Overview and Strategy Analysis of Technology-based Non-pharmacological Interventions for Delirium Prevention: Systematic Review (Preprint)

BACKGROUND Delirium prevention is crucial, especially in critically ill patients. Increasingly, non-pharmacological multicomponent interventions for preventing delirium are recommended and technology-based interventions have developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview. OBJECTIVE The systematic review was carried out to answer the following questions: (1) What are technologies currently used in non-pharmacological technology-based interventions for preventing and reducing delirium?, (2) What are the strategies underlying these currently used technologies? METHODS A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made following the PRISMA guideline. Studies were eligible if they contained any types of technology-based interventions and assessed delirium-/risk factor-related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form. RESULTS A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. The review revealed eight different technology types and 14 strategies that were categorized into seven pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, provide (5) a sense of security, (6) a sense of control, and (7) a sense of being connected. For all technology types, significant positive effects were found on direct and/or indirect delirium outcome. Several similarities were found across effective interventions: using a multicomponent approach and/or including components comforting psychological needs of patients (e.g., familiarity, distraction and soothing elements). CONCLUSIONS Technology-based interventions have a high potential when multidimensional needs of patients (e.g., physical, cognitive and emotional) are incorporated. The seven pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the Intensive Care Unit (ICU) into a healing environment as a powerful tool to prevent delirium.

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A Systematic Review of the Use of Telemedicine in the Military Forces Worldwide

Shiraz E-Medical Journal ◽

10.5812/semj.99343 ◽

2020 ◽

Vol 21 (11) ◽

Author(s):

Reza Mohammadi ◽

Zeinab Tabanejad ◽

Shahabeddin Abhari ◽

Behnam Honarvar ◽

Mina Lazem ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Healthcare Providers ◽

Military Medicine ◽

Healthcare Services ◽

Developed Countries ◽

The United States ◽

Positive Effects ◽

Military Forces ◽

The Military

Context: Considering the pivotal role of telemedicine in providing healthcare services for remote areas, some of the military medical centers, especially in developed countries, use different types of telemedicine programs. Objectives: The present study aimed at identifying the implemented telemedicine projects in military medicine worldwide and introducing their features. Evidence Acquisition: The current systematic review was performed in 2018. PubMed, Scopus, Embase, and Web of Science databases were searched for articles published from 2014 to 2018 by a combination of related keywords, and the related original articles were then selected based on the inclusion and exclusion criteria. Data were collected by a data extraction form, and then the data were summarized and reported based on the study objectives. Results: Of the 173 articles retrieved from the first round of search, 12 were included in the study; five (41.66%) studies had used the synchronous (real-time telemedicine) method. The United States, with nine studies, had the highest number of projects in military telemedicine. Most studies (n = 7) were performed on tele-psychology and the application of telemedicine in psychology. All selected studies reported the positive effects of telemedicine on providing healthcare for military forces. Conclusions: The proper utilization of telemedicine equipment is effective in saving time for both patients and healthcare providers, reducing costs, supporting in natural disasters, and satisfying patients with military medicine. To achieve telemedicine program objectives, they should be set precisely. Considering the importance of timely healthcare services, it is suggested to utilize synchronous methods and tools such as video conferencing.

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Development of an Automated, Real Time Surveillance Tool for Predicting Readmissions at a Community Hospital

Applied Clinical Informatics ◽

10.4338/aci-2012-12-ra-0058 ◽

2013 ◽

Vol 04 (02) ◽

pp. 153-169 ◽

Cited By ~ 6

Author(s):

R. Gildersleeve ◽

P. Cooper

Keyword(s):

Real Time ◽

Community Hospital ◽

Validation Cohort ◽

Data Extraction ◽

Characteristic Curve ◽

Hospital Setting ◽

Data Repository ◽

Derivation Cohort ◽

Effective Interventions ◽

Patients At Risk

SummaryBackground: The Centers for Medicare and Medicaid Services’ Readmissions Reduction Program adjusts payments to hospitals based on 30-day readmission rates for patients with acute myocardial infarction, heart failure, and pneumonia. This holds hospitals accountable for a complex phenomenon about which there is little evidence regarding effective interventions. Further study may benefit from a method for efficiently and inexpensively identifying patients at risk of readmission. Several models have been developed to assess this risk, many of which may not translate to a U.S. community hospital setting.Objective: To develop a real-time, automated tool to stratify risk of 30-day readmission at a semi-rural community hospital.Methods: A derivation cohort was created by extracting demographic and clinical variables from the data repository for adult discharges from calendar year 2010. Multivariate logistic regression identified variables that were significantly associated with 30-day hospital readmission. Those variables were incorporated into a formula to produce a Risk of Readmission Score (RRS). A validation cohort from 2011 assessed the predictive value of the RRS. A SQL stored procedure was created to calculate the RRS for any patient and publish its value, along with an estimate of readmission risk and other factors, to a secure intranet site.Results: Eleven variables were significantly associated with readmission in the multivariate analysis of each cohort. The RRS had an area under the receiver operating characteristic curve (c-statistic) of 0.74 (95% CI 0.73-0.75) in the derivation cohort and 0.70 (95% CI 0.69-0.71) in the validation cohort.Conclusion: Clinical and administrative data available in a typical community hospital database can be used to create a validated, predictive scoring system that automatically assigns a probability of 30-day readmission to hospitalized patients. This does not require manual data extraction or manipulation and uses commonly available systems. Additional study is needed to refine and confirm the findings.Citation: Gildersleeve R, Cooper P. Development of an automated, real time surveillance tool for predicting readmissions at a community hospital. Appl Clin Inf 2013; 4: 153–169http://dx.doi.org/10.4338/ACI-2012-12-RA-0058

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A Systematic Review of Interventions to Increase Awareness, Knowledge, and Folic Acid Consumption before and during Pregnancy

American Journal of Health Promotion ◽

10.4278/06051566r2.1 ◽

2008 ◽

Vol 22 (4) ◽

pp. 237-245 ◽

Cited By ~ 21

Author(s):

Corina Mihaela Chivu ◽

Theodore H. Tulchinsky ◽

Karla Soares-Weiser ◽

Rony Braunstein ◽

Mayer Brezis

Keyword(s):

Systematic Review ◽

Folic Acid ◽

Data Extraction ◽

Interrupted Time Series ◽

Cochrane Library ◽

Case Control Studies ◽

Effective Interventions ◽

Before And After ◽

Quasi Experimental ◽

Time Series Studies

Objective. We conducted a systematic review of studies designed to increase awareness of, knowledge about, and consumption of folic acid before and during pregnancy. Data sources. Studies were identified from Cochrane Library, Medline, and the references of primary studies and reviews. Study inclusion and exclusion criteria. Studies included randomized controlled trials, quasi-experimental interrupted time series studies, follow-up studies, case-control studies, and before-and-after studies, all of which were conducted between 1992 and 2005 on women ages 15 to 49 years and/or health professionals, evaluating awareness and/or knowledge and/or consumption of folic acid both before and after intervention. Studies were excluded if data were not presented both before and after intervention or were other outcomes than those mentioned here. Data extraction. Data were extracted in relation to characteristics of studies, participants, interventions, and outcomes. Data synthesis. Because of heterogeneity, we performed a narrative synthesis describing the direction and the size of effects. Results. On average, women's awareness increased from 60% to 72%, knowledge from 21% to 45%, and consumption from 14% to 23%. Conclusions. Interventions had a positive effect on folic acid intakes before and during pregnancy, although the average usage reached less than 25%. So what? Further research is needed to design more effective interventions to increase periconceptional use of folic acid.

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Interventions to support people with dementia and their informal caregivers during the transition from home care to nursing home care – a protocol for a systematic review / Interventionen zur Unterstützung von Menschen mit Demenz und ihren Angehörigen während des Übergangs von der häuslichen Pflege ins Pflegeheim – ein Studienprotokoll für eine systematische Übersichtsarbeit

International Journal of Health Professions ◽

10.1515/ijhp-2016-0020 ◽

2016 ◽

Vol 3 (2) ◽

pp. 122-135

Author(s):

Christian Müller ◽

Janine Puls ◽

Sindy Lautenschläger ◽

Astrid Stephan ◽

Gabriele Meyer

Keyword(s):

Systematic Review ◽

Nursing Home ◽

Home Care ◽

Data Extraction ◽

Informal Caregivers ◽

The Body ◽

Nursing Home Care ◽

Bibliographic Databases ◽

People With Dementia ◽

Mrc Framework

Abstract Background The transition from home care to nursing home care is a significant event in the life of a person with dementia and also for informal caregiver, who deal with many crises and changes. Aim To describe a protocol for a systematic review based on the `‘PRISMA-P 2015 statement`. We will carry out this review firstly to identify interventions that support people with dementia and their informal caregivers in the transition from home care to nursing home care, secondly to synthesise the available evidence for the efficacy of identified interventions, and thirdly to examine whether the identified interventions have been systematically developed, evaluated and implemented according to the MRC framework. Design This systematic review will be conducted according to the recommendations specified in the Cochrane Handbook for Intervention Reviews; reporting will follow the PRISMA statement. Methods The search strategy covers six electronic bibliographic databases, Google Scholar and ALOIS. In addition, backward citation tracking will be applied. The protocol includes decisions made on the research questions, inclusion/exclusion criteria, search methods, study selection, data extraction, assessment of risk of bias, data synthesis and plans for dissemination and funding. Discussion This systematic review will summarise the body of evidence of interventions supporting people with dementia and their informal caregivers during the transition from home care to nursing home care. Protocol Registration This review protocol has been registered on the Prospective Register of Systematic Reviews (PROSPERO 2015: CRD42015019839).

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Factors that contribute to effective online nutrition education interventions: a systematic review

Nutrition Reviews ◽

10.1093/nutrit/nuz032 ◽

2019 ◽

Vol 77 (10) ◽

pp. 663-690 ◽

Cited By ~ 1

Author(s):

Mary W Murimi ◽

Bong Nguyen ◽

Ana F Moyeda-Carabaza ◽

Hyun-Jung Lee ◽

Oak-Hee Park

Keyword(s):

Systematic Review ◽

Nutrition Education ◽

Tracking System ◽

Data Extraction ◽

Smartphone Application ◽

Text Messages ◽

Online Interventions ◽

Assessment Development ◽

Effective Interventions ◽

Use Of The Internet

Abstract Context The use of the internet and technology as a medium for delivering online nutrition education (ONE) has increased; however, evidence-based studies exploring factors that contribute to best practices in online interventions have not emerged. Objective The purpose of this systematic review was to identify factors that contributed to successful ONE interventions in relation to research studies published between 2009 and 2018. Data sources Following the PRISMA guidelines, relevant studies were identified through PubMed, Medline, Web of Science, Science Direct, and Education Resources Information Center (ERIC) databases. Data extraction Five authors screened and determined the quality of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and extracted the data from the articles. Data analysis Twenty-seven studies were included: 21 studies were website-based, 3 were delivered through smartphone application, 2 were delivered as online courses, and 1 used text messages. Tailored messages/feedback, interaction between participants and investigators, identification of specific behaviors, use theory, adequate duration, and alignment between stated objectives and activities were factors that contributed to successful online interventions, while comparison bias and the lack of specific details on duration and dosage, tracking system, objective outcome measurements, and follow-up were factors that may have interfered with successful ONE interventions. Conclusions The findings underscore the importance of developing ONE intervention designs that utilize factors unique to online platforms for effective interventions aimed at behavior change.

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The experience of delirium in palliative care settings for patients, family, clinicians and volunteers: A qualitative systematic review and thematic synthesis

Palliative Medicine ◽

10.1177/02692163211006313 ◽

2021 ◽

pp. 026921632110063

Author(s):

Imogen Featherstone ◽

Annmarie Hosie ◽

Najma Siddiqi ◽

Pamela Grassau ◽

Shirley H Bush ◽

...

Keyword(s):

Systematic Review ◽

Palliative Care ◽

Medical Condition ◽

Quality Appraisal ◽

Thematic Synthesis ◽

Care Services ◽

Effective Interventions ◽

Qualitative Systematic Review ◽

Delirium Prevention ◽

Palliative Care Services

Background: Delirium is common in palliative care settings and is distressing for patients, their families and clinicians. To develop effective interventions, we need first to understand current delirium care in this setting. Aim: To understand patient, family, clinicians’ and volunteers’ experience of delirium and its care in palliative care contexts. Design: Qualitative systematic review and thematic synthesis (PROSPERO 2018 CRD42018102417). Data sources: The following databases were searched: CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Embase, MEDLINE and PsycINFO (2000–2020) for qualitative studies exploring experiences of delirium or its care in specialist palliative care services. Study selection and quality appraisal were independently conducted by two reviewers. Results: A total of 21 papers describing 16 studies were included. In quality appraisal, trustworthiness (rigour of methods used) was assessed as high ( n = 5), medium ( n = 8) or low ( n = 3). Three major themes were identified: interpretations of delirium and their influence on care; clinicians’ responses to the suffering of patients with delirium and the roles of the family in delirium care. Nursing staff and other clinicians had limited understanding of delirium as a medical condition with potentially modifiable causes. Practice focused on alleviating patient suffering through person-centred approaches, which could be challenging with delirious patients, and medication use. Treatment decisions were also influenced by the distress of family and clinicians and resource limitations. Family played vital roles in delirium care. Conclusions: Increased understanding of non-pharmacological approaches to delirium prevention and management, as well as support for clinicians and families, are important to enable patients’ multi-dimensional needs to be met.

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Diabetes, Age, and Duration of Supplementation Subgroup Analysis for the Effect of Coenzyme Q10 on Oxidative Stress: A Systematic Review and Meta-Analysis

Complementary Medicine Research ◽

10.1159/000515249 ◽

2021 ◽

pp. 1-14

Author(s):

Ghazaleh Hajiluian ◽

Javad Heshmati ◽

Sahar Jafari Karegar ◽

Mahdi Sepidarkish ◽

Ali Shokri ◽

...

Keyword(s):

Oxidative Stress ◽

Systematic Review ◽

Coenzyme Q10 ◽

Antioxidant Defense ◽

Randomized Clinical Trials ◽

Assessment Tool ◽

Meta Analysis ◽

The Body ◽

Cochrane Library ◽

Positive Effects

Background: Coenzyme Q10 (CoQ10) has been known as ubiquinone or ubidecarenone, which is a kind of lipid-soluble and vitamin-like antioxidant. It has a potent antioxidant effect against oxidation status via various mechanisms, including its ability to regenerate other antioxidants, such as vitamin E and vitamin C, and to increase antioxidant enzymes. Moreover, CoQ10 can quench free radicals and prevent lipid peroxidation. The aim of this systematic review and meta-analysis was to evaluate the effect of CoQ10 on oxidative stress variables. Methods: A comprehensive electronic database search in Scopus, Web of Science, Embase, Cochrane Library, and Medline was performed to identify eligible randomized clinical trials. A meta-analysis of included studies was performed on selected variables using a random-effects model. Quality assessment was conducted by means of the Cochrane risk of bias assessment tool. Results: To evaluate the effect of CoQ10 supplementation, 17 trials and 972 participants were included for the meta-analysis. The pooled analysis of primary studies showed that CoQ10 increased serum total antioxidant capacity (standardized mean difference [SMD] 0.62 mmol/L, 95% CI 0.18–1.05, I2 = 76.1%, p ˂ 0.001) and superoxide dismutase (SMD 0.40 U/mg, 95% CI 0.12–0.67, I2 = 9.6%, p ˂ 0.345) levels and decreased malondialdehyde (SMD –1.02 mmol/L, 95% CI –1.60 to –0.44, I2 = 88.2%, p ˂ 0.001) level significantly compared to the placebo group. Although the effect of CoQ10 on nitric oxide (SMD 1.01 µmol/L, 95% CI –1.53 to 3.54, p ˂ 0.001, I2 = 97.8%) and glutathione peroxidase (SMD –0.01 mmol/L, 95% CI –0.86 to 0.84, p ˂ 0.001, I2 = 88.6%) was not significant, CoQ10 can be mentioned as an improvement in antioxidant defense status against reactive oxygen species. Conclusion: These supplements have positive effects on antioxidant defense against oxidizing agents and elevate antioxidant enzyme levels in the body. However, due to limited research the results should be taken with caution.

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The application of the tracer method with peer observation and formative feedback for professional development in clinical practice: a scoping review

Perspectives on Medical Education ◽

10.1007/s40037-021-00693-6 ◽

2021 ◽

Author(s):

Rudi A. Steenbruggen ◽

Marjo J. M. Maas ◽

Thomas J. Hoogeboom ◽

Paul L. P. Brand ◽

Philip J. van der Wees

Keyword(s):

Professional Development ◽

Scoping Review ◽

Healthcare Professionals ◽

Hospital Setting ◽

The Body ◽

Formative Feedback ◽

Peer Observation ◽

Tracer Method ◽

Equal Status ◽

Positive Effects

Abstract Introduction The tracer method, commonly used for quality assessment, can also be used as a tool for peer observation and formative feedback on professional development. This scoping review describes how, by whom, and with what effect the tracer method is applied as a formative professional development instrument between healthcare professionals of equal status and aims to identify the types of scientific evidence for this use of the tracer method. Methods The authors searched four electronic databases for eligible articles, which were screened and assessed for eligibility by two independent researchers. From eligible studies, data were extracted to summarize, collate, and make a narrative account of the findings. Results The electronic search yielded 1757 unique studies, eight of which were included as valid and relevant to our aim: five qualitative, two mixed methods, and one quantitative study. Seven studies took place in hospitals and one in general practice. The tracer method was used mainly as a form of peer observation and formative feedback. Most studies evaluated the tracer method’s feasibility and its impact on professional development. All but one study reported positive effects: participants described the tracer method generally as being valuable and worth continuing. Discussion Although the body of evidence is small and largely limited to the hospital setting, using the tracer method for peer observation and formative feedback between healthcare professionals of equal status appears sufficiently useful to merit further rigorous evaluation and implementation in continuous professional development in healthcare.

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A Systematic Review of Parent Training for Children with Communication Disorders in Korea

Communication Sciences & Disorders ◽

10.12963/csd.21826 ◽

2021 ◽

Vol 26 (3) ◽

pp. 727-741

Author(s):

Youngmee Lee ◽

Heesun Park ◽

Youjin Lee

Keyword(s):

Systematic Review ◽

Language Development ◽

Parent Training ◽

Data Extraction ◽

Communication Disorders ◽

Training Intervention ◽

Speech And Language ◽

Positive Effects ◽

Current Systematic Review ◽

Speech And Language Development

Objectives: The purpose of this study was to review the research trends in regards to parent training and the speech and language development of children with communication disorders in Korea, to evaluate the effectiveness of parent training for improvement of children’s communication skills, and to provide evidence-based directions for parent training.Methods: A search of 4 databases, and manual searching resulted in the identification of 1,222 relevant articles in domestic journals. The 19 articles published from 2001 to 2020 in domestic journals were selected according to the Participants, Intervention, Comparison, and Outcomes (PICO) criteria. Three authors did article selection, data extraction, and quality assessment using the Risk of Bias for Nonrandomized studies (ROBANS).Results: First, the quality of selected articles was high overall. Second, very few studies have empirically examined the effectiveness of parent training intervention on the speech and language development of children with communication disorders. Third, most programs have been provided for mothers and no program focused on supporting fathers. Most programs focused on infants, toddlers, and preschoolers with communication disorders. Fourth, regarding studies on research type and method of data collection; most studies were conducted by experimental study. Lastly, areas of measurement involved participant interactions, development, parent perceptions, and parent experiences. The research studies reported positive effects of parent training intervention on the speech and language development of children with communication disorders.Conclusion: Based on these results, we discussed the limitations of identified studies and limitations of the current systematic review are discussed, as well as implications of the findings for research and practice for children with communication disorders regarding parent training intervention.

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Preclinical and clinical relevance of probiotics and synbiotics in colorectal carcinogenesis: a systematic review

Nutrition Reviews ◽

10.1093/nutrit/nuz087 ◽

2020 ◽

Vol 78 (8) ◽

pp. 667-687 ◽

Cited By ~ 5

Author(s):

Bruna C S Cruz ◽

Mariáurea M Sarandy ◽

Anny C Messias ◽

Reggiani V Gonçalves ◽

Célia L L F Ferreira ◽

...

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Data Extraction ◽

Experimental Studies ◽

Intestinal Barrier ◽

Colorectal Carcinogenesis ◽

Growth Modulation ◽

Positive Effects ◽

Study Selection ◽

Inhibition Of Tumor Growth

Abstract Context Recent evidence suggests that modulation of the gut microbiota may help prevent colorectal cancer. Objective The aim of this systematic review was to investigate the role of probiotics and synbiotics in the prevention of colorectal cancer and to clarify potential mechanisms involved. Data Sources The PubMed, ScienceDirect, and LILACS databases were searched for studies conducted in humans or animal models and published up to August 15, 2018. Study Selection Clinical trials and placebo-controlled experimental studies that evaluated the effects of probiotics and synbiotics in colorectal cancer and cancer associated with inflammatory bowel disease were included. Of 247 articles identified, 31 remained after exclusion criteria were applied. A search of reference lists identified 5 additional studies, for a total of 36 included studies. Data Extraction Two authors independently assessed risk of bias of included studies and extracted data. Data were pooled by type of study, ie, preclinical or clinical. Results The results showed positive effects of probiotics and synbiotics in preventing colorectal cancer. The main mechanisms identified were alterations in the composition and metabolic activity of the intestinal microbiota; reduction of inflammation; induction of apoptosis and inhibition of tumor growth; modulation of immune responses and cell proliferation; enhanced function of the intestinal barrier; production of compounds with anticarcinogenic activity; and modulation of oxidative stress. Conclusions Probiotics or synbiotics may help prevent colorectal cancer, but additional studies in humans are required to better inform clinical practice.

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