Vascular Pathology and Osteoarthritis: A Systematic Review

2019 ◽  
Vol 47 (5) ◽  
pp. 748-760 ◽  
Author(s):  
Sultana Monira Hussain ◽  
Chloe Dawson ◽  
Yuanyuan Wang ◽  
Andrew M. Tonkin ◽  
Louisa Chou ◽  
...  

Objective.Vascular pathology (changes in blood vessels) and osteoarthritis (OA) are both common chronic conditions associated with aging and obesity, but whether vascular pathology is a risk factor for OA is unclear. The aim of this study was to systematically review the evidence for an association between vascular pathology and risk of joint-specific OA.Methods.Scopus, Ovid Medline, and EMBASE were searched from inception to February 2019. MeSH terms and keywords were used to identify studies examining the association between vascular pathology and OA. Two reviewers independently extracted the data and assessed the methodological quality. Qualitative evidence synthesis was performed.Results.Fifteen studies with high (n = 3), fair (n = 3), or low (n = 9) quality were included. Features of vascular pathology included atherosclerosis, vascular stiffness, and endothelial dysfunction in different vascular beds. There was evidence for an association between vascular pathology and risk of hand OA in women but not men, and between vascular pathology and risk of knee OA in both men and women. Only 2 studies examined hip OA showing no association between vascular pathology and risk of hip OA.Conclusion.There is evidence suggesting an association between vascular pathology and risk of hand and knee OA, with a potential causal relationship for knee OA. Based on the limited evidence, it is hard to conclude an association for hip OA. Further stronger evidence is needed to determine whether there is a causal relationship.

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045233
Author(s):  
Nicola Farrar ◽  
Daisy Elliott ◽  
Marcus Jepson ◽  
Catherine Houghton ◽  
Bridget Young ◽  
...  

IntroductionRecruitment to randomised trials (RCTs) is often challenging. Reviews of interventions to improve recruitment have highlighted a paucity of effective interventions aimed at recruiters and the need for further research in this area. Understanding the perspectives and experiences of those involved in RCT recruitment can help to identify barriers and facilitators to recruitment, and subsequently inform future interventions to support recruitment. This protocol describes methods for a proposed qualitative evidence synthesis (QES) of recruiters’ perspectives and experiences relating to RCT recruitment.Methods and analysisThe proposed review will synthesise studies reporting clinical and non-clinical recruiters’ perspectives and experiences of recruiting to RCTs. The following databases will be searched: Ovid MEDLINE, CINAHL, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, ORRCA and Web of Science. A thematic synthesis approach to analysing the data will be used. An assessment of methodological limitations of each study will be performed using the Critical Appraisal Skills Programme tool. Assessing the confidence in the review findings will be evaluated using the GRADE Confidence in Evidence from Reviews of Qualitative research (GRADE-CERQual) tool.Ethics and disseminationThe proposed QES will not require ethical approval as it includes only published literature. The results of the synthesis will be published in a peer-reviewed journal and publicised using social media. The results will be considered alongside other work addressing factors affecting recruitment in order to inform future development and refinement of recruitment interventions.PROSPERO registration numberCRD42020141297.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e039348
Author(s):  
Nadine Janis Pohontsch ◽  
Thorsten Meyer ◽  
Yvonne Eisenmann ◽  
Maria-Inti Metzendorf ◽  
Verena Leve ◽  
...  

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.


Author(s):  
Esther Cores-Bilbao ◽  
María del Carmen Méndez-García ◽  
M. Carmen Fonseca-Mora

AbstractThe current European context is characterised by the emergence of socio-political tensions that threaten to derail the cohesion objectives traditionally promoted by the authorities of the European Union. With EU citizenship in the shadow of Brexit, the fear of dismemberment of the current Europe of the 28 looms over a renewed debate on concepts like European identity, European citizenship or EU legitimacy and the involvement of its constituents in European affairs, as well as the role of education for promoting democratic awareness among young Europeans. This work aims to collect, appraise and synthesise qualitative evidence obtained in primary research exploring the perceptions of European university students about their civic and cultural identity. This systematic analysis sets out to identify predictors of positive self-identification with the EU and its institutions, focusing on the impact that different educational interventions have had on the attitudes and perceptions expressed by university students, and the importance of foreign language learning in the results obtained. The authors report their assessment of quality of the findings in a Cochrane-style qualitative evidence synthesis (QES), based on the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) method. The 12 informed findings described in this study support decision-making in future education policy formulation.


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