scholarly journals The Current Description and Future Need for Multidisciplinary PCOS Clinics

2018 ◽  
Vol 7 (11) ◽  
pp. 395 ◽  
Author(s):  
Wendy M. Wolf ◽  
Rachel A. Wattick ◽  
Olivia N. Kinkade ◽  
Melissa D. Olfert

Polycystic Ovarian Syndrome (PCOS), with common symptoms of irregular menstrual cycles, ovarian cysts, and hirsutism, is thought to be the most common endocrine disorder found in women, and use of multidisciplinary teams has been shown to be effective. The purpose of this review is to determine the future need for specialized, comprehensive, multidisciplinary treatment for PCOS and the current description and efficacy of existing multidisciplinary clinics. The literature was searched using PubMed, CINAHL, PsycINFO, Medline, and the Cochrane Library. Keywords included treatment efficacy, polycystic ovary syndrome, treatment and collaboration. Results showed that while an increasing number of studies continue to come out expressing the need for multidisciplinary approaches to and clinics for the treatment of PCOS, there is still a large gap in the literature documenting actual multidisciplinary PCOS treatment facilities. The limited literature documenting the efficacy of multidisciplinary PCOS clinic have demonstrated increased weight loss, high patient satisfaction, and high retention compared to single-care providers. Data showed that these teams are most commonly made up of a combination of endocrinologists, psychologists, dietitians, gynecologists, and endocrine-specialized nurses. Data showed that there is a high degree of variability and rates of diagnosis between types of single-care providers, such as: endocrinology, dermatology, gynecology, and fertility. Individuals with PCOS are in need for specialized, individualized, and focused care from a diverse team of healthcare providers to treat PCOS comprehensively.

Author(s):  
Nikita Mohan ◽  
Muhammad Ali Fayyaz ◽  
Christopher del Rio ◽  
Navpreet Kaur Rajinder Singh Khurana ◽  
Sampada Sandip Vaidya ◽  
...  

Abstract Background The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information. Objective To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2. To identify neuro-invasive pathways of COVID infection. Methods Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020. Results Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases. Conclusion The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.


2021 ◽  
Author(s):  
B Dempsey ◽  
S Callaghan ◽  
MF Higgins

UNSTRUCTURED Background: Despite being one of the most common gynaecological procedures in the world, abortion care remains highly stigmatized. Internationally, providers have noted negative impacts related to their involvement in the services and abortion care has been described as “dirty work”. Though much of the existing research focuses on the challenges of providing, many have also highlighted the positive aspects of working in abortion care. Despite the steadily increasing interest in this area over the past decade, however, no one has sought to systematically review the literature to date. The aim of this review is to systematically explore published studies on the experiences of abortion care providers and to create a narrative review on the lived experience of providing abortion care. Methods: The review will be conducted according to the framework outlined by Levac et al., which expanded on the popular Arksey and O’Malley framework. We will systematically search for peer-reviewed articles in literature in six electronic databases: CINAHL, the Cochrane Library, EMBASE, PsycInfo, PubMed, and Web of Science. Following a pilot exercise, we have devised a search strategy to identify relevant studies. In this protocol, we outline how citations will be assessed for eligibility and what information will be extracted from the included articles. We also highlight how this information will be combined in the review. Discussion: The findings of this review will provide a comprehensive overview on the known experiences of providing abortion care. We also pre-empt that the findings will identify aspects of care and/or experiences that are not reflected in the available literature. We will disseminate the results via a publication in a peer-reviewed, academic journal and by presenting the findings at conferences in the areas of abortion care, obstetrics, and midwifery. As this review is a secondary analysis of published articles, ethical approval was not required.


2018 ◽  
Vol 39 (9) ◽  
pp. 1093-1107 ◽  
Author(s):  
Aline Wolfensberger ◽  
Lauren Clack ◽  
Stefan P. Kuster ◽  
Simone Passerini ◽  
Lona Mody ◽  
...  

AbstractObjectiveThe transfer of pathogens may spread antimicrobial resistance and lead to healthcare-acquired infections. We performed a systematic literature review to generate estimates of pathogen transfer in relation to healthcare provider (HCP) activities.MethodsFor this systematic review and meta-analysis, Medline/Ovid, EMBASE, and the Cochrane Library were searched for studies published before July 7, 2017. We reviewed the literature, examining transfer of pathogens associated with HCP activities. We included studies that (1) quantified transfer of pathogens from a defined origin to a defined destination surface; (2) reported a microbiological sampling technique; and (3) described the associated activity leading to transfer. For studies reporting transfer frequencies, we extracted data and calculated the estimated proportion using Freeman-Tukey double arcsine transformation and the DerSimonian-Laird random-effects model.ResultsOf 13,121 identified articles, 32 were included. Most articles (n=27, 84%) examined transfer from patients and their environment to HCP hands, gloves, and gowns, with an estimated proportion for transfer frequency of 33% (95% confidence interval [CI], 12%–57%), 30% (95% CI, 23%–38%) and 10% (95% CI, 6%–14%), respectively. Other articles addressed transfer involving the hospital environment and medical devices. Risk factor analyses in 12 studies suggested higher transfer frequencies after contact with moist body sites (n=7), longer duration of care (n=5), and care of patients with an invasive device (n=3).ConclusionsRecognizing the heterogeneity in study designs, the available evidence suggests that pathogen transfer to HCPs occurs frequently. More systematic research is urgently warranted to support targeted and economic prevention policies and interventions.


Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Athanasios Chalkias ◽  
Nicolas Mongardon ◽  
Vladimir Boboshko ◽  
Vladimir Cerny ◽  
Anne-Laure Constant ◽  
...  

Abstract Background Perioperative cardiac arrest is a rare complication with an incidence of around 1 in 1400 cases, but it carries a high burden of mortality reaching up to 70% at 30 days. Despite its specificities, guidelines for treatment of perioperative cardiac arrest are lacking. Gathering the available literature may improve quality of care and outcome of patients. Methods The PERIOPCA Task Force identified major clinical questions about the management of perioperative cardiac arrest and framed them into the therapy population [P], intervention [I], comparator [C], and outcome [O] (PICO) format. Systematic searches of PubMed, Embase, and the Cochrane Library for articles published until September 2020 were performed. Consensus-based treatment recommendations were created using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The strength of consensus among the Task Force members about the recommendations was assessed through a modified Delphi consensus process. Results Twenty-two PICO questions were addressed, and the recommendations were validated in two Delphi rounds. A summary of evidence for each outcome is reported and accompanied by an overall assessment of the evidence to guide healthcare providers. Conclusions The main limitations of our work lie in the scarcity of good quality evidence on this topic. Still, these recommendations provide a basis for decision making, as well as a guide for future research on perioperative cardiac arrest.


Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 63
Author(s):  
Francesca Malandrone ◽  
Federica Bevilacqua ◽  
Mariagrazia Merola ◽  
Niccolò Gallio ◽  
Luca Ostacoli ◽  
...  

Women who are diagnosed and treated for vulvar cancer are at higher risk of psychological distress, sexual dysfunction and dissatisfaction with partner relationships. The aim of this article is to provide a review of the psychological, relational and sexual issues experienced by women with vulvar cancer in order to highlight the importance of this issue and improve the quality of care offered to these patients. A review of the literature was performed using PubMed, CINAHL, PsycINFO, and the Cochrane Library. The results are presented as a narrative synthesis and highlight the massive impact of vulvar cancer: depressive and anxiety symptoms were more frequent in these women, and vulvar cancer may have a negative effect on sexuality from a physical, psychological and behavioural point of view. Factors that may negatively affect these women’s lives are shame, insecurity or difficulties in self-care and daily activities. This review highlights the psychosocial and psychosexual issues faced by women diagnosed and treated for vulvar cancer, although more studies are needed to better investigate this field of interest and to identify strategies to relieve their psychological distress. Care providers should implement an integrated care model to help women with vulvar cancer recognise and address their unmet needs.


2021 ◽  
pp. 105984052110456
Author(s):  
Emma Slas ◽  
Yen Nguyen ◽  
Kimberly McIltrot

School-based asthma programs have been proven to lessen the burden of pediatric asthma. There is a lack of successful care coordination between school nurses and primary care providers. This review examined strategies to increase communication and identified gaps in the literature. Databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and The Cochrane Library, were searched to identify relevant articles. This review included 12 articles consisting of randomized controlled trials, quasi-experimental studies, mixed method studies, qualitative studies, and other non-research articles. Four key findings emerged, including limited availability of asthma action plans, inclusion of parents in the communication triad, school nurse outreach to providers, and improved communication leads to positive outcomes for students with asthma including decreased use of emergency medication and increased self-management of asthma. Further research is needed to develop evidence-based interventions that can be implemented to improve communication between school nurses and primary care providers


Author(s):  
Sonia Gulati ◽  
David Dix ◽  
Anne Klassen

Pediatric oncology care in Canada is delivered by multidisciplinary teams consisting of healthcare providers with different areas of expertise. Limited information is available on how the multidisciplinary team influences jobrelated rewards, demands, and stress in pediatric oncology. A qualitative approach was adopted to learn about healthcare providers’ experiences of working within a multidisciplinary team in pediatric oncology. Qualitative interviews were conducted with 33 healthcare providers (13 oncologists, 9 nurses, 5 social workers, and 6 child-life specialists) from four pediatric oncology centres. Topics explored included: demands and rewards associated with how the multidisciplinary team worked; description of one’s area of expertise; and healthcare provider’s responsibilities. Thematic analysis was used to identify sources of demands and rewards of working in a multidisciplinary team. Healthcare providers described rewards of working within a multidisciplinary team in three areas: sharing expertise and collaboration; giving and receiving social and emotional support; and being valued by and valuing team members. Healthcare providers discussed demands of working within a multidisciplinary team in four areas: interpersonal and communication tensions; conflicting views about providing care; role confusion, overlap and being undervalued; and hospital environment. These findings may inform interventions that alleviate healthcare provider stress and promote strategies that lead to greater job satisfaction.


2020 ◽  
Vol 8 (2) ◽  
pp. e000351 ◽  
Author(s):  
Chenxi Liu ◽  
Dan Wang ◽  
Chaojie Liu ◽  
Junnan Jiang ◽  
Xuemei Wang ◽  
...  

The objective of this review was to clarify what health literacy represents. A systematic review with qualitative syntheses was performed (CRD42017065149). Studies concerning health literacy in all settings were included. Studies before 15 March 2017 were identified from PubMed, Medline, Embase, Web of Science, Scopus, PsycARTICLES and the Cochrane Library. The included literature either had defined the concept of health literacy or made a detailed explanation of health literacy. A total of 34 original studies met the inclusion criteria, including 13 involved in previous systematic reviews and 21 new studies. Health literacy was commonly conceptualised as a set of knowledge, a set of skills or a hierarchy of functions (functional-interactive-critical). The construct of health literacy covers three broad elements: (1) knowledge of health, healthcare and health systems; (2) processing and using information in various formats in relation to health and healthcare; and (3) ability to maintain health through self-management and working in partnerships with health providers. Health literacy is defined as the ability of an individual to obtain and translate knowledge and information in order to maintain and improve health in a way that is appropriate to the individual and system contexts. This definition highlights the diversity of needs from different individuals and the importance of interactions between individual consumers, healthcare providers and healthcare systems.


Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 144
Author(s):  
Wendy Wolf ◽  
Rachel Wattick ◽  
Pamela Murray ◽  
Melanie Clemmer ◽  
Melissa Olfert

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in females with insulin resistance playing a key role in pathogenesis. The objective of this study was to investigate current trends and future implications of multidisciplinary PCOS clinics with inclusion of dietitians. A two-phase, formative investigation on practitioners was conducted through an anonymous survey followed by focus groups. Survey respondents included 261 health care providers from around the world; the majority (59%) representing multidisciplinary teams. Focus group participants included four dietitians, three physicians, a health psychologist and a licensed nutritionist. Primary barriers for future multidisciplinary clinics included: money/resources, insurance reimbursement, and difference of opinions. Potential advantages included: more comprehensive and integrated care, greater convenience/efficiency, and better long-term outcomes. A majority of respondents (89%) stated that dietitians should be ‘involved’ or ‘highly involved’ in treatment. The greatest challenges for dietitians include insurance, limited disease knowledge, and lack of referrals. Most providers agreed that multidisciplinary clinics would lead to a better prognosis. A greater emphasis needs to be placed on educating professionals on the importance of nutrition counseling. Access to educated dietitians is likely the best way to ensure that PCOS patients have access to lifestyle interventions.


2008 ◽  
Vol 3 (2) ◽  
pp. 42
Author(s):  
Shandra Lee Protzko

A review of: Forbes, Dorothy, Christine Neilson, Janet Bangma, Jennifer Forbes, Daniel Fuller, and Shari Furniss. “Saskatchewan Residents’ Use of The Cochrane Library.” Partnership: the Canadian Journal of Library and Information Practice and Research 2.2 (2007). Objective – To evaluate the use of The Cochrane Library by librarians, health care providers and consumers in the Canadian province of Saskatchewan. Design – Volunteer telephone interviews and surveys of training participants at multiple time points; usage statistics. Setting – Saskatchewan. Subjects – Ninety-four volunteers participated in the study. Participants were self-selected from approximately 300 health practitioners and 100 public library staff attending training sessions, located primarily in rural areas. The majority of public library staff who attended training sessions were not professional librarians, although 31.5% of the study participants were librarians. Nurses made up the next largest group (16.3%), followed by therapists (7.6%), library support staff (5.4%), pharmacists (4.3%), physicians (3.3%), other health care providers (20.7%), and other (9.8%). Most were 40-65 years of age (71.6%) and female (92.4%). Methods – Forty-six training sessions were provided upon request between October 2004 and December 2006. Attendees were invited to participate in the study. Telephone interviews were conducted at three, six, nine, and twelve months following training sessions. Demographic information and data on the use of and satisfaction with The Cochrane Library were collected. Additionally, monthly statistics were tracked by Wiley-Blackwell for user sessions, number of searches, and the number of full-text articles and abstracts visited. Main Results – Telephone interviews revealed that 65.2% of participants had accessed The Cochrane Library at three months; 64.2% had at six months. At nine months access dropped to 45.2%. At twelve months only 27.4% of participants reported using the resource. Of those who used The Cochrane Library, 16.4% reported at the three-month interview that it was not helpful. This number decreased at six months (11.6%), nine months (7.7%) and twelve months (11.8%). 57.5% of respondents claimed to have learned something from The Cochrane Library, although a few (11.1%) reported that the information found had no impact. Others reported that the knowledge gained confirmed their beliefs (26.1%) and/or helped in decision-making (32.6%). No time points were reported for the data collected about the use and helpfulness of information found in The Cochrane Library. Three-year data from Wiley-Blackwell showed that The Cochrane Database of Systematic Reviews was most frequently accessed (abstracts=26,016; full texts=15,934). The Cochrane Central Register was accessed 5,640 times and Database of Abstracts of Reviews of Effects was accessed 1,612 times. Periods of low usage corresponded with summer and Christmas breaks. The type of search strategy used was tracked; the authors note that an emphasis on MeSH during training between October 2004 and December 2006 corresponded with the higher number of MeSH searches during the same time period. Participants reported using The Cochrane Library in response to patron requests, to prepare educational materials, and to support health care policy and practice changes. Reasons for not using The Cochrane Library included lack of time, limited access to the Internet, forgetting how to find and use the Web site, and disappointment with the content. Conclusion – Since the fall of 2004, The Cochrane Library has been promoted and made available free of charge to all Saskatchewan residents. Usage fluctuates during the year, with less use during the summer and winter holidays; it is reasonable to presume that students use The Cochrane Library during the academic school year. Most telephone interviewees who used The Cochrane Library reported that it was somewhat to very helpful; this number increased slightly over time while the number of respondents who used the resource fell measurably over twelve months. In other words, those who continued to use The Cochrane Library over time were more likely to report a higher level of satisfaction with the resource. Interviews indicated how librarians used The Cochrane Library, why they do or do not use the resource, and their level of satisfaction. The study revealed less about how others, such as practitioners or consumers, use the resource. Based on the limits of the telephone interviews, follow-up studies should try to capture more detailed usage data to describe the attributes of those who do and do not use The Cochrane Library. The authors note that additional data collected through online surveys or the Wiley-Blackwell website could help determine how to sustain use of the resource.


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