scholarly journals Telehealth Nursing Research: Adding to the Evidence-base for Healthcare

2020 ◽  
Vol 8 ◽  
Author(s):  
Claudia C Bartz
Keyword(s):  
Systematic Reviews ◽  
Care Delivery ◽  
Post Partum ◽  
Evidence Base ◽  
Intervention Research ◽  
Care Needs ◽  
Research Papers ◽  
Healthcare Needs ◽  
Meta Analyses ◽  
Practice Methods

This paper reviews recent, nurse-led telehealth research with the goal of describing research findings that provide evidence for practice. Methods: Using an iterative search method, of eight electronic databases, 84 nurse-led research papers were separated into intervention research, systematic reviews and meta-analyses, and descriptive research. The main emphasis was on full text analysis of the intervention research. Results: Fifteen intervention research papers reported findings related to cardiovascular disease, diabetes mellitus, older age, young adults, early adolescents, children with special health care needs, people with a stoma, post-partum mothers and nurses. Also reviewed for useable evidence for practice were 10 systematic reviews, two meta-analyses and two papers that described reviews plus meta-analyses. Resuts: Fifty-five papers with descriptive designs are briefly described. Nurse-led intervention research is increasing knowledge about the use of telehealth technology and applications in care delivery. People with healthcare needs do better with individual attention and increased follow-up. People have a tolerance for technology used with them to advance their quality of life and healing but there is a point at which too much technology is overwhelming. Clinical research is a challenge due to the number of extraneous variables that are difficult to control and that can affect a person’s response to the research intervention. Conclusion: Continuation of nurse-led telehealth intervention research will help to ensure that technology used to support and advance care delivery will be evidence-based.

scholarly journals Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

2020 ◽  
pp. 1-15
Author(s):  
Daniel Joseph Lamport ◽  
Claire Michelle Williams
Keyword(s):  
Systematic Reviews ◽  
Evidence Base ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Current Evidence Base ◽  
Cognitive Benefits ◽  
Meta Analyses ◽  
The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

Patient-Centered Palliative Care for Patients With Advanced Lung Cancer

2022 ◽  
Author(s):  
Jennifer S. Temel ◽  
Laura A. Petrillo ◽  
Joseph A. Greer
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Checkpoint Inhibitors ◽  
Care Delivery ◽  
Cancer Therapeutics ◽  
Evidence Base ◽  
Advanced Lung Cancer ◽  
Care Needs ◽  
Patient Centered ◽  
Patient Reported

The evidence base demonstrating the benefits of an early focus on palliative care for patients with serious cancers, including advanced lung cancer, is substantial. Early involvement of specialty-trained palliative care clinicians in the care of patients with advanced lung cancer improves patient-reported outcomes, such as quality of life, and health care delivery, including hospice utilization. Since the time that many of these palliative care trials were conducted, the paradigm of cancer care for many cancers, including lung cancer, has changed dramatically. The majority of patients with advanced lung cancer are now treated with immune checkpoint inhibitors or targeted therapies, both of which have had a significant impact on patient's experience and outcomes. With this changing landscape of lung cancer therapeutics, patients are facing new and different challenges, including dealing with novel side effect profiles and coping with greater uncertainty regarding their prognosis. Patients who are living longer with their advanced cancer also struggle with how to address survivorship issues, such as sexual health and exercise, and decision making about end-of-life care. Although palliative care clinicians remain well-suited to address these care needs, they may need to learn new skills to support patients treated with novel therapies. Additionally, as the experience of patients with advanced lung cancer is becoming more varied and individualized, palliative care research interventions and clinical programs should also be delivered in a patient-centered manner to best meet patient's needs and improve their outcomes. Tailored and technology-based palliative care interventions are promising strategies for delivering patient-centered palliative care.

scholarly journals Umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with autism spectrum disorder

2020 ◽  
Vol 218 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Ewelina Rydzewska ◽  
Kirsty Dunn ◽  
Sally-Ann Cooper
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Systematic Reviews ◽  
Sleep Problems ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Physical Conditions ◽  
Sensory Impairments ◽  
Meta Analyses

BackgroundComorbid physical conditions may be more common in people with autism spectrum disorder (ASD) than other people.AimsTo identify what is and what is not known about comorbid physical conditions in people with ASD.MethodWe undertook an umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with ASD. Five databases were searched. There were strict inclusion/exclusion criteria. We undertook double reviewing for eligibility, systematic data extraction and quality assessment. Prospective PROSPERO registration: CRD42015020896.ResultsIn total, 24 of 5552 retrieved articles were included, 15 on children, 1 on adults, and 8 both on children and adults. Although the quality of included reviews was good, most reported several limitations in the studies they included and considerable heterogeneity. Comorbid physical conditions are common, and some are more prevalent than in the general population: sleep problems, epilepsy, sensory impairments, atopy, autoimmune disorders and obesity. Asthma is not. However, there are substantial gaps in the evidence base. Fewer studies have been undertaken on other conditions and some findings are inconsistent.ConclusionsComorbid physical conditions occur more commonly in people with ASD, but the evidence base is slim and more research is needed. Some comorbidities compound care if clinicians are unaware, for example sensory impairments, given the communication needs of people with ASD. Others, such as obesity, can lead to an array of other conditions, disadvantages and early mortality. It is essential that potentially modifiable physical conditions are identified to ensure people with ASD achieve their best outcomes. Heightening clinicians’ awareness is important to aid in assessments and differential diagnoses, and to improve healthcare.

Oxygen therapy: evidence base

2020 ◽  
Vol 29 (Sup5b) ◽  
pp. S11-S22
Author(s):  
John Lantis
Keyword(s):  
Systematic Reviews ◽  
Oxygen Therapy ◽  
Clinical Evidence ◽  
Case Series ◽  
Evidence Base ◽  
Common Thread ◽  
Meta Analyses

The evidence base for the different methods of oxygen therapy ranges from systematic reviews and meta-analyses to case series evaluations. A common thread running through the assorted evidence is that oxygen therapy accelerates healing and reduces healing times. This article summarises the clinical evidence produced on this therapy

scholarly journals Transpersonal caring model in home-Care nursing for children with special care needs

2018 ◽  
Vol 9 (1) ◽  
pp. 105
Author(s):  
Luana Tonin ◽  
Maria R. Lacerda ◽  
Luciane Favero ◽  
Jaqueline D. Nascimento ◽  
Patricia K. Rocha ◽  
...  
Keyword(s):  
Home Care ◽  
Care Delivery ◽  
Theory And Practice ◽  
Initial Contact ◽  
Care Needs ◽  
Analytical Strategy ◽  
Analytical Technique ◽  
Home Care Nursing ◽  
Healthcare Needs ◽  
Care Nursing

The study was theoretically and philosophically guided by the Theory of Human Care, entailing the use of the Elements of the Clinical Caritas Process, having humanistic assumptions based on Home Care, and being operationalized by the following action steps: Initial Contact, Approaching, Transpersonal Encounter and Separation. It aimed to apply the Transpersonal Care Model in Home Care Nursing to children with special healthcare needs. Qualitative care-research (intervention), developed by means of five components: approaching the studied object; encounter with the cared-researched being; connections between theory and practice; separation from the researcher-caregiver being to the cared-researched being, and analysis of what has been learned by means of the General Analytical Strategy – Relying on theoretical propositions – and Specific Analytical Technique – Pattern Combination. The key results from the development of each one of the steps are, as follows: assumptions were applied 537 times, 322 usages of the Clinical Caritas Process, and 467 care needs were met by means of the model. The model potentialities were identified, understanding that it was built for the population at home care, thus enabling relation development, meeting their needs, and supporting nurses to foster care delivery.

Systematic reviews and meta-analyses in geriatric oncology.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21517-e21517
Author(s):  
Marek S. Poniewierski ◽  
Gary H. Lyman
Keyword(s):  
Geriatric Assessment ◽  
Systematic Reviews ◽  
English Language ◽  
Geriatric Oncology ◽  
The Elderly ◽  
Evidence Base ◽  
Multiple Cancer ◽  
Elderly Age ◽  
Steady Growth ◽  
Meta Analyses

e21517 Background: Cancer incidence for most malignancies increases with age with the majority diagnosed after age 65. Aging is also associated with an increasing number of major comorbidities and greater risk and consequences of treatment-related complications. Geriatric Oncology has emerged as a subdiscipline within oncology focused on clinical management and research related to the elderly. Methods: A comprehensive search of the English language literature between 1990-2016 was undertaken for systematic reviews or meta-analyses (SRMAs) related to geriatric oncology. Titles, abstracts and full text manuscripts when needed were reviewed. 1,088 potentially eligible records were identified including 703 not limited to elderly patients, 89 not cancer studies and 236 not SRMAs. Results:More than half of 61 eligible studies were published in the last five years including systematic reviews in 42 (69%), meta-analyses in 42 (69%) and both in 23 (40%). Studies came from Europe (30), US (14), Canada (9), Asia (7) and South America (1) with elderly age cutoffs ranging from > 60 to > 80. While 17 reviews included multiple cancer types, 44 were limited to lung cancer (9), colorectal cancer (8), breast cancer (7), multiple myeloma (5) and lymphoma (4). Research focus was survivorship or end-of-life (41), treatment (24), geriatric assessment (11) and supportive care (8). Studies were limited to randomized controlled trials (37), non-RCTs (9) and both (16). The primary outcome was overall survival (39), progression free or relapse-free survival (15), response or recurrence (11), treatment-related toxicity (21) and geriatric assessment or frailty (9). More than half of SRMAs included < 10 studies while 20% included > 30 with the number of subjects in included trials ranging from 153 to > 15,000. Conclusions: The development of Geriatric Oncology has spanned nearly three decades. While a strong evidence base of published research including rigorous SRMAs in Geriatric Oncology has only emerged over the past decade, steady growth across a range of topics and outcomes relevant to cancer in the elderly is apparent.

A Stepwise Approach to Systematic Reviews and Meta-analyses of Endovascular Interventions

2020 ◽  
Vol 27 (5) ◽  
pp. 805-817
Author(s):  
George A. Antoniou ◽  
Giuseppe Biondi-Zoccai ◽  
Francesco Versaci ◽  
Stavros A. Antoniou
Keyword(s):  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Evidence Base ◽  
Future Research ◽  
Specific Topic ◽  
Stepwise Approach ◽  
Endovascular Interventions ◽  
Statistical Precision ◽  
Meta Analyses

The accrual of clinical studies poses important challenges to researchers and practitioners, especially in the field of endovascular therapy, where patient, lesion, technique, and device subtleties abound. Systematic reviews and meta-analyses may prove particularly fruitful in such settings by increasing statistical precision and bolstering external validity if the evidence base on a specific topic is consistent or by highlighting important discrepancies in the opposite scenario. However, mastering the correct approach to systematic review and meta-analysis is challenging for careful readers or for those interested in conducting such an evidence synthesis exercise. The present article highlights a stepwise approach to systematic reviews and meta-analyses, focusing on endovascular interventions, which will prove useful to anyone reading or wishing to synthesize the evidence base on endovascular topics to optimize decision making or shape future research efforts.

The equifinality and multifinality of violent radicalization and mental health

2021 ◽  
pp. 125-136
Author(s):  
Paul Gill ◽  
Frank Farnham ◽  
Caitlin Clemmow
Keyword(s):  
Mental Health ◽  
Systematic Reviews ◽  
Mental Health Problems ◽  
Evidence Base ◽  
Health Problems ◽  
Poor Mental Health ◽  
Base Rate ◽  
Meta Analyses ◽  
The Relationship ◽  
Do So

The relationship between violent radicalization and poor mental health is complex and multilayered. We use the principles of equifinality and multifinality to demonstrate this complexity. In terms of equifinality, we draw upon the existing evidence base to demonstrate that the end outcome of violent radicalization has many paths into it. Some individuals will be touched by different aspects related to poor mental health along this path. In terms of multifinality, we demonstrate trajectories to multiple outcomes originating from poor mental health problems, where violent radicalization is a low base rate outcome, of many. To do so, we draw on the evidence base from various systematic reviews and meta-analyses of other public/personal harms. We also draw upon illustrations of different individuals displaying similar symptoms/diagnoses and map the mechanisms through which their end outcome differed (e.g. because of exposure to different influences, opportunity, and so on).

Speech Intervention Effects for Childhood Apraxia of Speech: Quality Appraisal of Systematic Reviews

2020 ◽  
Vol 5 (3) ◽  
pp. 646-653
Author(s):  
Alisha P. Springle ◽  
Amber Breeden ◽  
Anastasia M. Raymer
Keyword(s):  
Systematic Reviews ◽  
Controlled Trial ◽  
Evidence Base ◽  
Motor Programming ◽  
Measurement Tool ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Positive Effects ◽  
Treatment Research ◽  
Meta Analyses

Purpose A number of justification have examined the effects of speech interventions on outcomes in childhood apraxia of speech (CAS). The findings have been summarized in the form of systematic reviews (SRs) and meta-analyses, which are used to support evidence-based clinical practice decisions. Yet without acceptable rigor, SRs/meta-analyses may be biased in their recommendations. We appraised the quality of existing SRs for CAS treatment using a tool developed within epidemiology, the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews). Method A search of five databases to identify published SRs that coalesced treatment research for CAS revealed six systematic reviews that met inclusion criteria. Two examiners coded each article with the AMSTAR-2 to rate the methodologic rigor of the SRs and extracted summary data. Results One rigorous systematic review included only one randomized controlled trial. A second moderately rigorous review examined multiple single participant research designs. The weight of high-quality evidence supported the positive effects of motor programming treatments for children with CAS. Conclusions Findings of six systematic reviews, two of which were conducted with relative rigor, suggest that motor programming treatments have the best evidence base for treatment decisions pertaining to CAS. Clinicians are referred to online resources to implement these treatments according to published protocols.

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