scholarly journals One year into the COVID-19 pandemic: What do we know so far from studies assessing risk and mitigation of droplet aerosolisation during endonasal surgery? A systematic review

2021 ◽  
Author(s):  
Stephen Williams ◽  
Samuel Leong
Keyword(s):  
Systematic Review ◽  
Significant Risk ◽  
World Health Organisation ◽  
Evidence Base ◽  
Important Variable ◽  
Sinus Surgery ◽  
World Health ◽  
Endonasal Surgery ◽  
Eligibility Criteria ◽  
One Year

Objectives As we pass the anniversary of the declaration of a global pandemic by the World Health Organisation, it invites us to reflect upon the inescapable changes that coronavirus has wrought upon ENT and, in particular, rhinological practice. As it remains unclear when we will globally emerge from the shadow of COVID-19, a critical analysis of the evidence base on both the assessment and mitigation of risk is vital for ENT departments worldwide. This article presents a systematic review of the literature examining articles which consider either the quantification of risk or strategies to mitigate risk specifically in the setting of rhinological surgery. Design Systematic literature review. Results The literature search yielded a total of 3406 returns with 24 articles meeting eligibility criteria. A narrative synthesis stratified results into two broad themes: those which made an assessment as to the aerosolisation of droplets during sinus surgery, further subdivided into work which considered macroscopically visible droplets and that which considered smaller particles, and those studies which examined the mitigation of this risk. Conclusion Studies considering the aerosolisation of both droplets and smaller particles suggest endonasal surgery carries significant risk. Whilst results both highlight a range of innovative adjunctive strategies and support suction as an important variable to reduce aerosolisation, appropriate use of personal protective equipment (PPE) should be considered mandatory for all healthcare professionals involved in rhinological surgery given studies have demonstrated that close adherence to PPE use is effective at preventing COVID-19 infection.

scholarly journals Prevalence and Incidence Studies of Schizophrenic Disorders: A Systematic Review of the Literature

2002 ◽  
Vol 47 (9) ◽  
pp. 833-843 ◽  
Author(s):  
Elliot M Goldner ◽  
Lorena Hsu ◽  
Paul Waraich ◽  
Julian M Somers
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Incidence Rates ◽  
World Health ◽  
Significant Heterogeneity ◽  
Review Of The Literature ◽  
Local Data ◽  
Eligibility Criteria ◽  
Prevalence Studies ◽  
Incidence Studies

Objective: To present the results of a systematic review of the literature published between January 1, 1980, and December 31, 2000, that reports findings on the prevalence and incidence of schizophrenia and related disorders. Method: We conducted a literature search of schizophrenia-related epidemiological studies, using Medline and HealthSTAR databases and canvassing English-language publications. We used a set of predetermined inclusion-exclusion criteria to identify relevant studies. Eligible publications were restricted to age ranges of 18 years and over for prevalence studies and 15 years and over for incidence studies. Prevalence and incidence data were extracted and analyzed for heterogeneity. Results: A total of 18 prevalence and 8 incidence studies met eligibility criteria for the review. Heterogeneity analysis revealed significant differences across 1-year and lifetime prevalence and 1-year incidence of schizophrenia. The corresponding pooled rates were: 0.34 per 100, 0.55 per 100, and 11.1 per 100 000, respectively; the variation in rates between studies was generally between 2- and 5-fold. Conclusions: Although we restricted this review to studies using rigorous and relatively homogeneous methods, there remains significant heterogeneity of prevalence and incidence rates. This strengthens support for the hypothesis that there is real variation in the distribution of schizophrenia around the world. Health planners need to have local data on schizophrenia rates to improve the accuracy of their interventions, while clinicians and researchers need to continue to investigate the etiology of this variation.

scholarly journals Implementing Digital Storytelling for Health-Related Outcomes in Older Adults: Protocol for a Systematic Review

10.2196/15512 ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. e15512
Author(s):  
Jennifer Stargatt ◽  
Sunil Bhar ◽  
Jahar Bhowmik ◽  
Abdullah Al Mahmud
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Digital Storytelling ◽  
Data Extraction ◽  
Meta Analysis ◽  
Evidence Base ◽  
Eligibility Criteria ◽  
Psychological Comorbidities ◽  
Health Related

Background The number of older adults is increasing rapidly worldwide. Older adults face a unique set of challenges and may experience a range of psychological comorbidities. Advances in multimedia technology have allowed for digital storytelling to be utilized as an intervention for health-related outcomes. Objective The primary aim of the proposed systematic review is to examine the reported health-related outcomes for older adults engaged in digital storytelling. The review also aims to examine the methods associated with digital storytelling, characteristics of digital story products, and implementational considerations. Methods This protocol adheres to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will systematically search selected electronic databases to identify studies that meet our eligibility criteria. From the included studies, data will be extracted and synthesized using a narrative approach and summarized in tables. The methodological quality of the included studies will be assessed using the Mixed Methods Appraisal Tool. Results Systematic searches, data extraction and analysis, and writing of the systematic review are expected to be completed by the end of 2019. Conclusions The proposed systematic review will summarize the existing studies using digital storytelling to improve health-related outcomes for older adults. Results from this review will provide an evidence base for the development of digital storytelling interventions that are effective and implementable with older adults. International Registered Report Identifier (IRRID) PRR1-10.2196/15512

scholarly journals Pharmacy Education In Indonesia

2021 ◽  
pp. 432-442
Author(s):  
Fonny Cokro ◽  
Pretty Falena Kambira Atmanda ◽  
Reynelda Juliani Sagala ◽  
Sherly Tandi Arrang ◽  
Dion Notario ◽  
...  
Keyword(s):  
Pharmacy Practice ◽  
World Health Organisation ◽  
Pharmacy Education ◽  
World Health ◽  
Educational Systems ◽  
Pharmaceutical Sciences ◽  
Career Opportunities ◽  
The Government ◽  
One Year

Pharmacy education in Indonesia mainly involves a four-year undergraduate degree, followed by a one-year professional pharmacy programme. The curriculum and learning outcomes of undergraduate and professional pharmacy programmes follow academic standards set by the Association of Indonesian Pharmacy Higher Education, based on the Seven Star Pharmacist concept developed by the World Health Organisation (WHO). Most pharmacy undergraduate programmes are focused on general pharmacy skills and knowledge, which includes pharmaceutical sciences and clinical pharmacy. Professional pharmacy programmes provide more pharmacy practice training and skills; thus, graduates have broader career opportunities than undergraduates because they are prepared for higher responsibilities within pharmacy practice. Although there have been significant improvements in pharmacy education, there remain challenges related to government policies, stakeholder agreements, educational offerings, competencies, and training. This requires considerable collective efforts from the government, educational systems, associations, and other stakeholders to improve the role of pharmacists in Indonesia.

scholarly journals Baseline results of a living systematic review for COVID-19 funded research projects

2020 ◽  
Vol 5 ◽  
pp. 209 ◽  
Author(s):  
Alice Norton ◽  
Adrian Bucher ◽  
Emilia Antonio ◽  
Nicole Advani ◽  
Henrike Grund ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thematic Analysis ◽  
Research Collaboration ◽  
Descriptive Analysis ◽  
World Health Organisation ◽  
World Health ◽  
Research Projects ◽  
Funded Research ◽  
The World ◽  
Global Research

Background: The coronavirus disease 2019 (COVID-19) has resulted in an unprecedented research response, demonstrating exceptional examples of rapid research and collaboration. There is however a need for greater coordination, with limited resources and the shifting global nature of the pandemic resulting in a proliferation of research projects underpowered and unable to achieve their aims. Methods: The UK Collaborative on Development Research (UKCDR) and Global Research Collaboration for Infectious Disease Preparedness (GloPID-R), two funder coordination groups have collaborated to develop a live database of funded research projects across the world relating to COVID-19. Drawing data continually from their members and further global funding bodies, as of 15th July 2020 the database contains 1,858 projects, funded by 25 funders, taking place across 102 countries. To our knowledge it is one of the most comprehensive databases, covering a wide breadth of research disciplines. The database is aligned to the World Health Organisation (WHO) Global Research Roadmap: 2019 Novel Coronavirus. It is being used by the WHO, governments and multi-lateral policy makers, research funders and researchers. This living systematic review aims to supplement the database by providing an open accessible and frequently updated resource summarising the characteristics of the COVID-19 funded research portfolio. Both descriptive and thematic analysis will be presented and updated frequently to aid interpretation of the global COVID-19 funded research portfolio. Results: In this baseline analysis we provide the first detailed descriptive analysis of the database and focus our thematic analysis on research gaps, study populations and research locations (with a focus on resource-limited countries). Conclusions: This living systematic review will help both funders and researchers to prioritise resources to underfunded areas where there is greatest research need and facilitate further strategic collaboration.

scholarly journals Orthodoxy, illusio, and playing the scientific game: a Bourdieusian analysis of infection control science in the COVID-19 pandemic

2021 ◽  
Vol 6 ◽  
pp. 126
Author(s):  
Trisha Greenhalgh ◽  
Mustafa Ozbilgin ◽  
Damien Contandriopoulos
Keyword(s):  
Infection Control ◽  
Scientific Evidence ◽  
World Health Organisation ◽  
Evidence Base ◽  
World Health ◽  
Airborne Transmission ◽  
Science And Policy ◽  
Evidence Quality ◽  
Vested Interests ◽  
Scientific Capital

Background: Scientific and policy bodies’ failure to acknowledge and act on the evidence base for airborne transmission of SARS-CoV-2 in a timely way is both a mystery and a scandal. In this study, we applied theories from Bourdieu to address the question, “How was a partial and partisan scientific account of SARS-CoV-2 transmission constructed and maintained, leading to widespread imposition of infection control policies which de-emphasised airborne transmission?”. Methods: From one international case study (the World Health Organisation) and four national ones (UK, Canada, USA and Japan), we selected a purposive sample of publicly available texts including scientific evidence summaries, guidelines, policy documents, public announcements, and social media postings. To analyse these, we applied Bourdieusian concepts of field, doxa, scientific capital, illusio, and game-playing. We explored in particular the links between scientific capital, vested interests, and policy influence. Results: Three fields—political, state (policy and regulatory), and scientific—were particularly relevant to our analysis. Political and policy actors at international, national, and regional level aligned—predominantly though not invariably—with medical scientific orthodoxy which promoted the droplet theory of transmission and considered aerosol transmission unproven or of doubtful relevance. This dominant scientific sub-field centred around the clinical discipline of infectious disease control, in which leading actors were hospital clinicians aligned with the evidence-based medicine movement. Aerosol scientists—typically, chemists, and engineers—representing the heterodoxy were systematically excluded from key decision-making networks and committees. Dominant discourses defined these scientists’ ideas and methodologies as weak, their empirical findings as untrustworthy or insignificant, and their contributions to debate as unhelpful. Conclusion: The hegemonic grip of medical infection control discourse remains strong. Exit from the pandemic depends on science and policy finding a way to renegotiate what Bourdieu called the ‘rules of the scientific game’—what counts as evidence, quality, and rigour.

scholarly journals Oral rehydration of malnourished children with diarrhoea and dehydration: A systematic review

2017 ◽  
Vol 2 ◽  
pp. 66 ◽  
Author(s):  
Kirsty A. Houston ◽  
Jack G. Gibb ◽  
Kathryn Maitland
Keyword(s):  
Systematic Review ◽  
Severe Acute Malnutrition ◽  
Significant Risk ◽  
Acute Malnutrition ◽  
World Health ◽  
Who Guidelines ◽  
Oral Rehydration ◽  
Malnourished Children ◽  
Rehydration Solutions ◽  
Severe Hyponatraemia

Background: Diarrhoea complicates over half of admissions to hospital with severe acute malnutrition (SAM). World Health Organization (WHO) guidelines for the management of dehydration recommend the use of oral rehydration with ReSoMal (an oral rehydration solution (ORS) for SAM), which has lower sodium (45mmols/l) and higher potassium (40mmols/l) content than old WHO ORS. The composition of ReSoMal was designed specifically to address theoretical risks of sodium overload and potential under-treatment of severe hypokalaemia with rehydration using standard ORS. In African children, severe hyponatraemia at admission is a major risk factor for poor outcome in children with SAM complicated by diarrhoea. We therefore reviewed the evidence for oral rehydration therapy in children with SAM. Methods: We conducted a systematic review of randomised controlled trials (RCTs) on 18th July 2017 comparing different oral rehydration solutions in severely malnourished children with diarrhoea and dehydration, using standard search terms. The author assessed papers for inclusion. The primary endpoint was frequency of hyponatraemia during rehydration. Results: Six RCTs were identified, all published in English and conducted in low resource settings in Asia. A range of ORS were evaluated in these studies, including old WHO ORS, standard hypo-osmolar WHO ORS and ReSoMal. Hyponatraemia was observed in two trials evaluating ReSoMal, three children developed severe hyponatraemia with one experiencing convulsions. Hypo-osmolar ORS was found to have benefits in time to rehydration, reduction of stool output and duration of diarrhoea. No trials reported over-hydration or fatalities. Conclusions: Current WHO guidelines strongly recommend the use of ReSoMal based on low quality of evidence. Studies indicate a significant risk of hyponatraemia on ReSoMal in Asian children, none have been conducted in Africa, where SAM mortality remains high. Further research should be conducted in Africa to evaluate optimal ORS for children with SAM and to generate evidence based, practical guidelines

scholarly journals Corneal Collagen Cross-Linking for Keratoconus: Systematic Review

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Hidenaga Kobashi ◽  
Shi Song Rong
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Control Group ◽  
Significant Heterogeneity ◽  
Eligibility Criteria ◽  
Significant Difference ◽  
One Year ◽  
Collagen Cross Linking

Purpose. To evaluate the efficacy of collagen cross-linking (CXL) one year after treatment for keratoconus compared to no treatment by summarizing randomized controlled trials (RCTs) using a systematic review. Methods. Trials meeting the selection criteria were quality appraised, and the data were extracted by two independent authors. The outcome parameters included maximum keratometry (Kmax), corneal thickness at the thinnest point, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), spherical equivalent (SE) refraction, and cylindrical refraction one year after CXL. We compared the changes in the above parameters with the control group. Results. We identified five RCTs involving 289 eyes that met the eligibility criteria for this systematic review. The changes in BSCVA from baseline to one year exhibited a significant difference between the two groups. There was no statistically significant difference between the two groups for changes in corneal thickness and cylindrical refraction. We did not conduct a meta-analysis in Kmax, UCVA, and SE refraction because their I2 values were greater than 50%. Conclusions. According to the systematic review, CXL may be effective in halting the progression of keratoconus for one year under certain conditions, although evidence is limited due to the significant heterogeneity and paucity of RCTs.

A Systematic Review of the Qualitative Evidence for the Use of Lifestyle Planning in People with Learning Disabilities

1999 ◽  
Vol 3 (3) ◽  
pp. 148-158 ◽  
Author(s):  
D. Rowe ◽  
A. Rudkin
Keyword(s):  
Systematic Review ◽  
Learning Disabilities ◽  
Planning Process ◽  
Evidence Base ◽  
Outcome Data ◽  
Current Evidence ◽  
Future Research ◽  
Eligibility Criteria ◽  
Qualitative Evidence ◽  
Current Evidence Base

Lifestyle planning (LP) for people with learning disabilities is largely supported by qualitative rather than quantitative research. LP is a time-consuming and potentially resource-intensive area of practice which is becoming more prevalent in the UK. We present the first systematic review of the qualitative evidence base for the use of LP in people with learning disabilities. Such evidence concerns the special characteristics of LP and its outcomes in descriptive rather than quantitative terms. Qualitative research is usually aimed at enhancing validity by grounding theory in data collected. Twenty-one studies passed eligibility criteria for inclusion in this review, but only ten provided any outcome data, the others being concerned with process only. A replicable search strategy was employed and the resulting original data sources were critically reviewed with respect to major concepts and categories in the areas of: planning process, choices and preferences, ethics and outcomes. Explicitly person-centred approaches such as essential lifestyle planning are contrasted with more service-led methods such as individual programme planning. There are major methodological limitations in much of the available literature and suggestions for future research to clarify matters are made. The current evidence base suggests that no form of LP has significantly better outcomes than any other form and that it is not clear if LP in general enhances outcomes. Ongoing use of person centred planning in particular is informed by ethical considerations and is evolving in its structure and function.

scholarly journals Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review

2020 ◽  
Vol 42 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Elaine C. Toomey ◽  
Yvonne Conway ◽  
Chris Burton ◽  
Simon Smith ◽  
Michael Smalle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Evidence Base ◽  
World Health ◽  
Healthcare Organizations ◽  
Surgical Masks ◽  
Single Use ◽  
Current Guidance ◽  
The Impact

AbstractBackground:Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.Objectives:To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators.Data sources:We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews.Methods:Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized.Results:In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.Conclusions:Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

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