e042354

Author(s):

David McEvoy ◽

Conor McAloon ◽

Aine Collins ◽

Kevin Hunt ◽

Francis Butler ◽

...

Keyword(s):

Scoping Review ◽

Quantitative Measure ◽

Contact Tracing ◽

Cochrane Library ◽

International Studies ◽

Screening Process ◽

Modelling Studies ◽

Asymptomatic Individuals ◽

Definition Of ◽

The Cochrane Library

ObjectivesThe aim of this study was to determine the relative infectiousness of asymptomatic SARS-CoV-2 infected persons compared with symptomatic individuals based on a scoping review of available literature.DesignRapid scoping review of peer-reviewed literature from 1 January to 5 December 2020 using the LitCovid database and the Cochrane library.SettingInternational studies on the infectiousness of individuals infected with SARS-CoV-2.ParticipantsStudies were selected for inclusion if they defined asymptomatics as a separate cohort distinct from presymptomatics and if they provided a quantitative measure of the infectiousness of asymptomatics relative to symptomatics.Primary outcome measuresPCR result (PCR studies), the rate of infection (mathematical modelling studies) and secondary attack rate (contact tracing studies) - in each case from asymptomatic in comparison with symptomatic individuals.ResultsThere are only a limited number of published studies that report estimates of relative infectiousness of asymptomatic compared with symptomatic individuals. 12 studies were included after the screening process. Significant differences exist in the definition of infectiousness. PCR studies in general show no difference in shedding levels between symptomatic and asymptomatic individuals; however, the number of study subjects is generally limited. Two modelling studies estimate relative infectiousness to be 0.43 and 0.57, but both of these were more reflective of the infectiousness of undocumented rather than asymptomatic cases. The results from contact tracing studies include estimates of relative infectiousness of 0, but with insufficient evidence to conclude that it is significantly different from 1.ConclusionsThere is considerable heterogeneity in estimates of relative infectiousness highlighting the need for further investigation of this important parameter. It is not possible to provide any conclusive estimate of relative infectiousness, as the estimates from the reviewed studies varied between 0 and 1.

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Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980820000355 ◽

2021 ◽

pp. 1-19

Author(s):

Jonathan Plante ◽

Karine Latulippe ◽

Edeltraut Kröger ◽

Dominique Giroux ◽

Martine Marcotte ◽

...

Keyword(s):

Cognitive Impairment ◽

Length Of Stay ◽

Acute Care ◽

Scoping Review ◽

Research Question ◽

Positive Association ◽

Well Being ◽

Future Research ◽

Care Hospital ◽

The Impact

Abstract Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

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Psychosocial Interventions Situated Within the Natural Environment with Young People Who Have Experienced Trauma: A Scoping Review

The British Journal of Social Work ◽

10.1093/bjsw/bcaa093 ◽

2020 ◽

Author(s):

Jennifer Boddy ◽

Maddy Slattery ◽

Jianqiang Liang ◽

Hilary Gallagher ◽

Amanda Smith ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Scoping Review ◽

Natural Environment ◽

Psychosocial Interventions ◽

Database Search ◽

Inclusion Criteria ◽

Clinical Change ◽

Social Work Interventions ◽

The Impact

Abstract The natural environment is increasingly used in therapeutic psychosocial interventions for young people who have experienced trauma. However, as the research in this area has yet to be synthesised, very little is known about the types and outcomes of interventions. This prevents the optimisation of social work interventions in outdoor settings. Consequently, a scoping review of peer-reviewed research published from 2008 to 2018 was undertaken to examine how nature is being used in psychosocial interventions with young people aged ten to twenty-four years who have experienced trauma and the impact of these interventions on young people’s mental health. The database search identified 5,425 records; however, only ten papers met the inclusion criteria. These papers suggested that positive changes across a range of mental health outcomes for young people were achieved in psychosocial interventions which were situated in, or made use of the natural environment, although it is unclear whether the environment influenced the outcomes. The scoping review also highlighted the need for conducting further research that examines how environmental factors contribute to clinical change for young people who have experienced trauma.

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

BMJ Open ◽

10.1136/bmjopen-2020-040556 ◽

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.

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Excess weight and dyslipidemia and their complications during pregnancy: a systematic review

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042016000200002 ◽

2016 ◽

Vol 16 (2) ◽

pp. 93-101 ◽

Cited By ~ 2

Author(s):

Iramar Baptistella do Nascimento ◽

Willian Barbosa Sales ◽

Raquel Fleig ◽

Grazielle Dutra da Silva ◽

Jean Carl Silva

Keyword(s):

Systematic Review ◽

Key Words ◽

Excess Weight ◽

Cochrane Library ◽

Obstetric Outcomes ◽

Lipid Disorders ◽

Key Words Lipids ◽

The Cochrane Library ◽

The Impact ◽

In Pregnancy

Abstract Objectives: to identify bibliographically disorders related to excess weight, dyslipidemia and their complication during pregnancy and in the fetus and newborn. Methods: a systematic review including observational and interventional studies and reviews, based on MEDLINE, LILACS, Embase and the Cochrane Library between 2000 and 2015. The key-words "lipids, pregnancy, obesity and newborn" were used to establish a selective stage for inclusion/exclusion of titles, repeated studies, key-words, abstracts, methodological incompatibility and correlation with objectives. Results: 58 studies were selected, of which 36 (62%) addressed prevention and the risk in pregnancy of excess weight and lipid disorders and 19 (32.7%) suggestions and/or consequences for the fetus and newborn. Conclusions: excess weight and lipidemic disorders in pregnancy are causes for concern in scientific studies, posing risks both for the mother and the newborn. Higher prevalence of caesarian and pre-eclampsia were the two most noteworthy complications for gestational outcomes. In short, the impact on care of maternal habits and excess weight during pregnancy is highly significant, owing to the different degrees of complication in obstetric outcomes and their influence on the clinical characteristics of the newborn.

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