scholarly journals Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review

2021 ◽  
Vol 18 (22) ◽  
pp. 12083
Author(s):  
Isabelle Weld-Blundell ◽  
Marissa Shields ◽  
Alexandra Devine ◽  
Helen Dickinson ◽  
Anne Kavanagh ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Competitive Employment ◽  
Adults With Autism ◽  
Individual Placement And Support ◽  
Psychosocial Disability ◽  
Employment Participation ◽  
The Cochrane Collaboration ◽  
Individual Placement

Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled trials (RCTs) of interventions aimed at increasing participation in open/competitive or non-competitive employment were eligible for inclusion. We included studies with adults with psychosocial disability autism and/or intellectual disability. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias II Tool. Data were qualitatively synthesized. Our review was registered with PROSPERO (CRD42020219192). Results: We included 26 RCTs: 23 targeted people with psychosocial disabilities (n = 2465), 3 included people with autism (n = 214), and none included people with intellectual disability. Risk of bias was high in 8 studies, moderate for 18, and low for none. There was evidence for a beneficial effect of Individual Placement and Support compared to control conditions in 10/11 studies. Among young adults with autism, there was some evidence for the benefit of Project SEARCH and ASD supports on open employment. Discussion: Gaps in the availability of high-quality evidence remain, undermining comparability and investment decisions in vocational interventions. Future studies should focus on improving quality and consistent measurement, especially for interventions targeting people with autism and/or intellectual disability.

Systemic therapy for nonmetastatic castrate-resistant prostate cancer (M0 CRPC): A systematic review and network meta-analysis (NMA).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 113-113
Author(s):  
Ellen Cusano ◽  
Richard M. Lee-Ying ◽  
Devon J. Boyne ◽  
Darren Brenner ◽  
Marcus Vaska
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Similar Efficacy ◽  
Risk Of Bias ◽  
Fixed Effects Model ◽  
Castrate Resistant Prostate Cancer ◽  
Grade 3 ◽  
Castrate Resistant ◽  
The Cochrane Collaboration

113 Background: The treatment landscape for M0 CRPC has changed following the demonstrated efficacy of new agents in recent randomized control trials (RCT). However, the comparative effectiveness of these novel agents is unknown. This NMA indirectly compared the efficacy and safety of available therapies for M0 CRPC. Methods: A literature search of MEDLINE (Ovid), EBM Reviews, HealthSTAR, PubMed, PubMed Central, CINAHL, and TRIP Database was performed. Studies were screened by two independent reviewers. Hazard ratios (HR) and confidence intervals were extracted for the primary outcome metastasis-free survival (MFS) and the secondary outcomes overall survival (OS) and grade 3 or higher adverse events (AE). Bone MFS was used as a surrogate for MFS when MFS was not reported. Risk of bias was assessed using the Cochrane Collaboration tool. A Bayesian NMA was performed using a fixed-effects model. Results: Four RCT were analyzed (n=5549). Each trial compared either apalutamide (APA), enzalutamide (ENZA), darolutamide (DARO), or denosumab (DENO) plus androgen deprivation therapy (ADT) to placebo plus ADT. Risk of bias was low. For MFS, APA and ENZA had similar efficacy (Table), and Surface Under the Cumulative Ranking Analysis demonstrated a 59% probability that APA was preferred for MFS, followed by ENZA (41%). There was a trend for improved OS for APA, DARO and ENZA, but no meaningful differences between these agents. APA, ENZA, and DARO had a similar risk of AEs and all had a greater risk of AEs compared to DENO. Conclusions: APA and ENZA appear to be the most efficacious treatments for MFS in M0 CRPC, though more data for OS is required. Compared to DARO, APA and ENZA’s demonstrated efficacy is not at the expense of added toxicity.[Table: see text]

scholarly journals Generalisability of the individual placement and support model of supported employment: results of a Canadian randomised controlled trial

2006 ◽  
Vol 189 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Eric A. Latimer ◽  
Tania Lecomte ◽  
Deborah R. Becker ◽  
Robert E. Drake ◽  
Isabelle Duclos ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Supported Employment ◽  
Control Group ◽  
Competitive Employment ◽  
Individual Placement And Support ◽  
Vocational Services ◽  
The Usa ◽  
The Individual ◽  
Individual Placement

BackgroundStudies conducted in the USA have found the individual placement and support model of supported employment to be more effective than traditional vocational rehabilitation at helping people with severe mental illness to find and maintain competitive employment.AimsTo determine the effectiveness of the individual placement and support (supported employment) model in a Canadian setting.MethodA total of 150 adults with severe mental illness, who were not currently employed and who desired competitive employment, were randomly assigned to receive either supported employment (n=75) or traditional vocational services (n=75).ResultsOver the 12 months of follow-up, 47% of clients in the supported employment group obtained at least some competitive employment, v. 18% of the control group (P<0.001). They averaged 126 h of competitive work, v. 72 inthe control group (P<0.001).ConclusionsSupported employment proved more effective than traditional vocational services in a setting significantly different from settings in the USA, and may therefore be generalised to settings in other countries.

Nutritional interventions in community-dwelling Alzheimer patients with (risk of) undernutrition: a systematic review

2014 ◽  
Vol 26 (9) ◽  
pp. 1445-1453 ◽  
Author(s):  
Erika Droogsma ◽  
Dieneke van Asselt ◽  
Jolanda van Steijn ◽  
Nic Veeger ◽  
Ingeborg van Dusseldorp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nutritional Supplements ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Nutritional Interventions ◽  
Oral Nutritional Supplements ◽  
The Cochrane Collaboration ◽  
Negative Health Outcomes ◽  
Current Guidelines

ABSTRACTBackground:Weight loss and undernutrition are common in patients with Alzheimer's disease (AD) and associated with negative health outcomes. In the current guidelines on diagnosis and treatment of AD, no recommendations for treatment of (risk of) undernutrition in community-dwelling AD patients are given.Methods:We conducted a systematic review on the effect of nutritional interventions in community-dwelling AD patients with (risk of) undernutrition, according to the methods outlined by the Cochrane Collaboration. Three electronic databases and three trial registers were searched from inception till April 2013.Results:Literature search in the electronic databases yielded 546 records of which one was relevant for this review. This study, with a high risk of bias, demonstrated that oral nutritional supplements improved nutritional outcomes without effect on clinical and biochemical outcomes. The search in the trial registers yielded 369 records of which two were relevant. One trial was terminated because of failing inclusion, the other is ongoing.Conclusions:This systematic review on the effect of nutritional interventions in community-dwelling AD patients with (risk of) undernutrition, reveals a serious lack of evidence. Therefore, it is not possible to state what the best approach is.

scholarly journals Effectiveness of pharmacological treatments in Duchenne muscular dystrophy: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029341 ◽  
Author(s):  
Carlos Pascual Morena ◽  
Vicente Martinez-Vizcaino ◽  
Celia Álvarez-Bueno ◽  
Ruben Fernández Rodríguez ◽  
Estela Jiménez López ◽  
...  
Keyword(s):  
Systematic Review ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Walking Distance ◽  
Pharmacological Treatments ◽  
Registration Number ◽  
The Cochrane Collaboration

IntroductionIn recent years, important advances have been made in the treatment of Duchenne muscular dystrophy (DMD). This protocol proposes a methodology for carrying out a systematic review and meta-analysis that aims to: (1) improve the evidence of the benefits of different pharmacological treatments in boys with DMD, and (2) compare the benefit of treatments specifically aimed at delaying the progression of disease in the functional outcomes.Methods and analysisThis protocol is guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. A thorough selection of the literature will be done through the MEDLINE, EMBASE and Web of Science databases. The search will be conducted in English and Spanish. The Risk of Bias 2.0 tool from the Cochrane Collaboration will be used to assess the risk of bias. A narrative synthesis of the data will be performed. Meta-analysis will be conducted for effect of treatment on the 6 min walking distance (6MWD), North Star Ambulatory Assessment and Timed Functional Tests. Subgroup analyses will be performed by age or baseline values of the 6MWD, and overall bias.Ethics and disseminationThe approval of an ethical committee is not required. All the included trials will comply with the current ethical standards and the Declaration of Helsinki. The results of this proposed systematic review and meta-analysis will provide a general overview and evidence concerning the effectiveness of pharmacological treatments in Duchenne muscular dystrophy. Findings will be disseminated to academic audiences through peer-reviewed publications, as well as to clinical audiences, patients’ associations and policy makers, and may influence guideline developers in order to improve outcomes for these patients.PROSPERO registration numberCRD42018102207

scholarly journals Risk of histologic Barrett’s esophagus between African Americans and non-Hispanic whites: A meta-analysis

2017 ◽  
Vol 6 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Ahmad Alkaddour ◽  
Carlos Palacio ◽  
Kenneth J Vega
Keyword(s):  
African Americans ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Risk Difference ◽  
Risk Of Bias ◽  
Bias Risk ◽  
Genetic Mechanisms ◽  
The Cochrane Collaboration

Background Barrett’s esophagus (BE) is rare in African Americans (AA). However, the risk difference magnitude in histologic BE prevalence between AA and non-Hispanic whites (nHw) has not been quantified to date. Objective The objective of this article is to determine the degree of histologic BE risk difference between AA and nHw. Methods PubMed, Web of Science and EMBASE were searched for studies reporting histologic BE in AA/nHw for inclusion. Pooled odds ratios (ORs) with risk estimates of histologic BE occurrence between AA/nHw were calculated along with 95% confidence intervals (CIs). Forest plots were used to quantify heterogeneity. Funnel plots and the Cochrane Collaboration Risk of Bias tool were used to assess bias risk. Results Eight studies reported BE histologic confirmation in AA/nHw. Analysis demonstrated a nearly 400% increased histologic BE risk in nHw patients compared to AA (OR 3.949, 95% CI 3.069–5.082). In the model without the case-control study, histologic BE risk remained elevated at approximately 360% in nHw compared to AA (OR 3.618, 95% CI 2.769–4.726). Heterogeneity was not present in either model. Risk of bias was significant. Conclusions Histologic BE risk is elevated in nHw by 3.6–4 times compared to AA. Investigation into understanding any clinical, molecular or genetic mechanisms underlying this risk disparity is warranted.

Service Intensity as a Predictor of Competitive Employment in an Individual Placement and Support Model

2011 ◽  
Vol 62 (9) ◽  
pp. 1066-1072 ◽  
Author(s):  
Alan B. McGuire ◽  
Gary R. Bond ◽  
Daniel R. Clendenning ◽  
Marina Kukla
Keyword(s):  
Competitive Employment ◽  
Individual Placement And Support ◽  
Service Intensity ◽  
Individual Placement ◽  
Support Model
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