scholarly journals Impact of residents’ involvement in urological surgeries: a systematic review

2021 ◽  
Vol 8 (4) ◽  
pp. 2012
Author(s):  
Wedyan Salem Basaif ◽  
Faisal Abdulaziz Almukhlifi ◽  
Abdulhadi Turki Alsubaie ◽  
Ali Mohammed Alzarqa ◽  
Ahmed Abdulsalam Alsaedi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Time ◽  
Controlled Trial ◽  
World Health ◽  
Cochrane Library ◽  
Primary Surgery ◽  
Urological Procedures ◽  
Health Organization ◽  
Randomised Controlled ◽  
The Impact

Many investigations have reported the impact of resident involvement in urological surgeries. We aimed to conduct this systematic review to create enough evidence regarding this impact based on the outcomes obtained from the relevant studies. We have performed both manual and electronic search through many databases like Google Scholar, Web of science, PubMed, Scopus, Cochrane library, the international standard randomised controlled trial number registry, and the world health organization virtual health library to obtain all the relevant citations. Our intended outcomes included the risk of developing complications, operative time, and rate of reoperations. We have included 17 studies that reported the impact of residents’ involvement in urological surgical operations. while some studies reported some complications, the risk of developing complications was not significantly associated with residents' involvement according to most studies. Only one study reported that complications were significantly associated with residents’ involvement. The rate of reoperation and readmission after the primary surgery was also non-significant. On the other hand, most of the included studies showed that residents’ involvement was significantly associated with increased hospital stay and prolonged operative time. Our results indicate the residents’ involvement does not impact the overall safety of the urological procedures and that this practice should be encouraged with adequate supervision. 

scholarly journals Views of commissioners, managers and healthcare professionals on the NHS Health Check programme: a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018606 ◽  
Author(s):  
Katie Mills ◽  
Emma Harte ◽  
Adam Martin ◽  
Calum MacLure ◽  
Simon J Griffin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare Professionals ◽  
Health Management ◽  
Controlled Trial ◽  
Health Check ◽  
Public Access ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
The Impact ◽  
Nhs Health Check

ObjectiveTo synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice.DesignA systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data.Data sourcesAn electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers.Inclusion criteriaPrimary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice.ResultsOf 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues.ConclusionsThe success of the NHS Health Check Programme relies on engagement by those responsible for its commissioning, management and delivery. Recognising and addressing the challenges identified in this review, in particular the concerns of GPs, are important for the future of the programme.

scholarly journals The conjunctival transcriptome in Ethiopians after trichiasis surgery: associations with the development of eyelid contour abnormalities and the effect of oral doxycycline treatment

2019 ◽  
Vol 4 ◽  
pp. 130
Author(s):  
Tamsyn Derrick ◽  
Esmael Habtamu ◽  
Zerihun Tadesse ◽  
E. Kelly Callahan ◽  
Abebaw Worku ◽  
...  
Keyword(s):  
Controlled Trial ◽  
World Health Organisation ◽  
World Health ◽  
Doxycycline Treatment ◽  
Post Surgery ◽  
Outcome Group ◽  
Transcriptional Changes ◽  
Randomised Controlled ◽  
Upregulated Genes ◽  
The Impact

Background: Surgery to correct trichiasis is a key component of the World Health Organisation trachoma control strategy, however unfavourable outcomes such as eyelid contour abnormalities (ECA) following surgery are relatively common. This study aimed to understand the transcriptional changes associated with the early development of ECA and the impact of doxycycline, which has anti-inflammatory and anti-fibrotic properties, upon these transcription patterns. Methods: One thousand Ethiopians undergoing trichiasis surgery were enrolled in a randomised controlled trial following informed consent. Equal groups of randomly assigned individuals were orally administered with 100mg/day of doxycycline (n=499) or placebo (n=501) for 28 days. Conjunctival swabs were collected immediately prior to surgery and at one- and six-months post-surgery. 3’ mRNA sequencing was performed on paired baseline and one-month samples from 48 individuals; 12 in each treatment/ECA outcome group. qPCR validation was then performed for 46 genes of interest in 145 individuals who developed ECA at one month and 145 matched controls, using samples from baseline, one and six months. Results: All treatment/outcome groups upregulated genes associated with wound healing pathways at one month relative to baseline, however no individual differences were detected between groups. The summed expression of a highly coexpressed cluster of pro-fibrotic genes was higher in patients that developed ECA in the placebo group relative to controls. qPCR validation revealed that all genes in this cluster and a number of other pro-inflammatory genes were strongly associated with ECA, however these associations were not modulated by trial arm. Conclusions: The development of post-operative ECA is associated with overexpression of pro-inflammatory and pro-fibrotic genes including growth factors, matrix metalloproteinases, collagens and extracellular matrix proteins. There was no evidence that doxycycline modulated the association between gene expression and ECA.

scholarly journals TP9.2.18Are delays to diagnosis and treatment associated with reduced survival in oesophageal cancer?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Matteo Magnoli ◽  
Ellen Murgitroyd ◽  
Peter J Lamb ◽  
Richard JE Skipworth
Keyword(s):  
Systematic Review ◽  
Clinical Outcome ◽  
Oesophageal Cancer ◽  
Survival Rates ◽  
Tnm Stage ◽  
Diagnosis And Treatment ◽  
Cochrane Library ◽  
Optimal Timing ◽  
Randomised Controlled ◽  
The Impact

Abstract Aims Oesophageal cancer has low survival rates due to diagnosis commonly occurring in advanced stages. We performed a systematic review of delays to diagnosis and treatment in oesophageal cancer, and the impact of delay on clinical outcome. Methods A systematic review of Pubmed, Embase and Cochrane Library was carried out using the following search terms: (esophageal cancer) AND ((time) OR (diagnosis)) AND ((delay) OR (wait)). 821 results in English were retrieved and independently reviewed by two researchers. Studies were included if they were randomised controlled trials (RCT), meta-analyses or observational studies, and assessed delay in relation to at least one clinical outcome or TNM stage at diagnosis. Results 15277 patients across 12 studies were included. 10/12 studies were retrospective, and there were no RCT. Heterogeneity existed amongst the studies in defining delay and outcomes (morbidity = 1/12, mortality = 2/12, disease-free = 2/12 or overall survival = 5/12, TNM stage = 6/12). No studies demonstrated that reduced delay improved clinical outcome. Longer patient delay correlated with presence of malnutrition in one study but did not result in reduced survival. Conclusions Systematic review of published literature did not demonstrate a relationship between diagnosis/treatment delay and patient outcome in oesophageal cancer. Multi-centre prospective studies/RCTs are required to identify the impact of delay and the optimal timing of treatment.

scholarly journals The Impact of the World Health Organization Essential Newborn Package on Newborn Care Practices and Survival Rates in Sub-Saharan Africa: A Systematic Literature Review

2019 ◽  
Vol 9 (1) ◽  
pp. 19-29
Author(s):  
Andy Emmanuel ◽  
Victoria Kain ◽  
Elizabeth Forster
Keyword(s):  
Systematic Review ◽  
Health Workers ◽  
Newborn Care ◽  
Sub Saharan Africa ◽  
World Health ◽  
Essential Newborn Care ◽  
The World ◽  
Sub Saharan ◽  
Health Organization ◽  
The Impact

Sub-Saharan Africa, has the highest child mortality rate in the world (World Health Organization [WHO], 2016). However, there is a paucity of current systematic reviews on the impact of essential newborn care interventions in Africa. Therefore, the aim of this systematic review was to summarize evidence about the impact of essential newborn care interventions in Africa. Numerous databases were searched to retrieve articles that reported interventions in newborn care in Africa. The search was limited to the English language and to articles published between 2007 and 2017. Nine articles were selected for inclusion in this systematic review. Overall, these papers demonstrated an increase in performance of health workers (between 8 and 400%) following a test of knowledge, while health workers practical performance increased by 34%. Moreover, neonatal mortality was reduced by 45%, while perinatal mortality was reduced by 30%. Training healthcare workers is one of the most effective ways of improving newborn care and neonatal survival in Africa. However, there is a need for additional evidence to support this, because none of the reviewed studies assessed the impact of training by examining variables such as trainees' satisfaction with training, the knowledge and skills developed, and the health outcomes achieved.

scholarly journals Impact of social distancing measures for preventing coronavirus disease 2019 [COVID-19]: A systematic review and meta-analysis protocol

2020 ◽  
Author(s):  
Krishna Regmi ◽  
Cho Mar Lwin
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
List Type ◽  
Social Distancing ◽  
Randomised Controlled ◽  
The Impact

AbstractIntroductionSocial distancing measures (SDMs) protect public health from the outbreak of coronavirus disease 2019 (COVID-19). However, the impact of SDMs has been inconsistent and unclear. This study aims to assess the effects of SDMs (e.g. isolation, quarantine) for reducing the transmission of COVID-19.Methods and analysisWe will conduct a systematic review meta-analysis research of both randomised controlled trials and non-randomised controlled trials. We will search MEDLINE, EMBASE, Allied & Complementary Medicine, COVID-19 Research and WHO database on COVID-19 for primary studies assessing the effects of SDMs (e.g. isolation, quarantine) for reducing the transmission of COVID-19, and will be reported in accordance with PRISMA statement. The PRISMA-P checklist will be used while preparing this protocol. We will use Joanna Briggs Institute guidelines (JBI Critical Appraisal Checklists) to assess the methodological qualities and synthesised performing thematic analysis. Two reviewers will independently screen the papers and extracted data. If sufficient data are available, the random-effects model for meta-analysis will be performed to measure the effect size of SDMs or the strengths of relationships. To assess the heterogeneity of effects, I2 together with the observed effects (Q-value, with degrees of freedom) will be used to provide the true effects in the analysis.Ethics and disseminationEthics approval and consent will not be required for this systematic review of the literature as it does not involve human participation. We will be able to disseminate the study findings using the following strategies: we will be publishing at least one paper in peer-reviewed journals, and an abstract will be presented at suitable national/international conferences or workshops. We will also share important information with public health authorities as well as with the World Health Organization. In addition, we may post the submitted manuscript under review to bioRxiv, medRxiv, or other relevant pre-print servers.Strengths and limitations of this studyTo our knowledge, this study will be the first systematic review to examine the impact of social distancing measures to reduce transmission of COVID-19.This study will offer highest level of evidence for informed decisions, drawing a broader framework.This protocol reduces the possibility of duplication, provides transparency to the methods and procedures that will be used, minimise potential biases and allows peer-review.This research is not externally funded, and therefore time and resource will be constrained.If included studies will be variable in sample size, quality and population, which may open to bias, and the heterogeneity of data will preclude a meaningful meta-analysis to measure the impact of specific SDMs

416 A NARRATIVE SYSTEMATIC REVIEW OF POSTOPERATIVE REHABILITATION FOLLOWING SURGERY FOR ESOPHAGEAL CANCER

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
P Prasad ◽  
K Hardy ◽  
J Chmelo ◽  
M Navidi ◽  
A Phillips
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Positive Impact ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Risk Of Bias ◽  
Moderate Intensity ◽  
Cochrane Library ◽  
The Impact

Abstract   Esophagectomy is a complex procedure with associated high levels of morbidity. Rehabilitation programmes are being developed and increasingly utilised in the perioperative period and comprise a variety of physical, nutritional and psychological interventions. Such strategies may help reduce the incidence of postoperative complications, mitigate sarcopenia, prevent progressive frailty and restore quality of life. This systematic review aimed to identify and analyse studies reporting outcomes of post-esophagectomy rehabilitative interventions. Methods Major reference databases (PubMed, Medline, EMBASE, Cochrane Library and Google scholar) were interrogated and a systematic search with a pre-defined search strategy was performed up until January 2020. All eligible articles were screened in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria for cohort studies and the Cochrane risk of bias tool for randomised studies. Results Three studies (n = 1 pilot study; n = 1 feasibility study and n = 1 randomised controlled trial) including some 108 patients were included in this narrative review, of whom 64 patients had undergone esophagectomy. Rehabilitative strategies utilised included a combination of physical activities such as walking and low- to moderate-intensity exercises, dietary counselling, psychological support and occupational therapy input. There was wide variation in the outcomes assessed between studies. Postoperative physical activity with exercises consistently demonstrated maximum positive impact upon cardiopulmonary fitness. The median MINORS score for included studies was 9 (8-10) and the risk of bias in the included randomised trial was low. Conclusion There is a paucity of data currently to help determine the impact that rehabilitation may have on clinical outcomes and quality of life following esophagectomy. While improved physical function has been demonstrated, there is a need to determine which interventions patients deem most important and acceptable to help them return to as close to baseline as possible. Additionally, there is a need to further understand the impact rehabilitation may have upon long-term outcomes.

scholarly journals Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis

2017 ◽  
Vol 67 (663) ◽  
pp. e684-e691 ◽  
Author(s):  
Ruth Victoria Pritchett ◽  
Amanda J Daley ◽  
Kate Jolly
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Aerobic Exercise ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
World Health ◽  
Cochrane Library ◽  
Group Exercise ◽  
Postpartum Depressive Symptoms ◽  
Health Organization

BackgroundThere is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent.AimTo assess the effectiveness of aerobic exercise on postpartum depressive symptoms.Design and settingSystematic review and meta-analysis. There was no restriction to study site or setting.MethodThe databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched. Titles and abstracts, then full-text articles, were screened against inclusion criteria: RCTs measuring depressive symptoms in mothers ≤1 year postpartum; and interventions designed to increase aerobic exercise compared with usual care or other comparators. Included studies were assessed using the Cochrane Collaboration’s risk of bias tool. Meta-analysis was conducted. Pre-planned subgroup analyses explored heterogeneity.ResultsThirteen RCTs were included, with 1734 eligible participants. Exercise significantly reduced depressive symptoms when all trials were combined (standardised mean difference −0.44; 95% confidence interval = −0.75 to −0.12). Exploration of heterogeneity did not find significant differences in effect size between women with possible depression and in general postpartum populations; exercise only and exercise with co-interventions; and group exercise and exercise counselling.ConclusionThis systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias.

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