scholarly journals Protocol for a constructivist metasynthesis of qualitative research of heroism and paramedic practice

2021 ◽  
Vol 6 (2) ◽  
pp. 34-39
Author(s):  
Nigel Rees ◽  
Julia Williams ◽  
Chloe Hogan ◽  
Lauren Smyth ◽  
Thomas Archer

Background: Exceptional demands have been placed on paramedics and other healthcare workers (HCWs) during the COVID-19 pandemic. An overwhelming outpouring of public support has unfolded, bringing into focus the relationship between paramedics, other HCWs and society, where they are portrayed as heroes. Scholars have studied the notion of heroism to society, and characteristics of such heroic status include: the voluntary nature of a heroic act, risk of physical or social harm, willingness to accept the consequences of action, acting for the benefit of others and without the expectation of gain. While some HCWs and paramedics may reflect these characteristics, many may not. Such heroic narratives can be damaging, stifling meaningful discussion around limits to duties, failing to acknowledge the importance of reciprocity and potentially imposing demands on paramedics and HCWs to be heroic.Aim: This article prospectively presents the protocol for a metasynthesis which aims to identify, appraise and synthesise the qualitative literature in order to develop theory on heroism and paramedic practice.Methods: Evolved grounded theory methodology is followed along with the procedural guidelines of Noblit and Hare (1988) to guide the analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) have also been adopted when preparing this protocol and will be followed in the study proper. The protocol has been registered with the International Prospective Register of Systematic Reviews PROSPERO 2021, registration number CRD42021234851.Results: We do not currently have results, but PRISMA guidelines will be followed when reporting our findings.Conclusion: Current narratives on heroism and paramedic practice are important in terms of the relationship between paramedics and society. The metasynthesis prospectively reported in this article serves as the first point in our journey of making sense of and developing theory on heroism and paramedic practice.

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245061
Author(s):  
Monica C. O’Neill ◽  
Shaylea Badovinac ◽  
Rebecca Pillai Riddell ◽  
Jean-François Bureau ◽  
Carla Rumeo ◽  
...  

The present study aimed to systematically review and meta-analyze the concurrent and longitudinal relationship between caregiver sensitivity and preschool attachment measured using the Main and Cassidy (1988) and Cassidy and Marvin (1992) attachment classification systems. This review was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO; Registration Number CRD42017073417) and completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The present review identified 36 studies made up of 21 samples (N = 3, 847) examining the relationship between caregiver sensitivity and preschool attachment. Eight primary meta-analyses were conducted separately according to the proximity of the assessment of sensitivity to attachment (i.e., concurrent versus longitudinal), operationalization of caregiver sensitivity (i.e., unidimensional versus multidimensional) and attachment categorizations (i.e., secure-insecure versus organized-disorganized). Overall, the meta-analyses revealed higher levels of caregiver sensitivity among caregivers with secure and organized preschoolers, relative to insecure and disorganized preschoolers, respectively. Medium effect sizes (g = .46 to .59) were found for both longitudinal and concurrent associations between caregiver sensitivity and preschool attachment when a unidimensional measure of caregiver sensitivity was employed, compared to small to medium effect sizes (g = .34 to .49) when a multidimensional measure of caregiver sensitivity was employed. Child age at attachment measurement was a significant moderator of the longitudinal association between unidimensional caregiver sensitivity and preschool attachment. Future directions for the literature and clinical implications are discussed.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.


BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e027904 ◽  
Author(s):  
Łukasz Przepiórka ◽  
Przemysław Kunert ◽  
Jarosław Żyłkowski ◽  
Jan Fortuniak ◽  
Patrycja Larysz ◽  
...  

IntroductionThe ongoing need for dural tenting sutures in a contemporary neurosurgical practice has been questioned in the literature for over two decades. In the past, these sutures were supposed to prevent blood collecting in the potential space between the skull and the dura by elevating the latter. Theoretically, with modern haemostasis and proper postoperative care, this technique should not be necessary and the surgery time can be shortened. Unfortunately, there is no evidence-based proof to either support or reject this hypothesis.Methods and analysisThe systematic review will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and The Cochrane Handbook for Systematic Reviews of Interventions. Eight electronic databases of peer-reviewed journals will be searched, as well as other sources. Eligible articles will be assessed against inclusion criteria. The intervention is not tenting the dura and this will be compared with the usual dural tenting sutures. Where possible, ‘summary of findings’ tables will be generated.Ethics and disseminationEthical committee approval is not required for a systematic review protocol. Findings will be presented at international neurosurgical conferences and published in a peer-reviewed medical journal.PROSPERO registration numberCRD42018097089.


2017 ◽  
Author(s):  
Eiko I Fried ◽  
Beyon Miloyan

The objective of this study is to explain inconsistencies in the relationship between depression and all-cause mortality by performing a reassessment of the included studies of previous systematic reviews. We assessed study-level methodological variables with a focus on sample size and follow-up period, measurement and classification of depression, and model adjustment. We included the constituent studies of fifteen systematic reviews on depression and mortality, yielding 488 articles after the removal of duplicates. 333 studies were extracted, 40 of which used data that overlapped with other included studies. We included 313 estimates from 293 articles in the meta-analysis with a total sample of 3,604,005 participants and over 417,901 deaths. We identified a pronounced publication bias favoring large, positive associations in imprecise studies. Several factors moderated the relationship between depression and mortality. Most importantly, the 16 estimates adjusting for at least one comorbid mental condition (Pooled Effect: 1.08; 95% CI: 0.98-1.18), and the fraction of 8 of those estimates also adjusting for health variables (e.g., smoking, alcohol use, or physical inactivity; Pooled Effect: 1.04; 95% CI: 0.87-1.21), reported considerably smaller associations than the 204 unadjusted estimates (Pooled Effect: 1.32; 95% CI: 1.28-1.36). The sizable relationship of depression and mortality reported in previous systematic reviews is largely based on low-quality studies; controlling for important covariates attenuates the association considerably. Higher quality studies are needed based on large community samples, extensive follow-up, adjustment for health behaviors and mental disorders, and time-to-event outcomes based on survival analysis methodology.


2021 ◽  
Vol 6 ◽  
pp. 363
Author(s):  
Abdulazeez Imam ◽  
Sopuruchukwu Obiesie ◽  
Jalemba Aluvaala ◽  
Michuki Maina ◽  
David Gathara ◽  
...  

Background: Adequate staffing is key to the delivery of nursing care and thus to improved inpatient and health service outcomes. Several systematic reviews have addressed the relationship between nurse staffing and these outcomes. Most primary studies within each systematic review are likely to be from high-income countries which have different practice contexts to low and middle-income countries (LMICs), although this has not been formally examined. We propose conducting an umbrella review to characterise the existing evidence linking nurse staffing to key outcomes and explicitly aim to identify evidence gaps in nurse staffing research in LMICs. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). Literature searching will be conducted across Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Two independent reviewers will conduct searching and data abstraction and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be performed using the AMSTAR-2. Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals. PROSPERO registration number: CRD42021286908


2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110532
Author(s):  
Ping Chen ◽  
Yuhao Li ◽  
Liangliang Li ◽  
Guixin Zhang ◽  
Feng Zhang ◽  
...  

Objective This meta-analysis was conducted to investigate the relationship between the interleukin (IL)-17A rs2275913 polymorphism and rheumatoid arthritis (RA) susceptibility. Methods Eligible studies were retrieved from PubMed, Embase, and Web of Science. The fixed- or random-effects model was used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) on the basis of heterogeneity. Results Overall, 11 studies containing 4019 RA patients and 4137 controls were included in this meta-analysis. The results suggested a significant association between the IL-17A rs2275913 polymorphism and RA susceptibility in the overall population (allelic model A vs. G: OR = 0.89, 95%CI: 0.83–0.95; heterozygote model GA vs. GG: OR = 0.87, 95%CI: 0.78–0.96; homozygote model AA vs. GG: OR = 0.82, 95%CI: 0.71–0.96; dominant model GA + AA vs. GG: OR = 0.86, 95%CI: 0.78–0.94). In the subgroup analyses, the IL-17A rs2275913 polymorphism was significantly associated with RA risk in Europeans (allelic model A vs. G: OR = 0.87, 95%CI: 0.78–0.97; heterozygote model GA vs. GG: OR = 0.79, 95%CI: 0.68–0.93; dominant model GA + AA vs. GG: OR = 0.79, 95%CI: 0.68–0.92), but not in Africans or Americans. Conclusion This study suggests that the IL-17A rs2275913 polymorphism is significantly associated with RA susceptibility in Europeans. INPLASY registration number: INPLASY202170056.


2020 ◽  
pp. 1-26
Author(s):  
Chunjiang Yang ◽  
Aobo Chen

BACKGROUND: Despite the obvious importance of emotional labor for employees, organizations, and customers, a lack of coherence and clarity around the construct has impeded its development. OBJECTIVE: Our study aims to provide a comprehensive review of emotional labor spanning about 40 years. METHODS: Our study used a qualitative literature review method along with a theoretically derived path diagram of key emotional labor constructs. We also used meta-analysis to explore the relationship between emotional labor and outcomes in different national contexts. RESULTS: We expect our research to expand the field in five different ways. First, we review contemporary theoretical conceptualizations of emotional labor and its dimensions. Second, we summarize seven existing measures of emotional labor in light of their contents. Third, we map the theoretical and nomological network of emotional labor about its antecedents, outcomes, moderators, mediators. Fourth, we use meta-analysis to explore the relationship between emotional labor and other variables in different contexts. Finally, we conclude by showing a detailed future research agenda to bring the field forward from different perspectives, including theoretical and empirical advancement. CONCLUSIONS: Overall, our review provides a whole picture of where the literature has been and where it should go.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042525
Author(s):  
Michail Arvanitidis ◽  
Deborah Falla ◽  
Andy Sanderson ◽  
Eduardo Martinez-Valdes

IntroductionPerforming contractions with minimum force fluctuations is essential for everyday life as reduced force steadiness impacts on the precision of voluntary movements and functional ability. Several studies have investigated the effect of experimental or clinical musculoskeletal pain on force steadiness but with conflicting findings. The aim of this systematic review is to summarise the current literature to determine whether pain, whether it be clinical or experimental, influences force steadiness.Methods and analysisThis protocol for a systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Cochrane Handbook for Systematic Reviews of Interventions. Key databases will be searched from inception to 31 August 2020, including MEDLINE, EMBASE, PubMed, CINAHL Plus, ZETOC and Web of Science. Grey literature and key journals will be also reviewed. Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. If homogeneity exists between groups of studies, meta-analysis will be conducted. Otherwise, a narrative synthesis approach and a vote-counting method will be used, while the results will be presented as net increases or decreases of force steadiness.Ethics and disseminationThe findings will be presented at conferences and the review will be also submitted for publication in a refereed journal. No ethical approval was required.PROSPERO registration numberCRD42020196479


2021 ◽  
Vol 5 (1) ◽  
pp. e001200
Author(s):  
Katelyn Sushko ◽  
Nada Al-Rawahi ◽  
Kristi Watterberg ◽  
John Van Den Anker ◽  
Catherine Litalien ◽  
...  

BackgroundImpaired adrenal function is a well-described entity in critically ill term and preterm neonates with systemic hypotension. The standard treatment for neonatal hypotension includes volume expanders and vasopressors. Recent evidence supports the use of glucocorticoids for the primary or rescue treatment of neonatal hypotension associated with impaired adrenal function. However, inconsistency regarding the prescribed dosing regimen to provide the best balance between efficacy and safety in this vulnerable population remains an area of concern.MethodsWe will conduct a systematic review and meta-analysis to evaluate low-dosing compared with high-dosing regimens of hydrocortisone for the treatment of hypotension in critically ill term, preterm and very low birth weight neonates. Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and Web of Science will be searched from inception to November 2021. Study screening and selection will be completed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Our primary outcomes will be (1) an improvement in end-organ perfusion, defined as an increase in blood pressure along with an increase in urine output or a reduction in serum lactate and (2) mortality prior to discharge. Our secondary outcomes will be the development of (1) major neurosensory abnormality, (2) bronchopulmonary dysplasia and (3) the occurrence of adverse events.DiscussionHydrocortisone may be beneficial in the treatment of hypotension associated with impaired adrenal function among critically ill neonates. However, its optimal dosing to balance desired efficacy with the risk of adverse events is yet to be determined. Our systematic review and meta-analysis aims to address this evidence gap, providing valuable knowledge for a large audience, including guideline developers, policy-makers and clinicians.PROSPERO registration numberThis protocol is submitted for registration to the international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).


2022 ◽  
pp. rapm-2021-102981
Author(s):  
Rachel H McGregor ◽  
Freda M Warner ◽  
Lukas D Linde ◽  
Jacquelyn J Cragg ◽  
Jill A Osborn ◽  
...  

BackgroundIn an attempt to aggregate observations from clinical trials, several meta-analyses have been published examining the effectiveness of systemic, non-opioid, pharmacological interventions to reduce the incidence of chronic postsurgical pain.ObjectiveTo inform the design and reporting of future studies, the purpose of our study was to examine the quality of these meta-analyses.Evidence reviewWe conducted an electronic literature search in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews. Published meta-analyses, from the years 2010 to 2020, examining the effect of perioperative, systemic, non-opioid pharmacological treatments on the incidence of chronic postsurgical pain in adult patients were identified. Data extraction focused on methodological details. Meta-analysis quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) critical appraisal tool.FindingsOur search yielded 17 published studies conducting 58 meta-analyses for gabapentinoids (gabapentin and pregabalin), ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and mexiletine. According to AMSTAR 2, 88.2% of studies (or 15/17) were low or critically low in quality. The most common critical element missing was an analysis of publication bias. Trends indicated an improvement in quality over time and association with journal impact factor.ConclusionsWith few individual trials adequately powered to detect treatment effects, meta-analyses play a crucial role in informing the perioperative management of chronic postsurgical pain. In light of this inherent value and despite a number of attempts, high-quality meta-analyses are still needed.PROSPERO registration numberCRD42021230941.


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