scholarly journals Sedation Practices for Routine Gastrointestinal Endoscopy: A Systematic Review of Recommendations

2020 ◽  
Author(s):  
Fahima Dossa ◽  
Olivia Megetto ◽  
Mafo Yakubu ◽  
David D.Q. Zhang ◽  
Nancy N. Baxter
Keyword(s):  
English Language ◽  
Gastrointestinal Endoscopy ◽  
Blood Pressure Monitoring ◽  
Professional Associations ◽  
Healthcare Personnel ◽  
Supporting Evidence ◽  
Level Of Evidence ◽  
Moderate Sedation ◽  
Registration Number

Abstract Background Sedation is commonly used in gastrointestinal endoscopy; however, considerable variability in sedation practices has been reported. The objective of this review was to identify and synthesize existing recommendations on sedation practices for routine gastrointestinal endoscopy procedures. Methods We systematically reviewed guidelines and position statements identified through a search of PubMed, guidelines databases, and websites of relevant professional associations from January 1, 2005 to May 10, 2019. We included English-language guidelines/position statements with recommendations relating to sedation for adults undergoing routine gastrointestinal endoscopy. Documents with guidance only for complex endoscopic procedures were excluded. We extracted and synthesized recommendations relating to: 1) choice of sedatives, 2) sedation administration, 3) personnel responsible for monitoring sedated patients, 4) skills and training of individuals involved in sedation, and 5) equipment required for monitoring sedated patients. We assessed the quality of included documents using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results We identified 19 guidelines and 7 position statements meeting inclusion criteria. Documents generally agreed that a single, trained registered nurse can administer moderate sedation, monitor the patient, and assist with brief, interruptible tasks. Documents also agreed on the routine use of pulse oximetry and blood pressure monitoring during endoscopy. However, recommendations relating to the drugs to be used for sedation, the healthcare personnel capable of administering propofol and monitoring patients sedated with propofol, and the need for capnography when monitoring sedated patients varied. Only 9 documents provided a grade or level of evidence in support of their recommendations. Conclusions Recommendations for sedation practices in routine gastrointestinal endoscopy differ across guidelines/position statements and often lack supporting evidence with potential implications for patient safety and procedural efficiency. Registration Number CRD42019141076

scholarly journals Sedation Practices for Routine Gastrointestinal Endoscopy: A Systematic Review of Recommendations

2020 ◽  
Author(s):  
Fahima Dossa ◽  
Olivia Megetto ◽  
Mafo Yakubu ◽  
David D.Q. Zhang ◽  
Nancy N. Baxter
Keyword(s):  
English Language ◽  
Gastrointestinal Endoscopy ◽  
Blood Pressure Monitoring ◽  
Professional Associations ◽  
Healthcare Personnel ◽  
Supporting Evidence ◽  
Level Of Evidence ◽  
Moderate Sedation ◽  
Registration Number

Abstract Background: Sedation is commonly used in gastrointestinal endoscopy; however, considerable variability in sedation practices has been reported. The objective of this review was to identify and synthesize existing recommendations on sedation practices for routine gastrointestinal endoscopy procedures. Methods: We systematically reviewed guidelines and position statements identified through a search of PubMed, guidelines databases, and websites of relevant professional associations from January 1, 2005 to May 10, 2019. We included English-language guidelines/position statements with recommendations relating to sedation for adults undergoing routine gastrointestinal endoscopy. Documents with guidance only for complex endoscopic procedures were excluded. We extracted and synthesized recommendations relating to: 1) choice of sedatives, 2) sedation administration, 3) personnel responsible for monitoring sedated patients, 4) skills and training of individuals involved in sedation, and 5) equipment required for monitoring sedated patients. We assessed the quality of included documents using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results: We identified 19 guidelines and 7 position statements meeting inclusion criteria. Documents generally agreed that a single, trained registered nurse can administer moderate sedation, monitor the patient, and assist with brief, interruptible tasks. Documents also agreed on the routine use of pulse oximetry and blood pressure monitoring during endoscopy. However, recommendations relating to the drugs to be used for sedation, the healthcare personnel capable of administering propofol and monitoring patients sedated with propofol, and the need for capnography when monitoring sedated patients varied. Only 9 documents provided a grade or level of evidence in support of their recommendations. Conclusions: Recommendations for sedation practices in routine gastrointestinal endoscopy differ across guidelines/position statements and often lack supporting evidence with potential implications for patient safety and procedural efficiency. Registration Number CRD42019141076

scholarly journals Sedation Practices for Routine Gastrointestinal Endoscopy: A Systematic Review of Recommendations

2020 ◽  
Author(s):  
Fahima Dossa ◽  
Olivia Megetto ◽  
Mafo Yakubu ◽  
David D.Q. Zhang ◽  
Nancy N. Baxter
Keyword(s):  
English Language ◽  
Gastrointestinal Endoscopy ◽  
Blood Pressure Monitoring ◽  
Professional Associations ◽  
Healthcare Personnel ◽  
Supporting Evidence ◽  
Level Of Evidence ◽  
Moderate Sedation ◽  
Registration Number

Abstract Background: Sedation is commonly used in gastrointestinal endoscopy; however, considerable variability in sedation practices has been reported. The objective of this review was to identify and synthesize existing recommendations on sedation practices for routine gastrointestinal endoscopy procedures.Methods: We systematically reviewed guidelines and position statements identified through a search of PubMed, guidelines databases, and websites of relevant professional associations from January 1, 2005 to May 10, 2019. We included English-language guidelines/position statements with recommendations relating to sedation for adults undergoing routine gastrointestinal endoscopy. Documents with guidance only for complex endoscopic procedures were excluded.We extracted and synthesized recommendations relating to: 1) choice of sedatives, 2) sedation administration, 3) personnel responsible for monitoring sedated patients, 4) skills and training of individuals involved in sedation, and 5) equipment required for monitoring sedated patients. We assessed the quality of included documents using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool.Results: We identified 19 guidelines and 7 position statements meeting inclusion criteria. Documents generally agreed that a single, trained registered nurse can administer moderate sedation, monitor the patient, and assist with brief, interruptible tasks. Documents also agreed on the routine use of pulse oximetry and blood pressure monitoring during endoscopy. However, recommendations relating to the drugs to be used for sedation, the healthcare personnel capable of administering propofol and monitoring patients sedated with propofol, and the need for capnography when monitoring sedated patients varied. Only 9 documents provided a grade or level of evidence in support of their recommendations.Conclusions: Recommendations for sedation practices in routine gastrointestinal endoscopy differ across guidelines/position statements and often lack supporting evidence with potential implications for patient safety and procedural efficiency.Registration Number: CRD42019141076

scholarly journals Sedation practices for routine gastrointestinal endoscopy: a systematic review of recommendations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahima Dossa ◽  
Olivia Megetto ◽  
Mafo Yakubu ◽  
David D. Q. Zhang ◽  
Nancy N. Baxter
Keyword(s):  
English Language ◽  
Gastrointestinal Endoscopy ◽  
Blood Pressure Monitoring ◽  
Professional Associations ◽  
Healthcare Personnel ◽  
Supporting Evidence ◽  
Level Of Evidence ◽  
Moderate Sedation ◽  
And Training

Abstract Background Sedation is commonly used in gastrointestinal endoscopy; however, considerable variability in sedation practices has been reported. The objective of this review was to identify and synthesize existing recommendations on sedation practices for routine gastrointestinal endoscopy procedures. Methods We systematically reviewed guidelines and position statements identified through a search of PubMed, guidelines databases, and websites of relevant professional associations from January 1, 2005 to May 10, 2019. We included English-language guidelines/position statements with recommendations relating to sedation for adults undergoing routine gastrointestinal endoscopy. Documents with guidance only for complex endoscopic procedures were excluded. We extracted and synthesized recommendations relating to: 1) choice of sedatives, 2) sedation administration, 3) personnel responsible for monitoring sedated patients, 4) skills and training of individuals involved in sedation, and 5) equipment required for monitoring sedated patients. We assessed the quality of included documents using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results We identified 19 guidelines and 7 position statements meeting inclusion criteria. Documents generally agreed that a single, trained registered nurse can administer moderate sedation, monitor the patient, and assist with brief, interruptible tasks. Documents also agreed on the routine use of pulse oximetry and blood pressure monitoring during endoscopy. However, recommendations relating to the drugs to be used for sedation, the healthcare personnel capable of administering propofol and monitoring patients sedated with propofol, and the need for capnography when monitoring sedated patients varied. Only 9 documents provided a grade or level of evidence in support of their recommendations. Conclusions Recommendations for sedation practices in routine gastrointestinal endoscopy differ across guidelines/position statements and often lack supporting evidence with potential implications for patient safety and procedural efficiency.

Early palliative care in haematological patients: a systematic literature review

2020 ◽  
Vol 10 (4) ◽  
pp. 395-403
Author(s):  
Silvia Tanzi ◽  
Francesco Venturelli ◽  
Stefano Luminari ◽  
Franco Domenico Merlo ◽  
Luca Braglia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Early Palliative Care ◽  
Study Results ◽  
Registration Number ◽  
Integrated Or ◽  
The Impact

BackgroundEarly palliative care together with standard haematological care for advanced patients is needed worldwide. Little is known about its effect. The aim of the review is to synthesise the evidence on the impact of early palliative care on haematologic cancer patients’ quality of life and resource use.Patients and methodsA systematic review was conducted. The search terms were early palliative care or simultaneous or integrated or concurrent care and haematological or oncohaematological patients. The following databases were searched: PubMed, Embase, Cochrane, CINHAL and Scopus. Additional studies were identified through cross-checking the reference articles. Studies were in the English language, with no restriction for years. Two researchers independently reviewed the titles and abstracts, and one author assessed full articles for eligibility.ResultsA total of 296 studies titles were reviewed. Eight articles were included in the synthesis of the results, two controlled studies provided data on the comparative efficacy of PC interventions, and six one-arm studies were included. Since data pooling and meta-analysis were not possible, only a narrative synthesis of the study results was performed. The quality of the two included comparative studies was low overall. The quality of the six non-comparative studies was high overall, without the possibility of linking the observed results to the implemented interventions.ConclusionsStudies on early palliative care and patients with haematological cancer are scarce and have not been prospectively designed. More research on the specific population target, type and timing of palliative care intervention and standardisation of collected outcomes is required.PROSPERO registration numberCRD42020141322.

scholarly journals A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update

2019 ◽  
Vol 105 (4) ◽  
pp. e937-e946 ◽  
Author(s):  
Andrea Giustina ◽  
Ariel Barkan ◽  
Albert Beckers ◽  
Nienke Biermasz ◽  
Beverly M K Biller ◽  
...  
Keyword(s):  
English Language ◽  
Critical Discussion ◽  
Diagnosis And Treatment ◽  
Grade System ◽  
Evidence Based ◽  
Supporting Evidence ◽  
Consensus Recommendations ◽  
Consensus Group ◽  
Corporate Funding

Abstract Objective The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013. Participants The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration. Evidence This evidence-based consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities. Consensus Process Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system. Conclusions Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality.

Four Points to Be Considered when Writing “A History of Science and Civilisation in Korea”

2015 ◽  
Vol 42 (1) ◽  
pp. 73-92
Author(s):  
Hong-key Yoon
Keyword(s):  
History Of Science ◽  
English Language ◽  
Historical Data ◽  
Cross Cultural ◽  
Supporting Evidence ◽  
Cultural Approach ◽  
Folk Traditions ◽  
Science Technology ◽  
History Of

A research project entitled “A History of Science and Civilisation in Korea” is planning to publish an English-language monograph series that endeavours to learn from established scholarship on the history of science by benefiting from its accomplishments and overcoming some of its shortcomings. This paper argues that the following four points are important for Korean historians of science to consider: (1) overcoming ‘presentism’— to avoid writing history from a contemporary standpoint and to justify present-day Korea, (2) adopting a cross-cultural approach—to avoid unjustified nationalistic and ethno-centric interpretations of historical data, (3) considering both elite traditions and folk traditions in Korea—to present a more balanced view on different traditions in Korea, and (4) adopting traditional Korean concepts and categories of knowledge, if necessary; that is, that when no Western concepts are suitable for reference but indigenous Korean concepts are, adopting traditional Korean concepts is preferable. For example, the adoption of p’ungsu (geomancy) as a category of the Korean body of scientific knowledge. In this paper these four points will be discussed with supporting evidence, and I believe that using these four points as guidelines will enhance the quality of new writings on the history of Korean science by overcoming some of the shortcomings of existing scholarship on the history of science, technology and medicine in Korea or elsewhere.

Food procurement in English-language Canadian public schools: Opportunities and challenges

2019 ◽  
Vol 6 (1) ◽  
pp. 75-99
Author(s):  
Shawna Holmes
Keyword(s):  
Public Schools ◽  
Food Environment ◽  
Nutritional Quality ◽  
English Language ◽  
Nutrient Content ◽  
Food Environments ◽  
School Food ◽  
Provincial Level ◽  
School Food Environment

This paper examines the changes to procurement for school food environments in Canada as a response to changes to nutrition regulations at the provincial level. Interviews with those working in school food environments across Canada revealed how changes to the nutrition requirements of foods and beverages sold in schools presented opportunities to not only improve the nutrient content of the items made available in school food environments, but also to include local producers and/or school gardens in procuring for the school food environment. At the same time, some schools struggle to procure nutritionally compliant foods due to increased costs associated with transporting produce to rural, remote, or northern communities as well as logistic difficulties like spoilage. Although the nutrition regulations have facilitated improvements to food environments in some schools, others require more support to improve the overall nutritional quality of the foods and beverages available to students at school.

Productive Vocabulary Knowledge of ESL Learners

2018 ◽  
Vol 1 (1) ◽  
pp. 32-41 ◽  
Author(s):  
Abdulmalik Usman ◽  
Dahiru Musa Abdullahi
Keyword(s):  
Teaching And Learning ◽  
English Language ◽  
Vocabulary Knowledge ◽  
Writing Quality ◽  
Lexical Frequency ◽  
Frequency Profile ◽  
Esl Learners ◽  
The Relationship

The paper seeks to investigate the level of productive knowledge of ESL learners, the writing quality and the relationship between the vocabulary knowledge and the writing quality. 150 final year students of English language in a university in Nigeria were randomly selected as respondents. The respondents were asked to write an essay of 300 words within one hour. The essays were typed into Vocab Profiler of Cobb (2002) and analyzed the Lexical Frequency Profile of the respondents. The essays were also assessed by independent examiners using a standard rubric. The findings reveal that the level of productive vocabulary knowledge of the respondents is limited. The writing quality of the majority of the respondent is fair and there is a significant correlation between vocabulary and the witting quality of the subjects. The researchers posit that productive vocabulary is the predictor of writing quality and recommend various techniques through which teaching and learning of vocabulary can be improved.

“The Past, Present, and Future of Accounting History”: A Comment on the State of Accounting History

2020 ◽  
Vol 47 (1) ◽  
pp. 89-95 ◽  
Author(s):  
Garry D. Carnegie
Keyword(s):  
English Language ◽  
Research Field ◽  
The State ◽  
International Accounting ◽  
Scholarly Research ◽  
Recent Contribution ◽  
Global Society ◽  
Accounting History ◽  
The Past

ABSTRACT This response to the recent contribution by Matthews (2019) entitled “The Past, Present, and Future of Accounting History” specifically deals with the issues associated with concentrating on counting publication numbers in examining the state of a scholarly research field at the start of the 2020s. It outlines several pitfalls with the narrowly focused publications count analysis, in selected English language journals only, as provided by Matthews. The commentary is based on three key arguments: (1) accounting history research and publication is far more than a “numbers game”; (2) trends in the quality of the research undertaken and published are paramount; and (3) international publication and accumulated knowledge in accounting history are indeed more than a collection of English language publications. The author seeks to contribute to discussion and debate between accounting historians and other researchers for the benefit and development of the international accounting history community and global society.

scholarly journals Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes

2020 ◽  
Author(s):  
Adam Runacres ◽  
Kelly A. Mackintosh ◽  
Melitta A. McNarry
Keyword(s):  
General Population ◽  
Cancer Mortality ◽  
English Language ◽  
Meta Analysis ◽  
Premature Mortality ◽  
Epidemiological Studies ◽  
Registration Number ◽  
Mortality Ratio ◽  
Former Elite Athletes

Abstract Introduction Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes. Methods 38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio’s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis. Results Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61–0.78]; female SMR 0.51 [95% CI 0.40–0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91–1.12]). Although male athlete’s CVD (SMR 0.73 [95% CI 0.62–0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63–0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86–1.40]) or END athletes cancer mortality (SMR 0.73 [0.50–1.07]). There was insufficient data to calculate female sport-specific SMR’s. Discussion Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).

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