The Concept of Vulnerability in Aged Care: A Systematic Review of Argument-Based Ethics Literature

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 154-155
Author(s):  
Virginia Sanchini ◽  
◽  
Roberta Sala ◽  
Chris Gastmans ◽  
◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Ethics ◽  
Critical Reflection ◽  
Web Of Science ◽  
The Elderly ◽  
Aged Care ◽  
Ageing Population ◽  
Analysis Process ◽  
Ethical Concept ◽  
Anthropological Literature

"Background. Vulnerability is a key concept in traditional – as well as contemporary – bioethics and medical ethics (Ten Have 2015, 2016). Within this literature, the concept of vulnerability is mostly defined in relation to autonomy: vulnerability refers to conditions of impaired and/or diminished autonomy (Belmont Report 1979; CIOMS 1991, 1993, 2002; WMA 2000, 2008; Bracken-Roche et al. 2017). Historically, vulnerability has been associated with several categories of agents, amongst which the elderly are paramount. However, no clear and unique conceptualization of vulnerability, when referred to the ageing population, is currently present – especially in domains other than research ethics: some refer to physiological degradation as a defining tenet, some others appeal to autonomy impairment, some others point to loneliness and isolation (Kahana et al. 1995; Slaets 2006; Dodds 2007; Andrew et al. 2008: Sternberg et al. 2011; Clegg et al. 2013). To fill this gap, we examined the meaning, foundations, and uses of vulnerability as ethical concept in the literature of aged care. Method. Using PRISMA procedure, we conducted a systematic review of argument-based ethics publications in 4 major databases (Pubmed, Embase, Web of Science, and Philosopher’s Index) of biomedical, philosophy, bioethical, and anthropological literature that focused on vulnerability in aged care. 5,735 results were obtained. Titles and abstracts were all screened. We are now in the process of full articles screening. All includes articles will then be critically analyzed. The results of this analysis process as well as a critical reflection on the results will be presented at the EACME conference. "

scholarly journals Tools for evaluation of restriction on auditory participation: systematic review of the literature

CoDAS ◽  
2015 ◽  
Vol 27 (4) ◽  
pp. 400-406 ◽  
Author(s):  
Valquíria Conceição Souza ◽  
Stela Maris Aguiar Lemos
Keyword(s):  
Systematic Review ◽  
Hearing Aids ◽  
Observational Studies ◽  
Web Of Science ◽  
The Elderly ◽  
Review Of The Literature ◽  
Aural Rehabilitation ◽  
Isi Web Of Science ◽  
Hearing Handicap ◽  
Bibliographic Collection

PURPOSE: To systematically review studies that used questionnaires for the evaluation of restriction on auditory participation in adults and the elderly.RESEARCH STRATEGY: Studies from the last five years were selected through a bibliographic collection of data in national and international journals in the following electronic databases: ISI Web of Science and Virtual Health Library - BIREME, which includes the LILACS and MEDLINE databases.SELECTION CRITERIA: Studies available fully; published in Portuguese, English, or Spanish; whose participants were adults and/or the elderly and that used questionnaires for the evaluation of restriction on auditory participation.DATA ANALYSIS: Initially, the studies were selected based on the reading of titles and abstracts. Then, the articles were fully and the information was included in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.RESULTS: Three-hundred seventy studies were found in the researched databases; 14 of these studies were excluded because they were found in more than one database. The titles and abstracts of 356 articles were analyzed; 40 of them were selected for full reading, of which 26 articles were finally selected. In the present review, nine instruments were found for the evaluation of restriction on auditory participation.CONCLUSION: The most used questionnaires for the assessment of the restriction on auditory participation were the Hearing Handicap Inventory for the Elderly (HHIE), Hearing Handicap Inventory for Adults (HHIA), and Hearing Handicap Inventory for the Elderly - Screening (HHIE-S). The use of restriction on auditory participation questionnaires can assist in validating decisions in audiology practices and be useful in the fitting of hearing aids and results of aural rehabilitation.

scholarly journals Physical exercise, IGF-1 and cognition A systematic review of experimental studies in the elderly

2018 ◽  
Vol 12 (2) ◽  
pp. 114-122 ◽  
Author(s):  
Angelica Miki Stein ◽  
Thays Martins Vital Silva ◽  
Flávia Gomes de Melo Coelho ◽  
Franciel José Arantes ◽  
José Luiz Riani Costa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Longitudinal Studies ◽  
Web Of Science ◽  
Experimental Studies ◽  
The Elderly ◽  
Inclusion Criteria ◽  
Exercise Induced ◽  
Assessment Results

ABSTRACT One of hypothetical mechanisms related to cognition is exercise-induced IGF-1. Objective: The aim of this study was to analyze the effects of exercise on IGF-1 levels and cognition in the elderly. Methods: The article searches were conducted on Pubmed, Web of Science, PsycINFO and Scielo databases and reviewed according to PRISMA guidelines. The inclusion criteria were: [1] original articles published up to 2017; [2] samples including elderly; [3] protocols including physical exercise; [4] longitudinal studies having exercise as main outcome; [5] assessment of IGF-1; [6] cognition assessment. Results: Seven studies were included in this review. Three of the studies showed an exercise-induced increase in IGF-1; three found stable IGF-1 levels and one found a reduction in IGF-1; with and without improvement in cognition. Conclusion: Disparities in the type of physical exercise, protocols and samples under different conditions hinder the establishment of a consensus on IGF-1, cognition and physical exercise.

scholarly journals NIGELLA SATIVA HAS BENEFICIAL EFFECT ON OSTEOPOROSIS AND BONE HEALING. IS IT FACT OR FICTION? A SYSTEMATIC REVIEW

2017 ◽  
Vol 10 (5) ◽  
pp. 41
Author(s):  
Muhamed T Osman
Keyword(s):  
Systematic Review ◽  
Bone Healing ◽  
Web Of Science ◽  
Nigella Sativa ◽  
Experimental Studies ◽  
Molecular Targets ◽  
The Elderly ◽  
Potential Effect ◽  
Beneficial Effects ◽  
Black Seed

Osteoporosis is the most common reason for a broken bone among the elderly. Several experimental studies have been reported that Nigella sativa(NS) and/or its major component thymoquinone (TQ) have good effects on osteoporosis and bone healing. We conducted this systematic review toevaluate these relevant studies to prove whether NS and/or TQ has potential effect on osteoporosis and can stop pathogenesis of this disease or thismatter still just a fiction. A search on published studies was done using databases including Scopus, PubMed, Google Scholar, Web of Science, andCINAHIL. Terms searched included “Nigella sativa, black seed, TQ, osteoporosis, bone healing.” Initially, 213 articles were extracted. After reviewing their titles and abstracts, 124 articles (Medline, 43; Scopus, 67; EBSCO, 14) were retrieved for further evaluation. However, after excluding the clinical trial studies, human reviews, removal of abstracts and unrelated studies, seven studies were considered finally as eligible for our review. Finally, seven studies were considered eligible for our review. The total number of animals used was 220 (150 rats and 70 rabbits) from different experimental study. Based on the results of this systematic review, we conclude that NS or TQ extract therapy for osteoporosis cannot be recommended yet and these data will not suffice to exclude the beneficial effects of NS on bone turnover reliably. Therefore, more studies are required to explore the specific cellular and molecular targets of NS or TQ using animal osteoporosis models. Once the anti-osteoporotic effectiveness of NS or TQ will be established, human studies can be carried out.Keywords: Nigella sativa, Black seed, Thymoquinone, Osteoporosis, Bone healing.

scholarly journals Relationship between cognition and frailty in elderly: A systematic review

2015 ◽  
Vol 9 (2) ◽  
pp. 110-119 ◽  
Author(s):  
Allan Gustavo Brigola ◽  
Estefani Serafim Rossetti ◽  
Bruna Rodrigues dos Santos ◽  
Anita Liberalesso Neri ◽  
Marisa Silvana Zazzetta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Search Strategy ◽  
Web Of Science ◽  
The Elderly ◽  
Cross Sectional ◽  
Cognitive Domains ◽  
The Subject ◽  
The Relationship

OBJECTIVE: The aim of this study was to analyze the relationship between cognition and frailty in the elderly. METHODS: A systematic review on the currently existing literature concerning the subject was carried out. The search strategy included LILACS, SCOPUS, SciELO, PsycINFO, PubMed and Web of Science databases. RESULTS: A total of 19 studies were selected for review, from which 10 (52.6%) were cross-sectional and 9 (47.4%) longitudinal, and the majority Brazilian. All of the studies established a link between cognition and frailty. There was a relationship between components of frailty and the cognitive domains. Risk of Mild Cognitive Impairment (MCI), dementia and mortality were all evidenced in the relationship between frailty and cognitive impairment. CONCLUSION: The theory remains limited, but results show the variables that appear to be linked to cognition and frailty in elderly. This data can help in implementing actions to improve the quality of life among elderly.

scholarly journals Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 777
Author(s):  
Woon-Man Kung ◽  
Sheng-Po Yuan ◽  
Muh-Shi Lin ◽  
Chieh-Chen Wu ◽  
Md. Mohaimenul Islam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Observational Studies ◽  
Web Of Science ◽  
Meta Analysis ◽  
The Elderly ◽  
Previous Evidence ◽  
Increased Risk ◽  
Meta Analyses ◽  
Risk Ratios

Background: Cognitive impairment is one of the most common, burdensome, and costly disorders in the elderly worldwide. The magnitude of the association between anemia and overall cognitive impairment (OCI) has not been established. Objective: We aimed to update and expand previous evidence of the association between anemia and the risk of OCI. Methods: We conducted an updated systematic review and meta-analysis. We searched electronic databases, including EMBASE, PubMed, and Web of Science for published observational studies and clinical trials between 1 January 1990 and 1 June 2020. We excluded articles that were in the form of a review, letter to editors, short reports, and studies with less than 50 participants. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We estimated summary risk ratios (RRs) with random effects. Results: A total of 20 studies, involving 6558 OCI patients were included. Anemia was significantly associated with an increased risk of OCI (adjusted RR (aRR) 1.39 (95% CI, 1.25–1.55; p < 0.001)). In subgroup analysis, anemia was also associated with an increased risk of all-cause dementia (adjusted RR (aRR), 1.39 (95% CI, 1.23–1.56; p < 0.001)), Alzheimer’s disease [aRR, 1.59 (95% CI, 1.18–2.13; p = 0.002)], and mild cognitive impairment (aRR, 1.36 (95% CI, 1.04–1.78; p = 0.02)). Conclusion: This updated meta-analysis shows that patients with anemia appear to have a nearly 1.39-fold risk of developing OCI than those without anemia. The magnitude of this risk underscores the importance of improving anemia patients’ health outcomes, particularly in elderly patients.

scholarly journals Long-term Health Effects of Antipyretic Drug Use in the Ageing Population: A Systematic Review

2021 ◽  
Author(s):  
Seema Mahesh ◽  
Esther van der Werf ◽  
Mahesh Mallappa ◽  
George Vithoulkas ◽  
Nai Ming Lai
Keyword(s):  
Systematic Review ◽  
Health Effects ◽  
Primary Outcome ◽  
Case Reports ◽  
Case Series ◽  
The Elderly ◽  
Risk Of Bias ◽  
Ageing Population ◽  
Patient Reported

Abstract Background: It is unclear whether fever suppression is beneficial or harmful in the long term in the elderly, due to different immune profile and body temperature compared to the young. Our objective was to determine the long-term health effects of antipyretic treatment in the elderly during infections.Methods: A systematic review was carried out using PubMed, Embase and Cochrane CENTRAL databases. Studies with a sample age ≥60 years investigating any antipyretic drug during infections, comparing with any other drug/therapy/placebo/none were included. Studies in which these drugs were used in roles other than antipyresis were excluded. Databases were searched from their inception until the date of last analysis (27/03/2021). Primary outcome was the onset or worsening of chronic inflammatory diseases. Secondary outcomes were fever reduction, length of hospital stay, patient satisfaction, mortality, laboratory parameters indicative of morbidity, and progress to complications. The Risk of Bias (ROB) was assessed for each study type with the respective ROB formats– Cochrane’s ROB tool for RCTs, ROBINS-I tool for observational studies, Joanna Brigg’s critical appraisal tool for case series and the Cochrane handbook prescribed domains for case reports. Narrative synthesis was performed because high heterogeneity rendered meta-analysis impossible.Results: Of 11481, 17 studies (2 RCTs, 7 observational, 1 case series and 7 case reports) were included. No studies investigated the primary outcome and patient-reported outcomes.The Risk-of-bias of the studies was unclear to high. Fever reduction was significant in the RCTs, in the antipyretic group. BP drop was significant in five studies, in the antipyretic group. Morbidity indicators and length of stay were available only in studies that reported adverse events. Mortality was significant for these drugs in one observational study. The certainty of evidence (GRADE) was low to very low for all outcomes, including fever reduction and mortality. Discussion/Conclusions: There is insufficient evidence regarding the long-term benefit or harm from fever suppression with antipyretics during infections in the elderly. Systematic review registration: This study was funded by the Taylor’s University Ageing Flagship Program and the protocol was registered on PROSPERO (registration number: CRD42020160854)

scholarly journals Efectos del entrenamiento en intervalos de alta intensidad en adultos mayores: una revisión sistemática (Effects of high-intensity interval training in older adults: a systematic review)

2021 ◽  
Vol 16 (48) ◽  
Keyword(s):  
Systematic Review ◽  
Functional Capacity ◽  
High Intensity ◽  
Web Of Science ◽  
Experimental Studies ◽  
Interval Training ◽  
The Elderly ◽  
Positive Effects ◽  
Revisión Sistemática ◽  
High Intensity Interval

El objetivo de este estudio fue realizar una revisión sistemática de la literatura sobre las características de los programas de entrenamiento basados en la modalidad de intervalos de alta intensidad (HIIT, siglas en inglés) en adultos mayores, y a su vez, describir los efectos sobre la capacidad física y funcional en esta población. Se realizó una búsqueda de literatura de 5 bases de datos (DIALNET, DOAJ, Elsevier, PubMed y Web of Science). Los criterios de inclusión incluyeron estudios experimentales aplicados en personas mayores de 60 años. La escala PEDro se utilizó para la evaluación de la calidad de los estudios elegibles. La búsqueda identificó 126 artículos y se evaluaron 12 artículos en texto completo. Todos los estudios eran de buena calidad metodólogica y tenían un bajo riesgo de sesgo. En conclusión, el entrenamiento HIIT ha sido aplicado por un periodo de 6 a 16 semanas, en la modalidad “HIIT-aeróbico” con efectos positivos sobre la capacidad aeróbica y funcional de las personas mayores, además ha reducido la carga patológica en artritis reumatoidea, obesidad y/o dinapenia. === The objective of this study was to do a systematic review of the literature about the characteristics of training programs based on the high intensity interval modality (HIIT) in elderly, and at the same time, to describe the effects on physical and functional capacity in this population. A literature search of 5 databases (DIALNET, DOAJ, Elsevier, PubMed and Web of Science) was performed. The inclusion criteria included experimental studies applied in people older than 60 years. The PEDro scale was used for quality evaluation of eligible studies. The search identified 126 articles and evaluated 12 articles in full text. All studies were of good methodological quality and had a low risk of bias. In conclusion, HIIT training has been applied for a period of 6 to 16 weeks, in the “HIIT-aerobic” modality with positive effects about the aerobic and functional capacity of the elderly, it has also reduced the pathological burden in rheumatoid arthritis, obesity and / or dynapenia.

scholarly journals Long-term health effects of antipyretic drug use in the ageing population: protocol for a systematic review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1288
Author(s):  
Seema Mahesh ◽  
Esther van der Werf ◽  
Mahesh Mallappa ◽  
George Vithoulkas ◽  
Nai Ming Lai
Keyword(s):  
Systematic Review ◽  
Health Effects ◽  
Experimental Studies ◽  
Connective Tissue Diseases ◽  
Case Series ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Ageing Population ◽  
Antipyretic Treatment

Background: Fever is suppressed with drugs due to discomfort and risk of organ damage. However, there is some compelling evidence for the benefits of fever. The elderly are a special population in this regard as they have a blunted fever response. The benefit-harm balance of antipyretic use in this population is unclear.   This study aims to provide the synthesized best evidence regarding long-term health effects of antipyretic treatment in the elderly during infections, investigating the onset/worsening of common chronic diseases, for e.g., thyroid disorders, connective tissue diseases and chronic obstructive pulmonary disease/asthma. Methods: A systematic review will be performed to establish the best evidence available regarding antipyretic treatment in the elderly, searching databases such as Medline, Embase and Cochrane CENTRAL from their inception till date for all types of studies. Studies that consider the drugs in analgesic role will be excluded. The search will be reported following the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ (PRISMA) guidelines. Randomized control trials, quasi experimental studies, observational studies, case series and reports will be included. The primary outcome measure being onset/worsening of chronic inflammatory diseases. Other outcomes include relief of symptoms, length of hospital stay, patient satisfaction, mortality, blood/immune parameters indicative of morbidity and complications of the infection. Risk of biases in randomized studies will be assessed through the Cochrane risk of bias tool. For other study types, appropriate tools such as CASP/QUIPS/Cochrane non-randomised studies tool will be used. Meta-analysis will be conducted on the Cochrane RevMan software and where pooling of data is not possible, a narrative synthesis will be performed. Overall certainty of evidence will be assessed through the GRADE approach. Discussion: The study aims to provide evidence regarding benefit-harm balance of antipyretic use in the elderly population to inform clinical practice and future research.  Systematic review registration: PROSPERO CRD42020160854

scholarly journals Depression in the Iranian Elderly: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hedayat Jafari ◽  
Dariush Ghasemi-Semeskandeh ◽  
Amir Hossein Goudarzian ◽  
Tahereh Heidari ◽  
Azar Jafari-Koulaee
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Meta Analysis ◽  
The Elderly ◽  
Future Research ◽  
Exclusion Criteria ◽  
Standard Scale ◽  
Keywords Screening ◽  
Prevalence Of Depression

Depression can lead to increased medical costs, impaired individual and social functioning, nonadherence to therapeutic proceeding, and even suicide and ultimately affect quality of life. It is important to know the extent of its prevalence for successful planning in this regard. This study was conducted to determine the prevalence of depression in the Iranian elderly. This systematic review and meta-analysis study was done through Medline via PubMed, SCOPUS, Web of Science, ProQuest, SID, Embase, and Magiran with determined keywords. Screening was done on the basis of relevance to the purpose of the study, titles, abstracts, full text, and inclusion and exclusion criteria. The quality of the articles was assessed using the Newcastle-Ottawa standard scale. After primary and secondary screening, 30 articles were finally included in the study. According to the 30 articles reviewed, the prevalence of depression in the Iranian elderly was 52 percent based on the random-effects model (CI 95%: 46–58). According to the results of the present study, depression in the Iranian elderly was moderate to high. Therefore, more exact assessment in terms of depression screening in elderly people seems necessary. Coherent and systematic programs, including psychosocial empowerment counselling for the elderly and workshops for their families, are also needed. Researchers can also use the results of this study for future research.

Vulnerability: An integrative bioethics review and a proposed taxonomy

2021 ◽  
pp. 096973302097618
Author(s):  
Merve Mergen ◽  
Aslıhan Akpınar
Keyword(s):  
Systematic Review ◽  
Medical Ethics ◽  
Research Ethics ◽  
Research Design ◽  
Nursing Care ◽  
Web Of Science ◽  
Ethical Considerations ◽  
Care Policies ◽  
Definition Of ◽  
Scientific Standards

Background: Vulnerability is a concept frequently encountered in the bioethical literature, particularly in the context of research ethics. It can be said that the usage of the concept expanded in the 2000s and started to be used in many new contexts in the literature. However, there appears to be no systematic review that examines the definition of the concept of vulnerability. Objectives: The rationale for this study constitutes the questions regarding how vulnerability is defined and which components are used to define the concept of vulnerability in the bioethics literature. Research design: The integrative review method was conducted to reach various definitions of the concept of vulnerability in bioethics. Whittemore and Knafl’s revised framework for integrative reviews guided the analysis. ‘Vulnerability’ and ‘vulnerable’ keywords, intercrossing with the words ‘bioethics’ and ‘medical ethics’, were searched in three different databases (PubMed, Web of Science and Scopus). Collected data were analysed thematically and a taxonomy was developed. Findings: A total of 1287 studies obtained through search were reduced to 123 that kept the definition of vulnerability. As a result of the review, a comprehensive taxonomy of vulnerability has been proposed. The proposed taxonomy of vulnerability has two categories, ontological and circumstantial, with three subcategories each, which might provide a multidimensional perspective. Discussion: Publication dates, origins and contexts of included publications were discussed. Specifications of the term vulnerability and components of its definition and factors that constitute these components provided from the view were evaluated and also discussed. Conclusion: The proposed taxonomy provides a useful classification for assessing vulnerability in bioethics. It is hoped that the taxonomy we put forward as a result of the review will increase awareness on the issue and also take into account the factors that create vulnerability in the context of research, healthcare and nursing care policies. Ethical considerations: The review was conducted in accord with ethical and scientific standards.

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