scholarly journals A Systematic Review of Enteral Feeding By Nasogastric Tube in Young People With Eating Disorders

2021 ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Young People ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Oral Intake ◽  
Risk Of Bias ◽  
Primary Research ◽  
Tube Removal ◽  
Wide Range

Abstract BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding to provide lifesavinglifesaving treatment.Nasogastric feeding (NGF) is a method of enteral nutrition often used in inpatient settings to treat medical instability, to supplement minimal poor oral intake or to boostincrease nutritional intake. This systematic review sets out to describe current practice for of NG in young people with eating disordersF. MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms were: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and participants over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles. Quality assessment, including risk of bias, was conducted by all authors. Results29 studies met the full criteria. 86% of studies were deemed high or medium risk of bias due to the type of study: 34.4% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) a wide range of practices in different countries, settings, and the reason for initiation; 2) In the UK, standard practice is to introduce Nasogastric feeds (NG) if medically unstable or oral intake is inadequate; 3) NG may enable greater initial weight gain due to increased caloric intake; 4) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 5) high calorie feeds are not typically associated with increased risk of refeeding syndrome; 6) complications included nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 7) length of stay in hospital is dependent on reason of initiating NG; 8) psychiatric and medical wards differ in approach; 9) therapeutic interventions can occur alongside NG.ConclusionsA large number of studies were deemed to have a high risk of bias and no studies were able to provide a direct comparison between continuous, nocturnal or bolus NG feeds. This review highlights the need for further high quality research in this area.

scholarly journals A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

2021 ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Oral Intake ◽  
Risk Of Bias ◽  
Primary Research ◽  
Increased Risk ◽  
Tube Removal ◽  
Wide Range

Abstract BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding to provide lifesaving treatment.Nasogastric feeding (NGF) is a method of enteral nutrition often used in inpatient settings to treat medical instability, to supplement minimal oral intake or to boost nutritional intake. This systematic review sets out to describe current practice for NGF. MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms were: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles. Quality assessment, including risk of bias, was conducted by all authors. Results29 studies met the full criteria. 86% of studies were deemed high or medium risk of bias due to the type of study: 34.4% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) a wide range of practices in different countries, settings, and the reason for initiation; 2) In the UK, standard practice is to introduce NGF if either oral intake is not met or patients are medically unstable; 3) NGF may enable greater initial weight gain due to increased caloric intake; 4) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 5) high calorie feeds are not typically associated with increased risk of refeeding syndrome; 6) complications included nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 7) length of stay in hospital is dependent on reason of initiating NGF; 8) psychiatric and medical wards differ in approach; 9) concurrent therapy is often used to facilitate NGF.ConclusionsNGF is currently often implemented in specialist settings where oral intake has been refused or insufficient, in hospital due to medical instability, nocturnally to supplement day-time oral intake, or continuously as standard protocol. Due to high risk of bias as a result of the nature of the studies conducted in adolescents with ED, recommendations for clinical practice cannot yet be justified.

scholarly journals A systematic review of enteral feeding by nasogastric tube in young people with eating disorders

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Young People ◽  
Enteral Feeding ◽  
Oral Intake ◽  
Risk Of Bias ◽  
Calorie Intake ◽  
Primary Research ◽  
Total Calorie ◽  
Total Calorie Intake

Abstract Background Adolescents with severe restrictive eating disorders often require enteral feeding to provide lifesaving treatment. Nasogastric feeding (NG) is a method of enteral nutrition often used in inpatient settings to treat medical instability, to supplement poor oral intake or to increase nutritional intake. This systematic review sets out to describe current practice of NG in young people with eating disorders. Methods A systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000 to 2020. Inclusion terms were: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: psychiatric disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and participants over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles. Quality assessment, including risk of bias, was conducted by all authors. Results Twenty-nine studies met the full criteria. 86% of studies were deemed high or medium risk of bias due to the type of study: 34.4% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) a wide range of refeeding regimes depending on country, settings, and the reason for initiation; 2) standard practice is to introduce Nasogastric feeds (NG) if medically unstable or oral intake alone is inadequate; 3) NG may enable greater initial weight gain due to increased caloric intake; 4) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 5) complications included nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 6) where NG is routinely implemented to increase total calorie intake, length of stay in hospital may be reduced; however where NG is implemented in correlation to severity of symptoms, it may be increased; 7) both medical and psychiatric wards most commonly report using NG in addition to oral intake. Conclusions NG feeding is a safe and efficacious method of increasing total calorie intake by either supplementing oral intake or continuously. There are currently no direct comparisons between continuous, nocturnal or bolus regimes, which may be used to direct future treatment for YP with ED.

When Food is Feared: A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

2020 ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Young People ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Primary Research ◽  
Nasogastric Feeding ◽  
Nasal Irritation ◽  
Increased Risk ◽  
Tube Removal

Abstract BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding. Nasogastric feeding is occasionally used during hospitalisation to treat medical instability as a result of malnourishment, or in a specialist setting to supplement minimal oral intake by underweight patients. There is minimal guidance for clinicians to determine when nasogastric feeding should be implemented, how it should be provided and how to complement feeding with a nasogastric tube. This systematic review sets out to determine best practice for NG feeding.MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms used were as follows: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles.Results28 studies met the full criteria. 51.7% of studies were deemed high risk of bias due to the type of study: 37.9% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) 6-66% required NG feeding; 2) staff and young people understand its necessity but generally view it negatively; 3) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 4) high calorie feeds are not associated with increased risk of refeeding syndrome; 5) Common complications were nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 6) length of stay in hospital may be longer in patients requiring NG feeding; 7) psychiatric and medical wards differ in approach; 8) concurrent therapy reduces NG use and aids recovery.ConclusionsAll studies which reviewed the use of NG over a period of time found that it had increased significantly in recent years. Due to the possibility of patient removal of the tube, it may be beneficial in practice to deliver feeds using a bolus regime which has been tailored to the individual caloric needs of the patient. This review enables cautious recommendations to be made and highlights the lack of high-quality evidence around the use of NG feeding in eating disordered young people.

scholarly journals Predictors and moderators of outcome of psychotherapeutic interventions for mental disorders in young people: Protocol for systematic reviews

2020 ◽  
Author(s):  
Eleni Vousoura ◽  
Vera Gergov ◽  
Bogdan Tudor Tulbure ◽  
Nigel Camilleri ◽  
Andrea Saliba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Mental Disorders ◽  
Systematic Reviews ◽  
Evidence Base ◽  
Risk Of Bias ◽  
Treatment Modalities ◽  
Psychotherapeutic Treatment ◽  
Psychotherapeutic Interventions ◽  
Wide Range

Abstract Background: Adolescence and young adulthood is a risk period for the emergence of mental disorders. There is strong evidence that psychotherapeutic interventions are effective for most mental disorders. However, very little is known about for whom different psychotherapeutic treatment modalities are effective. This large systematic review aims to address this critical gap within the literature on non-specific predictors and moderators of the outcomes of psychotherapeutic interventions among young people with mental disorders. Methods: Pubmed and PsycINFO databases were searched for randomized controlled and quasi-experimental/naturalistic clinical trials. Studies were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias of all included studies will be assessed by RoB1 and ROBINS-I risk of bias tools. The quality of predictor and moderator variables will be also assessed. A narrative synthesis will be conducted for all included studies. Discussion: This systematic review will strengthen the evidence base on effective mental health interventions for young people, being the first to explore predictors and moderators of outcome of psychotherapeutic interventions for a wide range of mental disorders in young people. Systematic review registration: PROSPERO (CRD42020166756)

scholarly journals Prevalence of health misinformation in social media: a systematic review (Preprint)

2019 ◽  
Author(s):  
Victor Suarez-Lledo ◽  
Javier Alvarez-Galvez
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Social Media ◽  
Eating Disorders ◽  
Communicable Disease ◽  
Health Concern ◽  
Public Health Concern ◽  
Medical Treatments ◽  
Wide Range ◽  
Social Media Platforms

BACKGROUND The propagation of health misinformation through social media has become a major public health concern over the last two decades. Although today there is broad agreement among researchers, health professionals, and policy makers on the need to control and combat health misinformation, the magnitude of this problem is still unknown. Consequently, before adopting the necessary measures for the adequate control of health misinformation in social media, it is fundamental to discover both the most prevalent health topics and the social media platforms from which these topics are initially framed and subsequently disseminated. OBJECTIVE This systematic review aims to identify the main health misinformation topics and their prevalence on different social media platforms, focusing on methodological quality and the diverse solutions that are being implemented to address this public health concern. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). We searched PubMed, MEDLINE, Scopus and the Web of Science for articles published in English before March 2019 with a particular focus on studying health misinformation in social media. We defined health misinformation as a health-related claim based on anecdotal evidence, false, or misleading due to the lack of existing scientific knowledge. The criteria for inclusion were: 1) articles that focused on health misinformation in social media, including those in which the authors discussed the consequences or purposes of health misinformation; and 2) studies that described empirical findings regarding the measurement of health misinformation in these platforms. RESULTS A total of 69 studies were identified as eligible, covering a wide range of health topics and social media platforms. The topics were articulated around six principal categories: vaccines (32%), drugs or smoking (22%), non-communicable disease (19%), pandemics (10%), eating disorders (9%), and medical treatments (7%). Studies were mainly based on five methodological approaches: Social Network Analysis (28%), Evaluating Content (26%), Evaluating Quality (24%), Content/Text analysis (16%) and Sentiment Analysis (6%). Health misinformation proved to be the most more prevalent in studies related to smoking products and drugs such as opioids or marijuana. Posts with misinformation reached 87% in some studies focused in smoking products. Health misinformation about vaccines was also very common (43%), but studies reported different levels of misinformation depending on the different vaccines, with the Human Papilloma Virus (HPV) vaccine being the most affected. Secondly, health misinformation related to diets or pro eating disorders (pro-ED) arguments were moderate in comparison to the aforementioned topics (36%). Studies focused on diseases (i.e. non-communicable diseases and pandemics) also reported moderate misinformation rates (40%), especially in the case of cancer. Finally, the lowest levels of health misinformation were related to medical treatments (30%). CONCLUSIONS Prevalence of health misinformation was most common on Twitter and on issues related to smoking products and drugs. However, misinformation is also high on major public health issues such as vaccines and diseases. Our study offers a comprehensive characterization of the dominant health misinformation topics and a comprehensive description of their prevalence in different social media platforms, which can guide future studies and help in the development of evidence-based digital policy actions plans. CLINICALTRIAL

scholarly journals Comparative efficacy of teat sealants given prepartum for prevention of intramammary infections and clinical mastitis: a systematic review and network meta-analysis

2019 ◽  
Vol 20 (2) ◽  
pp. 182-198 ◽  
Author(s):  
C. B. Winder ◽  
J. M. Sargeant ◽  
D. Hu ◽  
C. Wang ◽  
D. F. Kelton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Clinical Mastitis ◽  
Risk Of Bias ◽  
Comparative Efficacy ◽  
Primary Research ◽  
Quality Of Reporting ◽  
Intramammary Infections ◽  
Bismuth Subnitrate

AbstractA systematic review and network meta-analysis were conducted to assess the relative efficacy of internal or external teat sealants given at dry-off in dairy cattle. Controlled trials were eligible if they assessed the use of internal or external teat sealants, with or without concurrent antimicrobial therapy, compared to no treatment or an alternative treatment, and measured one or more of the following outcomes: incidence of intramammary infection (IMI) at calving, IMI during the first 30 days in milk (DIM), or clinical mastitis during the first 30 DIM. Risk of bias was based on the Cochrane Risk of Bias 2.0 tool with modified signaling questions. From 2280 initially identified records, 32 trials had data extracted for one or more outcomes. Network meta-analysis was conducted for IMI at calving. Use of an internal teat sealant (bismuth subnitrate) significantly reduced the risk of new IMI at calving compared to non-treated controls (RR = 0.36, 95% CI 0.25–0.72). For comparisons between antimicrobial and teat sealant groups, concerns regarding precision were seen. Synthesis of the primary research identified important challenges related to the comparability of outcomes, replication and connection of interventions, and quality of reporting of study conduct.

scholarly journals Towards the best kidney failure prediction tool: a systematic review and selection aid

2019 ◽  
Vol 35 (9) ◽  
pp. 1527-1538 ◽  
Author(s):  
Chava L Ramspek ◽  
Ype de Jong ◽  
Friedo W Dekker ◽  
Merel van Diepen
Keyword(s):  
Systematic Review ◽  
Kidney Failure ◽  
External Validation ◽  
Model Development ◽  
Risk Of Bias ◽  
Future Research ◽  
Prediction Tool ◽  
Clinical Value ◽  
Wide Range ◽  
And Performance

Abstract Background Prediction tools that identify chronic kidney disease (CKD) patients at a high risk of developing kidney failure have the potential for great clinical value, but limited uptake. The aim of the current study is to systematically review all available models predicting kidney failure in CKD patients, organize empirical evidence on their validity and ultimately provide guidance in the interpretation and uptake of these tools. Methods PubMed and EMBASE were searched for relevant articles. Titles, abstracts and full-text articles were sequentially screened for inclusion by two independent researchers. Data on study design, model development and performance were extracted. The risk of bias and clinical usefulness were assessed and combined in order to provide recommendations on which models to use. Results Of 2183 screened studies, a total of 42 studies were included in the current review. Most studies showed high discriminatory capacity and the included predictors had large overlap. Overall, the risk of bias was high. Slightly less than half the studies (48%) presented enough detail for the use of their prediction tool in practice and few models were externally validated. Conclusions The current systematic review may be used as a tool to select the most appropriate and robust prognostic model for various settings. Although some models showed great potential, many lacked clinical relevance due to being developed in a prevalent patient population with a wide range of disease severity. Future research efforts should focus on external validation and impact assessment in clinically relevant patient populations.

Psychosocial Interventions Targeting Recovery in Child and Adolescent Burns: A Systematic Review

2019 ◽  
Author(s):  
Nancy Hornsby ◽  
Lisa Blom ◽  
Mathilde Sengoelge
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioral Therapy ◽  
Burn Injury ◽  
Psychosocial Support ◽  
Behavioral Therapy ◽  
Full Range ◽  
Psychosocial Interventions ◽  
Risk Of Bias ◽  
Cognitive Behavioral ◽  
Wide Range

Abstract Children post-burn injury experience a range of psychosocial sequelae that benefit from early provision of psychosocial support. However, no systematic review exists evaluating the full range of psychological interventions. Objective To critically evaluate psychosocial interventions for children (<18 years old) with burn injuries in improving psychosocial recovery. Study design All-language studies were identified from inception to March 2018 in six electronic databases and appraised according to PRISMA checklist and Cochrane Risk of Bias Tool for quality. Studies were stratified into three groups: distraction (virtual reality, child life therapy, imagery-based therapy, hypnosis), burn camps, and other (social skills, cognitive behavioral therapy, parent group counseling). Results Out of a total of 5,456 articles identified, 297 underwent full review resulting in 27 included articles published between 1986 and 2018. Sample sizes ranged from 9 to 266, comprising child and adult participants. A range of interventions and psychosocial outcome measures were found. Several studies (n = 21) reported statistically significant improvements in outcome; the majority were distraction interventions to reduce pain and anxiety. A limited number of studies showing effect was found for cognitive behavioral therapy and parent counseling. Risk of bias was high in studies of burn camps and mixed for all other interventions. Conclusions A range of psychosocial interventions and outcome tools exist in pediatric burns. Distraction interventions prior to and/or during dressing changes or physical therapy were shown to effectively reduce pain and anxiety for a wide range of pediatric ages.

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