Prevalence and Antimicrobial Resistance of Staphylococcus Species in Operation Room: Systematic Review and Meta-Analysis Protocol.

Abstract Background Pathogenic Staphylococcus species in routine medical care settings poses an increased risk of healthcare-associated infections that causes severe infections in humans and increased morbidity and mortality. These species are the most frequently transmitted infectious agents in the operating room that contributed to more than half of surgical site infections. Thus, this study aimed to estimate the global prevalence of staphylococcus species and their antimicrobial resistance profile in operating rooms of health care facilities. Methods Nine electronic databases including MEDLINE, Embase, Psych INFO, PubMed, Scopus, Web of Science, google scholar, Science Direct, and CINAHL will be used to collect the articles. To address the articles missed from the above databases, a direct search from google will be made. Similarly, the reference lists of the included articles will be searched manually. The search for the grey literature will be conducted using national or international repositories. Articles written in the English language, and conducted across the world that reported the prevalence of Staphylococcus species in the operating room will be included. Newcastle-Ottawa scale will be used to assess the quality of the included articles. The data will be extracted using Microsoft Excel 2016 and exported to STATA 16.0 software for the analyses. Pooled estimation of the outcome will be performed using DerSimonian-Laird random-effects model. Heterogeneity and publication bias of the studies will be presented with I2 statistics and funnel plots, respectively. Discussion Even though several studies laid out sources of microbial contamination as diverse and gram-positive bacteria is a common contaminant in the hospital setting, the prevalence and resistance profile of these contaminants in the operation room is not mentioned. This systematic review will provide evidence on the staphylococcus species in the operation room, the prevalence and antimicrobial resistance of each species. These findings will provide knowledge to clinicians on the level of contamination due to staphylococcus. Only studies published in English will be included and this may limit the current systematic review. Registration: Submitted to PROSPERO on 26/7/2021.

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P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽

10.1017/cem.2017.272 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S102

Author(s):

S.W. Kirkland ◽

A. Soleimani ◽

B.H. Rowe ◽

A.S. Newton

Keyword(s):

Systematic Review ◽

Health Care ◽

Emergency Department ◽

Health Care Services ◽

Grey Literature ◽

Study Data ◽

Care Utilization ◽

Alternative Source ◽

Increased Risk ◽

The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

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Perceptions of risk in pregnancy with chronic disease: A systematic review and thematic synthesis

PLoS ONE ◽

10.1371/journal.pone.0254956 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254956

Author(s):

Elizabeth R. Ralston ◽

Priscilla Smith ◽

Joseph Chilcot ◽

Sergio A. Silverio ◽

Kate Bramham

Keyword(s):

Systematic Review ◽

Chronic Disease ◽

Chronic Diseases ◽

Perceived Risk ◽

Risk Perceptions ◽

Grey Literature ◽

Pregnancy Risk ◽

Thematic Synthesis ◽

Increased Risk ◽

In Pregnancy

Background Women with chronic disease are at increased risk of adverse pregnancy outcomes. Pregnancies which pose higher risk, often require increased medical supervision and intervention. How women perceive their pregnancy risk and its impact on health behaviour is poorly understood. The aim of this systematic review of qualitative literature is to evaluate risk perceptions of pregnancy in women with chronic disease. Methods Eleven electronic databases including grey literature were systematically searched for qualitative studies published in English which reported on pregnancy, risk perception and chronic disease. Full texts were reviewed by two researchers, independently. Quality was assessed using the Critical Appraisal Skills Programme Qualitative checklist and data were synthesised using a thematic synthesis approach. The analysis used all text under the findings or results section from each included paper as data. The protocol was registered with PROSPERO. Results Eight studies were included in the review. Three themes with sub-themes were constructed from the analysis including: Information Synthesis (Sub-themes: Risk to Self and Risk to Baby), Psychosocial Factors (Sub-themes: Emotional Response, Self-efficacy, Healthcare Relationship), and Impact on Behaviour (Sub-themes: Perceived Risk and Objective Risk). Themes fitted within an overarching concept of Balancing Act. The themes together inter-relate to understand how women with chronic disease perceive their risk in pregnancy. Conclusions Women’s pregnancy-related behaviour and engagement with healthcare services appear to be influenced by their perception of pregnancy risk. Women with chronic disease have risk perceptions which are highly individualised. Assessment and communication of women’s pregnancy risk should consider their own understanding and perception of risk. Different chronic diseases introduce diverse pregnancy risks and further research is needed to understand women’s risk perceptions in specific chronic diseases.

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PP39 What is the risk of major trauma following a fall down stairs? – A systematic review

Emergency Medicine Journal ◽

10.1136/emermed-2021-999.39 ◽

2021 ◽

Vol 38 (9) ◽

pp. A16.2-A16

Author(s):

Christopher Holt ◽

Samuel Keating ◽

Michael Tonkins ◽

Daniel Bradbury ◽

Gordon Fuller

Keyword(s):

Systematic Review ◽

Major Trauma ◽

Alcohol Intoxication ◽

Grey Literature ◽

Developed Countries ◽

Risk Of Bias ◽

Qualitative Synthesis ◽

Increased Risk ◽

Study Heterogeneity ◽

Serious Injury

BackgroundSpecific mechanisms of injury are stated in pre-hospital triage tools to identify suspected cases of major trauma. Falls down stairs are common presentations in UK emergency departments, yet are frequently overlooked as a causative mechanism of major trauma. No prior systematic review has examined this association.MethodsSeven internationally recognised literature databases and seven grey literature databases were screened utilising a common search strategy from inception until 31 December 2019. Abstracts were screened for relevance by a single reviewer. Full texts were screened and subsequently extracted by 3 separate reviewers against strict inclusion/exclusion criteria. A risk of bias assessment based on GRADE recommendations was performed. In the absence of study heterogeneity, a narrative synthesis was planned. The reporting of this systematic review followed PRISMA 2009 statement guidelines.Results5240 articles were identified from database searching, 89 articles had their full texts assessed for eligibility and 6 articles were included for qualitative synthesis. All studies were retrospective in nature and originated from more economically developed countries. 7431 patients who fell down stairs were analysed, of which, 707 (9.5%) met major trauma definitions. Falls down stairs resulted in a significantly increased risk of serious injury compared to other fall mechanisms (OR: 1.621, 95% CI: 1.381 – 1.902, p<0.0005). Analysis of confounding factors demonstrated age (OR: 2.59, 95% CI: 1.57 – 4.28, p<0.001) and alcohol intoxication (OR: 2.6, 95% CI: 1.4 – 4.7, p=0.001) to be significantly associated with major trauma. Risk of bias was moderate to high across all 6 studies.ConclusionThis systematic review highlighted the paucity of literature surrounding the incidence of major trauma following falls down stairs.A retrospective cohort study is currently being undertaken to analyse the risk of major trauma following falls down stairs. On completion, the results will be incorporated with the results of this systematic review.

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Characteristics and Recovery Methods of Studies Falsely Excluded During Literature Screening –A Systematic Review

10.21203/rs.3.rs-745015/v1 ◽

2021 ◽

Author(s):

Lisa Affengruber ◽

Andreea Dobrescu ◽

Emma Persad ◽

Irma Klerings ◽

Gernot Wagner ◽

...

Keyword(s):

Systematic Review ◽

Information Science ◽

Citation Index ◽

Grey Literature ◽

Case Series ◽

Rapid Review ◽

Reference List ◽

Search Methods ◽

Increased Risk ◽

The Impact

Abstract Background: Due to the growing need to provide evidence syntheses under time constraints, researchers have begun focusing on the exploration of rapid review methods, which often employ single-reviewer literature screening. However, single-reviewer screening misses, on average, 13% of relevant studies, compared to 3% with dual-reviewer screening. Little guidance exists regarding methods to recover studies falsely excluded during literature screening. Likewise, it is unclear whether specific study characteristics can predict an increased risk of false exclusion. This systematic review aimed to identify supplementary search methods that can be used to recover studies falsely excluded during literature screening. Moreover, it strove to identify study-level predictors that indicate an elevated risk of false exclusions of studies during literature screening. Methods: We performed literature searches for eligible studies in Medline, Science Citation Index Expanded, Social Sciences Citation Index, Current Contents Connect, Embase, Epistemonikos.org, and Information Science & Technology Abstracts from 1999 to June 23, 2020. We searched for grey literature, checked reference lists, and conducted hand searches in two relevant journals and similar articles searches current to January 28, 2021. Two investigators independently screened the literature; one investigator performed the data extraction, a second investigator checked for correctness and completeness. Two reviewers assessed the risk of bias of eligible studies. We synthesized the results narratively. Results: Three methods studies, two with a case study design and one with a case series design, met the inclusion criteria. One study reported that all falsely excluded publications (8%) could be recovered through reference list checking compared to other supplementary search methods. No included methods study analyzed the impact of recovered studies on conclusions or meta-analyses. Two studies reported that up to 8% of studies were falsely excluded due to uninformative titles and abstracts, and one study showed that 11% of non-English studies were falsely excluded. Conclusions: Due to the limited evidence based on two case studies and one case series, we can draw no firm conclusion about the most reliable and most valid method to recover studies falsely excluded during literature screening or about the characteristics that might predict a higher risk of false exclusion. Systematic review registration: https://osf.io/v2pjr/

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Risk factors for mental illness in adults with atopic eczema or psoriasis: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-038324 ◽

2020 ◽

Vol 10 (12) ◽

pp. e038324

Author(s):

Elizabeth I Adesanya ◽

Yochai Schonmann ◽

Joseph F Hayes ◽

Rohini Mathur ◽

Amy R Mulick ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Mental Illness ◽

Atopic Eczema ◽

Skin Diseases ◽

Grey Literature ◽

Evaluation Framework ◽

Mental Illnesses ◽

Cochrane Library ◽

Increased Risk

IntroductionEvidence indicates that people with the common inflammatory skin diseases atopic eczema or psoriasis are at increased risk of mental illness. However, the reasons for the relationship between skin disease and common mental disorders (ie, depression and anxiety) or severe mental illnesses (ie, schizophrenia, bipolar disorder and other psychoses) are unclear. Therefore, we aim to synthesise the available evidence regarding the risk factors for mental illness in adults with atopic eczema or psoriasis.Methods and analysisWe will conduct a systematic review of randomised controlled trials, cohort, case–control and cross-sectional studies. We will search the following databases from inception to March 2020: Medline, Embase, Global Health, Scopus, the Cochrane Library, Web of Science, Base, PsycInfo, the Global Resource of Eczema Trials, and the grey literature databases Open Grey, PsycExtra and the New York Academy of Medicine Grey Literature Report. We will also search the bibliographies of eligible studies and relevant systematic reviews to identify additional relevant studies. Citation searching of large summary papers will be used to further identify relevant publications. Two reviewers will initially review study titles and abstracts for eligibility, followed by full text screening. We will extract data using a standardised data extraction form. We will assess the risk of bias of included studies using the Quality in Prognosis Studies tool. We will synthesise data narratively, and if studies are sufficiently homogenous, we will consider a meta-analysis. We will assess the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework.Ethics and disseminationEthical approval is not required for a systematic review. Results of the review will be published in a peer-reviewed journal and disseminated through conferences.PROSPERO registration numberCRD42020163941.

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Impact of obstetric unit closures, travel time and distance to obstetric services on maternal and neonatal outcomes in high-income countries: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-036852 ◽

2020 ◽

Vol 10 (12) ◽

pp. e036852

Author(s):

Reem Saleem Malouf ◽

Claire Tomlinson ◽

Jane Henderson ◽

Charles Opondo ◽

Peter Brocklehurst ◽

...

Keyword(s):

Systematic Review ◽

Grey Literature ◽

Risk Of Bias ◽

High Income ◽

Travel Distance ◽

Neonatal Outcomes ◽

Increased Risk ◽

Maternal And Neonatal Outcomes ◽

The Impact ◽

Travel Distances

ObjectivesTo systematically review (1) The effect of obstetric unit (OU) closures on maternal and neonatal outcomes and (2) The association between travel distance/time to an OU and maternal and neonatal outcomes.DesignSystematic review of any quantitative studies with a comparison group.Data sourcesEmbase, MEDLINE, PsycINFO, Applied Social Science Index and Abstracts, Cumulative Index to Nursing and Allied Health and grey literature were searched.MethodsEligible studies explored the impact of closure of an OU or the effect of travel distance/time on prespecified maternal or neonatal outcomes. Only studies of women giving birth in high-income countries with universal health coverage of maternity services comparable to the UK were included. Identification of studies, extraction of data and risk of bias assessment were undertaken by at least two reviewers independently. The risk of bias checklist was based on the Cochrane Effective Practice and Organisation of Care criteria and the Newcastle-Ottawa scale. Heterogeneity across studies precluded meta-analysis and synthesis was narrative, with key findings tabulated.Results31 studies met the inclusion criteria. There was some evidence to suggest an increase in babies born before arrival following OU closures and/or associated with longer travel distances or time. This may be associated with an increased risk of perinatal or neonatal mortality, but this finding was not consistent across studies. Evidence on other maternal and neonatal outcomes was limited but did not suggest worse outcomes after closures or with longer travel times/distances. Interpretation of findings for some studies was hampered by concerns around how accurately exposures were measured, and/or a lack of adjustment for confounders or temporal changes.ConclusionIt is not possible to conclude from this review whether OU closure, increased travel distances or times are associated with worse outcomes for the mother or the baby.PROSPERO registration numberCRD42017078503.

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Assessing the Risk of Respiratory-Related Healthcare Visits Associated with Wildfire Smoke Exposure in Children 0–18 Years Old: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168799 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8799

Author(s):

Shelby Henry ◽

Maria B. Ospina ◽

Liz Dennett ◽

Anne Hicks

Keyword(s):

Systematic Review ◽

Respiratory Symptoms ◽

Grey Literature ◽

Health Assessment ◽

Smoke Exposure ◽

Risk Of Bias ◽

Emergency Department Visits ◽

Cross Sectional ◽

Wildfire Smoke ◽

Increased Risk

Wildfires are increasing in frequency, size, and intensity, and increasingly affect highly populated areas. Wildfire smoke impacts cardiorespiratory health; children are at increased risk due to smaller airways, a higher metabolic rate and ongoing development. The objective of this systematic review was to describe the risk of pediatric respiratory symptoms and healthcare visits following exposure to wildfire smoke. Medical and scientific databases and the grey literature were searched from inception until December 2020. Included studies evaluated pediatric respiratory-related healthcare visits or symptoms associated with wildfire smoke exposure. Prescribed burns, non-respiratory symptoms and non-pediatric studies were excluded. Risk of bias was evaluated using the National Toxicology Program’s Office of Health Assessment and Translation Risk of Bias Rating Tool. Data are presented narratively due to study heterogeneity. Of 2138 results, 1167 titles and abstracts were screened after duplicate removal; 65 full text screens identified 5 pre-post and 11 cross-sectional studies of rural, urban and mixed sites from the USA, Australia, Canada and Spain. There is a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in children < 5 years old.

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Exposure to parental psychopathology and offspring's risk of suicide-related thoughts and behaviours: a systematic review

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000397 ◽

2017 ◽

Vol 28 (2) ◽

pp. 179-190 ◽

Cited By ~ 8

Author(s):

S. M. Goodday ◽

J. Shuldiner ◽

S. Bondy ◽

A. E. Rhodes

Keyword(s):

Systematic Review ◽

Suicide Attempts ◽

Psychiatric Symptoms ◽

Grey Literature ◽

Parental Psychopathology ◽

Primary Objective ◽

Mediating Effect ◽

Increased Risk ◽

Child Psychiatric ◽

Child Psychiatric Symptoms

Aims.The primary objective of this systematic review was to identify and synthesise analytic studies examining the association between exposure to parental psychopathology in childhood and the nature of subsequent suicide-related thoughts (SRT) and suicide-related behaviour (SRB) (severity of ideation, planned/unplanned attempts/lethality) and to describe the direction, and magnitude of associations. The secondary objective was to determine if the associations from the primary objective differ by the type(s) and timing of parental psychopathology, sex/gender of the parent and child and is mediated by child psychiatric symptoms and family functioning.Methods.A systematic review was conducted using guidelines from the PRISMA statement. MEDLINE, CINAHL, EMBASE, psycINFO, Web of Science and grey literature sources were searched by two reviewers to March, 2017. Studies were included if they examined any parental psychopathology (Diagnostic and Statistical Manual of Mental Disorders criteria or equivalent) or SRT or SRB and offspring SRT or SRB occurring from birth <25 years of age.Results.Out of 10 231 studies identified, 54 were included for review. Studies were clinically and methodologically heterogeneous with none at low risk of bias (ROB). Nine studies with moderate ROB indicated a significantly increased risk of offspring SRT, suicide attempts (SA) and suicide among those exposed to maternal SA and suicide in childhood or adolescence. In the remaining 45 studies with higher ROB this association persisted. Several studies (67%) did not confirm that the exposure occurred in the offspring's childhood or adolescence. Findings were suggestive of a mediating effect of offspring psychiatric symptoms, however, few studies examined mediation and effect modification of contextual variables.Conclusions.Offspring exposed to maternal SA are at an increased risk of these same behaviours early in life. Prospective attention to the types and timing of maternal and paternal psychopathology and the intermediate pathways to offspring SRT and SRB onset is needed and could have implications for informing modifiable targets for early intervention and prevention.

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Interventions to Reduce Patient Identification Errors in the Hospital Setting: A Systematic Review

The Open Nursing Journal ◽

10.2174/1874434602115010109 ◽

2021 ◽

Vol 15 (1) ◽

pp. 109-121

Author(s):

Helena De Rezende ◽

Marta M. Melleiro ◽

Paulo A. O. Marques ◽

Timothy H. Barker

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Hospital Setting ◽

Care Process ◽

Patient Identification ◽

High Quality Research ◽

Registration Number ◽

Educational Staff ◽

Identification Practices

Background: Patient identification is considered as a fundamental part of the care process and a relevant resource for safety practices in hospital settings. Objective: We aimed to review the literature on interventions to reduce patient identification errors in hospital settings. Methods: A systematic review of effectiveness using The Joanna Briggs Institute (JBI) methodology was conducted. A three-step search strategy was utilised to explore primary research published up to March 2020 in English, Spanish, and Portuguese across eight databases. Grey literature was also assessed. The titles and abstracts of the studies were screened for assessment of the inclusion criteria. Two reviewers independently appraised the full text of the selected studies and extracted data using standardised tools from JBI. Due to the heterogeneity of studies and insufficient data for statistical pooling, meta-analysis was not feasible. Therefore, the results were synthesised narratively. Results: Twelve studies met the review criteria; all were rated at a moderate risk of bias and four different groups of interventions were identified: educational staff interventions alone and those combined with a partnership with families and patients through education; and information technology interventions alone, and combined with an educational staff strategy. Although most studies showed a statistically significant reduction in patient identification errors, the overall quality of the evidence was considered very low. Conclusion: High-quality research is needed to understand the real impact of interventions to reduce patient identification errors. Nurses should recognise the importance of patient identification practices as a part of their overall commitment to improving patient safety. PROSPERO Registration Number: CRD42018085236

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Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates

BMJ Open ◽

10.1136/bmjopen-2020-036757 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036757

Author(s):

Amna Rabbani ◽

Zahra A Padhani ◽

Faareha A Siddiqui ◽

Jai K Das ◽

Zulfiqar Bhutta

Keyword(s):

Systematic Review ◽

Young Child ◽

Breast Feeding ◽

Grey Literature ◽

Bottle Feeding ◽

Child Feeding ◽

Young Child Feeding ◽

Conflict Settings ◽

Infant And Young Child ◽

Increased Risk

BackgroundBreast feeding in conflict settings is known to be the safest way to protect infant and young children from malnourishment and increased risk of infections. This systematic review assesses the evidence on infant and young child feeding (IYCF) practices in conflict settings.MethodologyWe conducted a search in PubMed and CENTRAL and also searched for grey literature from the year 1980 to August 2019. We included studies conducted in settings inflicted with armed conflict; which comprised settings undergoing conflict, as well as, those within 5 years of its cessation. Studies were included if they discussed IYCF practices, barriers, programmes and guidelines to promote and improve IYCF practices. Two review authors independently evaluated and screened studies for eligibility and extracted data; followed by a descriptive and thematic analysis.ResultsWe included 56 studies in our review including 11 published articles and 45 reports from grey literature and broadly classified into four predetermined sections: epidemiology (n=24), barriers/enablers (n=18), programmes/interventions (n=15) and implementation guidelines (n=30). Epidemiological evidence shows that IYCF practices were generally poor in conflict settings with median prevalence of exclusive breast feeding at 25%, continued breast feeding at 29%, bottle feeding at 58.3%, introduction to solid, semisolid or soft foods at 71.1% and minimum dietary diversity at 60.3%.IYCF practices were affected by displacement, stress, maternal malnutrition and mental health, family casualties and free distribution of breast milk substitutes. To improve IYCF, several interventions were implemented; including, training of health workers, educating mothers, community networking and mobilisation, lactation-support service, baby friendly hospital initiative, mother–baby friendly spaces and support groups.ConclusionThe evidence suggests that IYCF practices are generally poor in conflict inflicted settings. However, there is potential for improvement by designing effective interventions, responsibly disseminating, monitoring and implementing IYCF guidelines as prescribed by WHO development partners, government and non-government organisations with dedicated funds and investing in capacity development.

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