scholarly journals Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252461
Author(s):  
Athira Balakrishnan ◽  
Sandra Puthean ◽  
Gautam Satheesh ◽  
Unnikrishnan M. K. ◽  
Muhammed Rashid ◽  
...  

Background & objective Though blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education. Methods PubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify published literature. The retrieved studies from databases were screened for its title and abstracts followed by the full-text in accordance with the pre-defined inclusion and exclusion criteria. Methodological quality was appraised by modified Ottawa scale. Random effect model used for statistical modelling. Key findings A total of 26 studies were included for systematic review. Out of which 20 studies with 4525 participants for meta-analysis which employed traditional teaching in control group. Results showed a statistically significant positive effect size on knowledge (standardized mean difference [SMD]: 1.35, 95% confidence interval [CI]: 0.91 to 1.78, p<0.00001) and skill (SMD: 0.68; 95% CI: 0.19 to 1.16; p = 0.006) using a random effect model. Subgroup analysis of cohort studies showed, studies from developed countries had a larger effect size (SMD: 1.54, 95% CI: 1.01 to 2.06), than studies from developing countries(SMD: 0.44, 95% CI: 0.23 to 0.65, studies with MCQ pattern as outcome assessment had larger effect size (SMD: 2.81, 95% CI: 1.76 to 3.85) than non-MCQs (SMD 0.53, 95% CI 0.33 to 0.74), and BL with case studies (SMD 2.72, 95% CI 1.86–3.59) showed better effect size than non-case-based studies (SMD: 0.22, CI: 0.02 to 0.41). Conclusion BL is associated with better academic performance and achievement than didactic teaching in pharmacy education.

2020 ◽  
Vol 8 (3) ◽  
pp. 259-264
Author(s):  
Sanaz Musavi ◽  
Leila Nikniaz ◽  
Hosein Hoseinifard ◽  
Arezou Hamzehzadeh ◽  
Shabnam Vazifekhah

This systematic review and meta-analysis aimed to evaluate the effect of betamethasone and dexamethasone on biophysical profile (BPP) parameters. In addition, it was performed in 2017, using several databases such as PubMed/MEDLINE, Scopus, EMBASE, Cochrane library, ISI Web of science, Proquest, and Google scholar, along with Magiran SID and IranMedex. Eligible studies were selected by two reviewers and the outcomes of interest were extracted as well. Meta-analysis was done using the random effect model. Further, I-square statistic test was used for heterogeneity analysis and the presence of publication bias was also checked. At last, 12 studies were included and a random and fixed effect model was used for analysis. The pooled event rates were 4.5% (95% CI = 0.01-64.3, P=0.1), 76.8% (% 95 CI=33.5-95.6, P=0.21), 71.8% (% 95 CI=38.8-91.1, P=0.18), 70.9% (%95 CI=38.4-90.5, P=0.20), and 92.3% (%95 CI=76.0-97.8, P<0.001) for the reduced amniotic fluid volume, baseline fetal heart rate reactivity, fetal breathing, fetal movement, and heart rate variability, respectively. In summary, a significant decrease was observed in heart rate variability following betamethasone and dexamethasone administration. However, further systematic reviews are necessary to differentiate steroid induced changes in the fetal BPP from those due to fetal compromise


2017 ◽  
Vol 31 (4) ◽  
pp. 256-259 ◽  
Author(s):  
Jianneng Chen ◽  
Xuan Wang ◽  
Luzan Chen ◽  
Jie Liu

Introduction Hyaluronan nasal dressing might be promising in promoting reepithelialization after endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the effects of hyaluronan nasal dressing on clinical outcome after ESS. Methods Medical literature data bases were systematically searched. Randomized controlled trials (RCT) that assessed the effect of hyaluronan nasal dressing on the outcome after ESS were included. The results were searched and data were extracted and assessed for quality. The primary outcome was reepithelization. Meta-analysis was performed by using the random-effect model. Results Four RCTs, which involved 352 patients, were included in the meta-analysis. Overall, compared with control intervention, hyaluronan nasal dressing significantly promoted reepithelization (odds ratio [OR] 3.18 [95% confidence interval {CI}, 1.33-7.59]; p = 0.009) and reduced edema (OR 0.45 [95% CI, 0.23-0.89]; p = 0.02) after ESS. However, hyaluronan nasal dressing failed to reduce synechia (OR 0.45 [95% CI, 0.19-1.03]; p = 0.06), crust (OR 1.00 [95% CI, 0.20-5.09]; p = 1.00), and infection (OR 0.84 [95% CI, 0.46-1.53]; p = 0.56) compared with the control group in patients who underwent ESS. Conclusion Compared with “Control intervention” indicates standard nasal dressing without hyaluronan, resorbable hyaluronan nasal dressing could significantly improve reepithelization and decrease edema but had no influence on synechia, crust, and infection after ESS.


2021 ◽  
Vol 9 (1) ◽  
pp. 17-17
Author(s):  
Masood Shirmohammadi ◽  
Mohammad Hossein Somi ◽  
Morteza Ghojazadeh ◽  
Hossein Hosseinfard ◽  
Fatemeh Tahmasebi ◽  
...  

Background: Pancreatitis is considered as the most prevalent serious disorders of endoscopic retrograde cholangiopancreatography (ERCP). Different approaches have been suggested to prevent or reduce this complication. Therefore we aim to investigate them in the current study. This systematic review was performed in 2019 using Pubmed, Embase, google scholar and Cochrane library. Two reviewers selected eligible studies and outcomes of interest were extracted. Meta-analysis was done by using the random or fixed-effect models. I-square statistic test was used for heterogeneity analysis. Material and Methods: Totally, 2758 articles were searched. Thereafter duplicated and irrelevant articles were excluded, and six articles were entered to the present study. Six RCTs were considered eligible with a total participants of 1685. Results: The relative risk of PEP was not significantly different in NSAID and hydration groups (Pooled RR=1.19, 95%CI: 0.40 to 3.50, P-value=0.74). The random effect model indicated no significant differences between NSAID and NSAID+hydration groups regarding the incidence of PEP (Pooled RR=2.19, 95%CI: 0.70 to 6.88, P-value=0.17). Conclusion: Additionally, the results of one study showed that rectal indomethacin alone appeared to be more effective for preventing PEP than no prophylaxis, PSP alone, and the combination of indomethacin and PSP. Using NSAIDs alone or the combination of NSAIDs and hydration can reduce the risk of post-ERCP pancreatitis. Lack of studies comparing different approaches of prophylaxis in post-ERCP patient or the reporting of different parameters among the existing studies seriously limited the possibility and quality of meta-analysis. Further well-designed studies with accurate reporting of data is necessary to provide more reliable conclusion.


2021 ◽  
Vol 12 ◽  
Author(s):  
Xingyun Zhu ◽  
Lina Zhao ◽  
Jing Chen ◽  
Chu Lin ◽  
Fang Lv ◽  
...  

PurposeThe effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes.MethodsPubMed/MEDLINE, Embase, and Cochrane databases were searched for clinical trials that conducted in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of the mean amplitude of glycemic excursion (MAGE), time in range (TIR), time above range (TAR), or time below range (TBR). Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly.ResultsIn total, thirteen trials were included. Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% CI, 1.11 to 7.23%, P&lt;0.01), decreased MAGE (WMDs, -0.68 mmol/L; 95% CI, -1.01 to -0.36 mmol/L, P&lt;0.01) and decreased TAR (WMDs, -3.54%; 95% CI, -5.21 to -1.88%, P&lt;0.01) in patients with diabetes, but showed insignificant effects on TBR. Patients with higher baseline BMI levels was associated with a greater decrease in MAGE (β=-0.392, 95% CI: -0.710, -0.074), and patients with lower baseline HbA1c levels was associated with a greater increase in TBR during physical activities (β=-0.903, 95% CI: -1.550, -0.255).ConclusionPhysical activity was associated with significantly decreased glycemic variability in patients with diabetes. Patients with higher BMI might benefit more from physical activity therapy in terms of a lower MAGE. Hypoglycemia associated with physical activity treatment still warranted caution, especially in patients with intensive glycemic control.Systematic Review RegistrationPROSPERO [CRD42021259807].


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Liuting Zeng ◽  
Ganpeng Yu ◽  
Kailin Yang ◽  
Wensa Hao ◽  
Hua Chen

Aim. Probiotics are considered to be bone metabolism regulators, and their efficacy as an adjuvant treatment option for osteoporosis is still controversial. The purpose of this study is to compare the available data from randomized controlled trials (RCT) of probiotics in the treatment of osteoporosis and osteopenia. Methods. As of June 2021, databases such as Medline, Embase, Web of Science, and Central Cochrane Library have been used for English-language literature searches and CNKI and China Biomedical Database have been used for Chinese-language literature searches. RevMan 5.3 was used for bias risk assessment, heterogeneity detection, and meta-analysis. This research has been registered in PROSPERO (CRD42020085934). Results. This systematic review and meta-analysis included 10 RCTs involving 1156. Compared with the placebo, the absolute value of lumbar spine’s BMD was not statistically significant (WMD 0.04 (−0.00, 0.09), P = 0.07 , random effect model), while the percentage of lumbar spine’s BMD was higher (SMD 1.16 (0.21, 2.12), P = 0.02 , random effect model). Compared with the control group, the percentage of total hip’s BMD was not statistically significant (SMD 0.52 (−0.69, 1.73), P = 0.40 , random effect model). The safety analysis showed that, compared with control group, the adverse events in the experimental group were not statistically significant (RR 1.02 (0.92, 1.12), P = 0.70 , fixed effect model). Conclusion. Probiotics may be safety supplements to improve the lumbar spine’s BMD of patients with osteoporosis and osteopenia. More large-sample, random-controlled, high-quality RCTs are needed to further verify the effectiveness and safety of probiotics in intervening osteoporosis or osteopenia.


Author(s):  
Hong Wei ◽  
Zhenfu Jiang

Abstract Introduction The efficacy of adjuvant chloroquine for glioblastoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of adjuvant chloroquine on treatment efficacy for recurrent glioblastoma. Methods We search PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through January 2020 for randomized controlled trials (RCTs) assessing the efficacy of adjuvant chloroquine for glioblastoma. This meta-analysis is performed using the random-effect model. Results Three RCTs are included in the meta-analysis. Overall, compared with control group for glioblastoma, adjuvant chloroquine is associated with significantly reduced mortality (risk ratio [RR] = 0.59; 95% confidence interval [CI] = 0.47–0.72; p < 0.00001), improved remission (RR = 11.53; 95% CI = 1.53–86.57; p = 0.02), and prolonged survival time (Std.MD = 11.53; 95% CI = 1.53–86.57; p = 0.02), but has no substantial effect on recurrence (RR = 0.42; 95% CI = 0.12–1.49; p = 0.18). Conclusion Adjuvant chloroquine may provide additional benefits for the treatment of glioblastoma.


Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 127
Author(s):  
David Núñez-Fuentes ◽  
Esteban Obrero-Gaitán ◽  
Noelia Zagalaz-Anula ◽  
Alfonso Javier Ibáñez-Vera ◽  
Alexander Achalandabaso-Ochoa ◽  
...  

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Atlaw ◽  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Kenbon Seyoum ◽  
Damtew Solomon ◽  
...  

Abstract Background Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa. Methods The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A random-effect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran’s Q-statistics and I2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg ’s tests, and the association between determinant factors and NTDs was estimated using a random-effect model. Results Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19–0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04–10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99–5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27–4.31) were found to be determinants of NTDs. Conclusions The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.


2018 ◽  
Vol 94 (1111) ◽  
pp. 278-283 ◽  
Author(s):  
Xue-Feng Xie ◽  
Xiao-Hui Huang ◽  
Ai-Zong Shen ◽  
Jun Li ◽  
Ye-Huan Sun

AimLeptin, synthesised by adipocytes, has been identified as a hormone that can influence inflammatory activity. Several studies have investigated leptin levels in patients with multiple sclerosis (MS), but the results are not consistent. This study aims to derive a more precise evaluation on the relationship between circulating leptin levels and MS.DesignA comprehensive literature searched up to July 2017 was conducted to evaluate the association of circulating leptin levels and MS. The random-effect model was applied to calculate pooled standardised mean difference (SMD) and its 95% CI.Main outcome measuresCirculating leptin levels of patients with MS and healthy controls.ResultsOf 2155 studies identified, 33 met eligibility criteria and 9 studies with 645 patients with MS and 586 controls were finally included in the meta-analysis. Meta-analysis revealed that, compared with the healthy control group, the MS group had significantly higher plasma/serum leptin levels, with the SMD of 0.70% and 95% CI (0.24 to 1.15). Subgroup analyses suggested that the leptin levels of patients with MS were associated with region, age, study sample size, measurement type, gender and blood sample type.ConclusionOverall, our study suggests that patients with MS have a significantly higher leptin level than in healthy controls. Further mechanism studies and longitudinal large cohort studies are still needed to further reveal the role of leptin in the pathogenesis of MS.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Fushun Zhang ◽  
Yuanyuan Zhang ◽  
Nan Jiang ◽  
Qiao Zhai ◽  
Juanjuan Hu ◽  
...  

Background. Some studies published previously have shown a strong correlation between hypertension and psychological nature including impulsion emotion or mindfulness and relaxation temperament, among which mindfulness and relaxation temperament might have a benign influence on blood pressure, ameliorating the hypertension. However, the conclusion was not confirmed. Objective. The meta-analysis was performed to investigate the influence of mindfulness and relaxation on essential hypertension interventions and confirm the effects. Methods. Systematic searches were conducted in common English and Chinese electronic databases (i.e., PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, Cochrane Library, and Chinese Biomedical Literature Database) from 1980 to 2020. A meta-analysis including 5 studies was performed using Rev Man 5.4.1 software to estimate the influence of mindfulness and relaxation on blood pressure, ameliorating the hypertension. Publication bias and heterogeneity of samples were tested using a funnel plot. Studies were analyzed using either a random-effect model or a fixed-effect model. Results. All the 5 studies investigated the influence of mindfulness and relaxation on diastolic and systolic blood pressure, with total 205 participants in the control group and 204 in the intervention group. The random-effects model (REM) was used to calculate the pooled effect for mindfulness and relaxation on diastolic blood pressure (I2 = 0%, t2 = 0.000, P = 0.41 ). The random pooled effect size (MD) was 0.30 (95% CI = −0.81–1.42, P = 0.59 ). REM was used to calculate the pooled effect for mindfulness and relaxation on systolic blood pressure (I2 = 49%, t2 = 3.05, P = 0.10 ). The random pooled effect size (MD) was −1.05 (95% CI = −3.29–1.18, P = 0.36 ). The results of this meta-analysis were influenced by publication bias to some degree. Conclusion. All the results showed less influence of mindfulness and relaxation might act on diastolic or systolic blood pressure, when mindfulness and relaxation are used to intervene in treating CVD and hypertension.


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